COURT OF APPEALS OF VIRGINIA 

Present: Chief Judge Moon, Judges Coleman and Elder 

Argued at Richmond, Virginia 

CAPITAL TRUCK CENTER 

 MEMORANDUM OPINION* BY 

v. Record No. 0595-95-2 JUDGE LARRY G. ELDER 

 JANUARY 23, 1996 

CHARLES P. HIGHLANDER, SR. 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 William F. Karn (William B. Pierce, Jr.; 

 Williams & Pierce, on briefs), for appellants. 

 Laura L. Geller (Geoffrey R. McDonald; 

 McDonald & Snesil, P.C. on brief), for 

 appellee. 

 Capital Truck Center (employer) appeals the Workers' 

Compensation Commission's (commission) award of benefits to 

Charles P. Highlander, Sr. (claimant) for disability due to the 

occupational disease of "contact allergic dermatitis." Employer 

contends (1) sufficient evidence did not establish claimant 

suffered from a new occupational disease, instead of an 

aggravation of a pre-existing condition; and (2) the commission 

erred in failing to find claimant voluntarily exposed himself to 

work conditions which he was warned would lead to his condition 

becoming symptomatic. Because the commission committed no error, 

we affirm its decision. 

 

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

designated for publication. 
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 I. 

 FACTS 

 In 1979, the commission determined claimant had recurring 

"contact dermatitis" as a result of his employment as a diesel 

mechanic with a former employer. Accordingly, the commission 

awarded claimant temporary total disability benefits for two 

separate periods during 1979. As early as 1978, claimant's 

treating physician, Dr. L. William Kelly, Jr., and other 

physicians instructed claimant not to work in an environment that 

would expose him to diesel fuel, chromates, brake fluid, or 

antifreeze. 

 Despite these instructions, claimant accepted a job as a 

diesel engine mechanic with employer on approximately May 11, 

1984. From May 11, 1984 to August 1993, claimant experienced 

occasional problems with dermatitis. In August 1992, after he 

attended a week long diesel fuel school, claimant's condition 

worsened. On August 11, 1993, claimant filed a claim alleging 

the occupational disease "contact allergic dermatitis." 

 Medical records reveal claimant received dermatological care 

from Dr. Kelly for a period of twenty years. In 1979, Dr. Kelly 

diagnosed claimant as having "contact dermatitis hands & feet." 

Again, in 1981, Dr. Kelly stated claimant suffered from "eczema 

hands and feet [with] contact dermatitis." By letter dated 

August 11, 1993, Dr. Kelly provided the following diagnosis of 

claimant's condition: 
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[Claimant] has been followed in this office since April 

of 1972. He has a long history of contact, irritant

dermatitis involving his hands and feet. . . . In 

March, 1993, his skin eruption changed to contact 

allergic dermatitis with much more severe swelling and 

erythema and blister formation. 

 In April 1993, Dr. William P. Jordan, Jr. also examined 

claimant and concluded that while there were "suggestions that 

this could be an allergic contact dermatitis," a diagnosis of 

contact irritant dermatitis was appropriate. Dr. Jordan noted 

claimant's dermatitis entered a thirteen year remission before it 

returned in August 1992. In March 1994, Dr. James F. Robinson 

examined claimant and stated that he believed claimant's 

condition was "really the same problem that he has been having 

since 1972." 

 The deputy commissioner denied claimant's application for 

benefits, after finding his condition was an aggravation of his 

pre-existing disease and not a new occupational disease. The 

commission disagreed and awarded benefits, finding claimant 

suffered from a new occupational disease. 

 II. 

 NEW DISEASE 

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

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

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

commission's factual findings 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)(citation 
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omitted). "[I]t is fundamental that a finding of fact made by 

the [c]ommission is binding and conclusive upon this [C]ourt on 

review. A question raised by conflicting medical opinion is a 

question of fact." Commonwealth v. Powell, 2 Va. App. 712, 714, 

347 S.E.2d 532, 533 (1986). Finally, "[m]edical 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). 

 The record contains credible evidence that claimant 

developed a new occupational disease in March 1993 and that he 

did not suffer from an aggravation of his pre-existing dermatitis 

condition. Of greatest import to our analysis is Dr. Kelly's 

August 11, 1993 letter, which specifically noted the onset of a 

disease different from claimant's prior condition of contact 

irritant dermatitis. Dr. Kelly stated that beginning in March 

1993, claimant's skin eruptions changed to contact allergic

dermatitis with much more severe swelling and erythema and 

blister formation. Claimant testified that his symptoms worsened 

after the completion of diesel fuel school in August 1992, with 

physical manifestations including larger blisters and the 

appearance of puss. 

 Although other examining physicians did not arrive at a 

positive diagnosis of contact allergic dermatitis, where conflict 

in medical opinions exists, the general rule is that greater 

weight is accorded the treating physician's (Dr. Kelly) opinion 
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when he is positive in his diagnosis. Pilot Freight Carriers, 

Inc. v. Reeves, 1 Va. App. 435, 439, 339 S.E.2d 570, 572 

(1986)(citations omitted). Moreover, Dr. Robinson did not rule 

out a diagnosis of contact allergic dermatitis. Furthermore, Dr. 

Jordan stated, "[t]here are irregular patches and suggestions 

that this could be a contact allergic dermatitis." The 

commission considered all reports of the doctors. We cannot say 

the commission erred in relying on Dr. Kelly's positive medical 

opinion that in March 1993 claimant contracted contact allergic

dermatitis. Contact allergic is an occupational disease 

different from irritant dermatitis. 

 III. 

 WILFUL EXPOSURE TO HARMFUL WORKPLACE ENVIRONMENT 

 First, we disagree with claimant that Rule 5A:18 bars 

employer from raising this issue on appeal. The record shows 

that the issue was generally considered at the hearing; employer 

raised it on brief before the commission; and Commissioner Tarr, 

who dissented from the commission's opinion, directly addressed 

it. 

 Reaching the merits of the issue, the record reveals 

claimant's physicians warned him that his dermatitis condition 

would be exacerbated by exposure to diesel fuel, chromates, and 

other such chemicals. However, from 1979 through 1992, claimant 

worked as a diesel mechanic relatively symptom free from contact 

irritant dermatitis. Furthermore, as discussed in Section II, 
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claimant developed a different dermatitis condition as of March 

1993. While this new condition, contact allergic dermatitis, 

closely resembled claimant's pre-existing condition, contact 

irritant dermatitis, the commission, citing Attorney's Textbook 

of Medicine ¶65A.11 and ¶65A.12, found the two conditions 

distinguishable. Therefore, we cannot say the commission erred 

in finding claimant's disease was not the expected result of 

exposure to his workplace environment about which he had been 

warned. 

 Accordingly, we affirm the commission's decision. 

Affirmed.