COURT OF APPEALS OF VIRGINIA 

Present: Judges Benton, Coleman and Willis 

LYNCHBURG CITY SCHOOLS 

AND 

TRIGON ADMINISTRATORS MEMORANDUM OPINION*

 PER CURIAM 

v. Record No. 2498-95-3 APRIL 23, 1996 

 

SNOWIE A. E. DALTON 

 FROM THE VIRGINIA WORKERS' 

COMPENSATION COMMISSION 

 (Gregory P. Cochran; Caskie & Frost, on 

brief), for appellants. 

 (Sherwood S. Day; Day & Current, on brief), 

for appellee. 

 Lynchburg City Schools and its insurer (hereinafter 

collectively referred to as "employer") contend that the Workers' 

Compensation Commission erred in holding employer responsible for 

the cost of medical treatment rendered to Snowie A. E. Dalton by 

Dr. Verna Lewis. Specifically, employer argues that the 

commission erred in finding that Dalton had "good reason" for 

seeking medical treatment from Dr. Lewis. 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. Rule 5A:27. 

 

 *Pursuant to Code § 17-116.010 this opinion is not 

designated for publication. 

 On June 10, 1993, Dalton, a cafeteria worker, injured her 

neck in the course of her employment. Employer accepted Dalton's 
 2 

claim as compensable and the commission entered an award. 

 Dalton initially came under the care of Dr. Edward Stoll, a 

general practitioner. Dr. Stoll treated Dalton conservatively, 

and, upon his retirement, referred her to Dr. William Sullivan. 

On July 2, 1993, Dalton began treating with Dr. Sullivan, who 

diagnosed a cervical thoracic strain and treated Dalton 

conservatively. On October 4, 1993, Dr. Sullivan released Dalton 

to return to her regular work. However, due to Dalton's 

persistent complaints of neck pain, Dr. Sullivan referred her to 

Dr. Joseph H. Wombwell, an orthopedist. 

 On October 14, 1993, Dr. Wombwell noted "some definite 

psychological factors," referred Dalton to a psychologist, and 

Dr. Wombwell released her to return to work. When Dr. Wombwell 

saw Dalton again on December 10, 1993, he offered her no specific 

treatment and told her to return on an as-needed basis. On May 

13, 1994, Dr. Wombwell found minimal narrowing at the C5-6 level. 

 He advised Dalton to do neck exercises, to return to work, and 

to return to him if her pain worsened. 

 On September 27, 1994, Dalton sought medical treatment from 

Dr. Lewis. Dalton took this action on the advice of her 

attorney, because her symptoms had continued without relief and 

without a known cause. Dr. Lewis ordered an MRI, which revealed 

"moderate diffuse disc bulge . . . at C5-6 level causing moderate 

anterior impression upon the thecal sac." Dr. Lewis prescribed 

medication and ordered physical therapy. 
 3 

 The full commission affirmed the deputy commissioner's 

finding that Dalton had "good reason" to seek medical care from 

Dr. Lewis. In so holding, the commission made the following 

findings: 

 "[Dalton] complained of unremitting neck 

pain" to her authorized physicians. These 

doctors essentially concluded that [Dalton] 

had a resolved soft tissue injury and her 

remaining complaints were based on 

"psychological" factors and "secondary gain." 

 The Deputy Commissioner concluded that 

"[Dalton] understandably sought treatment 

elsewhere" and "fortuitously underwent 

cervical MRI scanning" by Dr. Lewis, who 

detected a disc defect. Although Dr. Lewis 

is not treating [Dalton] surgically at this 

point, this avenue is now open to [Dalton] if 

symptoms continue unabated. 

Factual findings made by the commission will be upheld on appeal 

if supported by credible evidence. James v. Capitol Steel 

Constr. Co., 8 Va. App. 512, 515, 382 S.E.2d 487, 488 (1989). 

 "Without a referral from an authorized treating physician, 

Code § 65.2-603(C) provides for treatment by an unauthorized 

physician in an 'emergency' or 'for other good reason.'" 

Shenandoah Products, Inc. v. Whitlock, 15 Va. App. 207, 212, 421 

S.E.2d 483, 485 (1992). 

 [I]f the employee, without authorization but 

in good faith, obtains medical treatment 

different from that provided by the employer, 

and it is determined that the treatment 

provided by the employer was inadequate 

treatment for the employee's condition and 

the unauthorized treatment received by the 

claimant was medically reasonable and 

necessary treatment, the employer should be 

responsible, notwithstanding the lack of 

prior approval by the employer. 
 4 

Id. at 212, 421 S.E 2d at 486. 

 Dalton's testimony and the medical records provide ample 

credible evidence to support the commission's factual findings. 

These findings support the commission's conclusion that Dalton 

acted in good faith when she sought treatment from Dr. Lewis, 

that the treatment provided by Dalton's authorized physicians was 

inadequate to diagnosis her condition, and that Dr. Lewis' 

treatment was medically reasonable and necessary. Despite 

Dalton's continuing cervical pain, none of her authorized 

physicians determined the cause of her condition or offered her 

the option of undergoing imaging studies. 

 We find that the commission did not err in holding employer 

responsible for the cost of Dr. Lewis' treatment. Therefore, we 

affirm the commission's decision. 

 Affirmed.