COURT OF APPEALS OF VIRGINIA

Present: Chief Judge Fitzpatrick, Judges Humphreys and Clements Argued at Alexandria, Virginia

BELL ATLANTIC - VIRGINIA, INC. AND VERIZON VIRG INIA, INC. MEMORANDUM OPINION * BY v. Record No. 2370-03-4 J UDGE ROBERT J. HUMPHREYS MARCH 9, 2004 DAVID N. JETT, III

FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION Eric J. Berghold (M cCandlish & Lillard, on brief), for appellant. David L. Bayne, Jr. (Ashcraft & Gerel, LLP, on brief), for appellee.

Bell Atlantic - Virginia, Inc. and its insurer, Verizon Virginia, Inc. (collectively “employer”), appeal from a decision of th e Workers’ Compensation Commission, awarding David N. Jett, III medical benefits related to recommended surgery for Jett’s left carpal tunnel syndrome. Employer contends the commission e rred in finding the evid ence sufficient, as a matter of law, to establish that Jett’s “left ca rpal tunnel syndrome,” a nd the associated surgery, were related to his compen sable accident of July 1, 1999. 1 We disagree and affirm the commission’s decision. In accord with settled principles of appella te review, the evidence must be construed in the light most favorable to the party that prevailed below. Crisp v. Brown’s Tysons Corner

* Pursuant to Code § 17.1-413, this opinion is not designated for publ ication. Moreover, as this opinion has no precedential value, we re cite only those facts necessary to our holding.

1 Employer actually raises four separate Qu estions Presented on appeal. However, the four questions, in essence, present this single issue.- 2 - Dodge, Inc. , 1 Va. App. 503, 504, 339 S.E.2d 916, 916 (1986). Furthermore, it is well-established that factual fi ndings made by the commission, which are supported by credible evidence, are conclusive and binding upon the Cour t of Appeals. Caskey v. Dan River Mills,

Inc. , 225 Va. 405, 411, 302 S.E.2d 507, 510-11 (1983). Thus, “[i]f there is evidence, or reasonable inferences can be drawn from the evidence, to support the Comm ission’s findings, they will not be disturbed on review, even though there is evid ence in the record to support a contrary finding .” Morris v. Badger Powhatan/Figgie Int’l, Inc. , 3 Va. App. 276, 279, 348 S.E.2d 876, 877 (1986); see Code § 65.2-706. “The actual dete rmination of causation is a factual finding[.]” Ingersoll-Rand Co. v. Musick , 7 Va. App. 684, 688, 376 S.E.2d 814, 817 (1989)[.] . . . Further, “[a] question raised by conflicting medical opinion is a question of fact .” Commonwealth v. Powell , 2 Va. App. 712, 714, 347 S.E.2d 532, 533 (1986) (citations omitted). Russell Stover Candies v. Alexander , 30 Va. App. 812, 825-26, 520 S.E.2d 404, 411 (1999) (emphases added). An employer’s responsibility for medical expenses depends upon “(1) whether the medical service was causally rela ted to the industrial injury; (2) whether such other medical attention was necessary; and (3) whether the treating physician made a referral to the patient.” Volvo White Truck Corp. v. Hedge , 1 Va. App. 195, 199, 336 S.E.2d 903, 906 (1985); Code § 65.2-603. The claimant bears the burden of pr oof on these issues. McGregor v. Crystal Food Corp. , 1 Va. App. 507, 508, 339 S.E.2d 917, 918 (1986). In the case at bar, employer argues only that the evidence failed to establish Jett’s left carpal tunnel syndrome, and therefore the associ ated surgery, was “causally related” to his work-related injury of July 1, 1999. However, wh en viewed appropriately, the evidence clearly supports the commission’s finding that the proposed surgery was re lated to Jett’s accident and resulting injury. Indeed, in the Memorandum of Agreement, filed by the parties in November of 1999, Jett and employer agreed that th e nature of his injury was “[c] ervical strain, lumbar strain,- 3 - [and] left carpal tunnel syndrome .” (Emphasis added). The co mmission subsequently awarded Jett various benefits, including medical be nefits “for as long as necessary.” Although Jett did not seek au thorization and payment for the left hand surgery until nearly three years later (Ja nuary 14, 2003), Jett’s medical records demonstrate that he experienced continuing problems with his left hand during that time frame. Perhaps more significantly, in April of 2002, Jett ’s treating physician, Dr. Rida N. Azer, diagnosed Jett with left carpal tunnel syndrome, noting that Jett su ffered “significant residuals from his work accident of 07/01/99.” Dr. Azer then referred Jett to Dr. Hampton Jackson for an evaluation concerning Jett’s “limb” impairment. In Dr. Jackson’s report, dated April 30, 2002, Dr. Jackson stated as follows, in relevant part: Mr. Jets [sic] was referred by Dr. Azer for evaluation for continued disability of his upper extremities, neck, and in fact the lower extremities. . . . I have expressed to this patient that because of his cervical disc injury sustained at work, his need for surgery, the subsequent late sequelae of ev ents, the degeneration after his surgery and the fact that he continues to need additional surgery, all as a result of the accident of 07/01/99 , he has a permanent and partial impairment of his arms. (Emphasis added). Dr. Azer subsequently r ecommended that Jett undergo surgery for his left carpal tunnel syndrome. As indicated above, “[w]e do not retry the facts before the Commission nor do we review the weight, preponderance of the evidence, or the credibility of witnesses.” Caskey , 225 Va. at 411, 302 S.E.2d at 510. Moreover, “[t]he probative we ight to be accorded [medical] evidence is for the Commission to decide; and if it is in conflict with other medical evidence, the Commission is free to adopt that view ‘which is most consiste nt with reason and justice.’” Georgia-Pacific Corp. v. Robinson , 32 Va. App. 1, 5, 526 S.E.2d 267, 269 (2000) (quoting C.D.S. Constr. Servs. v. Petrock , 218 Va. 1064, 1070, 243 S.E.2d 236, 241 (1978)). Thus, the fact that contrary evidence appears in the reco rd is inconsequential. Because we find that- 4 - credible evidence in the record supports the co mmission’s determination that Jett’s left carpal tunnel syndrome, and therefore the associated trea tment, was causally related to his work-related accident of July 1, 1999, we affirm its award of benefits to Jett. Affirmed.