COURT OF APPEALS OF VIRGINIA 

Present: Judges Willis, Frank and Clements 

KWANDWO ADU-GYAMFI 

 MEMORANDUM OPINION*

v. Record No. 0382-01-4 PER CURIAM 

 JUNE 26, 2001 

AUTOSTRADE INTERNATIONAL and 

 PACIFIC INDEMNITY COMPANY 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 (John E. Carter, on brief), for appellant. 

 (Robert C. Baker; Mell, Brownell & Baker, on 

brief), for appellees. 

 Kwandwo Adu-Gyamfi (claimant) contends that the Workers' 

Compensation Commission erred in finding that he failed to prove 

his cervical condition and surgery were causally related to his 

February 11, 1998 compensable injury by accident. Upon 

reviewing the record and the briefs of the parties, we conclude 

that this appeal is without merit. Accordingly, we summarily 

affirm the commission's decision. See Rule 5A:27. 

 On appeal, we view the evidence in the light most favorable 

to the prevailing party below. See R.G. Moore Bldg. Corp. v. 

Mullins, 10 Va. App. 211, 212, 390 S.E.2d 788, 788 (1990). 

Unless we can say as a matter of law that claimant's evidence 

sustained his burden of proof, the commission's findings are 

 

* Pursuant to Code § 17.1-413, this opinion is not 

designated for publication. 
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binding and conclusive upon us. See Tomko v. Michael's 

Plastering Co., 210 Va. 697, 699, 173 S.E.2d 833, 835 (1970). 

 So viewed, the evidence proved that claimant sustained 

compensable injuries to his teeth and eye when he slipped and 

fell while working for employer as a tollbooth operator. Since 

1997, Dr. Sarah Fletcher had treated claimant for neck and left 

arm pain and numbness/tingling. A January 28, 1998 cervical 

spine MRI showed severe spondylosis with severe spinal stenosis 

at C6-7. As a result, Dr. Fletcher referred claimant to Dr. 

James W. Melisi, an orthopedic surgeon. 

 On February 11, 1998, several hours before the compensable 

accident, Dr. Melisi examined claimant, who gave a history of 

neck and left arm pain and numbness of a three-month duration. 

After this examination and reviewing the MRI, Dr. Melisi 

recommended that claimant undergo a two-level anterior cervical 

disketomy at C5-6 and C6-7 with bone graft fusion. Dr. Melisi 

noted that claimant "agreed to proceed with surgery. We will go 

ahead and schedule him for surgery at his convenience." 

Claimant testified that he agreed to undergo the surgery, but 

wanted to postpone it until after a scheduled trip to Ghana. 

Dr. Melisi agreed to schedule the surgery around the trip. 

 Several hours after seeing Dr. Melisi on February 11, 1998, 

claimant slipped and fell at work. Claimant testified that the 

fall rendered him unconscious and paralyzed for four to five 

hours. Claimant was transported to the emergency room. The 
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emergency room report reflects that claimant was conscious and 

that he denied losing consciousness. It also reflects that 

claimant stated he was unable to move for about twenty minutes 

after the accident. An x-ray report showed degenerative 

spondylosis with disk space narrowing at C4-5, C5-6, with 

osteophytes and bilateral neural foraminal encroachment. 

 On February 20, 1998, Dr. Melisi performed the surgery he 

had proposed to claimant on February 11, 1998 before the 

accident, an anterior cervical diskectomy at C5-6 and C6-7 with 

bone fusion graft. The surgery relieved claimant's severe pain 

and left arm numbness. Claimant continued to treat with Dr. 

Melisi for the next three months. On April 22, 1998, Dr. Melisi 

noted that he scheduled claimant for three weeks of physical 

therapy "and otherwise discharged him from the office." 

 On May 25, 1999, Dr. John P. McConnell, an orthopedic 

surgeon, examined claimant and reviewed the medical records, 

except the x-rays and MRI scans. Dr. McConnell noted claimant's 

pre-existing significant cervical spondylosis, but concluded 

that the fall "clearly represents an aggravation of [his 

pre-existing] condition." Dr. McConnell opined that claimant 

could not return to his pre-injury employment at that time. 

 On October 21, 1999, Dr. Joseph Linehan, an orthopedic 

surgeon, performed an independent medical examination of 

claimant. Dr. Linehan noted as follows: 
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It is apparent from the records provided, 

the history and physical examination today 

that Mr. Adu-Gyamfi had cervical spondylosis 

with cervical disc disease and a cervical 

radiculopathy for which surgery had been 

recommended. When he slipped and fell on 

2/11/98 after visiting his neurosurgeon, his 

symptoms were worse and surgery was moved up 

and performed earlier than had originally 

been planned. However, in my opinion, the 

surgery performed was not affected by the 

injury of 2/11/98 nor has the outcome of the 

surgery in any way, shape or form been 

altered by that incident. 

 On December 9, 1999, Dr. Linehan wrote as follows: 

I have today reviewed the MRI scan of Mr. 

Adu-Gyamfi's cervical spine, which was 

performed on 1/29/98, 13 days before his 

slip and fall injury of 2/11/98. The MRI 

scan shows a herniated cervical disc at C5-6 

and C6-7. This in no way changes my opinion 

in my report of 10/21/99. I reiterate the 

fact that the man had cervical spondylosis, 

cervical disc disease and a cervical 

radiculopathy which needed surgery well 

documented before the slip and fall incident 

of 2/11/98. The incident of 2/11/98 in no 

way changed the necessity for his surgery 

nor did it change the surgery he underwent, 

nor did it alter the outcome from the 

surgery performed. 

 On June 15, 1998 and January 8, 1999, Dr. Bernard Rawlins, 

an orthopedic surgeon, treated claimant. In his October 29, 

1999 deposition, Dr. Rawlins opined that the February 11, 1998 

fall "exasperated [claimant's] neck symptoms to the point of 

becoming emergent requiring his neurosurgeon to perform surgery 

sooner rather than later . . . ." On cross-examination, Dr. 

Rawlins admitted that he had not reviewed the complete medical 

records, x-rays, or MRI scans. Dr. Rawlins testified that 
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claimant told him he was rendered unconscious due to the fall, 

but the emergency room report indicates that claimant denied 

loss of consciousness. Dr. Rawlins based his opinions on the 

increase in claimant's symptoms and his report that he was 

paralyzed for a brief period of time. 

 In ruling that claimant's cervical condition and surgery 

were not caused by the February 11, 1998 injury by accident, the 

commission made the following findings: 

While it is clear that the February 11, 

1998, fall caused an increase in the 

claimant's symptoms, there is no evidence 

that the claimant suffered a sudden 

mechanical change in his body as a result of 

the fall. X-rays and MRI scans taken both 

before and after the injury are essentially 

the same. The only symptom that the 

claimant claims to have experienced after 

the fall that he had not had prior to the 

fall—temporary paralysis—was fleeting and 

fully resolved before the claimant arrived 

at the hospital. . . . While the claimant's 

symptoms caused his surgery to by [sic] 

scheduled sooner than originally planned, 

the February 20, 1998, surgery was exactly 

the same surgery Dr. Melisi recommended a 

few hours before the work-related injury. 

 The commission's findings are amply supported by the 

record. Moreover, as fact finder, the commission was entitled 

to reject the opinions of Drs. McConnell and Rawlins, finding 

that Dr. McConnell offered no explanation as to how or why he 

concluded that the February 1998 fall aggravated claimant's 

pre-existing problems and Dr. Rawlins failed to identify any 

physical change in claimant's condition after the accident, only 
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a subjective increase in symptomatology. On the other hand, the 

commission was entitled to accept Dr. Linehan's opinions, which 

were supported by objective data. "Medical evidence is not 

necessarily conclusive, but is subject to the commission's 

consideration and weighing." Hungerford Mechanical Corp. v. 

Hobson, 11 Va. App. 675, 677, 401 S.E.2d 213, 215 (1991). 

Furthermore, "[q]uestions raised by conflicting medical opinions 

must be decided by the commission." Penley v. Island Creek Coal 

Co., 8 Va. App. 310, 318, 381 S.E.2d 231, 236 (1989). 

 Based upon the commission's factual findings and Dr. 

Linehan's opinions, we cannot find as a matter of law that 

claimant's evidence proved that his pre-existing cervical 

condition was aggravated or exacerbated by the February 11, 1998 

compensable injury by accident, resulting in his surgery and 

subsequent disability. 

 For these reasons, we affirm the commission's decision. 

Affirmed.