Title: Paul Johnson Plastering v. Johnson
Citation: N/A
Docket Number: 020994
State: Virginia
Issuer: Virginia Supreme Court
Date: February 28, 2003

PRESENT:  Hassell, C.J., Lacy, Keenan, Koontz, Kinser, and 
Lemons, JJ., and Carrico,1 S.J. 
 
PAUL JOHNSON PLASTERING, ET AL. 
 
v.  Record No. 020994       OPINION BY JUSTICE ELIZABETH B. LACY 
 
 
 
February 28, 2003 
PAUL JOHNSON 
 
FROM THE COURT OF APPEALS OF VIRGINIA 
 
 
This appeal involves an employee’s claim that he suffered a 
brain injury and is entitled to permanent total disability 
benefits pursuant to Code § 65.2-503(C)(3). 
Paul Johnson was employed as a plasterer and drywall 
installer.  On January 15, 1990, he fell while standing on 42" 
drywall stilts.  He was taken to a hospital emergency room, 
diagnosed with a fracture of the right wrist, and referred to an 
orthopedist.  He was also treated for abrasions on his forehead.  
Dr. Thomas S. Meade, Jr., an orthopedist, put a cast on 
Johnson's right arm and told him he could not work for at least 
two months. 
 
In March 1990, Johnson returned to Dr. Meade complaining of 
neck, hand, back, and leg pain which Johnson attributed to the 
January accident.  In May 1990, Johnson was still complaining of 
pain in his wrist and lower back and numbness in his left leg.  
He also complained of vision problems, headaches, and 
                     
 
1 Chief Justice Carrico presided and participated in the 
hearing and decision of this case prior to the effective date of 
his retirement on January 31, 2003. 
depression.  Johnson had residual effects from the wrist 
fracture and chronic low back pain.  He also continued to be 
depressed, a condition referred to as "chronic depression" by 
Dr. Meade.  Dr. Meade referred Johnson to Dr. Robert A. Nash, a 
neurologist, for evaluation.  In September 1990, Dr. Nash noted 
that Johnson was no longer in pain but was slightly depressed.  
Dr. Nash allowed Johnson to begin restricted work duties. 
In October 1990, Dr. Nash referred Johnson to Harold J. 
Kornylak, an osteopath, who apparently saw Johnson through March 
1991.  During this time Johnson complained of severe headaches, 
nausea, and difficulty hearing conversations because of 
"background noise."  Although Johnson tried to return to work, 
Dr. Meade noted that the stress of work was too much for Johnson 
to handle.  At this point, Dr. Meade referred Johnson to Dr. R. 
Jeremy A. Stowell, a psychiatrist, for treatment because Johnson 
was "chronically depressed" and not "tolerating his job well." 
Dr. Stowell diagnosed Johnson as having a major depressive 
disorder and recommended medical management.  Dr. Raymond G. 
Troiano performed a neurological consultation, reporting in 
August 1991 that Johnson's headaches, dizziness, and other 
neurological problems were related to depression which "could be 
triggered" by the head injury.  Dr. Troiano recommended a CT 
 
2
imaging of the brain2 which was performed by Dr. Mark Cramer on 
January 20, 1992.  His impression of the CT scan results was 
that it was a "normal study" and showed no signs of brain 
damage. 
Johnson filed a claim for workers' compensation benefits by 
letter dated November 27, 1990 in which he referred to the 
January 1990 accident as causing injury to his "rt. wrist, head, 
back, left leg and foot."  The employer agreed that Johnson had 
suffered a compensable injury by accident and Johnson received 
payments for both temporary total and temporary partial 
disability based on the wrist injury.  In 1993, the Commission 
entered an order based on a memorandum of agreement between 
Johnson and the compensation insurance carrier providing that 
Johnson was entitled to payment of his medical bills and 
temporary total disability benefits of $382.00 a week beginning 
December 11, 1991. 
The required payments were made and medical bills were paid 
for the following eight years.  During that time, Johnson 
continued to suffer from depression and associated problems and 
was treated by a number of doctors including Drs. Meade, 
Stowell, and Kornylak.  Dr. Stowell referred Johnson to Dr. 
                     
 
2 CT scan, or computed tomography, is a diagnostic procedure 
used to produce a series of cross-section images of internal 
body parts.  The Sloane-Dorland Annotated Medical-Legal 
Dictionary 536 (1992 Supp.). 
 
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James P. Polk for evaluation of Johnson’s cognitive defects, 
depression, headaches, and hallucinations.  Dr. Polk stated in 
both his 1995 and 1998 reports that Johnson's cognitive defects 
were "consistent with the diagnosis of a traumatic brain injury" 
sustained in the January 1990 industrial accident. 
In 1998, Johnson was evaluated by Charles DeMark, a 
certified rehabilitation counselor.  DeMark concluded that 
Johnson was permanently and totally disabled because of his 
"deficits due to the traumatic brain injury" and his physical 
limitations resulting from his wrist and back injuries. 
On May 1, 1999, three months before the statutory 
termination of his temporary total disability compensation 
benefits under Code § 65.2-500(D), Johnson filed an application 
with the Workers' Compensation Commission for permanent total 
disability benefits pursuant to Code § 65.2-503(C)(3), claiming 
that he suffered an injury to the brain.  Johnson maintained 
that his brain injury developed from the depression he suffered 
as a result of his wrist injury or, alternatively, that the 
brain injury was caused directly by the blow or trauma to his 
head when he fell in the 1990 industrial accident.  The 1998 
reports by DeMark and Dr. Polk were submitted in support of 
Johnson's application. 
At the hearing on Johnson's application, in addition to 
Johnson's testimony, the deputy commissioner admitted into 
 
4
evidence medical evaluations and notes regarding Johnson's 
condition including evaluations conducted for purposes of the 
hearing.  Briefly, this evidence included opinions by Johnson’s 
doctors that his disability resulted from a structural change in 
his brain or a brain injury that developed from his depression 
which in turn was caused by the injury to his wrist, or, 
alternatively, from a brain injury suffered when his head hit 
the ground in the 1990 fall.  Opinions of medical experts 
offered by the employer generally concluded that Johnson did not 
suffer a brain injury as a result of the 1990 fall and that 
depression, while causing some cognitive defects, does not cause 
brain injury, and did not cause the brain injury claimed in this 
case.  Based on this record, the deputy commissioner denied 
Johnson's claim. 
First, the deputy commissioner concluded that prior cases, 
including Daniel Construction Co. v. Tolley, 24 Va. App. 70, 480 
S.E.2d 145 (1997), precluded an award under Code § 65.2-
503(C)(3) for an injury that was a subsequent condition caused 
by an injury sustained in an industrial accident.  Therefore, 
the deputy commissioner held that, if the brain injury claimed 
by Johnson developed from his depression, it was not compensable 
because it was not directly caused by the 1990 accident. 
The deputy commissioner also denied compensation for a 
brain injury that Johnson claimed was caused directly by the 
 
5
1990 accidental fall.  The deputy commissioner stated two 
grounds for this holding.  First, the deputy commissioner 
determined that this claim was untimely because it was not filed 
within two years of the date of the accident.  See Code § 65.2-
601.  The claim filed in 1990 did not identify an injury to 
Johnson's brain, and none of the medical records for the time in 
question referred to an injury to the brain.  Further, the 
memorandum of agreement entered in 1991 recited that the January 
1990 accident resulted in an injury to Johnson's arm and that 
the memorandum settled "all matters in controversy."  The deputy 
commissioner observed that, based on this evidence, when the 
claim for benefits was made in 1990 and during the two year 
period following the accident, none of the parties treated or 
diagnosed Johnson as suffering from a brain injury sustained in 
the 1990 accident.  Therefore, the deputy commissioner concluded 
that the reference in Johnson's application for benefits to a 
"head" injury was not an application for benefits based on a 
brain injury; such an application was not made until 1999 and, 
therefore, was untimely. 
Alternately, the deputy commissioner concluded that the 
claim would be denied on the merits.  The deputy commissioner 
noted that the medical opinion in the case was virtually 
unanimous that the claimant suffers from depression and other 
psychological difficulties as a result of the pain and 
 
6
disability that he has suffered as a result of his arm injury of 
January 15, 1990, and he continues to be entitled to medical 
treatment for those conditions. Nevertheless, the deputy 
commissioner was persuaded based on the evidence in the record 
that Johnson "did not suffer an injury to the brain on January 
15, 1990, that resulted in cognitive defects that now render the 
claimant unemployable." 
Johnson appealed this decision to the full Commission.  The 
Commission, like the deputy commissioner, held that Johnson 
failed to timely file his claim for a brain injury.  The 
Commission further stated that, even if the 1990 claim for a 
head injury was broad enough to encompass a brain injury, the 
claimant abandoned his claim for a brain injury when he executed 
the memorandum of agreement in 1991 which resolved all matters 
in controversy and did not cover any claim for a head or brain 
injury.  The Commission did not address whether Johnson suffered 
a brain injury in the 1990 industrial accident.  Johnson 
appealed the Commission’s decision. 
The Court of Appeals in a published opinion affirmed the 
Commission's decision that the claim for a brain injury was 
untimely.  Johnson v. Johnson Plastering and National Surety 
Corp., 37 Va. App. 716, 561 S.E.2d 40 (2002).  The Court of 
Appeals, however, disagreed with the Commission's determination 
that permanent total disability benefits pursuant to Code 
 
7
§ 65.2-503(C)(3) are available only if such injury was directly 
caused by the industrial accident and held that benefits are 
available for an injury that is the consequence of the injury 
caused by the industrial accident.  The Court of Appeals ordered 
that the case be remanded to the Commission for a factual 
determination whether Johnson suffered a brain injury that was 
the consequence of the injury caused by the industrial accident.  
Id. at 728, 561 S.E.2d at 46. 
Both the employer and Johnson appealed to this Court.  The 
employer asserts that the order of remand was error, and Johnson 
asserts that the Court of Appeals erred in holding that the 1990 
filing for benefits based on a head injury was insufficient to 
constitute a claim for an injury to the brain.3
I. 
Johnson asks us to reverse the holding by the Court of 
Appeals that his claim for benefits based on a brain injury was 
not timely filed.  The record in this case shows, however, that 
even if we were to agree with Johnson's position, he would not 
be entitled to the benefits he seeks.  In addition to holding 
that the claim based on a brain injury was not timely filed, the 
                     
 
3 Johnson also asserted that the Court of Appeals erred in 
holding that execution of the memorandum of agreement waived any 
claim to an injury to the brain.  The Court of Appeals did not 
address this issue, however, and accordingly, we will not 
address this assignment of error.  Johnson, 37 Va. App. at 722 
n.3, 561 S.E.2d at 43 n.3. 
 
8
deputy commissioner concluded that the medical evidence did not 
support a finding that Johnson suffered a brain injury at the 
time of the January 1990 accident as a result of trauma to the 
head.  This factual finding was never set aside and precludes 
Johnson from receiving permanent total disability benefits based 
on his claim that he suffered a brain injury when he fell and 
hit his head in the 1990 accident.4  In light of this factual 
determination, resolution of the timeliness of his claim, the 
issue presented in his cross-error, would have no impact on 
Johnson's eligibility to receive the compensation benefits he 
seeks for a brain injury incurred in the January 1990 industrial 
accident.  Therefore, we will not address this issue. 
Whether Johnson is entitled to recover benefits for a brain 
injury developed from some other source is the issue raised by 
the employer's assignment of error, and we now turn to that 
issue. 
II. 
 
The employer assigns error to that part of the decision of 
the Court of Appeals remanding the matter to the Commission to 
determine whether the claimant "suffered an injury to the brain 
and, if he is so injured, whether a causal connection exists 
                     
 
4 Johnson appealed this finding to the Commission but the 
Commission did not address the finding and Johnson did not 
pursue the matter further. 
 
9
between his employment and the injury."  Johnson, 37 Va. App. at 
727, 561 S.E.2d at 46. 
 
The Court of Appeals' directive was predicated on its 
application of the doctrine of compensable consequence to claims 
for permanent total disability awards under Code § 65.2-
503(C)(3).  That section provides, in pertinent part, that a 
claimant may recover for permanent and total incapacity when 
there is "[i]njury to the brain which is so severe as to render 
the employee permanently unemployable in gainful employment."  
Code § 65.2-503(C)(3).  The deputy commissioner and the 
Commission, relying on Daniel Construction, held that awards 
under this statute could not be based on an injury to the brain 
that develops subsequent to an accident.  The Court of Appeals 
rejected this construction of the statute and of Daniel 
Construction, holding that an injury under Code § 65.2-503(C)(3) 
is compensable "when the injury does not arise on the day of the 
accident, but instead develops as a direct consequence of an 
initial injury."  Johnson, 37 Va. App. at 727, 561 S.E.2d at 46.  
This holding is consistent with the principle established in 
Amoco Foam Products Co. v. Johnson, 257 Va. 29, 510 S.E.2d 443 
(1999). 
In Amoco Foam, we held that an injury suffered as a direct 
result of an industrial accident may give rise to other 
compensable injuries.  In that case, the industrial accident 
 
10
directly injured the employee's left ankle.  While the employee 
was recovering from surgery necessitated by the left ankle 
injury, the left ankle gave way, causing injury to the 
employee's right knee.  Two years later, the employee's right 
knee "gave out" causing another fall.  Id. at 31, 510 S.E.2d at 
443.  We concluded that the initial injury to the right knee was 
compensable as a direct consequence of the left ankle injury but 
that the second injury to the right knee was not compensable.  
To be a compensable injury, the causation link "must directly 
connect the original accidental injury with the additional 
injury for which compensation is sought."  Id., 510 S.E.2d at 
445.  In Amoco Foam, the initial knee injury was the causal link 
between the left ankle injured in the industrial accident and 
the second right knee injury.  Without any direct link between 
an injury caused by the industrial accident and the injury for 
which compensation is sought, there can be no compensation.  Id. 
at 33, 510 S.E.2d 444-45. 
While we agree with the Court of Appeals' analysis, we 
disagree with its conclusion that a remand of the matter to the 
Commission for further factual findings is required. 
Johnson seeks permanent total disability benefits based on 
a brain injury.  He has consistently asserted that his brain 
injury was caused (1) by his depression which was caused by the 
initial injury to his wrist in the industrial accident; or (2) 
 
11
by the blow or trauma to his head when he fell in the industrial 
accident; or (3) by both.  Applying Amoco Foam, if the brain 
injury was caused by the depression which developed from the 
wrist injury, the brain injury is not compensable because, under 
this theory, there is no direct causal link between that brain 
injury and the original industrial accident injury, the wrist 
injury. 
The second claimed cause of the brain injury is the 
industrial accident itself.  Recovery under this theory does not 
involve the application of the compensable consequences 
doctrine; however, recovery under this theory has already been 
eliminated by the deputy commissioner's factual finding 
discussed above, that no brain injury was caused by the initial 
industrial accident. 
Johnson has not identified any other injury as the source 
of the brain injury for which he seeks benefits.  He has never 
asserted that his brain injury was a condition subsequent to any 
injury other than the depression.  Furthermore, nothing in the 
extensive medical testimony in this record suggests any other 
injury as the source of the brain injury.  All the doctors 
asserting that Johnson had a brain injury opined that either the 
depression or the initial trauma to the head caused the claimed 
brain injury.  On this record, therefore, there is no basis for 
remanding this case to the Commission. 
 
12
In summary, for the reasons stated, we will reverse that 
portion of the Court of Appeals' judgment remanding the case to 
the Commission and enter final judgment in favor of the 
employer. 
Reversed and final judgment.
 
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