COURT OF APPEALS OF VIRGINIA
Present: Chief Judge Decker, Judge Alston and Senior Judge Frank Argued by teleconference

CAROLYN BLOW MEMORANDUM OPINION * BY v. Record No. 1393-18-1 JUDGE ROBERT P. FRANK APRIL 16, 2109 YORK COUNTY PUBLIC SCHOOLS AND VIRGINIA ASSOCIATIO N OF COUNTIES GROUP

FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION Carolyn M. Blow, pro se . Faraaz A. Jindani 1 (Scott C. Ford; Ford Ri chardson, PC, on brief), for appellees.
Carolyn Blow, claimant, appeals a decision of the Virginia Wor kers’ Compensation Commission (the Commission) findi ng that she did not injure her neck in a work accident, her disability from Januar y 2017 through May 22, 2017, was not rela ted to a work accident, and York County Public Schools and Vir ginia Association of Counties Group (collectively “employer”) were responsible for only her medical treatment at Patient First on August 12, 2015. On appeal, claimant contends tha t the Commission erred (1) in f ailing to consider all of her medical records and (2) in denying h er claim for wage benefits and medical benefits. We affirm the Commission’s decision.

* Pursuant to Code § 17.1-413, this op inion is not designated fo r publication.

1 On April 5, 2019, this Court approv ed the substitution of Fara az A. Jindani, Esq. to present oral argument on behalf of appellees in this case.UNPUBLISHED- 2 - BACKGROUND On appeal, we view the evidence in the light most favorable to employer, the party prevailing below. See R.G. Moore Bldg. Corp. v. Mullins, 10 Va . App. 211, 212 (1990). So viewed, the evidence esta blished the following: Claimant was employed as a school bus driver for employer. Du ring the summer, when school was not in session, her j ob required her to wash the sch ool buses. On August 12, 2015, while washing a bus, she slipped on a slippery step from the to p step of the bus, falling to the concrete floor. At the Janua ry 31, 2018 hearing before the dep uty commissioner, claimant testified she injured her hip, back, and neck. 2 However, we note th at on her January 23, 2017 original claim for benefits, cla imant indicated she injured her lower back, pelvis, shoulder, and spine, but not her neck. Claimant visited Patient Fir st on the same day of the injury. The medical records from that date indicated claimant suffered multiple contusions and w as released to return to full duty on August 13, 2015. The medical records also state claimant’s “Chief complaint” was “Fell down the steps and hit the lower back against the edge of the s teps and fell on the concrete while washing a school bus.” Claimant went back to work “a c ouple of days” after the fall, a nd in December 2016, she claimed she was having “a lot of pain” “generating” in her shou lder. According to claimant, her doctor thought her shoulder pain “was coming from her neck.” C laimant explained that although she worked from August 2015 until December 2016, she continued having physical problems with her neck, back, and right hip.

2 Claimant withdrew any claims fo r injury to her right shoulder, spine, and pelvis, leaving only her claim for her lower bac k and neck injuries. The deput y commissioner dismissed her claims for injuries to her ri ght shoulder, spine, and pelvis.- 3 - Claimant testified that she left work in December 2016, and, f rom December 2016 until May 22, 2017, she treated with Dr. J ackson B. Salvant, Jr., Dr. Jesus Lizarzaburu, and with medical providers at Rebound Chir opractic. She testified she t old these medical providers about her August 12, 2015 work accident. Claimant explained that fro m December 2016 through May 2017, she complained of “a severe burning” in her neck, lower b ack pain, and numbness in her hand. Claimant testified tha t since August 12, 2015, she has h ad problems in her hip, back, and neck. Medical providers held cla imant out of work from January 9, 2017 through May 22, 2017. The following is a summary of claimant’s medical treatment: On December 30, 2016, claimant treate d at Riverside Regional Pr imary, where she complained of right shoulder a nd neck pain for a week prior to December 30, 2016, and indicated her pain was worseni ng. The doctor’s diagnosis notes also reflected “degenerative disease of neck and shoulder.” On December 31, 2016, claimant treat ed at Mary Immaculate Hospi tal, where she complained that she had had rig ht shoulder pain for approximate ly one week. She indicated she did not suffer an injury, trauma or fall. The report stated “[ t]here was no injury mechanism,” and “[t]here is no histor y of shoulder injury.” On January 4, 2017, claimant treated with Michael B. Potter, M. D. at Tidewater Physicians Multispecialty Gr oup for right shoulder pain. She c ompleted a New Patient History Form in which she indicated her symptoms had started a week ago , but she did not have an injury. Dr. Potter’s notes refle ct claimant was under his care and was unable to work at that time. Dr. Potter’s notes also s tated claimant “may return back to work as of” January 9, 2017. On January 17, 2017, claimant return ed to Patient First, compla ining of right shoulder pain that had begun approximatel y two weeks earlier. She repor ted that the pain “radiated- 4 - down” to her right hand. The hi story section of the office not es states, “This is a Worker’s Compensation issue.” The doctor diagnosed contusion of her rig ht shoulder. On February 3, 2017, claimant treat ed with Dr. Salvant at CIOX Health, complaining of numbness in her right hand for t he past two year s and pain radi ating down her right shoulder and arm from her right neck for the last two months. Dr. Savant’s assessment was “[r]ight-sided cervical radiculitis” and “[a] bnormal cervical radiographs with cervical spondylosis.” On March 6, 2017, claimant again tre ated with Dr. Salvant at R iverside Regional Medical for evaluation of the recently c ompleted MRI scan of her cervic al spine. She gave a history of “multiple falls” off of a bus. D r. Salvant referred claimant b ack to her primary care physician and opined that her neck pain “ma y be due to muscular overuse o r sprain.” On June 13, 2017, Dr. Jeffrey R. Carlson performed an Independ ent Medical Evaluation (IME) on claimant. Dr. Carlson reviewed claimant’s medical rec ords dating back to 2007 and completed a physical examination of claimant. Dr. Carlson’s ev aluation of claimant’s medical records revealed past complaint s of back pain as well as knee p ain, knee arthritis, and a possible ACL injury. Dr. Carlson also rev iewed claimant’s MRI scan repo rt, which revealed degenerative disc disease at C3 thr ough C6 with mild spinal stenosis at C5-6 . Dr. Carlson reviewed claimant’s EMG/nerve conducti on study, which revealed no cervic al radiculopathy and borderline carpal tunnel syndrome. Dr. Carlson’s impression was t hat claimant had a fall on Augus t 12, 2015, and was not having any pain in her neck, bac k, or hip prior to that acciden t. Dr. Carlson responded to the following questions that are re levant to this analysis: Do you agree that any complaints, i f any, [claimant] is current ly experiencing to her lower back a re not related to her August 12 , 2015 work accident? She complained of back pain on the right side since her injury Augus t 12, 2015 and was seen in the Emergency Room at Patient First f or that back pain related to t he- 5 - August 12, 2105 incident, and her back and hip complaints could be related to that. What injuries do you believe, if a ny, did the complainant susta in as a result of her August 12, 2015 acci dent? Please explain. I d o believe that she inju red her lower back with contusion of the right-sided lower back, buttock s and hip, as documented on her initial evaluation from Patient First from her injury on August 12, 2015. Do you agree that no further medical treatment is reasonable, necessary, or related to [ claimant]’s August 12, 2015 work accident? At this point she has almost completely resolved the lower back pain and hip pain, which is the only injury related to August 12, 2015. She would not need any further medical treatment at this time. Do you agree that any complaints, if any, [complainant] is currently experiencing to her n eck are not related to her Augus t 12, 2015 work accident? Since the neck pain was not documented at the initial visit, I do no t believe it is rel ated to the August 12, 2015 incident. On January 23, 2017, claimant file d a claim for benefits, alle ging injuries to her lower back, pelvis, shoulder, and spine . She also filed claims for b enefits on March 31, 2017, and June 6, 2017. Claimant requested compensation from December 31, 201 6, through May 22, 2017, payment of certain medical bills, and a medical award. The deputy commissioner found that claimant sustained compensa ble injuries to her low back and right hip on August 12, 2015 and found employer respon sible for claimant’s medical treatment at Patient First on August 12, 2015. However, the de puty found no medical evidence to support claimant’s assertion t hat she suffered a neck injury on August 12, 2015, thus denying her claim for neck injury. The deputy concluded as follows: We now consider the claimant’s medical treatment beginning December 2016 through the present and the claimant’s request for compensation from December 2016 through May 2017. We recognize the claimant has tr eated with a numb er of medical providers since December 2016. However, upon careful review of- 6 - the medical evidence, we find no m edical evidence relating the claimant’s medical treatme nt beginning in December 2016 through the present to her August 12, 2015 i ndustrial accident besides Dr. Carlson’s statement that claimant’s current back and hip complaints “could be related” to her August 12, 2015 accident. We do not find Dr. Carlson’s opini on on this issue rises to the level of medical causation. We recogni ze the claimant’s testimony th at since August 2015, she continued ha ving problems with her neck, back, and right hip. However, we fi nd it significant that ther e is no medical evidence that the cla imant treated with any medical providers from August 2015 through December 2016. The parties stipulated that the claimant was taken out of work from January 9, 2017 through May 22, 2017 and did not work for the employer from December 31, 2016 through May 22, 2017. Based upon medical records from Dr. Potter, we find the claimant’s disability bega n on January 4, 2017. However, we fi nd no medical evidence that the cla imant’s disability from January 2017 through May 22, 2017 was related t o her industrial injury. Upon review by the full Commi ssion, the deputy’s opinion was a ffirmed, finding claimant did not prove her curre nt neck problem was related to the August 12, 2015 work accident. The full Commission concluded as follows: The claimant’s testimony w as not consistent with the medical evidence. The accident was on August 12, 2015. She reported a neck injury to her em ployer on that date. However, the claimant did not seek any treatme nt for her neck for more than a year after the accident. We consider it unlikely that a person with continuing neck complaints woul d not seek treatment for more than a year. Also, the medical report from December 30, 2016 refers to neck and right shoulder pain for a week. The claiman t did not attribute her neck pain to t he work accident. This pattern continued in the December 31, 2016 medical report from Mary Immaculate Hospital and th e January 4, 2017 evaluation by Dr. Michael Potter. The first r eference to a workers’ compensa tion complaint is the January 17, 2017 P atient First report. The tr eating physician diagnosed contusion of the right shoulder for the wor k accident. We therefore do not accept the claimant’s testimony in contradiction of this evidence. This appeal follows.- 7 - ANALYSIS On appeal, claimant contends t he Commission erred when it faile d to consider all of her medical records, maintaining her a ttorney failed to introduce c ertain records she had supplied to her attorney. 3 She also contends her medical r ecords proved th at her injury and resulting loss of wages and medical expenses wer e directly connected to her Augus t 12, 2015 workplace injury. Essentially, claimant challenges the sufficiency of the evidenc e, contending her testimony was credible. As the appellant in this case, the claimant bears the “burden o f showing” that the Commission committed “reversible error.” See Burke v. Catawba Hosp., 59 Va. App. 828, 838 (2012). The sole issue before us is causation. Claimant has t he burden to prove, by a preponderance of the evidence , “a causal connection between the work-related incident” and the injury. Hoffman v. Carter, 50 Va. App. 199, 214 (2007). In determining whether credibl e evidence exists to support the Commission’s findings of fact, “the appellate c ourt does not retry the facts, reweigh th e preponderance of the evidence, or make its own determination of the credibility of the witnesses. ” Pruden v. Plasser Am. Corp., 45 Va. App. 566, 574-75 (2005) (quoting Wagner Enter., Inc. v. Bro oks, 12 Va. App. 890, 894 (1991)). The Commission’s determ ination of causation is a find ing of fact. Lee Cty Sch. Bd. v. Miller, 38 Va. App. 253, 260 (2002). “[U]nlike the Commission, the reviewing court is not charged with determining anew whet her the employer’s evidence o f causation should be accorded sufficient weight to constitute a preponderance of the evidence on that issue.” Bass v.

3 We cannot consider medical reco rds not introduced before the C ommission. “[A]n appellate court’s re view of the case is limited to the record o n appeal.” Karr v. Va Dept. of Envtl Quality, 66 Va. App. 507, 520 (2016) (quot ing Wilkins v. Common wealth, 64 Va. App. 711, 717 (2015)).- 8 - City of Richmond Police Dep’t, 258 Va. 103, 115 (1999). “Causa tion is usually proven by medical evidence.” Clinch Va lley Med. Ctr v. Hayes, 34 Va. App . 183, 192 (2000). While claimant apparently attri buted her injuri es to the workpl ace accident, the Commission rejected her testim ony. “In determining the credibi lity of any witness, the fact finder may accept the parts of a witness’ testimony it finds be lievable and reject other parts as implausible.” United Airlin es, Inc. v. Hayes, 58 Va. App. 220, 238 (2011). Further, “[a] determination by the Commissi on upon conflicting facts as to ca usal relationship is conclusive and binding on appeal, absent fra ud, when such finding is suppo rted by competent, credible evidence.” Watkins v. Ha lco Eng’g, Inc., 225 Va. 97, 101 (1983 ). Upon a close review of the medi cal records, there is nothing to suggest any causation between claimant’s neck injury and the workplace accident. The August 12, 2015 report from Patient First indicated claiman t suffered from only multiple co ntusions after the workplace accident. While complaining of ri ght shoulder pain, claimant d id not seek treatment for neck pain until December 2016, more tha n one year after the workplac e accident. Furthermore, at that time, claimant told her medical provider that she had experienc ed the pain “for a week” prior to December 30, 2016. She did not attri bute her neck pain to the August 12, 2015 accident. Other than the records from August 12, 2015, the date of the wo rkplace injury, the next reference in the medical records to a workers’ compensation cla im is in the history section of the January 17, 2017 Patient First medical record. 4 On January 17, 2017, the t reating physician diagnosed claimant with a contus ion of the right shoulder. Mor eover, Dr. Carlson, who performed the IME on June 10, 2017, opined that claimant’s neck injury was not related to the

4 Claimant told the medical provider that she was initially seen on August 12, 2015 after falling at work.- 9 - August 12, 2015 accident, noting, “Since the neck pain was not documented at the initial visit, I do not believe it is related to t he August 12, 2015 incident.” The Commission expressly stated in its review opinion that it d id not accept claimant’s testimony “in contradiction” of the medical evidence in the cas e. See United Airlines, 58 Va. App. at 238 (the fact finder ma y reject parts of a witness’ testimony it finds implausible). Furthermore, there was sufficien t credible evidence in the reco rd to support that claimant did not establish a causal relationship be tween her accidental injury o f August 12, 2015 and her alleged neck pain. See Watkins, 225 Va . at 101 (the Commission’s deter mination upon conflicting facts concerning causal relationshi p is binding on appeal when suppor ted by credible evidence). Essentially, there is no evidence of causation and the Commissi on so found. Credible evidence supports the Commission’s denial of benefits. We conclude thatthe Commission did not err. For these reasons, we affirm the Commission’s decision. Affirmed.