COURT OF APPEALS OF VIRGINIA 

Present: Chief Judge Felton, Judge Petty and Senior Judge Coleman 

Argued at Salem, Virginia 

SOUTHWESTERN VIRGINIA MENTAL 

 HEALTH INSTITUTE 

 MEMORANDUM OPINION* BY 

v. Record No. 0489-06-3 CHIEF JUDGE WALTER S. FELTON, JR. 

 OCTOBER 10, 2006 

SHEILA MAE WRIGHT 

 FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION 

 Scott John Fitzgerald, Senior Assistant Attorney General (Robert F. 

McDonnell, Attorney General; Maureen Riley Matsen, Deputy 

Attorney General; Peter R. Messitt, Senior Assistant Attorney 

General, on brief), for appellant. 

 (Hilary K. Johnson; Hilary K. Johnson, P.C., on brief), for appellee. 

Appellee submitting on brief. 

 Southwestern Virginia Mental Health Institute (employer) asserts that the Virginia Workers’ 

Compensation Commission (commission) erred in awarding benefits to Sheila Mae Wright 

(claimant) for delayed post-traumatic stress disorder arising out of a sexual assault that occurred 

while claimant was on duty monitoring patients in employer’s dining facility. Finding credible 

evidence in the record to support the commission’s finding that claimant’s psychological disability 

resulted from a compensable injury by accident, we affirm the commission’s award. 

BACKGROUND 

 “On appeal, factual findings of the commission will not be disturbed if based on credible 

evidence.” Anthony v. Fairfax County Dep’t of Family Servs., 36 Va. App. 98, 103, 548 S.E.2d 

273, 275 (2001) (citing Morris v. Badger Powhatan/Figgie Int’l, Inc., 3 Va. App. 276, 279, 348 

 *

 Pursuant to Code § 17.1-413, this opinion is not designated for publication. 
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S.E.2d 876, 877 (1986)). “Whether credible evidence exists to support a factual finding is a 

question of law which is properly reviewable on appeal.” Hercules, Inc. v. Gunther, 13 Va. App. 

357, 361, 412 S.E.2d 185, 187 (1991) (citing Ablola v. Holland Road Auto Center, Ltd., 11 

Va. App. 181, 183, 397 S.E.2d 541, 542 (1990)). “Causation is a factual determination to be made 

by the commission, but the standards required to prove causation and whether the evidence is 

sufficient to meet those standards are legal issues which we must determine.” Anthony, 36 

Va. App. at 103, 548 S.E.2d at 276 (citing Morris v. Morris, 238 Va. 578, 385 S.E.2d 858 (1989)). 

In determining whether credible evidence exists to support the commission’s factual findings, we 

view the evidence in the light most favorable to claimant, the party prevailing below. Crisp v. 

Brown’s Tysons Corner Dodge, Inc., 1 Va. App. 503, 504, 339 S.E.2d 916, 916 (1986). 

 So viewed, the record shows that claimant worked as a psychiatric aide for employer at 

Southwestern Virginia Mental Health Institute, a facility that houses sexual offenders, among other 

patients. On June 30, 2002 while claimant was monitoring patients in employer’s dining room, 

Rusty Lewis and Chester Bobbitt, both convicted sex offenders and patients in employer’s facility, 

approached her. At the hearing before Deputy Commissioner Burchett, claimant testified that 

Lewis and Bobbitt 

got really close up in my face. They got so close that I couldn’t 

move. I asked them to step back away from me, and they started 

laughing. Then Rusty Lewis started rubbing my right arm, and 

Chester Bobbitt started rubbing my left arm, and they continued to 

laugh. I asked them to stop. I asked them to stop more than once. 

Chester Bobbitt reached to grab my left breast. 

* * * * * * * 

I went to move back. He did pinch it. When I moved back, I 

realized I was up against the wall, and I could do nothing. I was 

trapped in that corner. I don’t remember if it was Rusty or Chester 

that took the radio out of my hands. Then I realized they had taken 

control.
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 Claimant explained that “[i]t was something that happened really fast, but it felt like it went 

on forever.” Claimant was able to push her way through both men to reach the door beside her, 

obtain her radio, and put her key in the door. As claimant was going through the door, “Chester 

Bobbitt said he wanted to f-u-c-k [her]. He grabbed [her] crotch area, and they continued to laugh.” 

 Claimant immediately reported the incident to Peggy Brooks, the shift head nurse; Mike 

Stockberger, the shift supervisor; and Freddie Counts, the RN who worked with her on Ward G. 

She also reported the incident to her supervisor, Penny Pickle, the day shift head nurse, the 

following morning. Claimant told her supervisor that she was “going to try to be okay” and that she 

would continue working. She did not report the incident to law enforcement officials, and thereby 

was not entitled to the presumption provided in Code § 65.2-301(A).1

 

 Claimant conceded that there were no visible marks left on her body where the men had 

touched her. However, by January 2003 she began noticing that “something was wrong.” She 

reported that she suffered pain in her joints, nausea, severe insomnia, panic attacks, anxiety, and 

irritability. 

 In March 2003, claimant saw Dr. Brian H. Steifel, a family practitioner with Royal Oak 

Medical Associates. Dr. Steifel reported claimant complained of symptoms of chest congestion, 

cough, sore throat, and decreased energy. In April 2003, claimant told Dr. Patterson, her personal 

physician and a member of Royal Oak Medical Associates, that she was “[u]nder a great deal of 

pressure at her work place” and that she was “depressed, nervous, [and] anxious.” In May 2003, 

 1

 Code § 65.2-301(A) provides: 

Any employee who, in the course of employment, is sexually 

assaulted . . . and promptly reports the assault to the appropriate 

law-enforcement authority, where the nature of such employment 

substantially increases the risk of such assault, upon a proper 

showing of damages compensable under this title, shall be deemed 

to have suffered an injury arising out of the employment and shall 

have a valid claim for workers’ compensation benefits. 
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claimant saw Lynda Warner, a licensed clinical social worker. Warner diagnosed claimant with 

major depression.2 She continued to counsel claimant before referring her to Dr. Douglass, a 

psychiatrist, in July 2003. 

 In August 2003, claimant saw Dayle Zanzinger, a family nurse practitioner with Royal Oak 

Medical Associates. Zanzinger noted that claimant was 

under a lot of emotional stress. Reports she was sexually assaulted 

in July of 2002 by 2 patients. She first discussed this with JEP in 

August of 2002.3 She is seeing Linda Warner and just recently 

revealed this information to her.

Zanzinger diagnosed claimant with severe stress and probable post-traumatic stress disorder. 

 Royal Oak Medical Associates completed a “Workman’s Compensation Injury Report” on 

August 18, 2003. The report indicated that claimant suffered from post-traumatic stress disorder. 

After completing a psychiatric evaluation of claimant, Dr. Douglass concurred, diagnosing claimant 

with delayed post-traumatic stress disorder on September 9, 2003. Dr. Douglass referred claimant 

to Dr. Ludgate, a specialist in post-traumatic stress disorder, for treatment. 

 Dr. Ludgate evaluated claimant in October 2003. By letter dated January 13, 2004, Dr. 

Ludgate concluded that claimant suffered delayed post-traumatic stress disorder as a “direct 

consequence of the sexual assault she endured at her place of work on June 30, 2002.” He noted 

that “[a]fter the assault she initially went back to work, despite significant psychological distress 

(anxiety and hypervigilance).” Dr. Ludgate stated that claimant was unable to work due to her 

incapacitating symptoms, and opined that her condition should qualify as a workers’ compensation 

condition: 

 2

 A review of claimant’s medical records shows that she was undergoing treatment for 

depression prior to the June 30, 2002 sexual assault. 

3

 Zanzinger later corrected the record to read, “Discussion was on April 2003 instead of 

August 2002.” 
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The presence of a serious psychiatric disorder precipitated by a 

work assault is comparable to a disease in that the words disorder 

and disease are interchangeable in this regard. Also, she has 

suffered a work injury or trauma but this is of a psychological 

nature, which is as incapacitating as any physical injury. 

 The deputy commissioner determined that claimant had failed to prove a compensable 

injury by accident, noting that, “although the actions of the two inmates were egregious and 

noxious, we cannot say the circumstances were so shocking, frightening, traumatic, catastrophic, or 

unexpected to constitute a compensable injury under the Act.” In support of his determination, the 

deputy commissioner reasoned that there was “no evidence that the conduct of the two inmates was 

directed at claimant because of her status as an employee with this employer.” The deputy 

commissioner also articulated his concern that claimant had not reported the sexual assault to the 

numerous health care professionals from whom she was seeking treatment until August 15, 2003. 

From this observation, the deputy commissioner found that “the opinions expressed by Dr. Ludgate 

and Dr. Douglass relative to claimant’s condition being caused by the incident in question lack 

probative value because their opinions are not based upon complete and accurate histories.” 

Accordingly, he concluded that “there is no probative medical evidence to causally relate any injury 

or condition to” the sexual assault.

 On review, the full commission reversed, finding that the June 30, 2002 sexual assault was 

“sufficiently dramatic and unexpected so as to shock the conscience.” The commission stated that 

“[w]hile [] claimant’s work environment placed her where unacceptable conduct was anticipated 

and recurring, we do not think that touching where she was touched could be anticipated.” 

ANALYSIS 

 Employer argues the trial court erred in determining that claimant’s delayed post-traumatic 

stress disorder qualifies as a compensable psychological injury by accident. Specifically, employer 

contends that the sexual assault suffered by claimant does not constitute a precipitating event that is 
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so catastrophic, dramatic, or frightening as to shock the conscience because occurrences of assault, 

even sexual assault, are an anticipated and recurring part of claimant’s employment. 

 In order to qualify as a compensable injury by accident under the Virginia’s Workers’ 

Compensation Act, a purely psychological injury, such as delayed post-traumatic stress disorder, 

must be causally related to a physical injury or to an obvious sudden shock or fright arising in the 

course of employment. Anthony, 36 Va. App. at 103, 548 S.E.2d at 276; Owens v. Va. Dep’t of 

Transport., 30 Va. App. 85, 88, 515 S.E.2d 348, 349 (1999); Daniel Constr. Co. v. Tolley, 24 

Va. App. 70, 77, 480 S.E.2d 145, 148 (1997); Chesterfield County v. Dunn, 9 Va. App. 475, 477, 

389 S.E.2d 180, 182 (1990). 

 It is undisputed that the June 30, 2002 sexual assault arose in the course of claimant’s 

employment. Employer asserts on appeal that “[i]t is the very nature of [claimant’s] employment to 

interact with patients, including sex offenders, every day” and that assaults, including sexual 

assaults, are “expected and recurring” in claimant’s place of employment due to the character of its 

mission. Because “[a] physical assault [] constitute[s] an ‘accident’ within the meaning of the Act 

when it . . . was the result of an actual risk arising out of employment,” Butler v. Southern States 

Coop., Inc., 270 Va. 459, 465, 620 S.E.2d 768, 772 (2005) (quoting Reamer v. National Service 

Industries, 237 Va. 466, 470, 377 S.E.2d 627, 629 (1989)), the sole issue on appeal is whether the 

sexual assault on claimant was an “obvious sudden shock or fright,” Anthony, 36 Va. App. at 103, 

548 S.E.2d at 276, such that claimant’s delayed post-traumatic stress disorder qualifies as a 

compensable psychological injury by accident under the Act. 

 “[T]he types of precipitating events that give rise to purely psychological compensable 

injuries are consistently described as shocking, frightening, traumatic, catastrophic and 

unexpected.” Anthony, 36 Va. App. at 103-04, 548 S.E.2d at 276 (citing Burlington Mills Corp. 

v. Hagood, 177 Va. 204, 209-11, 13 S.E.2d 291, 293-94 (1941)). The record reflects that claimant 
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immediately reported the sexual assault to her superiors. “A complaint made by a victim of sexual 

assault ‘has long been considered a[] . . . natural expression of the victim’s feelings in response to 

the offense.’” Wilson v. Commonwealth, 46 Va. App. 73, 83, 615 S.E.2d 500, 505 (2005) (quoting 

Lindsey v. Commonwealth, 22 Va. App. 11, 14, 467 S.E.2d 824, 826 (1996)). Moreover, in her 

testimony before the deputy commissioner, claimant explained that she was “up against the wall, 

and [] could do nothing [because she] was trapped in th[e] corner.” She went on to explain that she 

“just couldn’t believe it was happening.” Claimant’s immediate report of the events to her 

supervisors following the sexual assault, and her description of the incident during her testimony 

clearly established that the sexual assault was traumatic, frightening, and unexpected. 

 Employer also argues that claimant’s psychological injury is not compensable because the 

precipitating event is indistinguishable from the precipitating event in Anthony. We disagree. In 

Anthony, a mother and grandmother pushed a Fairfax County social worker off a porch when the 

worker attempted to take emergency custody of two children at a day care center. We affirmed the 

commission’s denial of benefits, reasoning that the “incident did not rise to the level of the type of 

sudden shock or fright from which a compensable injury may arise” because claimant had admitted 

her work environment required contact with angry, confrontational parents. Anthony, 36 Va. App. 

at 105, 548 S.E.2d at 277. 

 Like the claimant in Anthony, claimant acknowledged that her work environment included 

interaction with sexual offenders and other aggressive patients and that physical assaults by patients 

were not out of the ordinary. However, the assault in Anthony was not sexual in nature. Here, two 

known sex offenders touched claimant’s breast and grabbed her genital area while laughing and 

making lewd comments. Claimant was cornered out of sight of the other staff members working in 

the dining room. During the attack the two patients took claimant’s radio, rendering her unable to 

call for assistance and more vulnerable to the patients’ attacks. 
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 We conclude credible evidence exists in the record to support the commission’s 

determination that the sexual assault on claimant constituted a precipitating event that was 

“sufficiently dramatic and unexpected so as to shock the conscience.” We further conclude from 

the unrefuted medical evidence in the record that claimant’s delayed post-traumatic stress disorder 

was causally related to the sexual assault she sustained in the course of her employment. 

Accordingly, we affirm the commission’s award of benefits. 

 Affirmed.