Title: Combs v. Virginia Power
Citation: N/A
Docket Number: 990534
State: Virginia
Issuer: Virginia Supreme Court
Date: March 3, 2000

Present:  Carrico, C.J., Compton,1 Lacy, Hassell, Keenan, 
Koontz, and Kinser, JJ. 
 
LAURA LEE COMBS 
 
v.  Record No. 990534  OPINION BY JUSTICE CYNTHIA D. KINSER 
 
 
 
 
 
 
 
 
March 3, 2000 
VIRGINIA ELECTRIC & POWER COMPANY, ET AL. 
FROM THE CIRCUIT COURT OF THE CITY OF RICHMOND 
Melvin R. Hughes, Jr., Judge 
 
  
In this personal injury action, the sole question is 
whether the circuit court correctly ruled that an 
employee’s exclusive remedy against an employer is under 
the Virginia Workers’ Compensation Act (the Act), Code 
§§ 65.2-100 through -1310.  Because we conclude that the 
employee suffered an “injury by accident arising out of and 
in the course of . . . employment,” Code § 65.2-101, we 
will affirm the circuit court’s judgment sustaining the 
employer’s special plea in bar. 
FACTS AND PROCEEDINGS 
 
Virginia Electric and Power Company (Virginia Power) 
arranged for an independent instructor to teach an aerobics 
class at its Richmond office for the benefit of its 
employees.  Participation in the class by Virginia Power’s 
employees was voluntary.  Virginia Power advertised the 
                     
1 Justice Compton participated in the hearing and 
decision of this case prior to the effective date of his 
retirement on February 2, 2000. 
class on its bulletin boards and in its newsletter.  It did 
not charge for the use of its facility, but participating 
employees were required to pay a fee to the instructor for 
the class. 
The plaintiff, Laura Lee Combs, was an employee of 
Virginia Power.  During her lunch hour on May 24, 1994, 
Combs participated in the aerobics class and, while doing 
so, developed a severe headache.  The aerobics instructor 
assisted Combs in lying down and then called Virginia 
Power’s Employee Health Services (EHS), as she had been 
instructed to do by the EHS coordinator of health programs.  
The EHS receptionist answered the call and informed Sharon 
Robinson, EHS coordinator of administrative support, that 
someone in the aerobics class had a headache and needed 
some medication.  Shortly thereafter, Robinson went to the 
aerobics room to determine what was happening with regard 
to Combs.  When Combs’ head pain did not subside, she was 
taken to the EHS “quiet room” to rest.  The “quiet room” is 
used by employees who become ill at work, or by 
recuperating employees who have returned to work after an 
accident or illness and need to rest during the workday.  
When an employee is using the room, an EHS staff member is 
required to be in the office, and the employee is to be 
checked at regular intervals. 
 
2
 
After she went to the “quiet room,” Combs was not 
examined by any medical or emergency personnel, nor was her 
condition regularly monitored by anyone.  Approximately two 
hours after Combs entered the “quiet room,” Robinson 
checked on Combs and discovered that Combs had vomited on 
herself and was in a coma-like state.  Robinson then called 
security.  Combs was eventually transported by ambulance to 
the Medical College of Virginia where she was diagnosed 
with intracranial bleeding, a right giant middle cerebral 
aneurysm, and an intraparenchymal hemorrhage.  She 
subsequently underwent two neurological operations.  After 
release from the hospital, she entered a rehabilitation 
center where she received therapy for her partial paralysis 
and cognitive brain damage. 
On April 30, 1996, Combs filed a motion for judgment 
against Virginia Power and four of its employees, alleging 
that the defendants owed her a duty to “have in place 
proper procedures, and to properly train . . . personnel, 
so that employees using EHS could do so without harm to 
themselves and detriment to their well-being.”  Combs 
further asserted that the defendants breached these duties 
and were negligent by, inter alia, failing to properly 
train non-medical personnel working in EHS; failing to 
implement procedures to provide appropriate medical care to 
 
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Virginia Power employees who seek treatment at EHS, 
especially when licensed healthcare professionals are 
unavailable; and failing to provide proper medical care and 
treatment when Combs suffered a medical emergency, thereby 
leaving her unattended for approximately two hours before 
calling security and a rescue squad.  Finally, Combs 
alleged that the defendants’ negligence proximately caused 
her injury and damages.2
 
In response, the defendants filed grounds of defense 
and a “Special Plea of Workers’ Compensation Bar.”  In the 
special plea, they asserted that the exclusivity provision 
of the Act, Code § 65.2-307, barred Combs’ claim and 
therefore deprived the circuit court of subject matter 
jurisdiction over her claim.3  Accordingly, the defendants 
asked the court to dismiss Combs’ action. 
After reviewing the parties’ memoranda, the circuit 
court sustained the special plea and dismissed Combs’ 
                     
2 Combs also filed a claim with the Virginia Workers’ 
Compensation Commission on May 23, 1996.  Virginia Power 
subsequently filed a report regarding the accident with the 
Commission. 
 
3 Code § 65.2-307 provides that “[t]he rights and 
remedies herein granted to an employee when his employer 
and he have accepted the provisions of this title 
respectively to pay and accept compensation on account of 
injury or death by accident shall exclude all other rights 
and remedies of such employee . . . on account of such 
injury . . . .” 
 
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action with prejudice.  In a letter opinion, the court 
concluded that the aggravation and acceleration of Combs’ 
pre-existing aneurysm was “an injury by accident arising 
out of and in the course of her employment with” Virginia 
Power, and that her action was therefore barred by the 
exclusivity provision of the Act.  We awarded Combs this 
appeal. 
ANALYSIS 
“An injury is subject to the exclusivity provision of 
the Act if it is the result of an accident and arises out 
of and in the course of the employment.” Richmond 
Newspapers, Inc. v. Hazelwood, 249 Va. 369, 372, 457 S.E.2d 
56, 58 (1995).  Thus, the critical inquiry in this appeal 
is whether Combs’ injury was (1) an injury by accident, (2) 
arising out of, (3) and in the course of, her employment.  
See Code § 65.2-101; Briley v. Farm Fresh, Inc., 240 Va. 
194, 197, 396 S.E.2d 835, 836 (1990).  If any one of these 
elements is missing, then Combs’ claim is not covered by 
the Act, Snead v. Harbaugh, 241 Va. 524, 526, 404 S.E.2d 
53, 54 (1991), and she can proceed with her personal injury 
claim in the circuit court.  Thus, we will address each of 
these criteria seriatim. 
I.  INJURY BY ACCIDENT 
 
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This Court recently addressed the requirements of an 
“injury by accident” in Southern Express v. Green, 257 Va. 
181, 509 S.E.2d 836 (1999).  There, we held that an “injury 
by accident” occurs when the injury appears “suddenly at a 
particular time and place[,] and upon a particular 
occasion[;]” when it is “caused by an identifiable incident 
[,]or sudden precipitating event[;]” and when the injury 
results “in an obvious mechanical or structural change in 
the human body.”  Id. at 187, 509 S.E.2d at 839.  The 
circuit court found all these factors present with regard 
to Combs’ injury, and we agree. 
At the outset, it must be emphasized that Combs’ 
injury is not the aneurysm itself.  Instead, her injury is 
the aggravation, exacerbation, and/or acceleration of the 
aneurysm.  That injury resulted from the alleged negligent 
emergency medical care, or lack thereof, that she received 
from Virginia Power and its EHS employees after she 
suffered a severe headache during the aerobics class.  
Thus, Combs’ argument that there is no evidence with regard 
to when the aneurysm initially started leaking or when she 
experienced the first onset of symptoms is irrelevant to 
the question whether she sustained an “injury by accident.” 
The record in this case, in particular Combs’ motion 
for judgment, demonstrates that she suffered an “injury by 
 
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accident” under Code § 65.2-101.  The particular time, 
place, and occasion of her injury was at the EHS “quiet 
room” in Virginia Power’s Richmond office, during the two 
to three hours that elapsed from when she first developed 
the headache and was taken to the “quiet room” until she 
was transported to the hospital.  The identifiable or 
precipitating event was the alleged negligent emergency 
medical treatment that she received during this span of 
time.  Finally, Combs’ paralysis and cognitive brain damage 
represent the mechanical or structural changes in her body 
that resulted from her injury.  Thus, all the requirements 
of an “injury by accident” are present in this case.  See 
Winn v. Geo. A. Hormel & Co., 560 N.W.2d 143, 149 (Neb. 
1997)(holding that negligent medical treatment at 
employer’s first-aid medical facility may constitute 
“accident”). 
II. ARISING OUT OF EMPLOYMENT 
The phrase “arising out of” pertains to the origin or 
cause of an injury.  County of Chesterfield v. Johnson, 237 
Va. 180, 183, 376 S.E.2d 73, 74 (1989); Bradshaw v. 
Aronovitch, 170 Va. 329, 335, 196 S.E. 684, 686 (1938).  In 
determining whether an injury arises out of employment, we 
have repeatedly quoted with approval the test enunciated in 
 
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In re Employers’ Liab. Assur. Corp., Ltd., 102 N.E. 697 
(Mass. 1913).  An injury 
 
arises “out of” the employment, when there is apparent 
to the rational mind upon consideration of all the 
circumstances, a causal connection between the 
conditions under which the work is required to be 
performed and the resulting injury.  Under this test, 
if the injury can be seen to have followed as a 
natural incident of the work and to have been 
contemplated by a reasonable person familiar with the 
whole situation as a result of the exposure occasioned 
by the nature of the employment, then it arises “out 
of” the employment.  But it excludes an injury which 
cannot fairly be traced to the employment as a 
contributing proximate cause and which comes from a 
hazard to which the workmen would have been equally 
exposed apart from the employment.  The causative 
danger must be peculiar to the work and not common to 
the neighborhood.  It must be incidental to the 
character of the business and not independent of the 
relation of master and servant.  It need not have been 
foreseen or expected, but after the event it must 
appear to have had its origin in a risk connected with 
the employment, and to have flowed from that source as 
a rational consequence. 
 
Id. at 697; accord Lucas v. Lucas, 212 Va. 561, 563, 186 
S.E.2d 63, 64 (1972); Conner v. Bragg, 203 Va. 204, 208-09, 
123 S.E.2d 393, 396-97 (1962); Bradshaw, 170 Va. at 335, 
196 S.E. at 686. 
In Virginia, we apply an “actual risk test,” meaning 
that the employment must expose the employee to the 
particular danger causing the injury, notwithstanding the 
public’s exposure generally to similar risks.  Lucas, 212 
Va. at 563, 186 S.E.2d at 64.  Thus, if there is a causal 
connection between Combs’ injury and the conditions of her 
 
8
employment, then her injury arose out of her employment.  
See United Parcel Serv. of Am. v. Fetterman, 230 Va. 257, 
258, 336 S.E.2d 892, 893 (1985) (“An accident arises out of 
the employment when there is a causal connection between 
the claimant’s injury and the conditions under which the 
employer requires the work to be performed.”). 
Combs argues that EHS was not actually a clinic for 
the treatment of employee health problems and that, 
therefore, it was not a condition of her employment.  Thus, 
she contends that her injury did not “arise out of” her 
employment.  Assuming that Combs is correct about the 
purpose of EHS, the fact remains that on the day in 
question, the risk of employment was the alleged negligent 
emergency medical treatment by EHS personnel, which 
aggravated her pre-existing aneurysm.  Combs was exposed to 
this risk or condition of employment solely because she was 
a Virginia Power employee.  The public generally would not 
have been exposed to the same risk because only Virginia 
Power employees could utilize EHS.  In fact, Combs alleged 
in her motion for judgment that Virginia Power and its 
employees owed certain duties to her “so that employees 
using EHS could do so without harm to themselves and 
detriment to their well-being,” and that the defendants 
violated those duties, thereby causing injury to her.  She 
 
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further asserted that the employee defendants were acting 
within the scope of their employment when they allegedly 
injured her. 
 
Combs, nevertheless, argues that her situation is like 
that of the employee in Taylor v. Mobil Corp., 248 Va. 101, 
444 S.E.2d 705 (1994), because she did not involuntarily, 
or out of “default[]” as the circuit court found, seek 
medical treatment at EHS.  In Taylor, an employee visited a 
doctor at his employer’s clinic for treatment of a heart 
condition.  The employee ultimately suffered a fatal heart 
attack at home although the doctor had advised him that he 
was not suffering from heart disease.  Id. at 103-04, 444 
S.E.2d at 706-07.  This Court concluded that the employee’s 
risk of exposure to negligent treatment by the doctor was 
not an actual risk of employment because the employee 
voluntarily opted to use the doctor at the employer’s 
clinic.  He was not required to do so by his employer, nor 
was he treated by that doctor because he became ill at 
work.  Id. at 107, 444 S.E.2d at 708. 
In contrast, Combs suffered her severe headache while 
participating in the aerobics class at Virginia Power’s 
office.  While taking part in that class was not required 
by Virginia Power, EHS personnel treated Combs because of 
her status as a Virginia Power employee.  In fact, the 
 
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aerobics instructor called EHS when Combs became ill 
because Virginia Power’s EHS coordinator had directed the 
instructor to do so.  Thus, the risk that led to Combs’ 
injury was part of her work environment.  See Briley, 240 
Va. at 198, 396 S.E.2d at 837. 
Additionally, the fact that her injury was the 
aggravation of a pre-existing condition does not alter the 
result that her injury arose out of her employment.  See 
Ohio Valley Const. Co. v. Jackson, 230 Va. 56, 58, 223 
S.E.2d 554, 555 (1985) (“When an injury sustained in an 
industrial accident accelerates or aggravates a pre-
existing condition, death or disability resulting therefrom 
is compensable under the Workers’ Compensation Act.”).  
Combs’ pre-existing aneurysm united with an actual risk of 
her employment to produce her injury. 
III. IN THE COURSE OF EMPLOYMENT 
 
“The phrase arising ‘in the course of’ [employment] 
refers to the time, place, and circumstances under which 
the accident occurred.”  Johnson, 237 Va. at 183, 376 
S.E.2d at 74.  “An accident occurs ‘in the course of the 
employment’ when it takes place within the period of the 
employment, at a place where the employee may reasonably 
be, and while he is reasonably fulfilling duties of his 
employment or engaged in doing something incidental 
 
11
thereto.”  Bradshaw, 170 Va. at 335, 196 S.E. at 686; 
accord Lucas, 212 Va. at 563, 186 S.E.2d at 64; Conner, 203 
Va. at 208, 123 S.E.2d at 396. 
 
Combs argues she was not performing any duty of her 
employment at the moment when she initially needed 
emergency medical treatment.  As she correctly notes, the 
pre-existing aneurysm was not caused by her employment, and 
she was participating in an aerobics class during her lunch 
hour when she first experienced the headache.  Thus, she 
contends that “the reason she ended up at EHS was not in 
any way connected with her employment[,]” and, therefore, 
that her injury did not occur during the course of her 
employment.  We do not agree. 
 
Combs’ position on this issue overlooks several 
salient facts.  First, Combs is not seeking redress for the 
onset of the symptoms associated with the aneurysm but for 
the aggravation of that pre-existing condition.  The 
aggravation of the aneurysm occurred after EHS personnel 
responded to the call for assistance from the aerobics 
instructor, during Combs’ period of employment, and at a 
place where she could reasonably be if she became ill at 
work, i.e., the “quiet room.”  The only reason that EHS 
responded to that call was because Combs was a Virginia 
Power employee.  Thus, Combs “was injured at a place where 
 
12
she was reasonably expected to be while engaged in an 
activity reasonably incidental to her employment” by 
Virginia Power.  Briley, 240 Va. at 198, 396 S.E.2d at 837.  
Her injury therefore occurred “in the course of” her 
employment. 
CONCLUSION 
 
For these reasons, we conclude that Combs’ injury was 
an “injury by accident arising out of and in the course of 
[her] employment” with Virginia Power, Code § 65.2-101, and 
is therefore compensable under the Act.  Her action in the 
circuit court is thus barred by Code § 65.2-307.  
Accordingly, we will affirm the judgment of the circuit 
court. 
Affirmed. 
 
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