COURT OF APPEALS OF VIRGINIA 

Present: Judges Frank, Humphreys and Agee 

Argued at Chesapeake, Virginia 

KENNETH P. THOMPSON 

 OPINION BY 

v. Record No. 0206-02-2 JUDGE ROBERT P. FRANK 

 AUGUST 13, 2002 

BRENCO, INC. AND 

 LUMBERMEN'S MUTUAL CASUALTY COMPANY 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 B. Mayes Marks, Jr. (Marks and Williams, on 

brief), for appellant. 

 S. Vernon Priddy III (William B. Judkins; 

Sands Anderson Marks & Miller, on brief), for 

appellees. 

 Kenneth P. Thompson (claimant) appeals from a decision of 

the Workers' Compensation Commission (commission) denying 

claimant's change of condition application. On appeal, claimant 

contends the commission erred in finding it did not have 

jurisdiction over his claim and in finding his claim failed to 

establish a causal connection between his original, compensated 

injury and his new injury. While we disagree with the 

commission's finding regarding its jurisdiction, we affirm the 

denial of benefits. 

Background

 Claimant was an employee of Brenco, Inc. (employer). He 

injured his left hip and femoral shaft, his right forearm, his 
head, and his left ear on December 13, 1995, when a ton of metal 

tubing fell on him at work. A Memorandum of Agreement between 

claimant and employer was filed with the commission on February 

23, 1996; the commission approved the agreement and entered an 

award order in March 1996. 

 Claimant continued to have problems with his limbs, 

especially his left knee. His legs began to "give out" on him, 

although he usually could stop himself from falling to the 

ground. Claimant testified his legs "kept on giving out" after 

his 1996 surgeries; however, the medical records indicate 

claimant did not know when his legs began "giving out." The 

records indicate he was improving until he saw Dr. Gurpal 

Bhuller in December 1999 and had a "new problem" of his left 

knee "giving out." This visit is the first indication in the 

medical records that claimant's knee was "giving out" and 

causing him to fall. At the hearing, claimant remembered only 

one fall with any specificity, when he fell on his back at work 

and hit his head on the floor, sometime in December 1999. 

 Dr. Bhuller became suspicious that this problem 

"represent[ed] spinal cause or spinal pathology." Dr. Bhuller 

ordered an EMG study, which indicated "the possibility of 

cervical spinal stenosis." The doctor then ordered an MRI, 

which confirmed claimant had "a tight spinal stenosis." 

- 2 -
Dr. Bhuller told claimant that the spinal stenosis might not be 

related to his 1995 injuries and later indicated to employer 

that the stenosis was not related to those earlier injuries. 

 Claimant was referred to a neurosurgeon and was examined by 

Dr. David Geckle. Dr. Geckle reviewed the MRI and found "what 

look[ed] like a congenitally narrow lumbar canal with four 

shortened pedicles." A CT scan showed "[c]ervical spondylosis 

at the C5-6 level with moderate foraminal stenosis." In May 

2000, Dr. Geckle performed a verebrectomy on claimant's neck 

"with autologous iliac crest graft fusion and planting" in hopes 

of correcting the problem. 

 Claimant filed a change of condition application with the 

commission on July 12, 2000. Included in the filed documents 

was a typed questionnaire, signed by Dr. Geckle. He marked 

"Yes" on the form, indicating claimant's "cervical problems" 

were "aggravated[d], accelerate[d], and/or exacerbate[d]" by the 

December 1995 accident, contributing to the need for the 

verebrectomy. No explanation for this conclusion was provided.1

 Employer asked several doctors to examine claimant's 

medical records. Dr. Leonard Green, a neurologist, found no 

indication that claimant suffered a cervical injury in 1995 and 

concluded the condition was congenital. He explained: 

 1

 Nothing in the medical records suggests claimant's 

condition could be aggravated by his falls, although falls are 

considered a symptom of his condition. 

- 3 -
The claimant's history of his cervical 

spinal problem is most consistent with 

natural progression related to ordinary 

"wear and tear" which almost always occurs 

with these spinal canal abnormalities. 

Consequently, it is clear and convincing 

that the claimant's cervical spinal canal 

problem was not causally related to the 

industrial accident of December 13, 1995. 

 Dr. Ralph Hagan, a neurologist, also reviewed claimant's 

records. He explained that claimant's problems were typical of 

patients with cervical spondylotic myelopathy. Dr. Hagan 

concluded: 

As Dr. Bhuller stated in his letter of 

[February 1, 2000], this condition is not 

causally related to his worker's 

compensation injury of [December 13, 1995]. 

Certainly he would have had symptoms prior 

to December 1999 if this condition were 

related to his worker's compensation injury 

four years earlier. 

 The only witness at the hearing before the deputy 

commissioner was claimant. After the hearing, claimant was 

awarded $236.76 per week for temporary total disability. The 

deputy commissioner accepted Dr. Geckle's "opinion" that 

claimant's cervical condition was aggravated by the accident. 

 The full commission reversed this decision. First, the 

commission found it did not have jurisdiction over the case 

because the claim was based on a "compensable consequence of a 

compensable consequence," referring to Amoco Foam Prods. Co. v. 

Johnson, 257 Va. 29, 510 S.E.2d 443 (1999). The commission also 

- 4 -
found the cervical condition was unrelated to the accident, 

accepting Drs. Bhuller's, Green's, and Hagan's opinions. 

Analysis

 Claimant admits his cervical problems were not solely 

caused by the 1995 accident. He argues instead that the 

accident exacerbated a pre-existing, congenital condition and, 

therefore, is compensable. He also argues the commission had 

jurisdiction to consider his change of condition claim. 

 The commission had jurisdiction to consider this claim. 

The commission's only basis for rejecting jurisdiction was based 

on Amoco.2 However, the Supreme Court did not address the issue 

of jurisdiction in that case. Rather, the Court examined the 

record and determined no "causal connection between the original 

injury and the November 1995 injury" was established. Id. at 

33, 510 S.E.2d at 444. The analysis explained what a claimant 

must prove to receive an award, not what must be alleged before 

the commission can consider the merits. See id. Clearly, as 

the Supreme Court did examine the merits of the claim, Amoco

does not limit the commission's jurisdiction. 

 The commission here found, in the alternative, that 

claimant had not established a causal connection between the 

 2

 The change of condition claim was timely filed under Code 

§ 65.2-708, which allows review of awards within "twenty-four 

months from the last day for which compensation was paid." 

Compensation was last paid to claimant on November 1, 1998, and 

his change of condition claim was filed on July 12, 2000. 

- 5 -
1995 incident and the cervical problems. The record supports 

this finding.3

 To receive an award, a claimant must prove his change of 

condition is causally related to the original occupational 

injury. Commonwealth/Cent. Virginia Training Ctr. v. Cordle, 37 

Va. App. 232, 237, 556 S.E.2d 64, 67 (2001). The commission's 

ruling on causation is a factual finding, which we review with 

great deference to the commission. Georgia-Pacific Corp. v. 

Robinson, 32 Va. App. 1, 4-5, 526 S.E.2d 267, 268 (2000). 

"'[A] finding of fact made by the commission 

is conclusive and binding upon this court on 

review.' 'That contrary evidence may be in 

the record is of no consequence if there is 

credible evidence to support the 

commission's findings.'" Sneed v. Morengo, 

19 Va. App. 199, 204, 450 S.E.2d 167, 171 

(1994) (citations omitted). 

Id. at 4, 526 S.E.2d at 268. 

 Claimant argues the accident exacerbated his pre-existing 

condition, not that the December 1995 accident directly caused 

the condition. Aggravation of a pre-existing condition is 

compensable under the Workers' Compensation Act. Manassas Ice & 

Fuel Co. v. Farrar, 13 Va. App. 227, 231-32, 409 S.E.2d 824, 827 

(1991). Claimant concedes the treating physician, Dr. Geckle, 

provided the only testimony in support of his position that the 

 3

 As Amoco ultimately held the injury was not related to the 

workplace accident, the commission was correct that Amoco's 

analysis prevents an award in this case. However, the issue is 

not jurisdictional, but instead is failure to prove an essential 

element of the claim. 

- 6 -
accident aggravated his cervical condition. However, examining 

the evidence in the light most favorable to the party prevailing 

before the commission, see id. at 229, 409 S.E.2d at 826, we 

find the commission had sufficient evidence to deny the request 

for benefits. 

 Dr. Geckle's only statement regarding causation was an "X" 

beside "Yes," in response to the written question, "In your 

opinion . . . did your patient's accident of December 13, 1995 

and/or its sequellae aggravate, accelerate, and/or exacerbate 

your patient's cervical problems . . . ." Nothing in his 

medical reports provides any support for this conclusion. 

Indeed, we are uncertain whether claimant believes the accident 

itself aggravated his condition or whether the injuries from the 

accident and their effects aggravated his cervical problem.4

 While a treating physician's opinion normally is given 

great weight, see Pilot Freight Carriers, Inc. v. Reeves, 1 Va. 

App. 435, 439, 339 S.E.2d 570, 572 (1986), such an opinion is 

not conclusive, especially when the opinion is not accompanied 

by any reasoning or explanation. Cf. Lanning v. Virginia Dep't 

of Transp., 37 Va. App. 701, 708-09, 561 S.E.2d 33, 36-37 (2002) 

(explaining that a "bald assertion" is not enough to prove 

causation nor are "talismanic words" necessary). Here, while 

 4

 The commission found no connection existed between the 

accident and claimant's cervical problems. Therefore, we need 

not address the issue of compensable consequences independently. 

- 7 -
the doctor used the "talismanic words," he provided no 

explanation for his conclusion. 

 On the other hand, Dr. Bhuller, who also treated claimant, 

Dr. Green, and Dr. Hagan, all agreed the cervical condition was 

not related to the 1995 accident. While they did not explicitly 

address the issue of aggravation, they completely rejected any

causal link between the injury and the accident. Dr. Bhuller 

called the failure of claimant's left knee a "new problem" in 

his medical report. Dr. Hagan concluded claimant "had two 

distinct problems," one caused by his accident and one caused by 

his spinal/cervical condition. Additionally, the explanations 

provided by Drs. Green and Hagan supported their conclusion. 

Both doctors noted that claimant's problems were related to a 

congenital disorder that appeared to develop along the typical 

course for such patients. Therefore, the doctors concluded the 

accident did not exacerbate the problem; it was progressing 

normally, as if the 1995 accident had not happened. 

 While the medical opinions conflicted, the commission was 

free to decide which evidence was more credible and should be 

weighed more heavily. See McPeek v. P. W. & W. Coal Co., Inc., 

210 Va. 185, 188, 169 S.E.2d 443, 445 (1969); Georgia-Pacific 

Corp., 32 Va. App. at 5, 526 S.E.2d at 269. We do not find the 

commission abused its discretion when it declined to believe 

claimant's physician. 

- 8 -
Conclusion

 Although the commission incorrectly found it did not have 

jurisdiction over this case, we affirm the commission's 

alternative finding that claimant failed to prove a causal link 

between his workplace accident and his cervical condition. We, 

therefore, affirm the commission's denial of benefits. 

Affirmed. 

- 9 -