COURT OF APPEALS OF VIRGINIA 

Present: Chief Judge Moon, Judge Willis and 

 Retired Judge Whitehurst*

Argued at Norfolk, Virginia 

EDITH A. CHANIN 

 OPINION BY 

v. Record No. 1808-94-1 JUDGE JERE M. H. WILLIS, JR. 

 JULY 25, 1995 

EASTERN VIRGINIA MEDICAL SCHOOL 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 

 Robert J. Macbeth, Jr. (Rutter & Montagna, on 

brief), for appellant. 

 David E. Constine, III (Dabney J. Carr, IV; 

Mays & Valentine, on brief), for appellee. 

 On appeal from the commission's decision that she does not 

suffer from a compensable ordinary disease of life under Code 

§ 65.2-401, Dr. Edith A. Chanin contends (1) that credible 

evidence does not support the commission's finding that her 

multiple chemical sensitivity syndrome (MCS) was an aggravation 

of a pre-existing ordinary disease of life, and (2) that her 

health and medical treatment prior to September 2, 1992 does not 

establish by a preponderance of the evidence that she suffered 

MCS prior to that date. We consolidate these contentions into 

one overall issue: whether credible evidence supports the 

commission's finding that Dr. Chanin failed to prove by clear and 

convincing evidence to a reasonable degree of medical certainty 

 

 *Retired Judge Alfred W. Whitehurst took part in 

consideration of this case by designation pursuant to Code 

§ 17-116.01. 
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that her disease (MCS) arose out of and in the course of her 

employment with Eastern Virginia Medical School (EVMS). Finding 

no error, we affirm the commission's decision. 

 EVMS employed Dr. Chanin as Director of the Gerontology 

Institute located at DePaul Medical Center, beginning September 

1, 1992. She spent four hours that day in her office, where she 

smelled a "musty, moldy chemical odor." From September 1 to 

November 4, 1992, she developed progressive respiratory problems. 

 During that time, her office was moved four times. She was 

examined by several physicians, who diagnosed her with MCS, but 

none identified the chemical causing the sensitivity. 

 On February 28, 1994, a deputy commissioner found that Dr. 

Chanin had not proved a compensable occupational disease because 

medical evidence showed that she had suffered from pre-existing 

symptoms, that there was no detectable level of "trigger 

mechanisms" at DePaul, and that she was exposed to toxins outside 

of her employment. The deputy commissioner stated, "[a]t best, 

Chanin's exposure at DePaul merely aggravated a pre-existing 

ordinary disease of life." On August 15, 1994, the full 

commission found that Dr. Chanin had failed to prove she suffered 

from a compensable ordinary disease of life. 

 Dr. Chanin concedes that MCS is an ordinary disease of life 

because it is a disease to which the general public is exposed 

outside of employment. For an ordinary disease of life to be 

compensable under § 65.2-401, [Chanin] must establish by "clear 
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and convincing evidence, to a reasonable medical certainty" that 

the disease (1) arose out of and in the course of employment, (2) 

did not result from causes outside of the employment, and (3) 

follows as an incident of an occupational disease, is an 

infectious disease or contagious disease contracted in the course 

of employment, or is characteristic of employment and was caused 

by conditions peculiar to the employment. 

Island Creek Coal v. Breeding, 6 Va. App. 1, 11, 365 S.E.2d 782, 

788 (1988). 

 Dr. Chanin contends that she met this burden. She argues 

that the evidence proved that she suffered from MCS and that the 

cause of the disease was injurious exposure to toxins at DePaul. 

 She argues that her disease and its employment-related cause 

were proven by the testimony of Drs. Ziem, Baker, Heuser, Cullen, 

and Lieberman. We disagree. 

 "Decisions of the commission as to questions of fact, if 

supported by credible evidence are conclusive and binding on this 

Court." Manassas Ice & Fuel Co. v. Farrar, 13 Va. App. 227, 229, 

409 S.E.2d 824, 826 (1991). "Whether a disease is causally 

related to the employment and not causally related to other 

factors is such a finding of fact." Breeding, 6 Va. App. at 12, 

365 S.E.2d at 788 (citing Watkins v. Halco Engineering, Inc., 225 

Va. 97, 101, 300 S.E.2d 761, 763 (1983)). "The fact that 

contrary evidence may be in the record is of no consequence if 

there is credible evidence to support the Commission's findings." 
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Russell Loungewear v. Gray, 2 Va. App. 90, 95, 341 S.E.2d 824, 

826 (1986). 

 The commission's decision denying Dr. Chanin disability 

benefits is supported by credible evidence. First, the 

commission found that the opinion of Dr. Ziem, Dr. Chanin's 

treating physician, was "based on an incorrect understanding of 

the facts of the claimant's work environment." Dr. Ziem based 

her diagnosis on the supposition that gasses were emitted by new 

carpet and renovations at DePaul. Neither condition existed. 

Furthermore, Dr. Ziem was unable to identify any substances in 

the DePaul environment that could have caused Dr. Chanin's MCS. 

 Second, the commission found that Dr. Chanin spent only 

fifty percent of her time at DePaul. Dr. Cullen, a professor of 

medicine at Yale University and a respected authority on MCS, 

reviewed Dr. Chanin's medical records. He concluded that she had 

MCS, but that it could not have been caused primarily by her 

exposure to the DePaul environment. Dr. Cullen stated, "the 

hallmark of MCS is development of the disease after repeated lowlevel chemical exposures or a single high level chemical 

exposure." Dr. Chanin worked only four hours at DePaul before 

the symptoms began. Thereafter, she spent only fifty percent of 

her time at DePaul. She has been exposed to aggravating 

chemicals in her home and in her neighborhood, both in New York 

where she lived previously and in Norfolk where she lives 

presently. She has not proved that her MCS "did not result from 
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causes outside of the employment." 

 Third, the commission found that no doctor isolated the 

chemical(s) causing the sensitivity. While the statute does not 

require that a single source of the claimant's disease be 

pinpointed, it does require that the "primary source [be] 

determined by 'reasonable medical certainty.'" Ross Laboratories 

v. Barbour, 13 Va. App. 373, 377, 412 S.E.2d 205, 208 (1991). 

Such a determination must be based on evidence that "it is at 

least more probable than not that the disease arose out of and in 

the course of employment." Westmoreland Coal Co. v. Campbell, 7 

Va. App. 217, 224, 372 S.E.2d 411, 416 (1988). Dr. Chanin 

offered no evidence of chemicals in Depaul's environment. 

Because no evidence exists of chemical exposure in Dr. Chanin's 

employment environment, we cannot find that she met her burden of 

proving by "clear and convincing evidence" to a reasonable 

medical certainty that her disease arose out of and in the course 

of her employment at DePaul, as required by Code § 65.2-401. 

 Fourth, Dr. Chanin admitted that symptoms of MCS may be 

instant or delayed. Thus, we cannot determine where or when the 

exposure occurred. Therefore, no evidence proved to a reasonable 

medical certainty that the environment at DePaul was the 

proximate cause of Dr. Chanin's disease. 

 The judgment of the commission is affirmed. 

 Affirmed.