Chapter 1. Definitions and General Provisions.

§ 65.2-100. Short title.

This title shall be known as the Virginia Workers’ Compensation Act.

History. Code 1950, § 65-1 ; 1968, c. 660, § 65.1-1 ; 1983, c. 239; 1991, c. 355.

Transition provisions.

House Joint Resolution 18 of the 1990 General Assembly directed the Virginia Code Commission to undertake a revision of Title 65.1. In January of 1991, the Commission sent to the Governor and General Assembly its report containing the proposed revision of Title 65.1 which was published as House Document No. 38 of the 1991 Session. The Commission’s draft of the revision of Title 65.1, as amended by the General Assembly, became c. 355 of the Acts of 1991 and was effective Oct. 1, 1991.

Many of the cases cited in the notes under the various sections of this title were decided under corresponding provisions of Title 65.1 or prior law.

Acts 1991, c. 355, cl. 2 provides that whenever any of the conditions, requirements, provisions or contents of any section or chapter of Title 65.1 or any other title of this Code as such titles existed prior to Oct. 1, 1991, are transferred in the same or modified form to a new section or chapter of this title or any other title of this Code and whenever any such former section or chapter is given a new number in this or any other title, all references to any such former section or chapter of Title 65.1 or any other title appearing in this Code shall be construed to apply to the new or renumbered section or chapter containing such conditions, requirements, provisions, contents or portions thereof.

Acts 1991, c. 355, cl. 3 provides that the rules and regulations of the Industrial Commission of Virginia in effect on the effective date of this act (Oct. 1, 1991) shall continue in effect to the extent that they are not in conflict with this act and shall be deemed to be regulations promulgated under this act.

Acts 1991, c. 355, cl. 4 provides that this recodification of Title 65.1 as Title 65.2 shall not be construed to require the reappointment of any officer or any member of a board, council, committee or other appointed body referred to in Title 65.2, and each such officer and member shall continue to serve the term for which appointed pursuant to the provisions of Title 65.1.

Acts 1991, c. 355, cl. 5 provides that the provisions of § 30-152 shall apply to the codification of Title 65.2 so as to give effect to other laws enacted at the 1991 Session of the General Assembly notwithstanding the delay in the effective date of this act (Oct. 1, 1991).

Editor’s note.

Acts 2002, c. 538, provides: “That the Workers’ Compensation Commission, by July 1, 2003, shall promulgate rules and regulations instituting an expedited calendar for the administration of claims under the Virginia Workers’ Compensation Act in which an employer’s denial of benefits satisfies criteria establishing that delays will cause an injured employee to incur severe economic hardship.”

Law Review.

For article, “Recovery for Accidental Injuries Under the Virginia Workmen’s Compensation Act,” see 14 U. Rich. L. Rev. 659 (1980).

For survey of Virginia law on practice and pleading for the year 1978-1979, see 66 Va. L. Rev. 343 (1980).

For article discussing workers’ compensation in the context of toxic substances litigation, see 16 U. Rich. L. Rev. 247 (1982).

For article, “Employment Discrimination and the Visually Impaired,” see 39 Wash. & Lee L. Rev. 69 (1982).

For comment discussing the relationships between employers, employees, and third parties within the context of the Workers’ Compensation Act, see 6 G.M.U. L. Rev. 273 (1983).

For survey on employment law in Virginia for 1989, see 23 U. Rich. L. Rev. 607 (1989).

For note, “Employer Intentional Torts in Virginia: Proposal for An Exception to The Exclusive Workers’ Compensation Remedy,” see 25 U. Rich. L. Rev. 333 (1991).

For 1991 survey on construction law, see 25 U. Rich. L. Rev. 699 (1991).

For article covering significant developments in workers’ compensation law in Virginia, since 1985, see 26 U. Rich. L. Rev. 903 (1992).

For a note, “Hanging in the Balance: Confidentiality Clauses and Postjudgment Settlements of Employment Discrimination Disputes,” see 86 Va. L. Rev. 1537 (2000).

For article, “Labor and Employment Law,” see 35 U. Rich. L. Rev. 725 (2001).

For essay, “An Analysis of Intentional Infliction of Emotional Distress Claims in the Virginia Workplace,” see 54 U. Rich. L. Rev. 283 (2019).

Research References.

Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 1 Courts. § 1.08 Workers’ Compensation Commission; Chapter 41 Rules of Procedure, § 41.05 Rules of the Virginia Workers’ Compensation Commission. Friend.

Larson’s Workers’ Compensation Law (Matthew Bender). Larson and Larson.

Larson’s Workers’ Compensation, Desk Edition (Matthew Bender). Larson and Larson.

Michie’s Jurisprudence.

For related discussion, see 9B M.J. Independent Contractors, § 13; 21 M.J. Workers’ Compensation, §§ 2, 54.

CASE NOTES

  • Analysis
  • I.General Consideration.

    Editor’s note.

    Some of the cases below were decided under former § 65.1-1 or prior law.

    History of Act. —

    For a resume of the history, nature, scope and effect of the Workmen’s (now Workers’) Compensation Act, see Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946).

    Workmen’s (now Workers’) Compensation Act and amendments constitute one complete act. Commonwealth v. Granger, 188 Va. 502 , 50 S.E.2d 390, 1948 Va. LEXIS 184 (1948).

    It is in aid of the Child Labor Law. —

    Liability imposed upon the employer by the Workmen’s (now Workers’) Compensation Act is in aid of the Child Labor Law rather than opposed to it; infants, whether lawfully employed or not, are within the language and intent of the Act, and the remedy afforded by the Act is exclusive of all other remedies. Chalkley v. Nolde Bros., 184 Va. 553 , 35 S.E.2d 827, 1945 Va. LEXIS 176 (1945).

    ERISA and state disability laws. —

    Employee Retirement Income Security Act (ERISA) does not preempt Virginia’s workers’ compensation scheme requiring employers to provide security for the payment of occupational injury and illness benefits. Employers Resource Mgt. Co. v. James, 62 F.3d 627, 1995 U.S. App. LEXIS 22126 (4th Cir. 1995).

    While a state may not require an employer to alter its Employee Retirement Income Security Act (ERISA) plan, it may force the employer to choose between providing disability benefits in a separately administered plan and including the state-mandated benefits in its ERISA plan. If the state is not satisfied that the ERISA plan comports with the requirements of its disability insurance law, it may compel the employer to maintain a separate plan that does comply. Employers Resource Mgt. Co. v. James, 62 F.3d 627, 1995 U.S. App. LEXIS 22126 (4th Cir. 1995).

    Congress did not intend, at the same time it preserved the role of state disability laws, to make enforcement of those laws impossible. A state may require an employer to maintain a disability plan complying with state law as a separate administrative unit. Employers Resource Mgt. Co. v. James, 62 F.3d 627, 1995 U.S. App. LEXIS 22126 (4th Cir. 1995).

    General effect of Act. —

    The Act is said to be in the nature of a compromise between employer and employee to settle their differences arising out of personal injuries, but it is a compromise greatly to the advantage of the employee. By it the question of the negligence of the employer is eliminated, the common-law doctrines of the assumption of risk, fellow servants, and contributory negligence are abolished, and the rules of evidence are laxly enforced — so laxly that an award may be made on hearsay evidence alone, if credible, and not contradicted. The relief afforded is fixed, certain and speedy, and at a time when most needed. Under it there is no doubt or uncertainty as to the right of recovery or the amount thereof. The damage resulting from an accident is treated as a part of the expense of the business and to be borne as such, as much as the expense of repairing a piece of machinery which has broken down. Humphries v. Boxley Bros. Co., 146 Va. 91 , 135 S.E. 890 , 1926 Va. LEXIS 314 (1926).

    Under the Act both employer and employee surrender former rights and gain certain advantages. The employee surrenders his right to bring an action at law against his employer for full damages and agrees to accept a sum fixed by statute. He gains a wider security in line with the more inclusive recovery afforded. The employer surrenders his right of defense on the grounds of contributory negligence, assumption of risk and the fellow servant rule. He is relieved from liability for damages to the employee for which in an ordinary negligence case he might otherwise be liable to a much greater extent. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    As to an employer coming within its terms, the Act imposes a legal obligation to compensate financially the injured employee for an injury received in the course of and arising out of his employment, or the employee’s dependents in the case of his death. Thus, the statute reads into every contract of employment within the purview of the Act the obligation of the employer to pay, and the right of the employee or his dependents to recover, such benefits. Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    United States Constitution does not prevent the Virginia Workers’ Compensation Act from applying to an accident, where the worker was employed by the employer as an insulator and was repairing insulation on board a vessel moored at the employer’s facility in Norfolk, Virginia; since the employee was injured in a local, maritime industrial accident. Norfolk Shipbuilding and Dry Dock Corporation v. Lathey, 8 Va. App. 306, 380 S.E.2d 665, 5 Va. Law Rep. 2661, 1989 Va. App. LEXIS 67 (1989), cert. denied, 493 U.S. 1079, 110 S. Ct. 1133, 107 L. Ed. 2d 1038, 1990 U.S. LEXIS 857 (1990).

    The Workers’ Compensation Commission has the power to make and enforce rules not inconsistent with the Workers’ Compensation Act, for carrying out the provisions of this Act. Thomas v. Nordstrom Pentagon City/Nordstrom, Inc., 22 Va. App. 626, 472 S.E.2d 288, 1996 Va. App. LEXIS 464 (1996).

    Act provides exclusive remedies in field of industrial accidents. —

    The Workmen’s (now Workers’) Compensation Act is exclusive insofar as it covers the field of industrial accidents, but no further. To the extent that the field is not touched by the statute, the legislature intended that the employee’s common-law remedies against his employer are to be preserved unimpaired. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    But common-law remedies are preserved for injuries not within its purview. —

    The filing of a claim for compensation under the Workmen’s (now Workers’) Compensation Act, which is dismissed because not within the purview of the Act, does not estop the employee from thereafter pursuing his common-law remedy, if any, against the employer. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    The purpose and effect of the Compensation Act are to control and regulate the relations between employer and employee. As between them the remedies therein provided are exclusive. It does not extinguish rights outside of and beyond the employment. Consequently, as to these, the employee’s common-law remedies remain unimpaired, and they are not to be considered as altered or changed except where the legislative intent has been plainly manifested by statute. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    Virginia system for workmen’s (now workers’) compensation operates in largely voluntary manner. —

    Dillard v. Industrial Comm'n, 416 U.S. 783, 94 S. Ct. 2028, 40 L. Ed. 2d 540, 1974 U.S. LEXIS 143 (1974).

    A fair reading of the act and its purposes treats the term “injury” as either a mental or a physical condition, affecting the employee’s person; thus, employee, whose defamation action claimed general damages and alleged no personal injury, was not bound by exclusivity provisions of the Act. Snead v. Harbaugh, 241 Va. 524 , 404 S.E.2d 53, 7 Va. Law Rep. 2386, 1991 Va. LEXIS 54 (1991) (decided under former § 65.1-1 ).

    False representation as to physical condition or health made by employee in procuring employment will preclude workers’ compensation benefits for an otherwise compensable injury if a causal relationship between the injury and the false representation is shown and if it is also shown that (1) the employee knew the representation to be false, (2) the employer relied upon the false representation, and (3) such reliance resulted in the consequent injury to the employee. McDaniel v. Colonial Mechanical Corp., 3 Va. App. 408, 350 S.E.2d 225, 3 Va. Law Rep. 1154, 1986 Va. App. LEXIS 375 (1986).

    Misrepresentation of eligibility status does not bar claim for benefits where an illegal alien who misrepresents his eligibility status at the time of hire subsequently obtains legal status. Billy v. Lopez, 17 Va. App. 1, 434 S.E.2d 908, 10 Va. Law Rep. 185, 1993 Va. App. LEXIS 402 (1993).

    Intentional concealment of fact on application did not bar benefits. —

    Employee’s intentional concealment of a material fact on an employment application did not bar his receipt of workers’ compensation benefits for a work-related injury. Where employee submitted second job application almost one year after the date of his first application, and the company assumed that employee’s responses to those unanswered questions would be the same as those given on his earlier application, there was credible evidence that the company’s decision to rehire employee was not made in reliance on his misrepresentation in the second application, but was founded on its assumption that he had no criminal record when he submitted the second application. Falls Church Constr. Co. v. Laidler, 254 Va. 474 , 493 S.E.2d 521, 1997 Va. LEXIS 108 (1997).

    Recovery under uninsured motorist policy. —

    Virginia law does not permit recovery by an insured’s estate under the uninsured motorist provisions of the insured’s policy (paid for by the insured), where the insured was killed in a work-related motor vehicle accident and where the employer/vehicle owner and co-employee/vehicle operator both had insurance, but where the exclusive remedy clause of the Virginia Workers’ Compensation Act bars recovery under those other policies. Aetna Cas. & Sur. Co. v. Dodson, 235 Va. 346 , 367 S.E.2d 505, 4 Va. Law Rep. 2530, 1988 Va. LEXIS 47 (1988) (see also Dodson v. Aetna Cas. & Sur. Co., 851 F.2d 736 (4th Cir. 1988)).

    Under Virginia law, the exclusive remedy clause of the Virginia Workers’ Compensation Act barred recovery under the decedent’s uninsured motorist insurance policy. Dodson v. Aetna Cas. & Sur. Co., 851 F.2d 736, 1988 U.S. App. LEXIS 9598 (4th Cir. 1988).

    Where an employer commits an intentional tort with the intent to injure an employee, an action by that employee is not barred by the Virginia Workers’ Compensation Act. McGreevy v. Racal-Dana Instruments, Inc., 690 F. Supp. 468, 1988 U.S. Dist. LEXIS 6655 (E.D. Va. 1988).

    Spouse in sham green card marriage. —

    Sham green-card marriages are voidable as they are not included in the list of void marriages under §§ 20-45.1 and 20-45.2 ; if the Virginia legislature desires to deny workers’ compensation dependent benefits under § 65.2-101 to the purported spouse in sham green card marriages, they may do so. Marblex Design Int'l, Inc. v. Stevens, 54 Va. App. 299, 678 S.E.2d 276, 2009 Va. App. LEXIS 292 (2009).

    II.Purpose and Scope.

    Statute was enacted for the beneficent purpose of attaining a humanitarian end which had, hitherto, been frustrated by the inexorable rules of the common law. A. Wilson & Co. v. Mathews, 170 Va. 164 , 195 S.E. 490 , 1938 Va. LEXIS 174 (1938); Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    The broad sweep of this act’s societal interests including: (1) charging the costs of an industrial accident to the industry involved through workers’ compensation coverage, and (2) assuring that others involved in that industry are immune from further common-law liability arising from those industrial accidents which are covered by the act. Counts v. Stone Container Corp., 239 Va. 152 , 387 S.E.2d 481, 6 Va. Law Rep. 1109, 1990 Va. LEXIS 8 (1990).

    Its purpose is to protect employees. —

    The purpose of the Workmen’s (now Workers’) Compensation Act is to protect the employee. Ellis v. Commonwealth, 182 Va. 293 , 28 S.E.2d 730, 1944 Va. LEXIS 178 (1944); Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953).

    The purpose of the Workmen’s (now Workers’) Compensation Act is to provide compensation to a workman for the loss of his opportunity to engage in work, when his disability is occasioned by an injury suffered from an accident arising out of and in the course of his employment. Burlington Mills Corp. v. Hagood, 177 Va. 204 , 13 S.E.2d 291, 1941 Va. LEXIS 207 (1941), limited, Chesterfield County v. Dunn, 9 Va. App. 475, 389 S.E.2d 180, 6 Va. Law Rep. 1384, 1990 Va. App. LEXIS 31 (1990).

    It is an effort on the part of the State to insure the workman to a limited extent against loss from accidents in his employment, to give him a speedy and expeditious remedy for his injury, and to place upon industry the burden of losses incident to its conduct. Humphries v. Boxley Bros. Co., 146 Va. 91 , 135 S.E. 890 , 1926 Va. LEXIS 314 (1926) (see also C & O Ry. v. Palmer, 149 Va. 560 , 140 S.E. 831 (1927)).

    And to place pecuniary loss from accidental injuries on industry. —

    The intent and purpose of the Workmen’s (now Workers’) Compensation Act is to make every industrial business bear the pecuniary loss, measured by the payment of compensation provided for in this title, of all accidental injuries to employees engaged therein to the hazard or risk of the happening of which the injured employee is exposed, in a peculiar or an abnormal degree, because of the fact that he is an employee engaged in the particular business. Honaker & Feeney v. Hartley, 140 Va. 1 , 124 S.E. 220 , 1924 Va. LEXIS 152 (1924); Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    As well as confine to the project the economic burden of all parties arising from personal injuries incident to an undertaking. Bristow v. Safway Steel Prods., 327 F.2d 608, 1964 U.S. App. LEXIS 6723 (4th Cir. 1964).

    It is the aim of the Workmen’s (now Workers’) Compensation Act that the financial risk of accidental personal injuries inherent in any project be borne by and limited to that project to the extent specified therein. Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964); Bergen v. Fourth Skyline Corp., 501 F.2d 1174, 1974 U.S. App. LEXIS 7193 (4th Cir. 1974).

    It does not apply to accidents outside field of industrial hazards. —

    The fundamental purpose of the Act is to give compensation for accidental injuries within the hazards of the employment. The Act does not apply to accidents outside the field of industrial hazards. Within that field the only remedies of the employee are those prescribed by the Act. Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946); Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953).

    Or to persons not occupying relationship of master and servant. —

    The Workmen’s (now Workers’) Compensation Act, as its title shows, relates to industrial accidents, and its well-known purpose was to substitute for the unsatisfactory common-law remedies a speedier and simpler and more equitable form of relief for personal injuries sustained by persons engaged in hazardous occupations. It would seem clear from the history and purposes and general provisions of the Act that the legislature did not have in mind as beneficiaries any other persons than such as are commonly understood as falling within a contractual relationship of master and servant. Mann v. City of Lynchburg, 129 Va. 453 , 106 S.E. 371 , 1921 Va. LEXIS 109 (1921).

    The history of the act clearly shows that the legislature did not have in mind as beneficiaries any persons other than those commonly understood as falling within a contractual relationship of employer and employee. Hamilton Trucking v. Springer, 10 Va. App. 710, 396 S.E.2d 379, 7 Va. Law Rep. 211, 1990 Va. App. LEXIS 151 (1990).

    The classification of a person as an employee or an independent contractor is governed, not by any express provision of the act, but by common law, and courts must look to it in determining who is an employee. Hamilton Trucking v. Springer, 10 Va. App. 710, 396 S.E.2d 379, 7 Va. Law Rep. 211, 1990 Va. App. LEXIS 151 (1990).

    Employers cannot simply designate persons as employees or independent contractors; the actual contract of employment determines whether the service is being performed by an employee or an independent contractor. Hamilton Trucking v. Springer, 10 Va. App. 710, 396 S.E.2d 379, 7 Va. Law Rep. 211, 1990 Va. App. LEXIS 151 (1990).

    Act balances needs of employers and employees. —

    In this legislation the General Assembly balanced the competing needs of employers and employees and enacted a statutory scheme which limits the employee’s recovery as compared to full tort damages, but guarantees the injured worker greater security in that to obtain compensation he need not prove negligence and counter traditional defenses such as contributory negligence and assumption of risk. The Supreme Court will not interfere with that far-reaching compromise by requiring the employer to provide compensation for claims which do not come within the statutory language. Low Splint Coal Co. v. Bolling, 224 Va. 400 , 297 S.E.2d 665, 1982 Va. LEXIS 309 (1982).

    Immunity provisions apply to insurance carrier when acting beyond scope of liabilities as insurer. —

    The immunity provisions of this title apply to an insurance carrier, as an employer, even when the employee’s claim rests on a breach of a voluntary undertaking assumed by the insurance carrier beyond its liabilities under this title as an insurer. Williams v. United States Fid. & Guar. Co., 358 F.2d 799, 1966 U.S. App. LEXIS 7090 (4th Cir. 1966).

    Negligence does not bar compensation where an employee, working at a place where his duties reasonably require him to be, is injured because he does his work in a negligent manner. Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939).

    Negligence is of no concern in a compensation case unless the injury is caused by the employee’s willful negligence or misconduct. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    As the Act provides compensation without regard to fault. —

    The Workmen’s (now Workers’) Compensation Act provides a system of compensation to an employee or his dependents for injury or death from an injury arising out of and in the course of the employment, without regard to fault as the cause of such injury or death. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    Negligence, either claimant’s or his employer’s, is immaterial in determining the right to recover under the Workers’ Compensation Act. Thus, the precautions taken by an employer before allowing an injured employee to return to work should not be considered in determining if a disability is compensable. Shelton v. Ennis Bus. Forms, Inc., 1 Va. App. 53, 334 S.E.2d 297, 1985 Va. App. LEXIS 59 (1985).

    Rabies injections not preventative medical treatment. —

    Workers’ compensation commission erred in denying workers’ compensation benefits to a veterinarian assistant who was given injections after her exposure to a probably rabid cat; the injections were not preventative medical treatment, but were given to prevent a life threatening illness, and the evidence proved a compensable injury by accident. Frey v. Gunston Animal Hosp., 39 Va. App. 414, 573 S.E.2d 307, 2002 Va. App. LEXIS 740 (2002).

    Application to nonresidents working in Virginia. —

    Although the compensation statutes make no reference to the status of nonresidents working in Virginia at the time of an accident, Virginia intended to grant such remedies to, and impose such restrictions and limitations upon, such nonresidents to the same extent as though they were residents and employed by a Virginia employer. McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    Infliction of emotional distress. —

    Generally, the damages that flow from an action for intentional or negligent infliction of emotional distress are not the result of an injury by accident within the meaning of the Workers’ Compensation Act, but result from a gradually incurred injury. Williams v. Garraghty, 249 Va. 224 , 455 S.E.2d 209, 1995 Va. LEXIS 38, cert. denied, 516 U.S. 814, 116 S. Ct. 66, 133 L. Ed. 2d 28, 1995 U.S. LEXIS 5402 (1995).

    Defamation. —

    Personal damages that employee sought to prove as a result of the defamation do not constitute such an injury by accident. Williams v. Garraghty, 249 Va. 224 , 455 S.E.2d 209, 1995 Va. LEXIS 38, cert. denied, 516 U.S. 814, 116 S. Ct. 66, 133 L. Ed. 2d 28, 1995 U.S. LEXIS 5402 (1995).

    There is no cause of action under the Virginia Workers’ Compensation Act for retaliatory discharge. Blevins v. GE Co., 491 F. Supp. 521, 1980 U.S. Dist. LEXIS 13480 (W.D. Va. 1980).

    Injury resulting from accident. —

    The Virginia Workers’ Compensation Act, § 65.2-100 et seq., does not require that a claimant feel or make a contemporaneous complaint of pain or seek immediate medical treatment; the requirement is that the injury result from the accident. Alexandria Hosp. v. Munjal, 2002 Va. App. LEXIS 448 (Va. Ct. App. Aug. 6, 2002).

    Sexual harassment related tort claims allowed. —

    Amendments to the Worker’s Compensation Act, which became effective on July 1, 1992, allow sexual harassment related tort claims apart from the Worker’s Compensation Act, and this includes a claim for intentional infliction of emotional distress. Beardsley v. Isom, 828 F. Supp. 397, 1993 U.S. Dist. LEXIS 16186 (E.D. Va. 1993), aff'd sub nom. Beardsley v. Webb, 30 F.3d 524, 1994 U.S. App. LEXIS 19151 (4th Cir. 1994).

    III.Construction.

    Construction of Indiana act adopted in this State. —

    The Virginia Workmen’s (now Workers’) Compensation Act, adopted in 1918, being, practically speaking, a copy of the Indiana act, the judicial construction placed upon the latter act in that state will be considered to have been adopted along with the act in this State. Big Jack Overall Co. v. Bray, 161 Va. 446 , 171 S.E. 686 , 1933 Va. LEXIS 335 (1933); Board of Supvrs. v. Boaz, 176 Va. 126 , 10 S.E.2d 498, 1940 Va. LEXIS 239 (1940).

    Indiana decisions are peculiarly applicable in workmen’s (now workers’) compensation cases because the Virginia statute on the subject is based upon the statute of Indiana. Cohen v. Cohen's Dept. Store, 171 Va. 106 , 198 S.E. 476 , 1938 Va. LEXIS 261 (1938); Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940) (see Morris v. Pulaski Veneer Corp., 184 Va. 424 , 35 S.E.2d 342 (1945); Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573 (1946); Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70 (1946)).

    The Virginia Workers’ Compensation Act was modeled after the analogous statute in Indiana. Virginia courts have therefore considered decisions interpreting the Indiana Act in construing the substantially similar statute in Virginia. Joyce v. A.C. & S., Inc., 785 F.2d 1200, 1986 U.S. App. LEXIS 22853 (4th Cir. 1986); Haigh v. Matsushita Elec. Corp. of Am., 676 F. Supp. 1332, 1987 U.S. Dist. LEXIS 12113 (E.D. Va. 1987).

    The Workmen’s (now Workers’) Compensation Act should be liberally construed in harmony with the humane purpose of the Act. Dixon v. Norfolk Shipbuilding & Dry Dock Corp., 182 Va. 185 , 28 S.E.2d 617, 1944 Va. LEXIS 166 (1944); Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947); Bailey v. Stonega Coke & Coal Co., 185 Va. 653 , 40 S.E.2d 254, 1946 Va. LEXIS 238 (1946); Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951); Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953).

    The Workmen’s (now Workers’) Compensation Act was adopted for the benefit of employees and their dependents, and it should be liberally construed in order to attain the desired results. Byrd v. Stonega Coke & Coal Co., 182 Va. 212 , 28 S.E.2d 725, 1944 Va. LEXIS 170, limited, Carter v. Hercules Powder Co., 182 Va. 282 , 28 S.E.2d 736, 1944 Va. LEXIS 177 (1944).

    The Workmen’s (now Workers’) Compensation Act is highly remedial and should be liberally construed in favor of the workman. Barker v. APCO, 209 Va. 162 , 163 S.E.2d 311, 1968 Va. LEXIS 210 (1968).

    Although in derogation of the common law. —

    The Workmen’s (now Workers’) Compensation Act, although in derogation of the common law, is highly remedial, and should be liberally construed in favor of the workman. Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925) (see also Humphrees v. Boxley Bros. Co., 146 Va. 91 , 135 S.E. 8 90 (1926); VEPCO v. Place, 150 Va. 562 , 143 S.E.2d 756 (1928); Bristol Bldrs. Supply Co. v. McReynolds, 157 Va. 468 , 162 S.E. 8 (1932); City of Alexandria v. McClary, 167 Va. 199 , 188 S.E. 158 (1936); A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 (1938); Burlington Mills Corp. v. Hagood, 177 Va. 204 , 13 S.E.2d 291 (1941); Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530 (1942); Carter v. Hercules Powder Co., 182 Va. 282 , 28 S.E.2d 736 (1944); Ellis v. Commonwealth, 182 Va. 293 , 28 S.E.2d 730 (1944)).

    Law, not facts, to be liberally construed. —

    It is true that the Workers’ Compensation Law should be construed liberally in favor of the worker, but it is the law that should be construed liberally, not the facts. Board of Supvrs. v. Martin, 3 Va. App. 139, 348 S.E.2d 540, 3 Va. Law Rep. 707, 1986 Va. App. LEXIS 346 (1986).

    Court cannot alter or extend Act’s provisions. —

    Liberality of construction does not authorize the amendment, alteration, or extension of the Act’s provisions. It does not go to the extent of requiring that every claim asserted should be allowed. Humphries v. Newport News Shipbuilding & Dry Dock Co., 183 Va. 466 , 32 S.E.2d 689, 1945 Va. LEXIS 193 (1945); Van Geuder v. Commonwealth, 192 Va. 548 , 65 S.E.2d 565, 1951 Va. LEXIS 202 (1951).

    The liberal construction which is to be given the Workmen’s (now Workers’) Compensation Act does not include a power of the courts to enlarge the limitations therein expressly set out. Commonwealth v. Granger, 188 Va. 502 , 50 S.E.2d 390, 1948 Va. LEXIS 184 (1948).

    The duty to construe the Act liberally does not authorize the amendment, alteration or extension of its provisions. Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978).

    While the Virginia Workers’ Compensation Act (Act), § 65.2-100 et seq., is to be liberally construed in favor of a worker, statutory construction may not be used to extend the rights created by the Act beyond the limitations and purposes set out therein. Hardee's of Clintwood v. Robinson, 2003 Va. App. LEXIS 70 (Va. Ct. App. Feb. 11, 2003).

    Claimant must be an “employee.” —

    Before an employee can claim the benefits of the Workers’ Compensation Act, or be subject to its restrictions, he or she must be considered an employee under its terms. Evans v. Hook, 239 Va. 127 , 387 S.E.2d 777, 6 Va. Law Rep. 1081, 1990 Va. LEXIS 22 (1990).

    To cover persons or occupations not within its scope. —

    The Workmen’s (now Workers’) Compensation Act is to be liberally construed to the end that its wise and humane purpose may be advanced; but its provisions cannot be extended by construction, so as to cover persons or occupations not within its scope and intent. Mann v. City of Lynchburg, 129 Va. 453 , 106 S.E. 371 , 1921 Va. LEXIS 109 (1921).

    This title is to be liberally construed in favor of the claimant, but this construction has not been expanded to include a third person as its beneficiary, in contradistinction to an employee suing his employer. Monumental Motor Tours v. Eaton, 184 Va. 311 , 35 S.E.2d 105, 1945 Va. LEXIS 151 (1945).

    And Act should not be converted into form of health insurance. —

    Liberal construction does not mean that the Act should be converted into a form of health insurance. Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953).

    Employer and the insurance carrier are entitled to fair consideration also. Raven Red Ash Coal Corp. v. Absher, 153 Va. 332 , 149 S.E. 541 , 1929 Va. LEXIS 266 (1929).

    A false representation on an employment application bars a claim for compensation benefits upon proof by the employer that: (1) the employee knew that the representation was false; (2) the employer relied upon the misrepresentation; (3) such reliance resulted in the consequent injury; and (4) there was a causal relationship between the injury in question and the false representation. Centreville Automotive v. Vanover, 1995 Va. App. LEXIS 199 (Va. Ct. App. Feb. 28, 1995).

    IV.Procedure.

    Proceeding under the Act is not one to recover damage for a wrong, for the employer’s liability is not based upon tort. Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    And the rules of the common law for tort actions do not apply to cases under the Workmen’s (now Workers’) Compensation Act. Under the Act, the proceeding is not one for damage for a wrong done, but to obtain compensation for a loss sustained by reason of disability. Burlington Mills Corp. v. Hagood, 177 Va. 204 , 13 S.E.2d 291, 1941 Va. LEXIS 207 (1941), limited, Chesterfield County v. Dunn, 9 Va. App. 475, 389 S.E.2d 180, 6 Va. Law Rep. 1384, 1990 Va. App. LEXIS 31 (1990).

    Plaintiff bears burden of proving his case. —

    Under the Workmen’s (now Workers’) Compensation Act the plaintiff must prove his case and the burden of doing so rests upon him. Carter v. Hercules Powder Co., 182 Va. 282 , 28 S.E.2d 736, 1944 Va. LEXIS 177 (1944); Van Geuder v. Commonwealth, 192 Va. 548 , 65 S.E.2d 565, 1951 Va. LEXIS 202 (1951).

    Trial court did not err in granting the subcontractor’s demurrer in the general contractor’s indemnity action against the subcontractor after the injured employee of the subcontractor obtained workers’ compensation benefits from the general contractor; the general contractor in its indemnity action had to show that the subcontractor was liable to pay the workers’ compensation benefits, but the general contractor failed to plead facts showing that the subcontractor, which had a principal place of business in Maryland, was subject to the Virginia Workers’ Compensation Act, § 65.2-100 et seq., as the general contractor did not show that the subcontractor had at least three employees regularly in the service of the Commonwealth. Mark Five Constr., Inc. v. Castle Contr., 274 Va. 283 , 645 S.E.2d 475, 2007 Va. LEXIS 80 (2007).

    Standard of proof. —

    A claimant must prove his case by a preponderance of the evidence, and if the evidence shows that it is just as probable that a disability resulted from a cause which is not compensable, as it is that it resulted from one which is compensable, the claimant has not sustained the burden of proof. Bergman v. L & W Drywall, 222 Va. 30 , 278 S.E.2d 801, 1981 Va. LEXIS 267 (1981).

    Doctrine of imposition did not apply to relieve employee of procedural default. —

    Where the Virginia Workers’ Compensation Commission characterized the employee’s claim for temporary total disability benefits as a change-of-condition request seeking additional benefits rather than as a mere enforcement action of an earlier award, the doctrine of imposition did not apply to relieve the employee of procedural default, as no evidence suggested that the employer misled the employee or used superior knowledge of or experience with the Virginia Workers’ Compensation Act, § 65.2-100 to deprive the employee of the employee’s claimed compensation. Morissette v. Custom Tel. Serv., 2003 Va. App. LEXIS 82 (Va. Ct. App. Feb. 19, 2003).

    Commission may not arbitrarily disregard uncontradicted evidence of unimpeached witnesses, which is not inherently incredible and not inconsistent with other facts in the record. Grove v. Allied Signal, 15 Va. App. 17, 421 S.E.2d 32, 9 Va. Law Rep. 162, 1992 Va. App. LEXIS 230 (1992).

    Improper determination of witness credibility. —

    The commission erred because it abused its discretion in determining witness credibility as the basis for reversing the deputy commissioner. McMurphy Coal Co. v. Miller, 20 Va. App. 57, 455 S.E.2d 265, 1995 Va. App. LEXIS 263 (1995).

    Appellate review. —

    The commission’s decision that an accident arises out of the employment involves a mixed question of law and fact and is thus reviewable on appeal. Southside Va. Training Ctr. v. Shell, 20 Va. App. 199, 455 S.E.2d 761, 1995 Va. App. LEXIS 342 (1995).

    Election of remedies. —

    The mere filing of a claim for workmen’s (now workers’) compensation does not bar a plaintiff under the doctrine of election of remedies from filing a claim in admiralty for negligence or unseaworthiness. Biggs v. Norfolk Dredging Co., 237 F. Supp. 590, 1965 U.S. Dist. LEXIS 7677 (E.D. Va. 1965), rev'd, 360 F.2d 360, 1966 U.S. App. LEXIS 6654 (4th Cir. 1966).

    Award of benefits affirmed. —

    Claimant’s immediate report of the events to her supervisors following a sexual assault, and her description of the incident during her testimony, clearly established that the sexual assault was traumatic, frightening, and unexpected, and the Virginia Workers’ Compensation Commission’s award of benefits was affirmed. Southwestern Va. Mental Health Inst. v. Wright, 2006 Va. App. LEXIS 454 (Va. Ct. App. Oct. 10, 2006).

    Termination of benefits due to misconduct. —

    While the commission applied the two-part Artis test to conclude that the employee’s misconduct in walking off of the job constituted misconduct that gave the employer just cause to terminate the employee, it failed to apply the second part of that test. The commission was also required to determine whether the employee was responsible for the misconduct, or, in other words whether the employee’s misconduct was voluntary or involuntary in order to determine whether workers’ compensation benefits previously awarded could be terminated. Patterson Bros. Paving v. Lacy, 2008 Va. App. LEXIS 15 (Va. Ct. App. Jan. 15, 2008).

    Although an employee’s poor work performance was sufficient to show conduct unrelated to the employee’s disability that warranted a permanent suspension of benefits, the Workers’ Compensation Commission made no findings and conducted no analysis with respect to whether the employee’s misconduct was voluntary or involuntary. Chem. Producers & Distribs. Ass'n v. Perry, 2009 Va. App. LEXIS 259 (Va. Ct. App. June 9, 2009).

    CIRCUIT COURT OPINIONS

    Jurisdiction of Worker’s Compensation Commission. —

    All matters falling within the purview of the Virginia Worker’s Compensation Act were the exclusive province of the Virginia Worker’s Compensation Commission, and a clear meaning of the words used exempted lump sum worker’s compensation awards from the Virginia Structured Settlement Protection Act, § 59.1-475 et seq.; a worker’s petition seeking approval of a transfer of a structured settlement payment rights relating to a worker’s compensation award in a circuit court was dismissed. In re Moore, 68 Va. Cir. 139, 2005 Va. Cir. LEXIS 67 (Portsmouth June 9, 2005).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Parties are charged with knowledge of the existing law. Application of the law is not dependent on whether a party professes knowledge of that law. Taylor v. Stone Builders, 75 O.W.C. 11 (1996).

    OPINIONS OF THE ATTORNEY GENERAL

    Covid-19. —

    If a first responder becomes ill from COVID-19 from an exposure at work, it is likely a compensable illness under the Workers’ Compensation Act. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    If COVID-19 is an upper respiratory disease, it falls under the heart and lung presumption of the Act for first responders, however the statutory presumption applies only to a limited class of first responders under certain circumstances and, therefore, would not have broad applicability to all or most of the first responders whose official duties regularly place them at far greater risk of contracting COVID-19 than the general public following social distancing guidelines. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A first responder who has the benefit of a presumption, has the initial burden of producing evidence to trigger the presumption (evidence of the disease, and evidence of disability or death caused by the disease); once the presumption is triggered, the burden shifts to the employer to rebut the presumption (that the disease was not caused by the employment and that there is a non-work-related cause). See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    § 65.2-101. Definitions.

    As used in this title:

    “Average weekly wage” means:

      1. The earnings of the injured employee in the employment in which he was working at the time of the injury during the period of 52 weeks immediately preceding the date of the injury, divided by 52; but if the injured employee lost more than seven consecutive calendar days during such period, although not in the same week, then the earnings for the remainder of the 52 weeks shall be divided by the number of weeks remaining after the time so lost has been deducted. When the employment prior to the injury extended over a period of less than 52 weeks, the method of dividing the earnings during that period by the number of weeks and parts thereof during which the employee earned wages shall be followed, provided that results fair and just to both parties will be thereby obtained. When, by reason of a shortness of time during which the employee has been in the employment of his employer or the casual nature or terms of his employment, it is impractical to compute the average weekly wages as above defined, regard shall be had to the average weekly amount which during the 52 weeks previous to the injury was being earned by a person of the same grade and character employed in the same class of employment in the same locality or community.
      2. When for exceptional reasons the foregoing would be unfair either to the employer or employee, such other method of computing average weekly wages may be resorted to as will most nearly approximate the amount which the injured employee would be earning were it not for the injury.
    1. Whenever allowances of any character made to an employee in lieu of wages are a specified part of the wage contract, they shall be deemed a part of his earnings. For the purpose of this title, the average weekly wage of the members of the Virginia National Guard and the Virginia Defense Force, registered members on duty or in training of the United States Civil Defense Corps of the Commonwealth, volunteer firefighters engaged in firefighting activities under the supervision and control of the Department of Forestry, and forest wardens shall be deemed to be such amount as will entitle them to the maximum compensation payable under this title; however, any award entered under the provisions of this title on behalf of members of the National Guard or their dependents, or registered members on duty or in training of the United States Civil Defense Corps of the Commonwealth or their dependents, shall be subject to credit for benefits paid them under existing or future federal law on account of injury or occupational disease covered by the provisions of this title.
    2. Whenever volunteer firefighters, volunteer emergency medical services personnel, volunteer law-enforcement chaplains, auxiliary or reserve police, auxiliary or reserve deputy sheriffs, members of volunteer search and rescue organizations, volunteer members of community emergency response teams, and volunteer members of medical reserve corps are deemed employees under this title, their average weekly wage shall be deemed sufficient to produce the minimum compensation provided by this title for injured workers or their dependents. For the purposes of workers’ compensation insurance premium calculations, the monthly payroll for each volunteer firefighter or volunteer who is an individual who meets the definition of “emergency medical services personnel” in § 32.1-111.1 shall be deemed to be $300.
    3. The average weekly wage of persons, other than those covered in subdivision 3 of this definition, who respond to a hazardous materials incident at the request of the Department of Emergency Management shall be based upon the earnings of such persons from their primary employers.

      “Award” means the grant or denial of benefits or other relief under this title or any rule adopted pursuant thereto.

      “Change in condition” means a change in physical condition of the employee as well as any change in the conditions under which compensation was awarded, suspended, or terminated which would affect the right to, amount of, or duration of compensation.

      “Client company” means any person that enters into an agreement for professional employer services with a professional employer organization.

      “Coemployee” means an employee performing services pursuant to an agreement for professional employer services between a client company and a professional employer organization.

      “Commission” means the Virginia Workers’ Compensation Commission as well as its former designation as the Virginia Industrial Commission.

      “Employee” means:

      1. Every person, including aliens and minors, in the service of another under any contract of hire or apprenticeship, written or implied, whether lawfully or unlawfully employed, except (i) one whose employment is not in the usual course of the trade, business, occupation or profession of the employer or (ii) as otherwise provided in subdivision 2 of this definition.
      2. Any apprentice, trainee, or retrainee who is regularly employed while receiving training or instruction outside of regular working hours and off the job, so long as the training or instruction is related to his employment and is authorized by his employer.
      3. Members of the Virginia National Guard, whether on duty in a paid or unpaid status or when performing voluntary service to their unit in a nonduty status at the request of their commander.Income benefits for members of the National Guard shall be terminated when they are able to return to their customary civilian employment or self-employment. If they are neither employed nor self-employed, those benefits shall terminate when they are able to return to their military duties. If a member of the National Guard who is fit to return to his customary civilian employment or self-employment remains unable to perform his military duties and thereby suffers loss of military pay which he would otherwise have earned, he shall be entitled to one day of income benefits for each unit training assembly or day of paid training which he is unable to attend.
      4. Members of the Virginia Defense Force.
      5. Registered members of the United States Civil Defense Corps of the Commonwealth, whether on duty or in training.
      6. Except as provided in subdivision 2 of this definition, all officers and employees of the Commonwealth, including (i) forest wardens; (ii) judges, clerks, deputy clerks and employees of juvenile and domestic relations district courts and general district courts; and (iii) secretaries and administrative assistants for officers and members of the General Assembly employed pursuant to § 30-19.4 and compensated as provided in the general appropriation act, who shall be deemed employees of the Commonwealth.
      7. Except as provided in subdivision 2 of this definition, all officers and employees of a municipal corporation or political subdivision of the Commonwealth.
      8. Except as provided in subdivision 2 of this definition, (i) every executive officer, including president, vice-president, secretary, treasurer or other officer, elected or appointed in accordance with the charter and bylaws of a corporation, municipal or otherwise and (ii) every manager of a limited liability company elected or appointed in accordance with the articles of organization or operating agreement of the limited liability company.
      9. Policemen and firefighters, sheriffs and their deputies, town sergeants and their deputies, county and city commissioners of the revenue, county and city treasurers, attorneys for the Commonwealth, clerks of circuit courts and their deputies, officers and employees, and electoral board members appointed in accordance with § 24.2-106 , who shall be deemed employees of the respective cities, counties and towns in which their services are employed and by whom their salaries are paid or in which their compensation is earnable. However, notwithstanding the foregoing provision of this subdivision, such individuals who would otherwise be deemed to be employees of the city, county, or town in which their services are employed and by whom their salaries are paid or in which their compensation is earnable shall be deemed to be employees of the Commonwealth while rendering aid outside of the Commonwealth pursuant to a request, approved by the Commonwealth, under the Emergency Management Assistance Compact enacted pursuant to § 44-146.28:1 .
      10. Members of the governing body of any county, city, or town in the Commonwealth, whenever coverage under this title is extended to such members by resolution or ordinance duly adopted.
      11. Volunteers, officers and employees of any commission or board of any authority created or controlled by a local governing body, or any local agency or public service corporation owned, operated or controlled by such local governing body, whenever coverage under this title is authorized by resolution or ordinance duly adopted by the governing board of any county, city, town, or any political subdivision thereof.
      12. Except as provided in subdivision 2 of this definition, volunteer firefighters, volunteer emergency medical services agency personnel, volunteer law-enforcement chaplains, auxiliary or reserve police, auxiliary or reserve deputy sheriffs, members of volunteer search and rescue organizations, volunteer members of regional hazardous materials emergency response teams, volunteer members of community emergency response teams, and volunteer members of medical reserve corps, who shall be deemed employees of (i) the political subdivision or public institution of higher education in which the principal office of such volunteer fire company, volunteer emergency medical services agency personnel, volunteer law-enforcement chaplains, auxiliary or reserve police force, auxiliary or reserve deputy sheriff force, volunteer search and rescue organization, regional hazardous materials emergency response team, community emergency response team, or medical reserve corps is located if the governing body of such political subdivision or public institution of higher education has adopted a resolution acknowledging those persons as employees for the purposes of this title or (ii) in the case of volunteer firefighters or volunteer emergency medical services personnel, the fire companies or emergency medical services agencies for which volunteer services are provided whenever such companies or squads elect to be included as an employer under this title.
        1. Volunteer firefighters, volunteer emergency medical services agency personnel, volunteer law-enforcement chaplains, auxiliary or reserve police, auxiliary or reserve deputy sheriffs, members of volunteer search and rescue organizations and any other persons who respond to an incident upon request of the Department of Emergency Management, who shall be deemed employees of the Department of Emergency Management for the purposes of this title.
        2. Volunteer firefighters when engaged in firefighting activities under the supervision and control of the Department of Forestry, who shall be deemed employees of the Department of Forestry for the purposes of this title.
      13. Any sole proprietor, shareholder of a stock corporation having only one shareholder, member of a limited liability company having only one member, or all partners of a business electing to be included as an employee under the workers’ compensation coverage of such business if the insurer is notified of this election. Any sole proprietor, shareholder or member or the partners shall, upon such election, be entitled to employee benefits and be subject to employee responsibilities prescribed in this title.When any partner or sole shareholder, member or proprietor is entitled to receive coverage under this title, such person shall be subject to all provisions of this title as if he were an employee; however, the notices required under §§ 65.2-405 and 65.2-600 shall be given to the insurance carrier, and the panel of physicians required under § 65.2-603 shall be selected by the insurance carrier.
      14. The independent contractor of any employer subject to this title at the election of such employer provided (i) the independent contractor agrees to such inclusion and (ii) unless the employer is self-insured, the employer’s insurer agrees in writing to such inclusion. All or part of the cost of the insurance coverage of the independent contractor may be borne by the independent contractor.When any independent contractor is entitled to receive coverage under this section, such person shall be subject to all provisions of this title as if he were an employee, provided that the notices required under §§ 65.2-405 and 65.2-600 are given either to the employer or its insurance carrier.However, nothing in this title shall be construed to make the employees of any independent contractor the employees of the person or corporation employing or contracting with such independent contractor.
      15. The legal representative, dependents and any other persons to whom compensation may be payable when any person covered as an employee under this title shall be deceased.
      16. Jail officers and jail superintendents employed by regional jails or jail farm boards or authorities, whether created pursuant to Article 3.1 (§ 53.1-95.2 et seq.) or Article 5 (§ 53.1-105 et seq.) of Chapter 3 of Title 53.1, or an act of assembly.
      17. AmeriCorps members who receive stipends in return for volunteering in local, state and nonprofit agencies in the Commonwealth, who shall be deemed employees of the Commonwealth for the purposes of this title.
      18. Food Stamp recipients participating in the work experience component of the Food Stamp Employment and Training Program, who shall be deemed employees of the Commonwealth for the purposes of this title.
      19. Temporary Assistance for Needy Families recipients not eligible for Medicaid participating in the work experience component of the Virginia Initiative for Education and Work, who shall be deemed employees of the Commonwealth for the purposes of this title.
    4. “Employee” shall not mean:
      1. Officers and employees of the Commonwealth who are elected by the General Assembly, or appointed by the Governor, either with or without the confirmation of the Senate. This exception shall not apply to any “state employee” as defined in § 51.1-124.3 nor to Supreme Court Justices, judges of the Court of Appeals, judges of the circuit or district courts, members of the Workers’ Compensation Commission and the State Corporation Commission, or the Superintendent of State Police.
      2. Officers and employees of municipal corporations and political subdivisions of the Commonwealth who are elected by the people or by the governing bodies, and who act in purely administrative capacities and are to serve for a definite term of office.
      3. Any person who is a licensed real estate salesperson, or a licensed real estate broker associated with a real estate broker, if (i) substantially all of the salesperson’s or associated broker’s remuneration is derived from real estate commissions, (ii) the services of the salesperson or associated broker are performed under a written contract specifying that the salesperson is an independent contractor, and (iii) such contract includes a provision that the salesperson or associated broker will not be treated as an employee for federal income tax purposes.
      4. Any taxicab or executive sedan driver, provided the Commission is furnished evidence that such individual is excluded from taxation by the Federal Unemployment Tax Act.
      5. Casual employees.
      6. Domestic servants.
      7. Farm and horticultural laborers, unless the employer regularly has in service more than three full-time employees.
      8. Employees of any person, firm or private corporation, including any public service corporation, that has regularly in service less than three employees in the same business within this Commonwealth, unless such employees and their employers voluntarily elect to be bound by this title. However, this exemption shall not apply to the operators of underground coal mines or their employees. An executive officer who is not paid salary or wages on a regular basis at an agreed upon amount and who rejects coverage under this title pursuant to § 65.2-300 shall not be included as an employee for purposes of this subdivision.
      9. Employees of any common carrier by railroad engaging in commerce between any of the several states or territories or between the District of Columbia and any of the states or territories and any foreign nation or nations, and any person suffering injury or death while he is employed by such carrier in such commerce. This title shall not be construed to lessen the liability of any such common carrier or to diminish or take away in any respect any right that any person so employed, or the personal representative, kindred or relation, or dependent of such person, may have under the act of Congress relating to the liability of common carriers by railroad to their employees in certain cases, approved April 22, 1908, or under §§ 8.01-57 through 8.01-62 or § 56-441.
      10. Employees of common carriers by railroad who are engaged in intrastate trade or commerce. However, this title shall not be construed to lessen the liability of such common carriers or take away or diminish any right that any employee or, in case of his death, the personal representative of such employee of such common carrier may have under §§ 8.01-57 through 8.01-61 or § 56-441.
      11. Except as provided in subdivision 1 of this definition, a member of a volunteer fire department or volunteer emergency medical services agency when engaged in activities related principally to participation as an individual who meets the definition of “emergency medical services personnel” in § 32.1-111.1 or a member of such fire department whether or not the volunteer continues to receive compensation from his employer for time away from the job.
      12. Except as otherwise provided in this title, noncompensated employees and noncompensated directors of (i) corporations exempt from taxation pursuant to § 501(c)(3) of Title 26 of the United States Code (Internal Revenue Code of 1954) or (ii) property owners’ associations as defined in § 55.1-1800 .
      13. Any person performing services as a sports official for an entity sponsoring an interscholastic or intercollegiate sports event or any person performing services as a sports official for a public entity or a private, nonprofit organization which sponsors an amateur sports event. For the purposes of this subdivision, “sports official” includes an umpire, referee, judge, scorekeeper, timekeeper or other person who is a neutral participant in a sports event. This shall not include any person, otherwise employed by an organization or entity sponsoring a sports event, who performs services as a sports official as part of his regular employment.
      14. Any person who suffers an injury on or after July 1, 2012, for which there is jurisdiction under either the Longshore and Harbor Workers’ Compensation Act, 33 U.S.C. § 901 et seq., and its extensions, or the Merchant Marine Act of 1920, 46 U.S.C. § 30104 et seq. However, this title shall not be construed to eliminate or diminish any right that any person or, in the case of the person’s death, his personal representative, may have under either the Longshore and Harbor Workers’ Compensation Act, 33 U.S.C. § 901 et seq., and its extensions, or the Merchant Marine Act of 1920, 46 U.S.C. § 30104 et seq.
      15. An owner-operator of a motor vehicle that is leased with or to a common or contract carrier in the trucking industry if (i) the owner-operator performs services for the carrier pursuant to a contract that provides that the owner-operator is an independent contractor and shall not be treated as an employee for purposes of the Federal Insurance Contributions Act, 26 U.S.C. § 3101 et seq., Social Security Act of 1935, P.L. 74-271, federal unemployment tax laws, and federal income tax laws and (ii) each of the following factors is present:
        1. The owner-operator is responsible for the maintenance of the vehicle;
        2. The owner-operator bears the principal burden of the vehicle’s operating costs;
        3. The owner-operator is the driver;
        4. The owner-operator’s compensation is based on factors related to the work performed and not on the basis of hours or time expended; and
        5. The owner-operator determines the method and means of performing the service. “Employer” includes (i) any person, the Commonwealth or any political subdivision thereof and any individual, firm, association or corporation, or the receiver or trustee of the same, or the legal representative of a deceased employer, using the service of another for pay and (ii) any volunteer fire company or volunteer emergency medical services agency electing to be included and maintaining coverage as an employer under this title. If the employer is insured, it includes his insurer so far as applicable. “Executive officer” means (i) the president, vice-president, secretary, treasurer or other officer elected or appointed in accordance with the charter and bylaws of a corporation and (ii) the managers elected or appointed in accordance with the articles of organization or operating agreement of a limited liability company. However, “executive officer” does not include (a) noncompensated officers of corporations exempt from taxation pursuant to § 501(c)(3) of Title 26 of the United States Code (Internal Revenue Code of 1954) or (b) noncompensated officers of a property owners’ association as such term is defined in § 55.1-1800 . “Filed” means hand delivered to the Commission’s office in Richmond or any regional office maintained by the Commission; sent by means of electronic transmission approved by the Commission; sent by facsimile transmission; or posted at any post office of the United States Postal Service by certified or registered mail. Filing by first-class mail, electronic transmission, or facsimile transmission shall be deemed completed only when the document or other material transmitted reaches the Commission or its designated agent. “Injury” means only injury by accident arising out of and in the course of the employment or occupational disease as defined in Chapter 4 (§ 65.2-400 et seq.) and does not include a disease in any form, except when it results naturally and unavoidably from either of the foregoing causes. Such term shall not include any injury, disease or condition resulting from an employee’s voluntary:
    5. Participation in employer-sponsored off-duty recreational activities which are not part of the employee’s duties; or
    6. Use of a motor vehicle that was provided to the employee by a motor vehicle dealer as defined by § 46.2-1500 and bears a dealer’s license plate as defined by § 46.2-1550 for (i) commuting to or from work or (ii) any other nonwork activity.Such term shall include any injury, disease or condition:
    7. Arising out of and in the course of the employment of (a) an employee of a hospital as defined in § 32.1-123 ; (b) an employee of a health care provider as defined in § 8.01-581.1 ; (c) an employee of the Department of Health or a local department of health; (d) a member of a search and rescue organization; or (e) any person described in clauses (i) through (iv), (vi), and (ix) of subsection A of § 65.2-402.1 otherwise subject to the provisions of this title; and
    8. Resulting from (a) the administration of vaccinia (smallpox) vaccine, Cidofivir and derivatives thereof, or Vaccinia Immune Globulin as part of federally initiated smallpox countermeasures, or (b) transmission of vaccinia in the course of employment from an employee participating in such countermeasures to a coemployee of the same employer.

      “Professional employer organization” means any person that enters into a written agreement with a client company to provide professional employer services.

      “Professional employer services” means services provided to a client company pursuant to a written agreement with a professional employer organization whereby the professional employer organization initially employs all or a majority of a client company’s workforce and assumes responsibilities as an employer for all coemployees that are assigned, allocated, or shared by the agreement between the professional employer organization and the client company.

      “Staffing service” means any person, other than a professional employer organization, that hires its own employees and assigns them to a client to support or supplement the client’s workforce. It includes temporary staffing services that supply employees to clients in special work situations such as employee absences, temporary skill shortages, seasonal workloads, and special assignments and projects.

    History. Code 1950, §§ 65-2 through 65-7.1, 65-24, 65-25; 1952, c. 551; 1954, c. 246; 1956, cc. 283, 479; 1956, Ex. Sess., c. 53; 1958, c. 187; 1960, c. 149; 1962, c. 530; 1964, c. 603; 1966, c. 200; 1968, c. 660, §§ 65.1-2, 65.1-3, 65.1-4, 65.1-5 through 65.1-8, 65.1-27, 65.1-28; 1970, c. 470; 1971, Ex. Sess., c. 7; 1972, cc. 464, 619; 1973, cc. 297, 542; 1975, c. 330, § 65.1-4.1; 1976, c. 187; 1977, c. 326; 1978, cc. 41, 841; 1979, c. 80, § 65.1-2.1; 1980, c. 421, § 65.1-4.2; 1983, c. 346; 1984, cc. 388, 694, 703, § 65.1-4.3; 1987, cc. 213, 308, § 65.1-4.4; 1988, c. 360; 1989, cc. 312, 319, 437, §§ 65.1-4.5, 65.1-4.6; 1990, c. 838, § 65.1-4.1:1; 1991, cc. 277, 354, 355; 1992, c. 12; 1993, c. 280; 1994, cc. 271, 286, 526; 1995, cc. 4, 168, 272, 288; 1996, cc. 250, 721; 1998, c. 52; 1999, c. 1006; 2000, cc. 301, 624, 718, 1018; 2002, c. 69; 2003, c. 999; 2004, cc. 888, 928; 2005, cc. 354, 368, 374, 472; 2006, c. 629; 2007, c. 475; 2010, cc. 158, 278; 2011, cc. 572, 586, 665; 2012, c. 654; 2014, c. 209; 2015, cc. 13, 221, 442, 447, 502, 503; 2019, c. 210.

    Cross references.

    As to amount of victim compensation award, see § 19.2-368.11:1 .

    As to worker misclassification, see § 58.1-1900 et seq.

    Editor’s note.

    Acts 1991, cc. 277 and 354 both amended former § 65.1-4.1, from which this section is derived. Pursuant to § 30-152 and Acts 1991, c. 355, cl. 5, the 1991 amendments by cc. 277 and 354 have been given effect in this section as set out above. The phrase “or state institution of higher education” was inserted in two places in subdivision A 12 in the paragraph defining “Employee” pursuant to c. 277. In accordance with c. 354, the phrase “volunteer law-enforcement chaplain” was inserted in one place in subdivision C in the paragraph defining “Average weekly wage,” and was also inserted in the paragraph defining “Employee,” throughout subdivision A 12 and in one place in subdivision A 13.

    Acts 1993, c. 930, cl. 3, as amended by Acts 1994, c. 564, cl. 2, and Acts 1996, c. 616, cl. 4, provided that the amendment to this section by Acts 1993, c. 930, cl. 1, would become effective June 1, 1998, “if state funds are provided, including all local costs, to carry out the purposes of this bill by the General Assembly.” The funding was not provided.

    Acts 2000, cc. 624 and 718, cls. 2 are identical, and provide: “That the provisions of this act shall be effective with respect to any workers’ compensation insurance policy issued to or renewed with a professional employer organization on or after January 1, 2001.”

    Acts 2002, c. 69, cl. 2, provides: “That the provisions of this act are declarative of existing law.”

    Acts 2003, c. 999, cl. 2, provides: “That the provisions of this act shall be effective retroactive to January 1, 2003.”

    Acts 2004, c. 928, cl. 2, provides: “That this act is declaratory of existing law.”

    At the direction of the Virginia Code Commission, “public institution of higher education” was twice substituted for “state institution of higher education” in subdivision 1 l of the definition of “Employee” to conform to Acts 2016, c. 588.

    To conform to the recodification of Title 55 by Acts 2019, c. 712, effective October 1, 2019, the following substitutions were made at the direction of the Virginia Code Commission: substituted “55.1-1800” for “55-509” in the definitions of “Employee” and “Executive officer.”

    The 1998 amendment, in the paragraph defining “Average weekly wage,” in subdivision 2, in the second sentence, inserted “the Virginia Naval Militia” in two places; in the paragraph defining “Employee,” in subdivision 1 c, in the first paragraph, inserted “and the Virginia Naval Militia,” and in the second paragraph, inserted “or Naval Militia” in the first and last sentences.

    The 1999 amendment, in the definition of “Average weekly wage,” inserted “volunteer firefighters engaged in firefighting activities under the supervision and control of the Department of Forestry” following “Commonwealth” in subdivision 2 and, in subdivision 1 m of the definition of “Employee,” inserted the (1) designation preceding “Volunteer firefighters,” and added subdivision m (2).

    The 2000 amendments.

    The 2000 amendment by c. 301 inserted references to regional hazardous emergency response teams throughout subdivision 1 l of the definition of “Employee” and made corresponding stylistic changes.

    The 2000 amendments by cc. 624 and 718 are identical, and added definitions for “Client company,” “Coemployee,” “Professional employer organization,” “Professional employer services” and “Staffing service.” For effective date of this amendment, see editor’s note.

    The 2000 amendment by c. 1018, effective April 19, 2000, in subdivision 1 a of the definition of “Employee” substituted “aliens and minors” for “a minor” and inserted “whether lawfully or unlawfully employed.”

    The 2002 amendments.

    The 2002 amendment by c. 69, in subdivision 1 f of the definition of “Employee,” inserted clause designations (i) and (ii) and inserted clause (iii).

    The 2003 amendments.

    The 2003 amendment by c. 999, effective January 1, 2003, substituted “52” for “fifty-two” throughout the definition of “Average weekly wage”; and in the definition of “Injury,” inserted “Such term shall include any injury, disease or condition” at the end of the first paragraph, and inserted subdivisions 1 and 2.

    The 2004 amendments.

    The 2004 amendment by c. 888, effective April 15, 2004, added subdivisions 1 r and 1 s in the definition of “employee.”

    The 2004 amendment by c. 928 inserted “and electoral board members appointed in accordance with § 24.2-106 ” and made a related change in subdivision 1 i in the definition of “employee.”

    The 2005 amendments.

    The 2005 amendments by cc. 354 and 374 are nearly identical, and in the definition of “Injury,” divided the former first paragraph into the present first, second, and fourth paragraphs by substituting “Such term shall” for “However, such term does,” inserted the first subdivision 1 designation and the first subdivision 2, and made a related change.

    The 2005 amendment by c. 368, in subdivision (3) of the definition of “Average weekly wage,” inserted “volunteer members of community emergency response teams, and volunteer members of medical reserve corps”; in subdivision 1 ( l ) of the definition of “Employee,” inserted “volunteer members of emergency response teams, and volunteer members of medical reserve corps” and “community emergency response team, or medical reserve corps,” and substituted “those persons” for “such volunteer firefighters, volunteer lifesaving or rescue squad members, volunteer law enforcement chaplains, auxiliary or reserve police, auxiliary or reserve deputy sheriffs, volunteer emergency medical technicians, members of volunteer search and rescue organizations, or regional hazardous materials emergency response team members”; and made minor stylistic changes.

    The 2005 amendment by c. 472 added subdivision 1 t; and made minor stylistic changes.

    The 2006 amendments.

    The 2006 amendment by c. 629, in subdivision 1 n of the paragraph defining “Employee,” in the first paragraph, inserted “shareholder of a stock corporation having only one shareholder, member of a limited liability company having only one member” in the first sentence and “shareholder or member” in the second sentence; and inserted “sole shareholder, member or” in the second paragraph.

    The 2007 amendments.

    The 2007 amendment by c. 475 added the last sentence in subdivision 1 i in the definition of “Employee.”

    The 2010 amendments.

    The 2010 amendments by cc. 158 and 278 are nearly identical, and in the definition of “Filed,” inserted “or other means of electronic transmission approved by the Commission” near the middle in the first sentence and in the last sentence, inserted “or other means of electronic transmission” and substituted “document or other material transmitted reaches the Commission or its designated agent” for “application actually reaches a Commission office.”

    The 2011 amendments.

    The 2011 amendments by cc. 572 and 586 are identical, and in the definition of “Average weekly wage,” in subdivision 2 and the definition of “Employee,” in subdivision 4 1 d, deleted “State” preceding “Defense Force.”

    The 2011 amendment by c. 665 substituted “three full-time employees” for “two full-time employees” in the definition of “Employee” in subdivision 4 2 g.

    The 2012 amendments.

    The 2012 amendment by c. 654 added subdivision 2 n in the definition of “Employee.”

    The 2014 amendments.

    The 2014 amendment by c. 209, in the definition of “Filed” deleted “telegraph, electronic mail or other” preceding “means of electronic” and substituted “Commission; sent by facsimile” for “Commission or facsimile” in the first sentence; and deleted “telegraph, electronic mail or other means of” following “first-class mail” near the beginning of the last sentence.

    The 2015 amendments.

    The 2015 amendments by cc. 13 and 447 are identical, and inserted subdivision 2 o in the definition of “Employee.”

    The 2015 amendment by c. 221 in subdivision 2 of the definition of “Average weekly wage,” substituted “Virginia National Guard” for “Virginia National Guard, the Virginia Naval Militia” twice and “the Commonwealth” for “this Commonwealth” twice; in the definition of “Employee,” in subdivision 1 c deleted “and the Virginia Naval Militia” following “National Guard” in the first paragraph and deleted “or Naval Militia” following “National Guard” twice in the second paragraph, and substituted “the Commonwealth” for “this Commonwealth” in subdivision 1 e.

    The 2015 amendment by c. 442 inserted the subdivision (i) designation and “or (ii) property owners’ associations as defined in § 55-509” in subdivision 2 l in the definition for “Employee”; in the definition for “Executive officer,” substituted “However, “"executive officer’ ” for “However, such term” inserted the clause (a) designation and added clause (b) at the end; and made minor stylistic changes.

    The 2015 amendments by cc. 502 and 503 are identical, and in subdivision 3 of the definition for “Average weekly wage,” substituted “emergency medical services personnel” for “lifesaving or volunteer rescue squad members” in the first sentence, deleted “volunteer emergency medical technicians” following “sheriffs” and substituted “who is an individual who meets the definition of ‘emergency medical services personnel’ in § 32.1-111.1 ” for “lifesaving or volunteer rescue squad member”; rewrote subdivision 1 l of the definition for “Employee”; in subdivision 1 m (1) of the definition for “Employee,” substituted “emergency medical services agency personnel” for “lifesaving or rescue squad members” and deleted “volunteer emergency medical technicians” following “sheriffs”; deleted “of this title” preceding “shall” in the second paragraph of subdivision 1 n of the definition for “Employee”; rewrote subdivision 2 k of the definition for “Employee”; substituted “emergency medical services agency” for “lifesaving or rescue squad” in the definition for “Employer”; deleted “of this title” following “(§ 65.2-400 et seq.)” in the definition for “Injury”; and made stylistic changes.

    The 2019 amendments.

    The 2019 amendment by c. 210 substituted “Virginia Initiative for Education and Work” for “Virginia Initiative for Employment Not Welfare Program” in subdivision 1 t. of the definition for “Employee.”

    Law Review.

    For article, “Recovery for Accidental Injuries Under the Virginia Workmen’s Compensation Act,” see 14 U. Rich. L. Rev. 659 (1980).

    For article discussing workers’ compensation in the context of toxic substances litigation, see 16 U. Rich. L. Rev. 247 (1982).

    For comment, “Do Recent Virginia Supreme Court Decisions Leave the Workers’ Compensation Claimant in No-Man’s Land?,” see 20 U. Rich. L. Rev. 209 (1985).

    For article reviewing recent developments and changes in legislation, case law, and Virginia Supreme Court Rules affecting civil litigation, see “Civil Practice and Procedure,” 26 U. Rich. L. Rev. 679 (1992).

    For article covering significant developments in workers’ compensation law in Virginia since 1985, see 26 U. Rich. L. Rev. 903 (1992).

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    For comment, “The NCAA and the Student-Athlete: Reform is on the Way,” see 46 U. Rich. L. Rev. 1141 (2012).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 3, 6-14, 17, 18, 20, 21, 23-26, 29, 42, 54, 57, 64, 71, 73.

    CASE NOTES

  • Analysis
  • Claimant must prove causal connection between accident and disability, etc. —

    I.General Consideration.

    Editor’s note.

    Some of the cases annotated below were decided under former Title 65.1 or prior law.

    Gratuitous services not within scope of act. —

    When services or labor are rendered voluntarily without a promise of compensation or remuneration of any kind, express or implied, then the one providing the services or labor has supplied them gratuitously and is not covered by the act. Humphries v. Thomas, 244 Va. 571 , 422 S.E.2d 755, 9 Va. Law Rep. 553, 1992 Va. LEXIS 113 (1992) (decided under former § 65.1-4).

    Comity barred tort action where employer compensated out of state. —

    Virginia would as a matter of comity treat an employee’s North Carolina compensation award as his exclusive remedy and hold his common-law tort action against his statutory employer as barred in Virginia. Kelly v. Guyon Gen. Piping, Inc., 882 F.2d 108, 1989 U.S. App. LEXIS 11971 (4th Cir. 1989).

    There is no per se rule that would bar employees with residual skills from receiving benefits under the Act if they fail to register with the State Employment Commission. There is no bright line test as to what constitutes marketing one’s residual capacity; it is better decided on a case-by-case basis. Herbert Brothers, Inc. v. Jenkins, 14 Va. App. 715, 419 S.E.2d 283, 8 Va. Law Rep. 3539, 1992 Va. App. LEXIS 172 (1992) (decided under former § 65.1-63).

    The Federal Employees’ Compensation Act does not exempt federal employees from the Virginia Workers’ Compensation Act (VWCA); the statute merely shields the United States from liability arising out of the death of a federal employee in any type of proceeding, including a proceeding brought under a state workers’ compensation act such as the VWCA. McCotter v. Smithfield Packing Co., 849 F. Supp. 443, 1994 U.S. Dist. LEXIS 5164 (E.D. Va. 1994).

    Third party liability. —

    The Federal Employee’s Compensation Act has no effect on the liability of a third party who asserts the exclusivity of a state workers’ compensation scheme to shield it from liability. McCotter v. Smithfield Packing Co., 849 F. Supp. 443, 1994 U.S. Dist. LEXIS 5164 (E.D. Va. 1994).

    Term “filed” applies to filing of answers to interrogatories. —

    The Workers’ Compensation Commission reasonably construed the term “filed” to apply to the filing of answers to interrogatories in a worker’s compensation case. Jeff Coal, Inc. v. Phillips, 16 Va. App. 271, 430 S.E.2d 712, 9 Va. Law Rep. 1261, 1993 Va. App. LEXIS 95 (1993).

    The legislature did not contemplate that registered agents, directors, and shareholders of corporations must also give notice to the insurance carrier for purposes of § 65.2-600 . Solid Gold Corp. v. Wang, 18 Va. App. 66, 441 S.E.2d 643, 10 Va. Law Rep. 1070, 1994 Va. App. LEXIS 126 (1994).

    The Commission has the power to enter awards granting or denying benefits under the Workers’ Compensation Act and dictating the terms under which those benefits will be paid as long as those terms do not conflict with the requirements of the Act. Rusty's Welding Serv., Inc. v. Gibson, 29 Va. App. 119, 510 S.E.2d 255, 1999 Va. App. LEXIS 67 (1999).

    Weighing of conflicting medical evidence. —

    In cases of conflicting medical evidence, the general rule is that when an attending physician is positive in his diagnosis, great weight will be given by the courts to his opinion. Sunnyside Presbyterian Home v. Shifflett, 1995 Va. App. LEXIS 821 (Va. Ct. App. Nov. 7, 1995).

    II.Average Weekly Wage.

    Editor’s note.

    Many of the cases annotated under the heading “Average Weekly Wage” were decided under former § 65.1-6 or prior law.

    Determination of average weekly wages was controlled by former § 65.1-6 and not by the provision defining who is covered by the Act. First Va. Banks, Inc. v. McNeil, 8 Va. App. 342, 381 S.E.2d 357, 6 Va. Law Rep. 1, 1989 Va. App. LEXIS 97 (1989).

    All earnings included in determining average weekly wage. —

    The plain meaning of former § 65.1-6 required that all earnings from employment, whether covered or not, would be included in determining the average weekly wage. First Va. Banks, Inc. v. McNeil, 8 Va. App. 342, 381 S.E.2d 357, 6 Va. Law Rep. 1, 1989 Va. App. LEXIS 97 (1989).

    Comparison of average weekly wage pre- and post-injury. —

    If the claimant suffers a disability as a result of the injury, the Commission must compare the claimant’s pre-injury average weekly wage to the wage he is able to earn after the injury to determine whether he is entitled to total or partial disability benefits and, if so, at what rate. Smith v. Smith, 32 Va. App. 242, 527 S.E.2d 463, 2000 Va. App. LEXIS 296 (2000).

    Paucity of evidentiary record. —

    In a workers’ compensation action, a finding that the claimant failed to prove that her deceased husband’s average weekly wage was $2,500 was appropriate given the paucity of the evidentiary record and given the fact that the claimant failed to show that the aberrational weekly wage figure would have been a fair and just approximation of future loss. One week’s high pay did not represent a realistic judgment of the employee’s future loss. Thorpe v. Clary, 57 Va. App. 617, 704 S.E.2d 611, 2011 Va. App. LEXIS 34 (2011), aff'd, 283 Va. 808 , 724 S.E.2d 728, 2012 Va. LEXIS 97 (2012).

    Virginia Workers’ Compensation Commission erred in awarding workers’ compensation benefits under § 65.2-101 as no evidence supported the finding that a decedent would have earned the federal minimum wage, multiplied by a 40-hour work week, were it not for his death where the decedent withdrew fluctuating amounts, weekly, as loans from his sole proprietorship’s draw account for the 52 weeks before his death; the number of hours the decedent worked each week was irrelevant. Key Risk Ins. Co. v. Crews, 60 Va. App. 335, 727 S.E.2d 436, 2012 Va. App. LEXIS 208 (2012).

    Dissimilar jobs with same employer. —

    Earnings from three dissimilar jobs with the same employer were properly combined to calculate claimant’s average weekly wage. City of Danville Sch. Bd. v. Watson, 2000 Va. App. LEXIS 86 (Va. Ct. App. Feb. 8, 2000).

    Profits of business not to be considered. —

    The general rule is that profits derived from a business, including a sole proprietorship, are not to be considered as earnings and cannot be accepted as a measure of loss of earning power unless they are almost entirely the direct result of the claimant’s personal management and endeavor. Smith v. Smith, 32 Va. App. 242, 527 S.E.2d 463, 2000 Va. App. LEXIS 296 (2000).

    Use of profit and loss statements for preceding 52 weeks. —

    Workers’ Compensation Commission’s use of profit and loss statements for the 52 weeks preceding a sole proprietor’s work-related injury, as opposed to his schedule C from his previous year’s tax return, to calculate his average weekly wage, was a more accurate method of determining his net earnings for the statutory period, and did not deprive him of the benefit of an increase in his income between the first of the year and the date of his accident. Brown v. Brown, 40 Va. App. 79, 577 S.E.2d 543, 2003 Va. App. LEXIS 121 (2003).

    Error to consider net taxable income of sole proprietorship. —

    Where the claimant, the owner of a sole proprietorship, was totally disabled for about eleven weeks and partially disabled for about eighteen weeks, it was error for the commission to determine his economic loss by comparing the net taxable income of the proprietorship for the year with that for the prior year. In using this approach, the Commission may unfairly have attributed to the period of disability income received in the same year but before or after the period of disability and may also have improperly included business profits rather than wages or their equivalent in its calculation of claimant’s pre- or post-injury wage. Smith v. Smith, 32 Va. App. 242, 527 S.E.2d 463, 2000 Va. App. LEXIS 296 (2000).

    Withdrawals from sole proprietorship operating at a loss. —

    Fluctuating amounts a decedent withdrew weekly from a draw account of his sole proprietorship did not constitute wages under § 65.2-101 , as they were loans; such income did not constitute earnings for purposes of calculating his average weekly wage under § 65.2-101 . Key Risk Ins. Co. v. Crews, 60 Va. App. 335, 727 S.E.2d 436, 2012 Va. App. LEXIS 208 (2012).

    Payment for single side job not to be considered. —

    The commission erred in calculating the average weekly wage of an employee working on a side job where it used the amount the employee was to be paid for that job as his average weekly wage; the evidence was insufficient to support this figure as it established that the employee had a regular job paying substantially less per week than the amount he was to be paid for the side job and there was no evidence that the employee intended to undertake other side jobs or that such jobs were available. Mount Vernon Bldrs., Inc. v. Rotty, 28 Va. App. 511, 507 S.E.2d 95, 1998 Va. App. LEXIS 616 (1998).

    The reason for calculating the average weekly wage is to approximate the economic loss suffered by an employee or his beneficiaries when there is a loss of earning capacity because of work-related injury or death. Bosworth v. 7-Up Distrib. Co., 4 Va. App. 161, 355 S.E.2d 339, 3 Va. Law Rep. 2205, 1987 Va. App. LEXIS 175 (1987).

    Award based on wages received from employment where employee exposed to element. —

    By using the phrase “in the employment in which he was working at the time of his injury” in former § 65.1-6, the legislature intended that the average weekly wage award be based upon the wages received from the employment where the employee was exposed to the element which caused the occupational disease for which claim is made. C & P Tel. Co. v. Williams, 10 Va. App. 516, 392 S.E.2d 846, 6 Va. Law Rep. 2775, 1990 Va. App. LEXIS 119 (1990).

    Compensation calculation if in concurrent employment. —

    Virginia follows the majority rule that when an employee is injured on one job while in concurrent employment, the average weekly wage compensated is based on the combined earnings of both jobs if, but only if, the employments are related or similar. County of Frederick Fire & Rescue v. Dodson, 20 Va. App. 440, 457 S.E.2d 783, 1995 Va. App. LEXIS 499 (1995).

    Similar employment analysis. —

    A straight quantitative approach, weighing the like duties against the distinct duties of two employments to reach a decision, will not always be determinative of the issue of whether employment is similar. Where, in the instant case, all of a claimant’s duties and skills in one job are utilized in the other job, which has a wider scope of employment, the general class of employment approach, focusing on the primary mission of an employee in both jobs, provides a more rational analysis for determining whether two employments are so related as to conclude they are substantially similar. County of Frederick Fire & Rescue v. Dodson, 20 Va. App. 440, 457 S.E.2d 783, 1995 Va. App. LEXIS 499 (1995).

    In every situation where the commission is asked to determine whether two or more jobs are substantially similar, it must consider not only the particular duties of each job, but also the general nature or type of employment of the two jobs. Creedle Sales Co. v. Edmonds, 24 Va. App. 24, 480 S.E.2d 123, 1997 Va. App. LEXIS 7 (1997).

    When an injured employee is disabled from performing his employment duties, the employee’s earnings from two or more jobs that are substantially similar may be combined. Creedle Sales Co. v. Edmonds, 24 Va. App. 24, 480 S.E.2d 123, 1997 Va. App. LEXIS 7 (1997).

    Where claimant’s skills as a plumber and as a mechanic were utilized substantially in both jobs, the commission correctly combined his salary from both in calculating his average weekly wage. Creedle Sales Co. v. Edmonds, 24 Va. App. 24, 480 S.E.2d 123, 1997 Va. App. LEXIS 7 (1997).

    The substantially similar doctrine prevents combining salaries from two separate jobs if the jobs are not similar; the rationale for applying the doctrine is not present when the two jobs are for same employer. Dinwiddie County Sch. Bd. v. Cole, 28 Va. App. 462, 506 S.E.2d 36, 1998 Va. App. LEXIS 555 (1998), aff'd, 258 Va. 430 , 520 S.E.2d 650, 1999 Va. LEXIS 114 (1999).

    The decision of the Workers’ Compensation Commission’s to calculate the average weekly wage by combining income from the two positions the claimant held with a single employer was in keeping with the purpose of the Act. Dinwiddie County Sch. Bd. v. Cole, 28 Va. App. 462, 506 S.E.2d 36, 1998 Va. App. LEXIS 555 (1998), aff'd, 258 Va. 430 , 520 S.E.2d 650, 1999 Va. LEXIS 114 (1999).

    In determining whether two jobs are “substantially similar,” the court looks at the following: (1) the duties and skills of each job and (2) the primary mission of the employee on each job. Mercy Tidewater Ambulance Serv. v. Carpenter, 29 Va. App. 218, 511 S.E.2d 418, 1999 Va. App. LEXIS 140 (1999).

    The term “similar” in this context may relate to the similarity of: (1) the work, (2) the industry in which the work is performed or (3) the degree of hazard to which the employee is exposed. Mercy Tidewater Ambulance Serv. v. Carpenter, 29 Va. App. 218, 511 S.E.2d 418, 1999 Va. App. LEXIS 140 (1999).

    Finding that worker’s two jobs, delivering appliances and delivering newspapers, were substantially similar for purposes of § 65.2-101 was proper because, duties and skills required in each job were substantially similar, in both jobs the worker picked up the product, followed a delivery route, and delivered the product; additionally, the “primary missions” of the two employments were similar, providing customer delivery services. Although the worker delivered different products, the duties required to deliver the products were substantially similar. Lowes No. 0509 & Lowes Home Ctrs., Inc. v. Stanley, 2007 Va. App. LEXIS 224 (Va. Ct. App. May 29, 2007).

    “Dissimilar employment rule” upheld. —

    Had the legislature intended to alter the “dissimilar employment rule,” it could have simply added language to former § 65.1-6 permitting the combination of wages earned in dissimilar employment for the purposes of computing a complainant’s pre-injury “average weekly wage.” Therefore, while claimant had demonstrated that certain inequities resulted from the application of the “dissimilar employment rule,” the Supreme Court’s decision in other cases as well as the absence of any amendment to former § 65.1-6, established this doctrine as the prevailing rule in Virginia. Hudson v. Arthur Treacher, 2 Va. App. 323, 343 S.E.2d 97, 1986 Va. App. LEXIS 275 (1986).

    Application of the “dissimilar employment rule.” —

    The “dissimilar employment rule” is equally applicable in defining an employee’s “average weekly wages” which he is able to earn after an injury as it is in defining his “average weekly wages” before the injury. City of Fairfax v. Massey, 11 Va. App. 238, 397 S.E.2d 679, 7 Va. Law Rep. 669, 1990 Va. App. LEXIS 188 (1990).

    Similar services. —

    An employee’s “average weekly wages” also include an employee’s earnings from similar services for employment not covered by the Workers’ Compensation Act. First Va. Banks, Inc. v. McNeil, 8 Va. App. 342, 381 S.E.2d 357, 6 Va. Law Rep. 1, 1989 Va. App. LEXIS 97 (1989).

    Domestic employers. —

    The statutory definition of “average weekly wages” does not incorporate an exclusion for domestic employees. First Va. Banks, Inc. v. McNeil, 8 Va. App. 342, 381 S.E.2d 357, 6 Va. Law Rep. 1, 1989 Va. App. LEXIS 97 (1989).

    Earnings from other similar employment may include domestic employment even though domestic employees are excluded from coverage under the act. Metropolitan Cleaning Corp. v. Crawley, 14 Va. App. 261, 416 S.E.2d 35, 8 Va. Law Rep. 2570, 1992 Va. App. LEXIS 112 (1992).

    Criteria for determining whether allowance paid to employee was in lieu of wages. —

    In determining whether the allowance paid to an employee was in lieu of wages, the pertinent question is whether the allowance represented a payment made in consideration for work and constituted an economic gain to him. Bosworth v. 7-Up Distrib. Co., 4 Va. App. 161, 355 S.E.2d 339, 3 Va. Law Rep. 2205, 1987 Va. App. LEXIS 175 (1987).

    An allowance paid to an employee must be included in the average weekly wage calculation if the allowance meets two conditions: first, the allowance must be specifically provided for in the contract of employment, and, second, the allowance must be of such character as to indicate that it is paid “in lieu of wages.” Bosworth v. 7-Up Distrib. Co., 4 Va. App. 161, 355 S.E.2d 339, 3 Va. Law Rep. 2205, 1987 Va. App. LEXIS 175 (1987).

    Payments made other than to the employee to secure fringe benefits for the employee are not “allowances . . . in lieu of wages” for purposes of computing average weekly wage. Gajan v. Bradlick Co., 4 Va. App. 213, 355 S.E.2d 899, 3 Va. Law Rep. 2554, 1987 Va. App. LEXIS 255 (1987).

    Automobile allowance not included for purposes of calculating average weekly wage. —

    Where employee was killed in an automobile collision arising out of and in the course of his employment as a travelling salesman, he had used his own automobile for his employment-related travel, and in return, his employer had paid to him an automobile allowance of $75.00 per week to cover the costs of depreciation, tires, oil, gas, insurance and other expenses associated with the operation of his automobile in his employment, the automobile allowance provided no financial gain to the employee but was rather in the nature of reimbursement for out-of-pocket related expenses. Therefore, the automobile allowance could not be included as wages for the purpose of calculating average weekly wage. Bosworth v. 7-Up Distrib. Co., 4 Va. App. 161, 355 S.E.2d 339, 3 Va. Law Rep. 2205, 1987 Va. App. LEXIS 175 (1987).

    Allowances for meals, lodging, and travel properly included. —

    There was credible evidence in the record to support the Commission’s decision that the allowances paid to the employee for meals, lodging, and travel were in lieu of wages and part of his wage contract; thus, they were properly included in calculating his average weekly wage. Southwest Architectural Prods., Inc. v. Smith, 4 Va. App. 474, 358 S.E.2d 745, 4 Va. Law Rep. 157, 1987 Va. App. LEXIS 201 (1987).

    Benefits to employee not “in lieu of wages.” —

    Commission determination that an employer was not entitled to a credit under § 65.2-712 for benefits paid to or on behalf of a worker was proper because the commission resolved any inconsistency in the testimony by crediting the charity motive as the driving force behind the benefits conferred on the worker, and was not persuaded that the allowances made to the worker were truly a substitute for wages. Fairfax Hosp. v. McKaveney, 2007 Va. App. LEXIS 365 (Va. Ct. App. Oct. 2, 2007).

    Promotion not found. —

    Virginia Workers’ Compensation Commission’s calculation of a claimant’s average weekly wage under § 65.2-101 was supported as the claimant was not promoted and her job classification did not change merely because she worked a few hours a week as a trainer at an increased hourly wage. Waters v. TGI Friday's, 2012 Va. App. LEXIS 129 (Va. Ct. App. Apr. 24, 2012).

    Similar employment found. —

    Credible evidence supported commission’s finding that claimant’s independent contractor work as a long-haul truck driver was sufficiently similar to his work for lumber company as a short-haul truck driver to permit the inclusion of his independent contractor earnings when calculating his average weekly wage. Wood Prods. v. James, 20 Va. App. 116, 455 S.E.2d 722, 1995 Va. App. LEXIS 333 (1995).

    Doctor’s restriction of claimant from performing one of the duties, firefighting, involved in her job with employer, did not require a finding that the jobs were dissimilar, nor did it necessitate a finding that claimant was not entitled to temporary partial disability benefits. While it is true, as employer contends, that claimant has been able to return to her work at the hospital but still cannot fight fires, this could be true of any number of jobs that are similar and of the same general class but in which one requires extra physical qualifications that the other does not. County of Frederick Fire & Rescue v. Dodson, 20 Va. App. 440, 457 S.E.2d 783, 1995 Va. App. LEXIS 499 (1995).

    Although claimant’s two jobs were performed in different settings (i.e., an ambulance versus an emergency room), the employments were of the same general class as both positions focused on providing emergency care services to patients, and therefore the positions were “substantially similar.” Mercy Tidewater Ambulance Serv. v. Carpenter, 29 Va. App. 218, 511 S.E.2d 418, 1999 Va. App. LEXIS 140 (1999).

    No error in amending wage to include full-time job earnings. —

    Commission did not err in amending claimant’s average weekly wage to include her earnings from full-time job. At the time of the first proceeding, only claimant’s part-time job with her earnings therefrom appeared relevant. Had the parties been aware that claimant would require surgery and would suffer loss of earnings from full-time job, their considerations would have been different. Thus, the evidence supported the commission’s finding that a mutual mistake of fact existed at the time the parties agreed to the stipulation. Colonnades Marriott Senior Living v. Durden, 1997 Va. App. LEXIS 661 (Va. Ct. App. Nov. 4, 1997).

    Deviation of average weekly wage in agreement from statutory guidelines. —

    The Workers’ Compensation Act is in the nature of a compromise between employers and employees; each surrenders certain rights to gain certain rights. An essential element of this compromise is the employer’s obligation to pay for compensable injuries at a rate contemplated by the Act. When the average weekly wage embodied in a memorandum of agreement substantially deviates from the statutory guidelines, the balance struck by the Act’s compromises is disrupted. The Commission has the power and authority to right this imbalance and thereby protect itself and its award from such imposition. John Driggs Co. v. Somers, 228 Va. 729 , 324 S.E.2d 694, 1985 Va. LEXIS 168 (1985).

    Correction of average weekly wage. —

    Virginia Workers’ Compensation Commission’s correction of a claimant’s average weekly wage under § 65.2-101 to $798.31 was proper as the agreed average weekly wage was based on an incorrect number of work weeks, and the claimant’s wages as reported in her pay stubs did not accurately reflect her 2006 earnings as unreported tips were not included in those figures. Waters v. TGI Friday's, 2012 Va. App. LEXIS 129 (Va. Ct. App. Apr. 24, 2012).

    Date of accident determinative, not date of disability. —

    This section provided in pertinent part: “Unless the context otherwise requires, ‘average weekly wages’ means the earnings of the injured employee in the employment in which he was working at the time of the injury during the period of 52 weeks immediately preceding the date of the injury, divided by 52 . . . .” This clear statutory language made the date of the accident determinative, not the date of disability. Green v. Nottoway Correctional Center, 13 Va. App. 301, 411 S.E.2d 231, 8 Va. Law Rep. 1450, 1991 Va. App. LEXIS 299 (1991).

    Unemployment for more than one year. —

    The average weekly wage is calculated in order to approximate the economic loss sustained by an employee suffering from a work-related injury or by his statutory beneficiaries in the case of his work-related death and, where an employee has earned no wages during the 52 weeks preceding his death or the 52 weeks preceding the communication of the diagnosis of his occupational disease, there has been no economic loss and there is no basis for awarding indemnity benefits to the employee’s statutory beneficiaries. Newton v. Fairfax County Police Dep't, 259 Va. 801 , 529 S.E.2d 794, 2000 Va. LEXIS 80 (2000).

    Retirement following injury does not affect average weekly wage. —

    Workers’ compensation benefits are intended to compensate the claimant for wage loss resulting from a compensable accident and the employee’s voluntary retirement from the employer does not remove or diminish his ability to earn wages; being temporarily and totally disabled does prevent the claimant from earning wages and, therefore, he is entitled to temporary total disability benefits based on his preinjury average weekly wage. Burlington Indus., Inc. v. Golda, 2000 Va. App. LEXIS 595 (Va. Ct. App. Aug. 15, 2000).

    Proper method used to calculate average weekly wage. —

    The commission did not err in concluding that because of the casual nature or terms of defendant’s employment, simply dividing his income for the year by the number of days in the year preceding his injury was inadequate to determine a weekly wage and the commission properly resorted to using the proved hourly rate to determine the statutory definition of “average weekly wage.” Dominion Assocs. Group v. Queen, 17 Va. App. 764, 441 S.E.2d 45, 10 Va. Law Rep. 906, 1994 Va. App. LEXIS 90 (1994).

    Finding that $48.08 was the decedent’s average weekly wage applicable to the workers’ compensation claim was proper, because the decedent had never worked in the metal roofing and siding occupation before, and there was no evidence that he would do so in the future; it would not have been “fair and just to both parties” to assume he was hired for a continuing wage of $2,500 per week. Thorpe v. Ted Bowling Constr., 283 Va. 808 , 724 S.E.2d 728, 2012 Va. LEXIS 97 (2012).

    Workers’ Compensation Commission properly calculated a claimant’s average weekly wage for periods of temporary total disability by dividing her salary by 52 weeks instead of the 43 weeks that she actually worked each year because the claimant personally chose not to work summers even though summer work was available to her, she was not a seasonal employee, and her summer months were not “lost” time. Seminario v. Fairfax County Pub. Schs, 2014 Va. App. LEXIS 397 (Va. Ct. App. Dec. 9, 2014).

    Record supported the Workers’ Compensation Commission’s calculation of the employee’s average weekly wage because the employee suffered an injury before making the final professional football team roster, the football team never placed the employee on injured reserve, and therefore his earnings as a football player were entirely hypothetical. The Commission’s determination that the employee’s average weekly wage should be determined by his actual pre-injury earnings and not by speculative projections was proper. Jones v. Pro-Football, Inc., 69 Va. App. 732, 823 S.E.2d 20, 2019 Va. App. LEXIS 31 (2019).

    Although the claimant testified that he received housing, medical coverage, a gym membership, equipment, a $42 per diem, and coverage of his travel expenses, because he did not present any evidence on the issue of whether those allowances were provided in lieu of wages, he did not provide any testimony or evidence to address whether he received the per diem regardless of his actual expenses and that he was not required to account for his expense, and he failed to carry his burden of proving the value of other allowances besides his per diem, there was no evidence of the value of those allowances, and the Virginia Workers’ Compensation Commission could not have considered them even if the claimant had shown they constituted an economic gain. Johnston v. Echl Pers. Mgmt. of N.J. & Great Divide Ins. Co., 2020 Va. App. LEXIS 240 (Va. Ct. App. Oct. 6, 2020).

    Because the claimant earned $20,075.26 during the hockey season, and he did not seek or obtain other work during the off-season before his injury, during a 52-week period, he would have expected to make $20,075.26; thus, the Virginia Workers’ Compensation Commission’s calculations were correct as $20,075.26 divided by 52 weeks was $386.06; and a calculation of average weekly wage that used the number of weeks the claimant worked would have been unjust to his employer. Johnston v. Echl Pers. Mgmt. of N.J. & Great Divide Ins. Co., 2020 Va. App. LEXIS 240 (Va. Ct. App. Oct. 6, 2020).

    Improper method used to calculate weekly wage for employee hired for 1 day only. —

    Commission erred in basing amount of deceased worker’s death benefit compensation on the assumption of a 40-hour week, where worker was hired for only one day for $42.00 and was killed after working a portion of the day; instead, the amount of the award must be fixed based upon the actual weekly wage of $42.00. Uninsured Employer's Fund v. Thrush, 255 Va. 14 , 496 S.E.2d 57, 1998 Va. LEXIS 4 (1998).

    Wages calculated based on work being done at time of injury. —

    Where an employee had been previously employed by the employer in a lower-paying landscaping job but had been laid off from that job more than nine months before being rehired to do higher-paying seasonal decorating work, the commission properly calculated the employee’s average weekly wage by reference only to the seasonal work, including a bonus a received by the employee for that work. Ellen Kaye, Inc. v. Wigglesworth, 34 Va. App. 390, 542 S.E.2d 30, 2001 Va. App. LEXIS 89 (2001).

    This section contains the guideposts by which the commission may base its finding of average weekly wage. When the earnings of an injured employee are not amenable to the primary calculation specified in this section, “[t]he commission properly resort[s] to ‘such other method of computing average weekly wages . . . most nearly approximat[ing] the amount which the injured employee . . . earn[s].”’.Meredith Constr. Co. v. Holcombe, 21 Va. App. 537, 466 S.E.2d 108, 1996 Va. App. LEXIS 37 (1996).

    III.Change in Condition.

    Editor’s note.

    Many of the cases annotated under the heading “Change in Condition” were decided under former § 65.1-8 or prior law.

    Foundation for application based on change in condition. —

    This section was the foundation for an application based on a change in condition. It was distinct from and did not require a new industrial injury to support compensation for a change of condition. But if a new injury exacerbated a previous condition, the resulting accelerated disability was compensable. Manassas Ice & Fuel Co. v. Farrar, 13 Va. App. 227, 409 S.E.2d 824, 2000 Va. App. LEXIS 86 (1991).

    Where no “change of condition,” claim barred by res judicata. —

    Where the claimant’s second application was based upon the same medical results and findings as the first claim, explained in greater detail, the second application was barred by the doctrine of res judicata. Rusty's Welding Serv., Inc. v. Gibson, 27 Va. App. 733, 501 S.E.2d 444, 1998 Va. App. LEXIS 386 (1998), different results reached on reh'g, 29 Va. App. 119, 510 S.E.2d 255, 1999 Va. App. LEXIS 67 (1999).

    Although employee’s second claim related to a different time period than that claimed in first proceeding, second claim was barred by res judicata since medical evidence offered in second proceeding was identical to that offered in first proceeding. Aramark Corp. v. Terry, 2000 Va. App. LEXIS 192 (Va. Ct. App. Mar. 14, 2000).

    Change in condition not established. —

    Claimant could not establish a change in condition for period beginning March 27, 1997, where her disability after that date was the same as that which she experienced in period from November, 1996 through February 2, 1997 which, by stipulation, she conceded was not causally connected to her industrial accident. Aramark Corp. v. Terry, 2000 Va. App. LEXIS 192 (Va. Ct. App. Mar. 14, 2000).

    Employer failed to meet its § 65.2-101 burden to show a change in condition to allow termination of a workers’ compensation claimant’s temporary total disability benefits due to the claimant’s return to work by working 12 hours at a clothing store over two days about three weeks apart as the attempt was not of sufficient duration to show a change in condition; while a return to work might ordinarily be strong evidence that a claimant was capable of performing her pre-injury employment, it was not dispositive. Starbucks Coffee Co. v. Shy, 61 Va. App. 229, 734 S.E.2d 683, 2012 Va. App. LEXIS 396 (2012).

    Workers’ Compensation Commission did not err in finding that the medical evidence did not reflect a change in condition resulting in a total disability from work where specialists indicated that he was relatively stable and concluded that he was capable of work as long as he avoided exposure to chemicals and substances that aggravated his symptoms. Rexha v. Harrisonburg City Pub. Schs., 2020 Va. App. LEXIS 47 (Va. Ct. App. Feb. 25, 2020).

    Changes affecting compensation. —

    The statutory definition of change of condition, supplanting the one provided in J.A. Jones Constr. Co. v. Martin, 198 Va. 370 , 94 S.E.2d 202 (1956), does not limit changes in condition to changes in an employee’s physical condition, allowing in addition the consideration of any change in conditions which affect the right to, amount of or duration of compensation. Mace v. Merchants Delivery Moving & Storage, 221 Va. 401 , 270 S.E.2d 717, 1980 Va. LEXIS 257 (1980).

    Where an employee’s post-injury earnings were substantially below an agreed upon weekly wage after a job transfer, the workers’ compensation commission did not have to use a 52-week average to compute temporary partial disability benefits under § 65.2-502 . Fed. Mogul Friction Corp. v. Butcher, 2003 Va. App. LEXIS 478 (Va. Ct. App. Sept. 16, 2003).

    Capacity to work is a “condition.” —

    If the attending physician, reversing his former opinion, determines there has been a change in that condition sufficient to justify reinstatement of disability benefits, the inquiry is whether that change is causally connected with an injury suffered in an industrial accident. Absent proof of such connection, the change in condition is not compensable. King's Mkt. v. Porter, 227 Va. 478 , 317 S.E.2d 146, 1984 Va. LEXIS 217 (1984).

    Changed condition does not include aggravated “mental state.” —

    Commission was in error in basing award of compensation on legal conclusion that if changed condition was an aggravated “mental state” resulting from termination of compensation, it was a compensable condition. Keller Mfg. Co. v. Hoke, 215 Va. 525 , 211 S.E.2d 82, 1975 Va. LEXIS 184 (1975).

    Injuries not result of “change in condition.” —

    Where the injuries sustained by plaintiff in the fall did not naturally flow from a progression, deterioration or aggravation of the injury sustained in the original industrial accident, the injuries were the result of a new and separate accident, not a “change in condition” resulting from his first accident. Leonard v. Arnold, 218 Va. 210 , 237 S.E.2d 97, 1977 Va. LEXIS 180 (1977).

    A change in an attending physician’s opinion concerning an employee’s ability to resume work met the criteria detailed in former § 65.1-8. Mace v. Merchants Delivery Moving & Storage, 221 Va. 401 , 270 S.E.2d 717, 1980 Va. LEXIS 257 (1980).

    Ability or capacity to work different than issue of causation. —

    Although in Mace v. Merchants Delivery Moving and Storage, 221 Va. 401 , 270 S.E.2d 717 (1980), the Supreme Court held that a change in an attending physician’s opinion concerning an employee’s ability to resume work meets the criteria detailed in this section, the ability or capacity to work is a different matter than the issue of causation. Amp, Inc. v. Ruebush, 10 Va. App. 270, 391 S.E.2d 879, 6 Va. Law Rep. 2321, 1990 Va. App. LEXIS 85 (1990).

    A change in an attending physician’s opinion concerning an employee’s ability to resume work meets the criteria detailed in this section. This holding, however, does not alter the basic rule that an employee claiming reinstatement of disability benefits on account of a change in condition bears the burden of proving that his present condition resulted naturally and unavoidably from the accident. King's Mkt. v. Porter, 227 Va. 478 , 317 S.E.2d 146, 1984 Va. LEXIS 217 (1984).

    When employee files application for reinstatement of disability benefits, two questions arise: (1) Has there been a change in the employee’s capacity to work; (2) if so, is the change due to a condition causally connected with the injury originally compensated. King's Mkt. v. Porter, 227 Va. 478 , 317 S.E.2d 146, 1984 Va. LEXIS 217 (1984).

    An injured employee may “cure” an unjustified refusal of selective employment provided or procured by the employer by accepting such employment or by obtaining comparable selective employment. Timbrook v. O'Sullivan Corp., 17 Va. App. 594, 439 S.E.2d 873, 10 Va. Law Rep. 816, 1994 Va. App. LEXIS 21 (1994).

    Proof of causal connection between industrial accident and disabling condition underlying the employee’s application for reinstatement of compensation due to change in condition must go beyond the realm of conjecture. If it is just as likely that the disabling condition resulted from a cause which is not compensable as it is that it resulted from an accident covered by the Workers’ Compensation Act, the employee has failed to establish the requisite causal connection. King's Mkt. v. Porter, 227 Va. 478 , 317 S.E.2d 146, 1984 Va. LEXIS 217 (1984).

    Causality not in issue upon employer’s application to terminate benefits. —

    With respect to an employer’s application for termination of benefits based upon a change in condition, the only question is whether the employee’s prior condition of work incapacity has changed; the question of causal connection is not in issue. King's Mkt. v. Porter, 227 Va. 478 , 317 S.E.2d 146, 1984 Va. LEXIS 217 (1984).

    Cost-of-living supplement requires change of condition application. —

    The statutory cost-of-living provision is not self-executing, and a claim for a cost-of-living supplement is cognizable only under the change-of-condition sections of the Virginia Workers’ Compensation Act, which require an application and a showing of eligibility by the claimant and an award by the Commission. Jewell Ridge Coal Corp. v. Wright, 222 Va. 68 , 278 S.E.2d 820, 1981 Va. LEXIS 276 (1981).

    In an action challenging a decision of the Compensation Commission which awarded a worker a cost-of-living supplement and attorney fees after he returned to work from a compensable injury, the plaintiff was not entitled to reversal of the Commission’s decision for the worker’s alleged failure to file an application for a cost-of-living supplement because during oral argument the plaintiff conceded that the worker had sent a letter to the Commission stating that the plaintiff had failed to pay the cost-of-living increase and inquiring about the status of the matter; thus, the letter to the Commission constituted sufficient application for a cost-of-living supplement. Jewell Ridge Coal Corp. v. Wright, 222 Va. 68 , 278 S.E.2d 820, 1981 Va. LEXIS 276 (1981).

    Economic change. —

    There was credible evidence in the record to support the Virginia Workers’ Compensation Commission’s finding that an economic change occurred pursuant to § 65.2-101 , as in December 2007 and January and February 2008, the claimant’s wages decreased as a result of a job for an employer that took longer than expected to complete, through no fault of the claimant’s; economic change may, under appropriate factual circumstances, constitute a change in condition, as defined by § 65.2-101 . Atlas Van Lines & Legion Ins. Co. v. Kerr, 2011 Va. App. LEXIS 127 (Va. Ct. App. Apr. 12, 2011).

    Change in condition found. —

    Worker’s compensation claimant was entitled to disability benefits based on a change in condition to a previously determined compensable injury where the claimant’s treating physician initially opined that the claimant could work within stated physical limitations, but the physician subsequently determined that the claimant was medically disabled from all employment. Dominion Va. Power & Dominion Res., Inc. v. Greene, 2010 Va. App. LEXIS 105 (Va. Ct. App. Mar. 23, 2010).

    Statute of limitations bar. —

    Although the workers’ compensation commission awarded medical benefits “for as long as necessary after the accident” to the employee regarding the employee’s work-related right knee injury pursuant to subdivision A 1 of § 65.2-603 , the employee was still required to file a change-in-condition application within two years of the time the employee last received disability benefits, pursuant to subsection A of § 65.2-708 , to have a viable change-in-condition claim regarding the pain in the employee’s left knee. Since the employee did not file his § 65.2-101 change-in-condition application within the required two-year time period, the employee’s claim for change-in-condition benefits was time barred by subsection A of § 65.2-708 . Tricord Homes, Inc. v. Smith, 2008 Va. App. LEXIS 573 (Va. Ct. App. Dec. 30, 2008).

    Burden of proof. —

    In an application for a review of an award on the ground of a change in condition the burden is on the party alleging such change to prove his allegation by a preponderance of the evidence. Causey v. Napit Contractors, No. 0309-85 (Ct. of Appeals Dec. 10, 1985).

    Commission not allowed unlimited discretion to readjudicate decisions. —

    A “change in condition” under former § 65.1-8 did not allow the commission unlimited discretion to readjudicate its decisions. Amp, Inc. v. Ruebush, 10 Va. App. 270, 391 S.E.2d 879, 6 Va. Law Rep. 2321, 1990 Va. App. LEXIS 85 (1990).

    Application of res judicata. —

    Where an application for workers’ compensation benefits based on a change in condition is filed for the sole purpose of presenting additional evidence in support of a claim that has previously been denied, res judicata will bar reconsideration of the claim, but res judicata does not bar a claim for resumption of benefits when a change in condition, as contemplated by the Virginia Code, has occurred which has not been previously considered by the Commission. Lowes of Christiansburg v. Clem, 37 Va. App. 315, 557 S.E.2d 745, 2002 Va. App. LEXIS 16 (2002).

    Presumption of permanent disability. —

    Workers’ Compensation Commission erred in not finding that worker’s cryptococcal meningitis gave him a conclusive presumption of permanent disability. Mister Kleen Maintenance Co. v. Clark, 17 Va. App. 474, 438 S.E.2d 304, 10 Va. Law Rep. 652, 1993 Va. App. LEXIS 634 (1993).

    IV.Employee.
    A.In General.

    “Trade,” “business,” “occupation,” “profession” defined. —

    The word “trade” signifies barter and exchange, not restricted to commodities, but including transactions involving the medium of money. The word “business” implies some constant and connected employment as distinguished from “an isolated act or two.” “Occupation” is that activity in which a person, natural or artificial, is engaged with the element of a degree of permanency attached. “Profession” is the method or means pursued by person of technical or scientific training. Board of Supvrs. v. Boaz, 176 Va. 126 , 10 S.E.2d 498, 1940 Va. LEXIS 239 (1940).

    Term “trade, business or occupation” refers to private business. —

    The expression “trade, business or occupation” in this section relates primarily to business operations of persons and private corporations rather than to the administrative functions of a political subdivision of the State. Board of Supvrs. v. Boaz, 176 Va. 126 , 10 S.E.2d 498, 1940 Va. LEXIS 239 (1940); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    Act is restricted to master and servant. —

    It would seem clear from the history and purpose and general provisions of the Workmen’s (now Workers’) Compensation Act that the legislature did not have in mind as beneficiaries any other persons than such as are commonly understood as falling within a contractual relationship of master and servant. Board of Supvrs. v. Lucas, 142 Va. 84 , 128 S.E. 574 (1925). For exceptions to this rule, see now §§ 65.2-302 through 65.2-304 .

    Test of master-servant relationship. —

    Upon the question whether the relationship of master and servant exists, there are four elements which are considered: (1) selection and engagement of the servant; (2) payment of wages; (3) power of dismissal; and (4) power of control of the servant’s action. But the first, second and third of these elements are not essential to the relationship. The power of control is the most significant element bearing on the question. Stover v. Ratliff, 221 Va. 509 , 272 S.E.2d 40, 1980 Va. LEXIS 272 (1980); Hamilton Trucking v. Springer, 10 Va. App. 710, 396 S.E.2d 379, 7 Va. Law Rep. 211, 1990 Va. App. LEXIS 151 (1990).

    The right of control includes not only the power to specify the result to be attained but the power to control the means and methods by which the result is to be accomplished. An employer/employee relationship exists if the party for whom the work is to be done has the power to direct the means and methods by which the other does the work; if the latter is free to adopt such means and methods as he chooses to accomplish the result, he is not an employee but an independent contractor. Better Home Servs., Inc. v. Medrano, 2000 Va. App. LEXIS 741 (Va. Ct. App. Nov. 21, 2000).

    A claimant seeking benefits under the Workers’ Compensation Act bears the burden of proving that he is an employee within the definition of this section. Sheridan v. Skyline Express, Inc., No. 2520-94-4 (Ct. of Appeals April 25, 1995).

    Although a claimant seeking benefits bears the burden of proving he is an employee within the definition in this section, nothing in this section or any other portion of the act requires the employee to elect the subsection or subsections under which he claims coverage; all the act requires is that the claimant’s evidence establish an entitlement to coverage. Thacker v. TNT Insulations Co., 2000 Va. App. LEXIS 507 (Va. Ct. App. July 11, 2000).

    Characterization of relationship by parties not controlling. —

    While written documents may be indicative of the parties’ intent and the intent of the parties is a factor to be considered, it is not determinative. The parties cannot merely designate or agree to a legal status in derogation of the relationship as established by the facts of a particular case in that the commission must look behind the agreement to determine the actual relationship and the status in fact. Better Home Servs., Inc. v. Medrano, 2000 Va. App. LEXIS 741 (Va. Ct. App. Nov. 21, 2000).

    Relationship determined from facts of case. —

    In determining the status of one who performs work for another, no hard and fast rule can be laid down. It must be determined from the facts of the particular case in light of well-settled principles. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    Frequency or length of employment irrelevant as to definition of “employee.” —

    Any person hired by the employer to work in the usual course of the employer’s business is an “employee” under the act, regardless of how often or for how long he may be employed. Cotman v. Green, 4 Va. App. 256, 356 S.E.2d 447, 3 Va. Law Rep. 2605, 1987 Va. App. LEXIS 260 (1987).

    Power of control an indicium of employment relationship. —

    As a general rule, a person is an employee if he works for wages or a salary and the person who hires him reserves the power to fire him and the power to exercise control over the work to be performed. The power of control is the most significant indicium of the employment relationship; other factors merely help to elucidate the manner and degree of control. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    The right of control is the determining factor in ascertaining the parties’ status in an analysis of an employment relationship. And the right of control includes not only the power to specify the result to be attained, but the power to control the means and methods by which the result is to be accomplished. Intermodal Servs., Inc. v. Smith, 234 Va. 596 , 364 S.E.2d 221, 4 Va. Law Rep. 1560, 1988 Va. LEXIS 4 (1988).

    The right of control is the determinative factor in ascertaining the parties status in an employment relationship. Howarth v. Rockingham Publishing Co., 20 F. Supp. 2d 959, 1998 U.S. Dist. LEXIS 15661 (W.D. Va. 1998).

    Cab driver was an employee of a cab company where: (1) cab company had the requisite exercise over the selection and engagement of the cab driver; (2) the power to dismiss the cab driver; and (3) most importantly, the power of control over the cab driver’s actions. Purvis v. Porter Cabs, Inc., 38 Va. App. 760, 568 S.E.2d 424, 2002 Va. App. LEXIS 523 (2002).

    Evidence that the employer hired the claimant to work on a full-time, hourly basis, not by the job or the day, that the owner decided which workers to assign to each job, and that the claimant was not permitted to hire subcontractors to perform his assigned work was sufficient to prove that the claimant was an employee and not an independent contractor. Chuck Bennett & Sons Heating & Air Conditioning v. Cottrell, 2003 Va. App. LEXIS 697 (Va. Ct. App. Dec. 30, 2003).

    Facts supported the Virginia Workers’ Compensation Commission’s finding that a claimant was not an employee because there was no evidence that the claimant worked for a contractor under a written employment contract or that his actions were directed or controlled by another, but rather, the claimant controlled his own work and that of his employees; whether the facts brought him within the definition of an employee was a finding of fact entitled to deference. Axelson v. Pifer Constr., Inc., 2017 Va. App. LEXIS 218 (Va. Ct. App. Aug. 22, 2017).

    Extent of reserved right of control may be determined by examining the performance of the parties in the activity under scrutiny. Intermodal Servs., Inc. v. Smith, 234 Va. 596 , 364 S.E.2d 221, 4 Va. Law Rep. 1560, 1988 Va. LEXIS 4 (1988).

    Must have power to control both means and result to be accomplished. —

    An employer-employee relationship exists only if the control reserved includes the power to control not only the result to be accomplished, but also the means and methods by which the result is to be accomplished. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    If under the contract the party for whom the work is being done may prescribe not only what the result shall be, but also direct the means and methods by which the other shall do the work, the former is an employer, and the latter an employee. But if the former may specify the result only, and the latter may adopt such means and methods as he chooses to accomplish that result, then the latter is not an employee, but an independent contractor. So the master test is the right to control the work. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    An employer-employee relationship exists if the party for whom the work is to be done has the power to direct the means and methods by which the other does the work; if the latter is free to adopt such means and methods as he or she chooses to accomplish the result, he or she is not an employee but an independent contractor. Howarth v. Rockingham Publishing Co., 20 F. Supp. 2d 959, 1998 U.S. Dist. LEXIS 15661 (W.D. Va. 1998).

    There was abundant evidence to support the holding that the claimant was not an employee of the owner, but merely another construction worker who was hired by the claimant to reconstruct a school; while the owner prescribed the result of the work done, she did not prescribe the means and methods by which that result was to be achieved, and despite the fact that the owner paid the claimant for his work, the owner did not control the work or maintain any authority over the claimant. Uninsured Employer's Fund v. Jeffreys, 2016 Va. App. LEXIS 136 (Va. Ct. App. Apr. 26, 2016).

    Right to discharge is an element of the power to control performance. An absolute right to discharge without cause or notice includes the power to compel obedience to instructions as given and, accordingly, is one of the earmarks of the employer-employee relationship. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    Power of control lacking by contractor over subcontractor’s employee. —

    Plaintiff was employed as carpenter by company which contracted to repair equipment used by defendant. Plaintiff’s employer paid his wages and gave him orders. Defendant could not fire him. Plaintiff’s and defendant’s relationship depended upon cooperation rather than subordination. Defendant had no power of control over plaintiff, therefore he was not an employee of defendant. Tidewater Stevedoring Corp. v. McCormick, 189 Va. 158 , 52 S.E.2d 61, 1949 Va. LEXIS 158 (1949).

    What constitutes an employee is a question of law, but whether the facts bring a person within the law’s designation is usually a question of fact. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923).

    When the evidence concerning what constitutes the “usual course” of the employer’s trade, business, occupation, or profession or the “casualness” of the claimant’s work is in conflict, it raises a question of fact. When there is no such conflict, what constitutes a covered employee under the Workmen’s (now Workers’) Compensation Act is a question of law. McCoy v. Mims, 219 Va. 616 , 248 S.E.2d 817, 1978 Va. LEXIS 221 (1978).

    Whether there exists a relationship of master and servant, rather than one of independent contractor or subcontractor, is a question of law and not of fact. Stover v. Ratliff, 221 Va. 509 , 272 S.E.2d 40, 1980 Va. LEXIS 272 (1980).

    When there are no material facts in dispute, the issue of whether an individual is an “employee” within the meaning of the act is a question of law. Humphries v. Thomas, 244 Va. 571 , 422 S.E.2d 755, 9 Va. Law Rep. 553, 1992 Va. LEXIS 113 (1992) (decided under former § 65.1-4).

    Mixed question of law and fact. —

    The question whether an individual is an employee entitled to compensation benefits under the Workers’ Compensation Act or an independent contractor is a mixed question of law and fact. Carey v. Grayson Mitchell, Inc., No. 1173-89-2 (Ct. of Appeals Aug. 28, 1990).

    Finding of fact. —

    Virginia Workers’ Compensation Commission exercised its discretion and did carefully consider whether a claimant was an employee under the statute, and thus, the denial of the claimant’s motion to vacate and reconsider was a factual finding that the claimant was not an employee. Axelson v. Pifer Constr., Inc., 2017 Va. App. LEXIS 218 (Va. Ct. App. Aug. 22, 2017).

    Acquisition of employee status by minor. —

    An employee under the act certainly can be a minor but such a minor acquires employee status only if the employer exercises the requisite control over him or her under a traditional common-law analysis of the master/servant relationship. Howarth v. Rockingham Publishing Co., 20 F. Supp. 2d 959, 1998 U.S. Dist. LEXIS 15661 (W.D. Va. 1998).

    Act applies to infants, whether or not lawfully employed. —

    The new and additional liability imposed upon the employer by this title is in aid of the Child Labor Law, rather than opposed to it; infants, whether lawfully employed or not, are within the language and intent of the Act, and the remedy afforded by the Act is exclusive of all other remedies. Chalkley v. Nolde Bros., 184 Va. 553 , 35 S.E.2d 827, 1945 Va. LEXIS 176 (1945).

    No exception because of family relationship. —

    The definition of employee makes no exception because of family relationship between employer and employee. See Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    Volunteer workers excluded. —

    Excluded from the definition of “employees” are workers who neither receive nor expect to receive remuneration of any kind for their services. Charlottesville Music Center v. McCray, 215 Va. 31 , 205 S.E.2d 674, 1974 Va. LEXIS 227 (1974).

    When services or labor are rendered voluntarily without a promise of compensation or remuneration of any kind, express or implied, then the one providing the services or labor has supplied them gratuitously, and is not covered by workmen’s (now workers’) compensation. Charlottesville Music Center v. McCray, 215 Va. 31 , 205 S.E.2d 674, 1974 Va. LEXIS 227 (1974).

    Prisoner not employee. —

    Prisoners in Virginia, who are not on a work release program, are not capable of making a true contract of hire with the Commonwealth or any of its agencies, therefore, they are not employees. Commonwealth v. Woodward, 249 Va. 21 , 452 S.E.2d 656, 1995 Va. LEXIS 8 (1995).

    Convicts on work release. —

    There is nothing in this section to indicate that once a convict on work release has started his day’s work that he is controlled in his activities other than by his employer. His pay is the same as other employees doing like work and is obviously afforded the benefits of the Virginia Workmen’s (now Workers’) Compensation law as is the case of other employees. Owens v. Swift Agric. & Chem. Corp., 477 F. Supp. 91, 1979 U.S. Dist. LEXIS 9887 (E.D. Va.), aff'd, 612 F.2d 1309 (4th Cir. 1979).

    Burden of proof. —

    Injured worker who was the proponent of the issue of whether he was an employee of the employer had the burden of producing evidence that an employment relationship existed between him and the company who hired him. Craddock Moving & Storage Co. v. Settles, 16 Va. App. 1, 427 S.E.2d 428, 9 Va. Law Rep. 1026, 1993 Va. App. LEXIS 44 (1993), aff'd, 247 Va. 165 , 440 S.E.2d 613, 10 Va. Law Rep. 935, 1994 Va. LEXIS 25 (1994).

    The workers’ compensation act covers employees but not independent contractors and this distinction must be determined from the facts of each case with the burden upon the person seeking benefits to prove the relationship contemplated by the act. Better Home Servs., Inc. v. Medrano, 2000 Va. App. LEXIS 741 (Va. Ct. App. Nov. 21, 2000).

    Assistant engaged by employee. —

    Whether a person engaged by an employee to assist him in the performance of the duties of the employer is also an employee depends upon whether the principal employer has knowledge of such employment and consents thereto. This knowledge may be actual or imputed. The consent may be express or implied. Chalkley v. Nolde Bros., 184 Va. 553 , 35 S.E.2d 827, 1945 Va. LEXIS 176 (1945).

    Loaned employee. —

    The Act is silent with reference to the status of a loaned employee; therefore, it will be assumed that the common-law rule applied as to that point. Ideal Steam Laundry v. Williams, 153 Va. 176 , 149 S.E. 479 , 1929 Va. LEXIS 254 (1929).

    Under the evidence as the jury could appraise it the decedent continued to be the employee of an independent contractor and was not the loaned employee of the defendant at the time of the accident. Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37, 1957 Va. LEXIS 205 (1957).

    Because an employee executed an agreement with a labor broker wherein the employee was told that the employee was the broker’s employee and not that of any client, and because the employee did not consent to becoming the employee of a client, the broker retained its status as the employee’s sole employer and was liable for compensation benefits under § 65.2-101 . Smith v. McMillan Pers. Serv., 48 Va. App. 208, 629 S.E.2d 707, 2006 Va. App. LEXIS 213 (2006).

    Injured employee not acting as employee. —

    Where employee requested to remain and was informed that he was “off the clock,” that he would not be paid for or receive benefits in return for remaining on the job site and his motivations for spending time off duty with his friend and co-worker were purely personal, the evidence supports the commission’s finding that injured employee did not stay to serve any purpose of his employer, and therefore, he was not acting as an employee when the injury occurred, but was, at best, a volunteer. Jackson v. Ratcliff Concrete Company, 8 Va. App. 592, 382 S.E.2d 494, 6 Va. Law Rep. 155, 1989 Va. App. LEXIS 108 (1989).

    Compensation under this Act does not preclude suit upon Jones Act or general maritime law. —

    An employee injured aboard his employer’s ship on navigable waters may, on the allegation that he is a seaman, sue his employer for damages upon the Jones Act or the general maritime law after deliberately obtaining compensation under Virginia’s industrial statute or under the Longshoremen’s and Harbor Workers’ Act, on the allegation that he is not a seaman, but if the plaintiff succeeds in his suit, the employer may recoup the amounts already paid by deducting them when satisfying the judgment. In the event the compensation was paid by one insurer and the judgment becomes payable by another, the employer as the legal debtor in both instances may retain from the settlement of the judgment the sums necessary to reimburse the compensation carrier. Biggs v. Norfolk Dredging Co., 360 F.2d 360, 1966 U.S. App. LEXIS 6654 (4th Cir. 1966).

    Exempted employers must give employees notice of intention to come under Act. —

    It is the manifest purpose of the rules of the Compensation Commission promulgated pursuant to the authority granted by former § 65.1-18 (now § 65.2-201 ) to require an employer of the class excluded by this section, including farmers, desiring to come within the purview of the Workmen’s (now Workers’) Compensation Act, to so notify his employees, either by posting notices of his intention in a place or places where they are likely to be seen by the employees, or, where such posting is not practicable, to give such employees actual notice of his intention. Any employee then has the right to reject the Act by so notifying the Compensation Commission, and in the absence of such notification the employees are presumed to have elected to be bound by the Act. Dey v. Logan, 175 Va. 68 , 7 S.E.2d 102, 1940 Va. LEXIS 147 (1940).

    Domestic servants. —

    The provision in the act excluding coverage for domestic servants, this section, does not affect the determination of a covered employee’s average weekly wages. First Va. Banks, Inc. v. McNeil, 8 Va. App. 342, 381 S.E.2d 357, 6 Va. Law Rep. 1, 1989 Va. App. LEXIS 97 (1989) (decided under former § 65.1-28).

    Real estate agent held to be an employee. —

    Where real estate agent’s employment contract did not contain a provision expressly stating that the agent would not be treated as an employee for federal income tax purposes, real estate agent was an employee for purposes of the Workers’ Compensation Act even though the employment contract stated the agent would “otherwise be deemed to be an independent contractor and not a servant, employee or partner of Broker.” Barr v. Town & Country Properties, Inc., 240 Va. 292 , 396 S.E.2d 672, 1990 Va. LEXIS 123 (1990) (decided under former § 65.1-4.3).

    Claimant held to be employee. —

    Claimant was in the service of lumber company where the company’s supervisor instructed claimant when to take breaks, including his lunch, and where to position his trailer for loading logs. Furthermore when claimant could not properly position trailer, the supervisor positioned it for him. James v. Wood Prods., 15 Va. App. 754, 427 S.E.2d 224, 9 Va. Law Rep. 888, 1993 Va. App. LEXIS 36 (1993).

    Virginia Workers’ Compensation Commission did not err in finding that a workers’ compensation claimant was an “employee” of a company under the Virginia Workers’ Compensation Act, § 65.2-101 , and not an independent contractor because the company controlled claimant’s work as it would any other employee doing similar jobs, and the company provided most of the tools and all of the materials that claimant needed to complete his tasks; the parties did not have a written contract, the company docked claimant’s pay unilaterally if the job took more hours than expected, and claimant’s work was part of the company’s usual course of business. Sherman & Sherman Props. v. Long, 2011 Va. App. LEXIS 128 (Va. Ct. App. Apr. 12, 2011).

    “Employee” for purposes of exclusivity. —

    Where a widow’s husband was killed in the course of his employment and she filed a wrongful death action against his employer and its subcontractors, the “employee,” as defined in § 65.2-101 , was the husband; as subsection A of § 65.2-307 precludes “all other rights and remedies” available to the personal representative of an employee who is covered by Virginia’s Workers’ Compensation Act, the widow’s claim was barred. Giordano v. McBar Indus., 284 Va. 259 , 729 S.E.2d 130, 2012 Va. LEXIS 138 (2012).

    B.Contract of Hire.

    Editor’s note.

    “Hire” connotes payment of some kind. Charlottesville Music Center v. McCray, 215 Va. 31 , 205 S.E.2d 674, 1974 Va. LEXIS 227 (1974).

    A “contract of hire” is usually defined as an agreement in which an employee provides labor or personal services to an employer for wages or remuneration or other thing of value supplied by the employer. Charlottesville Music Center v. McCray, 215 Va. 31 , 205 S.E.2d 674, 1974 Va. LEXIS 227 (1974).

    When implied contract of hire exists. —

    An implied contract of hire exists where one party has rendered services or labor of value to another under circumstances which raise the presumption that the parties intended and understood that they were to be paid for, or which a reasonable man in the position of the person receiving the benefit of the services or labor would or ought to know that compensation or remuneration of some kind was to be exchanged for them. Charlottesville Music Center v. McCray, 215 Va. 31 , 205 S.E.2d 674, 1974 Va. LEXIS 227 (1974).

    Finding of Commission on existence of employment contract is final. —

    The Compensation Commission found that from the evidence as a whole, claimant at the time he received his injury was in fact an employee of the defendant company. This finding involved a finding of the existence of a contract, express or implied, between the claimant and the defendant company, which finding was conclusive and binding unless obtained by fraud, or contradicted by and inconsistent with other findings of fact in the case. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923).

    Illegal alien cannot be employed lawfully in United States, and therefore, claimant was not eligible to receive compensation benefits as an “employee” under the Act because his purported contract of hire was void and unenforceable. Granados v. Windson Dev. Corp., 257 Va. 103 , 509 S.E.2d 290, 1999 Va. LEXIS 22 (1999).

    The rule that an illegal alien cannot enter into a lawful contract of employment applies even if the alien made no misrepresentation concerning his status and even if the employer made no inquiry concerning his status. Mendoza-Garcia v. Hwi, 2001 Va. App. LEXIS 158 (Va. Ct. App. Mar. 27, 2001).

    The case determining that the workers’ compensation commission has no jurisdiction over claims by illegal aliens did not overrule a prior judicial decision, establish a new principle of law, or construe new statutory language; that decision, therefore, may be applied retroactively and properly controls all subsequent decisions. Alvarado v. Krajewski, 2001 Va. App. LEXIS 2 (Va. Ct. App. Jan. 9, 2001).

    Because a claimant was an unauthorized alien at the time of his putative contract of hire with the employer and because the contract was, therefore, void and unenforceable, the claimant was not entitled to disability benefits. The fact that the claimant had married an American citizen and might qualify as a “permanent resident” did not require a different result where the claimant had failed to prove that he satisfied the statutory requirements to be a citizen or an alien lawfully admitted for permanent residence. Rios v. Ryan, Inc. Cent., 35 Va. App. 40, 542 S.E.2d 790, 2001 Va. App. LEXIS 99 (2001).

    Amendment extending coverage to illegal aliens not retroactive. —

    The amendment to this section extending coverage to aliens whether lawfully or unlawfully employed did not apply to a case arising prior to the effective date of the amendment. Mendoza-Garcia v. Hwi, 2001 Va. App. LEXIS 158 (Va. Ct. App. Mar. 27, 2001).

    No implied contract of hire. —

    Where plaintiff installed carpet for customers of defendant carpet salesman, the mere circumstance of this relationship did not raise a presumption that the parties intended and understood that plaintiff would be compensated in exchange for making a trip to pick up a trailer for defendant; thus there was no implied contract of hire. Consequently, plaintiff was not an “employee” within the purview of the act. Humphries v. Thomas, 244 Va. 571 , 422 S.E.2d 755, 9 Va. Law Rep. 553, 1992 Va. LEXIS 113 (1992) (decided under former § 65.1-4).

    Claimant failed to establish “contract of hire.” —

    Where the relationship between the claimant and business owner was one of reciprocal gratuity, terminable upon dissatisfaction, involving no specific employment obligations, no relationship between service and compensation, and no right of control over the performance of the claimant’s work, claimant failed to establish a “contract of hire” within the meaning of this section. Behrensen v. Whitaker, 10 Va. App. 364, 392 S.E.2d 508, 6 Va. Law Rep. 2457, 1990 Va. App. LEXIS 99 (1990).

    C.Independent Contractors.

    Editor’s note.

    Test of an independent contractor. —

    See Craig v. Doyle, 179 Va. 526 , 19 S.E.2d 675, 1942 Va. LEXIS 244 (1942).

    An employer-employee relationship exists if the party for whom the work is to be done has the power to direct the means and methods by which the other does the work. If the latter is free to adopt such means and methods as he chooses to accomplish the result, he is not an employee but an independent contractor. Intermodal Servs., Inc. v. Smith, 234 Va. 596 , 364 S.E.2d 221, 4 Va. Law Rep. 1560, 1988 Va. LEXIS 4 (1988).

    Written declaration of parties as evidence of relationship. —

    A contract provision that one of the parties is a “separate independent contractor” is not self-executing, but the nature of the relationship the parties intended to create is one of the factors to be considered, and a written declaration subscribed by the parties is relevant evidence of that intent. One person may elect to assume a servant’s status while another prefers to be his own master. When courts can determine that choice, they should accord it due deference. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    Employers cannot simply designate persons as employees or independent contractors; what the parties to such a contract call their relationship is but one factor to consider in determining the status of employee versus that of independent contractor, and the right of control is the determinative factor in ascertaining the parties’ status. Howarth v. Rockingham Publishing Co., 20 F. Supp. 2d 959, 1998 U.S. Dist. LEXIS 15661 (W.D. Va. 1998).

    Independent contractors or subcontractors are not countable as employees within the meaning of the Workers’ Compensation Act. The Act applies to the contractual relationship of master and servant. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    Whether a person is an employee or independent contractor is governed by common law, not by an express provision of the workers’ compensation law. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    The classification of a person as an employee or an independent contractor is governed, not by any express provision of the Workers’ Compensation Act, but by common law, and the courts must look to it in determining who is an employee. Howarth v. Rockingham Publishing Co., 20 F. Supp. 2d 959, 1998 U.S. Dist. LEXIS 15661 (W.D. Va. 1998).

    Rights as between owners and independent contractors not changed by Act. —

    The Act does not undertake to change, as between themselves, the rights of owners and independent contractors. It leaves that relationship as it was at common law, which must be looked to in determining who is master and who is servant. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    Chauffeur, who drove a limousine which was owned, fueled and repaired by employer, was an employee rather than an independent contractor. Corporate Limousine Serv., Inc. v. Gomez, No. 0615-92-4 (Ct. of Appeals Jan. 12, 1993).

    Truck driver engaged by Highway Department (now Department of Transportation) at fixed sum per hour for himself and his truck was held under the facts established to be an employee of the Highway Department and not an independent contractor. Phillips v. Brinkley, 194 Va. 62 , 72 S.E.2d 339, 1952 Va. LEXIS 207 (1952).

    Truck driver who entered lease agreement with corporation was independent contractor. —

    Evidence supported finding that truck driver, who entered into a lease agreement whereby a corporation leased his tractor trailer for exclusive use in the conduct of its business, was an independent contractor, where the lease merely required the corporation to compensate him for the services of any driver who actually hauled a load in his vehicle. Carey v. Grayson Mitchell, Inc., No. 1173-89-2 (Ct. of Appeals Aug. 28, 1990).

    Statutory remedies available to independent marine contractor. —

    Libellant, an independent marine surveyor, was an independent contractor, and was not limited to compensation under the Longshoremen’s and Harbor Workers’ Compensation Act, 33 U.S.C.A. § 901 et seq., or the Virginia Workmen’s (now Workers’) Compensation Act. Noel v. Isbrandtsen Co., 179 F. Supp. 325, 1959 U.S. Dist. LEXIS 2377 (D. Va. 1959), aff'd, 287 F.2d 783, 1961 U.S. App. LEXIS 5135 (4th Cir. 1961).

    Express limitation on right to terminate. —

    While an employer-employee relationship may be created by contract notwithstanding express limitations upon the employer’s right to terminate the relationship, such limitations are more characteristic of contracts negotiated by independent contractors. Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    Where the work consisted of the hauling of property, the question of who furnished the truck was subordinate to the question of who had the power of general control of the employee’s actions in determining who were employees and who were independent contractors. Stover v. Ratliff, 221 Va. 509 , 272 S.E.2d 40, 1980 Va. LEXIS 272 (1980).

    Worker held independent contractor. —

    Worker was independent contractor rather than employee where worker operated separate business entity through which he supplied trucks and drivers to employer in accordance with lease agreement, reported money which employer gave him to Internal Revenue Service as “nonemployee compensation,” and retained ultimate right of control of drivers. Smith v. Charles G. Crews Sons, No. 0246-88-3 (Ct. of Appeals March 7, 1989).

    Where the record clearly established that alleged employer exercised no control over claimant or his work, primarily provided unrelated administrative services for claimant, and did not pay him a salary or wages nor did it have the power to fire him, credible evidence supported the Workers’ Compensation Commission’s finding that claimant was not an employee but was an independent contractor. Whitlock v. Whitlock Mechanical/Check Servs., Inc., 25 Va. App. 470, 489 S.E.2d 687, 1997 Va. App. LEXIS 563 (1997).

    Workers’ compensation claimant was an independent contractor and was not within the scope of the Virginia Workers’ Compensation Act, § 65.2-101 et seq., as he maintained the right to control his work in that: (1) he approached the employer about doing yard work and other odd jobs, with a business card referring to his business; (2) the employer gave the claimant general instructions about performing the work, but it was up to the claimant to decide how the tasks would be accomplished; (3) the employer did not supervise the claimant’s work; (4) the claimant set his own schedule, kept his own time records, and was permitted to work for others; and (5) although the claimant used some of his employer’s tools, he also used some of his own tools. Darby v. Harvey, 2003 Va. App. LEXIS 366 (Va. Ct. App. June 24, 2003).

    Finding that an independent contractor was an employee for workers’ compensation purposes was inappropriate because the contractor prosecuted and directed the work; he used only his chosen methods to accomplish it; he provided the instrumentalities, supplies, and tools for his work; he alone reached agreement as to what tattoos would be inscribed; and the company’s owner had no list of rules involving breaks, or even hours, of the contractor’s work. Creative Designs Tattooing Assocs. v. Estate of Parrish, 56 Va. App. 299, 693 S.E.2d 303, 2010 Va. App. LEXIS 212 (2010).

    Workers’ Compensation Commission did not err in determining that, at the time of a construction site accident, the claimant was an independent contractor, and therefore not entitled to an award of benefits under the Workers’ Compensation Act, where the foreman did not tell the claimant how to perform the job, the claimant used his own equipment and tools for the project, the claimant could determine his schedule and the hours that he worked, and the claimant considered himself an independent contractor. Kirtley v. Cooper, 2017 Va. App. LEXIS 268 (Va. Ct. App. Oct. 31, 2017).

    Employment relationship not established. —

    The fact that independent contractor would tell plaintiff truck driver when and where to pick up a load, and when and where to deliver it is not sufficient control to establish an employment relationship. Penn v. Virginia Int'l Terms., Inc., 819 F. Supp. 514, 1993 U.S. Dist. LEXIS 14972 (E.D. Va. 1993).

    Worker held employee. —

    Where real estate agent’s employment contract did not contain a provision expressly stating that the agent would not be treated as an employee for federal income tax purposes, real estate agent was an employee for purposes of the Workers’ Compensation Act even though the employment contract stated the agent would “otherwise be deemed to be an independent contractor and not a servant, employee or partner of Broker.” Barr v. Town & Country Properties, Inc., 240 Va. 292 , 396 S.E.2d 672, 1990 Va. LEXIS 123 (1990).

    Evidence supported Commission’s finding that part-time security guard was an employee of appellant, rather than an independent contractor. Gipson's, Ltd. v. Prince, 1999 Va. App. LEXIS 657 (Va. Ct. App. Dec. 7, 1999).

    Even though his employer did not, in fact, dictate precisely how or during what hours claimant was to obtain and complete insulation jobs, the evidence as a whole established indicia of a retained power of control sufficient to compel the conclusion that the claimant was an employee as a matter of law where the claimant had no employment contract, placing him in the legal status of an at-will employee who could be fired at any time for any reason or no reason, the claimant was paid wages for his work, the employer withheld taxes from those wages, paid claimant’s workers’ compensation premiums and union dues and issued claimant a W-2 Form for each tax year, the employer provided claimant with a vehicle and insured that vehicle, the claimant purchased supplies in the name of the employer which were charged to the employer’s account and reflected in the profit and loss statement filed by the employer with its income taxes, the employer received all payments for work done by the claimant and, when the claimant worked for another company, he gave the payment he received to be deposited in the employer’s account. Thacker v. TNT Insulations Co., 2000 Va. App. LEXIS 507 (Va. Ct. App. July 11, 2000).

    Evidence supported the Workers’ Compensation Commission’s finding that the claimant was an employee, rather than an independent contractor, as the payment of wages, alone, was not the determinative factor, and the employer exercised a significant amount of control over the claimant. Diversified Tech., LLC v. Pancoast, 2002 Va. App. LEXIS 729 (Va. Ct. App. Dec. 10, 2002).

    Evidence that a home improvement company provided a worker with business cards which bore its name, scheduled jobs for the worker, and occasionally directed his work was sufficient to support the Virginia Workers’ Compensation Commission’s decision that the worker was an employee, not an independent contractor. North Star Home Improvement, Inc. v. Heddings, 2004 Va. App. LEXIS 81 (Va. Ct. App. Feb. 17, 2004).

    Notwithstanding a carpenter’s election to make his own withholding tax payments from his hourly wages, evidence that a construction company’s owner retained the right to control and did control the method and means of the work the carpenter performed supported a finding that he was an employee under § 65.2-101 . Dillon Constr. & Accident Fund Ins. Co. of Am. v. Carter, 55 Va. App. 426, 686 S.E.2d 542, 2009 Va. App. LEXIS 568 (2009).

    D.Municipal Employees.

    Editor’s note.

    Definition of employees of a municipal corporation is express and explicit and may not be added to or subtracted from. In the instant case claimant’s employer was an independent contractor and not an officer or employee of the city. City of Portsmouth v. Daniels, 157 Va. 614 , 162 S.E. 324 , 1932 Va. LEXIS 316 (1932).

    High constable of Richmond and his deputies are employees of the city, not of the State. Even though not mentioned specifically in the statute, the high constable is clearly the kind of officer contemplated by the legislature in its enumeration of municipal employees, whether or not he is an “officer of the State” as that term has been used in other contexts. City of Richmond v. Johnson, 202 Va. 33 , 115 S.E.2d 910, 1960 Va. LEXIS 187 (1960).

    Auxiliary police coverage. —

    The individual, not having been appointed an auxiliary police officer by the city’s chief of police, was not a member of the city’s auxiliary police force within the City Code, and thus, had not been extended workers’ compensation benefits under the City Code. Therefore, she did not meet the definition of “employee” under the Act. City of Va. Beach Police Dep't v. Compton-Waldrop, 252 Va. 302 , 477 S.E.2d 514, 1996 Va. LEXIS 113 (1996).

    Employment relationship. —

    Virginia Workers’ Compensation Commission properly found that a decedent was an employee of a county, rather than a town, for the purposes of payment of workers’ compensation benefits because: (1) the county supervised the decedent, controlled the method and manner of the decedent’s work, and oversaw the decedent’s training; and (2) the town’s control of the decedent was essentially limited to serving as a payroll agent for the county. County of Warren v. Donahoe, 2008 Va. App. LEXIS 24 (Va. Ct. App. Jan. 15, 2008).

    E.Sole Proprietors and Partners.

    Editor’s note.

    A sole proprietor may obtain workers’ compensation coverage as an “employee” under the Workers’ Compensation Act. Whitlock v. Whitlock Mechanical/Check Servs., Inc., 25 Va. App. 470, 489 S.E.2d 687, 1997 Va. App. LEXIS 563 (1997).

    Determination of sole proprietor’s status. —

    A sole proprietor may also elect to be an employee covered by the act. Whether a sole proprietor who does not so elect is an employee or an independent contractor depends upon the nature of the relationship, particularly whether the person who hires him or her retains the right to control the work to be performed. Metropolitan Cleaning Corp. v. Crawley, 14 Va. App. 261, 416 S.E.2d 35, 8 Va. Law Rep. 2570, 1992 Va. App. LEXIS 112 (1992).

    Workers’ compensation commission properly held that the employee was the sole proprietor of the business and that § 65.2-101 required the employee to give direct notice of his injury to the insurer in order to obtain benefits. Melkersen v. New Mkt. Metalcraft, Inc., 2002 Va. App. LEXIS 451 (Va. Ct. App. Aug. 6, 2002).

    Independent contractor who failed to elect coverage not entitled to sole proprietor benefits. —

    Claimant was an independent contractor who failed to properly elect coverage under the statutes, and therefore, was not entitled to benefits as a sole proprietor. Whitlock v. Whitlock Mechanical/Check Servs., Inc., 25 Va. App. 470, 489 S.E.2d 687, 1997 Va. App. LEXIS 563 (1997).

    Sole shareholder and officer of employer not equivalent to sole proprietor or partner. —

    Where a claimant completed an employer’s accident report almost two years after the accident, the Virginia Workers’ Compensation Commission properly found that he met § 65.2-600 ’s notice requirement, because the employer’s president and director — i.e., the claimant — received immediate and actual notice of the accident and injury. He was not obliged to file a notice of accident directly with the carrier “as soon as practicable” under § 65.2-101 , since that statute was limited to sole proprietors and partners who elected to be covered as employees. B & H Constr., Inc. v. Baker, 2006 Va. App. LEXIS 153 (Va. Ct. App. Apr. 25, 2006).

    Question concerning insurance policy’s coverage of other partner properly invoked commission’s jurisdiction. —

    Where an application for workers’ compensation coverage was completed by a partner on behalf of the partnership, the application contained an express election to include both partners as employees under the workers’ compensation coverage of the partnership as allowed by this section, a policy was then issued to the partnership, and the question before the commission concerned whether the insurance policy covered the other partner’s stipulated, compensable injury, the commission’s jurisdiction was properly invoked. Ace Metal Fabricators v. Counts, No. 0613-87-2 (Ct. of Appeals Feb. 26, 1988).

    Common-law right to sue abrogated. —

    A general partner’s statutory election to be covered as an employee by the Virginia Workers’ Compensation Act abrogated his common-law right to sue the owner of a project for injuries sustained while working on the project. Counts v. Stone Container Corp., 239 Va. 152 , 387 S.E.2d 481, 6 Va. Law Rep. 1109, 1990 Va. LEXIS 8 (1990).

    In binding partners to the provisions of former § 65.1-40 (now § 65.2-307 ) by way of former § 65.1-4.2 (see now subdivision 1 n under the paragraph defining “Employee”), the General Assembly considered that any insurance premiums paid by a partnership for individual coverage of its partners would ultimately be reflected in the cost of doing the various jobs on which the partners might be injured. Counts v. Stone Container Corp., 239 Va. 152 , 387 S.E.2d 481, 6 Va. Law Rep. 1109, 1990 Va. LEXIS 8 (1990).

    F.Employees of Independent Contractors.

    Editor’s note.

    Section preserves right to maintain action at common law. —

    The decisive factor in making the statutory employer determination under former § 65.1-30 (now § 65.2-302 ) is whether the work being performed by the injured workman was part of the trade, business or occupation of the general contractor. If the work being performed was not a part of the general contractor’s trade, business or occupation, then the general contractor is not a statutory employer under former § 65.1-40 (now § 65.2-307 ) and is not liable for workmen’s (now workers’) compensation. Furthermore, if the general contractor is not a statutory employer, the injured workman’s right to maintain an action at common law is preserved by this section. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    If a general contractor contracts with another contractor to perform work which is not a part of the general contractor’s trade, business or occupation, that other contractor is an independent contractor within the meaning of the Act, and under this section, workmen employed by the other contractor are not precluded from maintaining a common-law action against the general contractor. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    Former § 65.1-5 provides, in essence, that the mere fact a business owner engages an independent contractor does not make that independent contractor’s employees statutory employees of the owner. Henderson v. Central Tel. Co., 233 Va. 377 , 355 S.E.2d 596, 3 Va. Law Rep. 2494, 1987 Va. LEXIS 203 (1987).

    Former § 65.1-5 must be read and reconciled with former §§ 65.1-29 through 65.1-31 (now § 65.2-302 ). Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959); Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976).

    Former § 65.1-5 must be reconciled with former § 65.1-29 (now § 65.2-302 ). Holt v. Bowie, 343 F. Supp. 962, 1972 U.S. Dist. LEXIS 13479 (W.D. Va. 1972).

    Former § 65.1-5 must be read and reconciled with provisions of former § 65.1-30 (now § 65.2-302 ). Smith v. Weber, 3 Va. App. 379, 350 S.E.2d 213, 3 Va. Law Rep. 1114, 1986 Va. App. LEXIS 372 (1986).

    Workmen’s (now workers’) compensation liability attaches to employer who contracts out work generally done by himself. —

    There is a distinction between an owner or employer who contracts out work which he himself generally does perform or which in the ordinary course of his particular trade or business companies similarly situated actually do or could be expected to perform, and an owner or employer who contracts out work which he does not or never could be expected to perform. In the first situation liability of the owner under the Workmen’s (now Workers’) Compensation Act would attach; in the second case it would not. Holt v. Bowie, 343 F. Supp. 962, 1972 U.S. Dist. LEXIS 13479 (W.D. Va. 1972).

    Subcontractor’s employees. —

    The fact that laborers were provided by a personal agency and paid by the agency does not prevent their being the employees of subcontractor. Uninsured Employer's Fund v. Mayfield, 1995 Va. App. LEXIS 809 (Va. Ct. App. Nov. 7, 1995).

    G.Casual Employees.

    Editor’s note.

    “Casual” imports impermanence and has been contrasted with, or distinguished from, “casual,” “constant,” “important,” “material,” “regular,” and “stated,” and also contrasted with the phrase “of a casual nature.” Board of Supvrs. v. Boaz, 176 Va. 126 , 10 S.E.2d 498, 1940 Va. LEXIS 239 (1940).

    An employment cannot be said to be casual where it is in the usual course of the trade, business or occupation of the employer. But it is casual when not permanent or periodically regular, but occasional, or by chance, and not in the usual course of the employer’s trade or business. Hoffer Bros. v. Smith, 148 Va. 220 , 138 S.E. 474 , 1927 Va. LEXIS 223 (1927); Board of Supvrs. v. Boaz, 176 Va. 126 , 10 S.E.2d 498, 1940 Va. LEXIS 239 (1940).

    Even though a claimant under the Workmen’s (now Workers’) Compensation Act was a casual employee, this does not defeat his claim if such employment was in the usual course of the trade, business, occupation or profession of the employer. Board of Supvrs. v. Boaz, 176 Va. 126 , 10 S.E.2d 498, 1940 Va. LEXIS 239 (1940).

    The test is the nature of the employment and not the nature of the contract. Hoffer Bros. v. Smith, 148 Va. 220 , 138 S.E. 474 , 1927 Va. LEXIS 223 (1927); Board of Supvrs. v. Boaz, 176 Va. 126 , 10 S.E.2d 498, 1940 Va. LEXIS 239 (1940).

    Employee not necessarily covered even if not casual. —

    Even though a claimant is not a casual employee, he is excluded from coverage of the Act unless the work he did was in the usual course of the trade, business, occupation, or profession of the employer. Thus where the work a carpenter did in remodeling a riverfront cabin for a farmer was in no way connected with farmer’s usual occupation, although it might be fair to say that carpenter’s work was not casual and that the farmer retained control over the work product (as distinguished from work methods), carpenter who fell off scaffolding and was injured, was not an employee covered by the Act. McCoy v. Mims, 219 Va. 616 , 248 S.E.2d 817, 1978 Va. LEXIS 221 (1978).

    Question of fact or law. —

    When the evidence concerning what constitutes the “usual course” of the employer’s trade, business, occupation, or profession or the “casualness” of the claimant’s work is in conflict, it raises a question of fact. When there is no such conflict, what constitutes a covered employee under the Workmen’s (now Workers’) Compensation Act is a question of law. McCoy v. Mims, 219 Va. 616 , 248 S.E.2d 817, 1978 Va. LEXIS 221 (1978).

    One engaged by the janitor of a courthouse to repair a window was a casual employee. Board of Supvrs. v. Boaz, 176 Va. 126 , 10 S.E.2d 498, 1940 Va. LEXIS 239 (1940); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    H.Regularly in Service Less Than Three Employees.

    Editor’s note.

    In determining whether an employer has three or more employees “regularly in service,” the number of persons used to carry out the established mode of performing the work of the business is determinative, even though the work may be recurrent instead of constant. Cotman v. Green, 4 Va. App. 256, 356 S.E.2d 447, 3 Va. Law Rep. 2605, 1987 Va. App. LEXIS 260 (1987).

    Part-time as well as full-time employees “regularly in service” must be considered in determining whether an employer has at least three employees. Cotman v. Green, 4 Va. App. 256, 356 S.E.2d 447, 3 Va. Law Rep. 2605, 1987 Va. App. LEXIS 260 (1987).

    If an employer regularly employs three or more persons to carry out the established mode of performing the work of the business, he should remain subject to the provisions of the act, even if one or more of the employees works less than full-time, or if the number of his employees temporarily falls below three. Cotman v. Green, 4 Va. App. 256, 356 S.E.2d 447, 3 Va. Law Rep. 2605, 1987 Va. App. LEXIS 260 (1987).

    Both full-time and part-time employees who are regularly employed to carry out the trade or business of the employer must be counted in determining the number of employees “regularly in service” to the employer. Keene v. Boothe, 2001 Va. App. LEXIS 270 (Va. Ct. App. May 22, 2001).

    Virginia Workers’ Compensation applied the incorrect legal analysis in making its determination that an employer had three or more employees regularly in service under the Workers’ Compensation Act, § 65.2-101 , because the test the Commission used conflicted with the prior holdings of the court of appeals interpreting § 65.2-101 since without determining whether any three employees were “regularly in service,” the employer’s liability and the employee’s coverage could fluctuate rapidly based on the number of employees at work at the precise time of the accident; the legal standard the Commission applied also rendered its analysis inconsistent with the plain text of § 65.2-101, which expressly excluded employees from workers’ compensation if their employers had regularly in service less than three employees. Ragland v. Muguruza, 59 Va. App. 250, 717 S.E.2d 842, 2011 Va. App. LEXIS 396 (2011).

    Frequency and duration of employment not relevant. —

    Any person hired by an employer to work in the usual course of the employer’s business is an “employee” under the act regardless of how often or for how long he may be employed; the number of employees regularly in service of the employer is the number used to carry out the established mode of performing the work of the business, even though the work may be recurrent instead of constant. Keene v. Boothe, 2001 Va. App. LEXIS 270 (Va. Ct. App. May 22, 2001).

    Burden of proof on employer. —

    Employer who was the proponent of the issue of whether it had “regularly in service less than three employees in the same business within this Commonwealth” had the burden of producing evidence that it had less than three employees regularly employed in Virginia. Craddock Moving & Storage Co. v. Settles, 16 Va. App. 1, 427 S.E.2d 428, 9 Va. Law Rep. 1026, 1993 Va. App. LEXIS 44 (1993), aff'd, 247 Va. 165 , 440 S.E.2d 613, 10 Va. Law Rep. 935, 1994 Va. LEXIS 25 (1994).

    Once an employee proves that his injury occurred while employed in Virginia, the employer has the burden of producing sufficient evidence upon which the Commission can find that the employer employed less than three employees regularly in service in Virginia. Uninsured Employer's Fund v. Kramer, 32 Va. App. 77, 526 S.E.2d 304, 2000 Va. App. LEXIS 218 (2000).

    It is the employer’s burden to produce sufficient evidence upon which the Commission can find that the employer employed fewer than three employees regularly in service in Virginia and that it is thus exempt from the act. Keene v. Boothe, 2001 Va. App. LEXIS 270 (Va. Ct. App. May 22, 2001).

    “Full-time employment” imports a sense of permanence coupled with a commitment between the employer and employee whereby the latter’s normal employment capacity is essentially utilized. Lynch v. Thomas E. Lee & Sons, 12 Va. App. 933, 406 S.E.2d 423, 8 Va. Law Rep. 300, 1991 Va. App. LEXIS 177 (1991).

    The term “full-time employee” refers to a specific person whose employment satisfies the definition of full-time. It does not define an aggregation of part-time employees. Therefore, Commission’s standard that 2,000 hours of employment were equivalent to the employment of one full-time employee was erroneous. Lynch v. Thomas E. Lee & Sons, 12 Va. App. 933, 406 S.E.2d 423, 8 Va. Law Rep. 300, 1991 Va. App. LEXIS 177 (1991).

    Employees of subcontractor considered employees for determining applicability of act. —

    The subcontractor’s employees are employees of the contractor for purposes of liability. Since they are the contractor’s employees for purposes of determining liability, reason dictates that they should also be considered employees for determining applicability of the act. Smith v. Weber, 3 Va. App. 379, 350 S.E.2d 213, 3 Va. Law Rep. 1114, 1986 Va. App. LEXIS 372 (1986).

    Employer was not excluded under § 65.2-101 as it did not show that it regularly kept fewer than three employees in service, or that the nature of the business entailed the service of fewer than three employees; a former employee testified that during the employee’s brief employment, the employer hired three subcontractors, “so it was a total of eight people,” and as employees of the subcontractor were treated the same as the employer’s own employees, the burden was on the employer to prove the number of employees the subcontractors employed. The employer produced no evidence in that regard. Hoffman v. Carter, 50 Va. App. 199, 648 S.E.2d 318, 2007 Va. App. LEXIS 298 (2007).

    When contractor responsible for employees of subcontractors. —

    A contractor is responsible for workers’ compensation benefits for a subcontractor’s employee if the contractor has no employees but two of his subcontractors have a total of three employees between them. Smith v. Weber, 3 Va. App. 379, 350 S.E.2d 213, 3 Va. Law Rep. 1114, 1986 Va. App. LEXIS 372 (1986).

    Requisite full-time status under agriculture exemption not found. —

    Claimant failed to show that employer had at least three full-time employees regularly in service where sufficient credible evidence supported the commission’s finding that the laborers other than the two sons were part-time and seasonal. The laborers were free to work as much or as little as they wanted during the season and were paid by the hour or by the bushel. Also, the laborers did not work for an “indefinite period of time.” Their term of employment was fixed as the length of the season, and only the weather and the number of workers created any uncertainty as to the length of employment. Lynch v. Lee, 19 Va. App. 230, 450 S.E.2d 391, 1994 Va. App. LEXIS 668 (1994).

    An agricultural employee was not a full-time employee and, therefore, the employer only had two full-time employees, where the employee in question earned less than the other two employees and the employer did not use his normal employment capacity. Ray v. Radford, 1998 Va. App. LEXIS 312 (Va. Ct. App. June 2, 1998).

    High school students not full-time farm employees. —

    The Commission properly found that a partnership operating a dairy farm did not employ more than two full-time employees and, therefore, was not an “employer” under this section in that there was sufficient evidence for the commission to infer that no sense of permanence existed in the relationship between the employer and two high school students and that, because the boys were full-time students, the employer could not have utilized their normal employment capacity; credible evidence proved that the employer and the two boys all understood that the boys were full-time students who worked as their school and school-related activities permitted and as the needs of the employer required given the seasonal nature of farm work. Cosgrove v. Sowers, 2000 Va. App. LEXIS 692 (Va. Ct. App. Oct. 3, 2000).

    Total number of persons employed by subcontractors should be counted when calculating whether the contractor employs the minimum number of workers required for workers’ compensation coverage. Smith v. Weber, 3 Va. App. 379, 350 S.E.2d 213, 3 Va. Law Rep. 1114, 1986 Va. App. LEXIS 372 (1986).

    Failure to allege employment of requisite number of employees. —

    In action for wrongful death, in the absence of an allegation that the defendant had in its employ the requisite number of employees, or that it and its employees had voluntarily elected to be bound by the Act, as required by this section, it did not necessarily appear from the notice of motion for judgment that the Compensation Commission had jurisdiction of the subject matter of the litigation. Aistrop v. Blue Diamond Coal Co., 181 Va. 287 , 24 S.E.2d 546, 1943 Va. LEXIS 179 (1943).

    Regular employment of three or more employees not shown. —

    Painter who exempted himself from coverage under the Virginia Workers’ Compensation Act, who hired two employees on a part-time basis who worked sporadically less than 60 days out of the year, and who hired a worker who injured himself on the eighth day of his work on a project, did not regularly employ three or more persons in the operation of the business, even though all the people were working on the day of the accident, and the Virginia Workers’ Compensation Commission had no jurisdiction over the painter. Osborne v. Forner, 36 Va. App. 91, 548 S.E.2d 270, 2001 Va. App. LEXIS 431 (2001).

    Dismissal of workers’ compensation claim was affirmed where the employer presented evidence in the form of corporate minutes that it had fewer than three employees at the time of the claimant’s injury. Estate of Pelfrey v. Sorah, 2003 Va. App. LEXIS 387 (Va. Ct. App. July 8, 2003).

    The appeals court was bound by the Virginia Workers’ Compensation Commission’s findings that at the time of a claimant’s accident an employer did not “regularly employ” three or more employees to be subject to the Virginia Workers’ Compensation Act pursuant to § 65.2-101 ; the employer testified that his business only had two employees during the period from December of 2000 until August of 2001. The factual finding that the employer’s “established mode of performing business” did not regularly require three or more employees was supported by the employer’s testimony that he chose not to replace an employee because he did not need the additional worker. Perry v. Delisle, 46 Va. App. 57, 615 S.E.2d 494, 2005 Va. App. LEXIS 309 (2005).

    Appellate court did not have jurisdiction over the claim made by the decedent’s estate for death benefits pursuant to § 65.2-512 of the Virginia Workers’ Compensation Act, § 65.2-100 et seq.; in order for decedent to have been an employee whose estate was eligible for death benefits, the employer had to have had three employees “regularly in service” in the Commonwealth at the time of the death of decedent, pursuant to § 65.2-101 , and the employer only had two such employees, including decedent himself. Uninsured Employer's Fund v. Gabriel, 272 Va. 659 , 636 S.E.2d 408, 2006 Va. LEXIS 98 (2006) (reversing 47 Va. App. 95, holding that evidence in record did not support a finding that the Commission had jurisdiction.).

    Trial court did not err in granting the subcontractor’s demurrer in the general contractor’s indemnity action against the subcontractor after the injured employee of the subcontractor obtained workers’ compensation benefits from the general contractor; the general contractor in its indemnity action had to show that the subcontractor was liable to pay the workers’ compensation benefits, but the general contractor failed to plead facts showing that the subcontractor, which had a principal place of business in Maryland, was subject to the Virginia Workers’ Compensation Act, § 65.2-100 et seq., as the general contractor did not show that the subcontractor had at least three employees regularly in the service of the Commonwealth, as was required pursuant to § 65.2-101 to subject an employer to the Act. Mark Five Constr., Inc. v. Castle Contr., 274 Va. 283 , 645 S.E.2d 475, 2007 Va. LEXIS 80 (2007).

    Employer was not subject to the Workers’ Compensation Act under § 65.2-101 because the employer’s window replacement project took months to complete and during that interval, the employer hired three workers simultaneously for one and a half days, which did not constitute regularly-recurring periods; the employer installed at least half of the windows himself, without the help of any employees, and he did not regularly employ three or more employees. Ragland v. Muguruza, 59 Va. App. 250, 717 S.E.2d 842, 2011 Va. App. LEXIS 396 (2011).

    As there was sufficient evidence to support the finding that an employer did not have three or more employees regularly in its service prior to an employee’s injury pursuant to § 65.2-101 , it was properly determined that the Workers’ Compensation Commission lacked jurisdiction over the employee’s benefits request. Mirarchi v. Whistle Stop Hobbies, LLC, 2013 Va. App. LEXIS 129 (Va. Ct. App. Apr. 23, 2013).

    Regular employment of three or more employees shown. —

    Virginia Workers’ Compensation commission properly determined that an employer was subject to the commission’s jurisdiction in a victim’s claim for injuries sustained while working for the employer as a truck driver, as the employer had regularly in service, three or more employees at the time of the victim’s accident. Va. Uninsured Emplr. Fund v. Nunn, 2003 Va. App. LEXIS 156 (Va. Ct. App. Mar. 25, 2003).

    Employer, a professional ice hockey team, did not have more than three employees regularly in service within the Commonwealth of Virginia as required by § 65.2-101 and was, therefore, not subject to the Workers’ Compensation Act; therefore, claimant, an injured player was properly denied workers’ compensation benefits. Bois v. Huntington Blizzard, 39 Va. App. 216, 571 S.E.2d 924, 2002 Va. App. LEXIS 683 (2002).

    Regularly in service less than three employees. —

    Employer, whose son was properly deemed his third employee, was appropriately assessed a fine, pursuant to § 65.2-805 for failing to carry workers’ compensation coverage; evidence showed that the son worked at the employer’s direction, was paid a wage, used the company vehicle to various work sites, and the employer established quitting time, given the workers, including his son, their individual work assignments. Perkey v. Fridley, 2003 Va. App. LEXIS 31 (Va. Ct. App. Jan. 28, 2003).

    Mere fact that the employer performed only small percentage of its overall business in Virginia did not mean that the service of its employees within Virginia was not regular; the employer held itself out as willing and able to perform restoration work in Virginia and operated regularly in the state. Mark Five Constr. Co. v. Gonzalez, 42 Va. App. 59, 590 S.E.2d 81, 2003 Va. App. LEXIS 692 (2003).

    Workers’ Compensation Commission erred in assessing a fine against the company for failing to maintain workers’ compensation insurance; the Commission had found the company had a total of three employees, which triggered the necessity of maintaining workers’ compensation insurance. However, with the conclusion that an “employee” was actually an independent contractor, the company had less than three employees and was thus exempt from the provisions of the Workers’ Compensation Act; thus, the imposition of the fine by the Commission was erroneous. Creative Designs Tattooing Assocs. v. Estate of Parrish, 56 Va. App. 299, 693 S.E.2d 303, 2010 Va. App. LEXIS 212 (2010).

    V.Employer.

    Editor’s note.

    Many of the cases annotated under the heading “Employer” were decided under former § 65.1-3 or prior law.

    Family relationship between employer and claimant. —

    The definition of “employers” in former § 65.1-3 and the definition of “employee” in former § 65.1-4 were all inclusive and made no exception, as some of the Workmen’s (now Workers’) Compensation Acts do, because of family relationship between the employer and employee. Thus the fact that the employer was the husband of the claimant did not bar claimant from receiving death benefits payable to the dependents of a deceased employee. The rule that a wife could not sue her husband in tort did not bar such a recovery by the claimant because a proceeding under the Workmen’s (now Workers’) Compensation Act was not based upon tort. Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    Status as “employer” does not fluctuate. —

    Workers’ compensation claimant that worked for an employer with a seasonal amusement park business, in which there were well over three employees during the peak season, was entitled to workers’ compensation benefits when the claimant was injured on the job, even though the claimant was the only employee at the time of the claimant’s injury; the claimant’s status as a covered employee would not fluctuate merely because the injury occurred at the end of the season when the employer needed one employee on the payroll, as opposed to during the height of the amusement park season. Uninsured Employer's Fund v. Cornelius, 2003 Va. App. LEXIS 142 (Va. Ct. App. Mar. 18, 2003).

    Insurance carrier not excepted from definition of “employer.” —

    The modifying words “so far as applicable” in former § 65.1-3 did not except an insurance carrier from the definition of an employer. Williams v. United States Fid. & Guar. Co., 358 F.2d 799, 1966 U.S. App. LEXIS 7090 (4th Cir. 1966).

    Insurer is not merely made the guarantor of the employer, but rather the primary obligor answerable for all promises this title makes to the employee. Williams v. United States Fid. & Guar. Co., 358 F.2d 799, 1966 U.S. App. LEXIS 7090 (4th Cir. 1966).

    While not employers pursuant to this section, contractors may be liable under § 65.2-302 . —

    Where neither subcontractor nor general contractor used the service of any of the claimants for pay, neither falls within the definition of “employer” set forth in this section. However, both are subject to liability for awards to the claimants under the Virginia Workers’ Compensation Act because of their status as statutory employers pursuant to § 65.2-302 . Sites Constr. Co. v. Harbeson, 16 Va. App. 835, 434 S.E.2d 1, 10 Va. Law Rep. 107, 1993 Va. App. LEXIS 328 (1993).

    Virginia Workers’ Compensation Commission did not err in finding that a company was an “employer” under the Virginia Workers’ Compensation Act, subsection A of § 65.2-302 , because the company conducted its business primarily through the employees of its other family-owned business and contracted with that business to perform the upkeep and day-to-day operations of its business, and the Commission had sufficient evidence to conclude that those employees were engaged in the regular business of the company; as such, those employees were statutory employees of the company at the time of claimant’s accident, and the company fell under the jurisdiction of the Act. Sherman & Sherman Props. v. Long, 2011 Va. App. LEXIS 128 (Va. Ct. App. Apr. 12, 2011).

    Owner not construction worker’s statutory employer. —

    Decedent, an employee of a contractor hired by an owner to construct warehouses, was not engaged in the owner’s trade or business when he suffered fatal injuries in the course of employment, as his construction work was not part of the owner’s business, which was real estate development; thus, the owner was not his statutory employer, and workers compensation exclusivity under § 65.2-307 did not bar plaintiff’s wrongful death suit against the owner. Rodriguez v. Leesburg Bus. Park, LLC, 287 Va. 187 , 754 S.E.2d 275, 2014 Va. LEXIS 25 (2014).

    VI.Injury.
    A.In General.

    Editor’s note.

    A fair reading of the act and its purposes treats the term “injury” as either a mental or a physical condition, affecting the employee’s person; thus, employee, whose defamation action claimed general damages and alleged no personal injury, was not bound by exclusivity provisions of the Act. Snead v. Harbaugh, 241 Va. 524 , 404 S.E.2d 53, 7 Va. Law Rep. 2386, 1991 Va. LEXIS 54 (1991).

    The philosophy which supports the Workmen’s (now Workers’) Compensation Act is that the wear and tear of human beings in modern industry should be charged to the industry, just as the wear and tear of machinery has always been charged. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    Consistent with the philosophy of workers’ compensation, industry properly should be charged with the expense of injury which occurs at a place furnished as an incident to the employment and happens at a time when employees reasonably can be expected to use the designated area, even though the specific location is not owned or maintained by the employer. Barnes v. Stokes, 233 Va. 249 , 355 S.E.2d 330, 3 Va. Law Rep. 2332, 1987 Va. LEXIS 192 (1987).

    Former § 65.1-23.1 did not alter “injury by accident” definition. —

    The General Assembly, in enacting former § 65.1-23.1 (now § 65.2-301 ), did not alter the definition of “injury by accident” found in Virginia case law as it relates to intentional act of sexual assault as coming within, rather than excluded from, the purview of the Act. Haddon v. Metropolitan Life Ins. Co., 239 Va. 397 , 389 S.E.2d 712, 6 Va. Law Rep. 1613, 1990 Va. LEXIS 30 (1990).

    In order to recover compensation for a work-related injury under the Workers’ Compensation Act, one must satisfy the requirements of this section which prescribe the nature of compensable injuries. Vaden Co. v. Keiser, 1994 Va. App. LEXIS 24 (Va. Ct. App. Jan. 25, 1994).

    Compensation is provided for injuries which: (1) are caused by accident; (2) arise out of the employment; and (3) occur in the course of employment. Vaden Co. v. Keiser, 1994 Va. App. LEXIS 24 (Va. Ct. App. Jan. 25, 1994).

    Compensable consequences. —

    Any discussion of the doctrine of compensable consequences must recognize the basic concept that a disputed accidental injury must arise out of and be in the course of employment in order to be compensable. Amoco Foam Prods. Co. v. Johnson, 257 Va. 29 , 510 S.E.2d 443, 1999 Va. LEXIS 21 (1999).

    Workers’ Compensation Commission properly awarded medical benefits to an employee for a compensable consequence injury because after the first doctor performed arthroscopic surgery on the employee’s left knee, he found a fracture in that area of the knee that was subsequently determined to be directly related to the surgical reshaping of the knee during the surgery, which fracture was compensable, and nothing in the record indicated that employer instructed the employee to return to the first doctor. Vital Link, Inc. v. Hope, 69 Va. App. 43, 814 S.E.2d 537, 2018 Va. App. LEXIS 164 (2018).

    Under this section three elements must be proved: (1) an injury by accident; (2) the injury must have arisen out of the employment, and (3) it must have occurred in the course of employment. Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958).

    Injuries must be traced to employment as a cause. —

    Recovery may be had for accidental injuries arising out of and in the course of the employment. Such injuries must be traced to the employment as a cause. A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 , 1938 Va. LEXIS 287 (1938).

    Remedy not exclusive in absence of any of three elements. —

    The critical inquiry when an employer asserts that workers’ compensation is an employee’s exclusive remedy is whether the employee’s injury was (1) an injury by accident, (2) arising out of, (3) and in the course of, the employee’s employment; if any one of these elements is missing, then the employee’s claim is not covered by the workers’ compensation act and the employee can proceed with a personal injury claim in court. Combs v. VEPCO, 259 Va. 503 , 525 S.E.2d 278, 2000 Va. LEXIS 38 (2000).

    The link of causation must directly connect the original accidental injury with the additional injury for which compensation is sought. Amoco Foam Prods. Co. v. Johnson, 257 Va. 29 , 510 S.E.2d 443, 1999 Va. LEXIS 21 (1999).

    Causation proved. —

    Evidence supported the Virginia Workers’ Compensation Commission’s decision that the worker’s injury arose out of and in the course of her employment and that her disability was caused by that fall because, while the worker was unable to state with certainty what caused her fall, she consistently claimed that something on the floor caused her feet to slip out from underneath her when she turned the corner and, from the evidence, it was a reasonable inference that something on the floor caused the worker to fall; although the medical evidence did not establish that her injuries were caused by the slip and fall, the history recorded in her medical records was consistent with her testimony and reflected that the injury resulted from the work-related fall. Lakehouse Restaurant/Zak, Inc. v. Tiller, 2003 Va. App. LEXIS 618 (Va. Ct. App. Dec. 2, 2003).

    Stipulations. —

    Claimant suffered a compensable injury to the claimant’s right shoulder because the employer, by stipulating that several of the claimant’s injuries sustained in a slip and fall accident at work were compensable, conceded that the claimant suffered at least one sudden mechanical or structural change to the claimant’s body. thereafter, the claimant could prove an injury was compensable by causally connecting it to the accident, even if the claimant could not demonstrate it was connected to the mechanical or structural change. Alexandria City Pub. Schs. v. Handel, 70 Va. App. 349, 827 S.E.2d 384, 2019 Va. App. LEXIS 114 (2019), vacated, 299 Va. 191 , 848 S.E.2d 816, 2020 Va. LEXIS 115 (2020), different results reached on reh'g, No. 1582-18-4, 2021 Va. App. LEXIS 78 (Va. Ct. App. May 11, 2021).

    Had plaintiff, as a retired firefighter, been employed at the time of his incapacity, he would have been entitled to compensation. Plaintiff may have been entitled to compensation if he had even been actively seeking employment on the basis of lost earning capacity. Since neither of these situations applied to the plaintiff, he had no income for the preceding fifty-two weeks and he was not attempting to earn income at the time of his incapacity, and therefore, the plaintiff was not entitled benefits. Arlington County Fire Dept. v. Stebbins, 21 Va. App. 570, 466 S.E.2d 124, 1996 Va. App. LEXIS 55 (1996).

    Hearing loss caused by prolonged exposure to noise at work is a noncompensable gradually incurred injury. Allied Fibers v. Rhodes, 23 Va. App. 101, 474 S.E.2d 829, 1996 Va. App. LEXIS 584 (1996).

    Injury resulting from overuse is not compensable. —

    Injury resulting from cumulative trauma, or “overuse,” is not compensable. Merillat Indus., Inc. v. Parks, No. 0222-91-3 (Ct. of Appeals Mar. 31, 1992).

    “Injuries resulting from a repetitive trauma . . . as well as injuries sustained at an unknown time, are not ‘injuries by accident’ within the meaning of § 65.1-7 [now § 65.2-101 ].” Bowers v. TRW, Inc., 1996 Va. App. LEXIS 272 (Va. Ct. App. Apr. 16, 1996).

    Idiopathic condition. —

    When an employee’s injuries result from an idiopathic condition and no other factors intervene or operate to cause or contribute to the injuries sustained as a result of the idiopathic condition, no award shall be made. Sweet v. KMart Corp., 1995 Va. App. LEXIS 460 (Va. Ct. App. May 23, 1995).

    The effects of an idiopathic fall are compensable if the employment places the employee in a position increasing the dangerous effects of such a fall, such as on a height, near machinery or sharp corners, or in a moving vehicle. Sweet v. KMart Corp., 1995 Va. App. LEXIS 460 (Va. Ct. App. May 23, 1995).

    “Disease” does not equate with “injury.” —

    The language “injury” does not include a disease in any form, as used in this section, but is language of limitation. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Just because a doctor opines that a particular impairment is a “disease” does not necessarily make it so. Whether a claimant suffers from a disease within the contemplation of the Workers’ Compensation Act is a mixed question of law and fact. Whether a proper definition has been used to test the authenticity of a doctor’s opinion is strictly a legal question. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    An impairment resulting from cumulative trauma caused by repetitive motion is an impairment which must be classified as an injury, not a disease, and is not compensable. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Job-related impairments resulting from cumulative trauma caused by repetitive motion, however labeled or however defined, are, as a matter of law, not compensable under the present provisions of the Workers’ Compensation Act. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Evidence that existing disorder reaches point of disablement during employment does not prove accidental or other injury arising out of such employment. Liberty Mut. Ins. Co. v. Money, 174 Va. 50 , 4 S.E.2d 739, 1939 Va. LEXIS 140 (1939).

    Sudden shock or fright with no physical impact may be “injury.” —

    There is an accidental or personal injury within this section where an employee, in the course of his employment, receives a sudden shock or fright, involving no physical impact, which results in his disability. Burlington Mills Corp. v. Hagood, 177 Va. 204 , 13 S.E.2d 291, 1941 Va. LEXIS 207 (1941), limited, Chesterfield County v. Dunn, 9 Va. App. 475, 389 S.E.2d 180, 6 Va. Law Rep. 1384, 1990 Va. App. LEXIS 31 (1990).

    Reaction from former injury. —

    At the time of the accident, appellee was working at a machine near an electric motor on which there occurred a short circuit which produced an electrical flash. Appellee saw the flash and started to fall backwards when she was rescued by a coemployee. She continued to work for approximately one month, until while at work she looked up and suddenly saw the employee that had caught her when she fell before. She thereupon fainted, and did not return to work thereafter. It was held that the injury arose out of and in the course of her employment, since the subsequent happening was but a reaction from the injury of the former day. Burlington Mills Corp. v. Hagood, 177 Va. 204 , 13 S.E.2d 291, 1941 Va. LEXIS 207 (1941), limited, Chesterfield County v. Dunn, 9 Va. App. 475, 389 S.E.2d 180, 6 Va. Law Rep. 1384, 1990 Va. App. LEXIS 31 (1990).

    A finding that a pre-existing condition was accelerated or aggravated by an injury sustained in an industrial accident establishes a causal connection between the injury and the disability, and the disability resulting thereof is compensable under the Workers’ Compensation Act. Corning, Inc. v. Testerman, 25 Va. App. 332, 488 S.E.2d 642, 1997 Va. App. LEXIS 523 (1997).

    Injury by intentional tort of employer or fellow employee. —

    An injury caused by the intentional tort of an employer or fellow employee is within the definition of injury by accident under the Workers’ Compensation Act. Haddon v. Metropolitan Life Ins. Co., 239 Va. 397 , 389 S.E.2d 712, 6 Va. Law Rep. 1613, 1990 Va. LEXIS 30 (1990).

    Willful misconduct. —

    Virginia Workers’ Compensation Commission did not err in concluding that an employer proved its affirmative defense of willful misconduct because credible evidence supported a finding that the claimant’s willful violation of his employer’s rule and the statutory requirement proximately caused his injuries; the Commission could reasonably infer that the claimant’s injuries resulted from being thrown out of the driver’s seat, which was a consequence of his failure to wear a seatbelt. Mailloux v. Am. Transp., 2018 Va. App. LEXIS 260 (Va. Ct. App. Oct. 9, 2018).

    Injury from maritime tort. —

    When an employee suffers injury from a maritime tort, which is within the jurisdiction of admiralty, the workmen’s (now workers’) compensation statutes of the several states have no application. Colonna Shipyard, Inc. v. Bland, 150 Va. 349 , 143 S.E. 729 , 1928 Va. LEXIS 318 (1928); Colonna Shipyard v. Dunn, 151 Va. 740 , 145 S.E. 342 , 1928 Va. LEXIS 270 (1928), cert. denied, 279 U.S. 840, 49 S. Ct. 253, 73 L. Ed. 986, 1929 U.S. LEXIS 160 (1929).

    The workmen’s (now workers’) compensation statutes of the several states are, under the federal Constitution, invalid and ineffectual to the extent that they undertake to prescribe the rights, remedies, and liabilities, as between employer and employee, when the employee receives a maritime injury or suffers death through a maritime casualty, while engaged in a maritime employment or the performance of a maritime contract. Colonna Shipyard v. Dunn, 151 Va. 740 , 145 S.E. 342 , 1928 Va. LEXIS 270 (1928), cert. denied, 279 U.S. 840, 49 S. Ct. 253, 73 L. Ed. 986, 1929 U.S. LEXIS 160 (1929).

    Injury sustained while working on vessel on high land. —

    Where the employment related to work to be done on a completed vessel, which was on high land, and the injury was there sustained, the tort was nonmaritime, and came within this Act, the federal law being inapplicable. Colonna's Shipyard, Inc. v. Lowe, 22 F.2d 843, 1927 U.S. Dist. LEXIS 1610 (D. Va. 1927).

    Emergency situation. —

    Claimant’s testimony, along with doctor’s records, supported the commission’s finding that claimant’s treatment and surgery were required because of an emergency. John W. Daniel & Co. v. Hyler, 1994 Va. App. LEXIS 210 (Va. Ct. App. Apr. 5, 1994).

    Back injury, resulting from squatting, absent other evidence, not compensable. —

    An injury, such as claimant’s back injury, that results from merely squatting, absent evidence that the conditions of the workplace or that some significant work-related exertion caused the injury, is not compensable. Conley v. Celanese, 1994 Va. App. LEXIS 457 (Va. Ct. App. July 12, 1994).

    Twisting in chair. —

    Injuries from simple acts such as walking, bending, turning, or, in the instant case, twisting in a chair at work, do not arise out of the employment absent some condition of the employment which contributes to the injury. Beatty v. Narricot Indus., Inc., 1997 Va. App. LEXIS 281 (Va. Ct. App. Apr. 29, 1997).

    Where disability has two causes, one related to employment and one unrelated, benefits are allowed. Hechts v. Randolph, 1995 Va. App. LEXIS 106 (Va. Ct. App. Feb. 7, 1995).

    The principle is well established that where a disability has two causes: one related to the employment and one unrelated to the employment, full benefits will be allowed. Ferguson v. Limitorque Corp., 2000 Va. App. LEXIS 341 (Va. Ct. App. May 9, 2000).

    B.Accident.

    To establish a prima facie claim for compensation for an injury by accident, claimant must prove, by a preponderance of evidence: (1) an identifiable incident; (2) that occurred at some reasonably definite time; (3) with an obvious, sudden mechanical or structural change in the body; and (4) a causal connection between the incident and the bodily change. H.N. Funkhouser & Co. v. Kirby, No. 0999-91-4 (Ct. of Appeals Oct. 22, 1991); Southside Va. Training Ctr. v. Jones, No. 2898-98-2 (Ct. of Appeals Jan. 11, 2000).

    Injury must result from accident. —

    It is clear that the Virginia Workmen’s (now Workers’) Compensation Act, like the English workmen’s compensation law, provides compensation only for “injury by accident” (or occupational disease), and not for every “personal injury” an employee may sustain. The Virginia Act makes the occurrence of an accident a condition precedent to compensation. Clinchfield Carbocoal Corp. v. Kiser, 139 Va. 451 , 124 S.E. 271 , 1924 Va. LEXIS 122 (1924); Honaker & Feeney v. Hartley, 140 Va. 1 , 124 S.E. 220 , 1924 Va. LEXIS 152 (1924).

    To establish an “injury by accident,” a claimant must prove (1) that the injury appeared suddenly at a particular time and place and upon a particular occasion, (2) that it was caused by an identifiable incident or sudden precipitating event, and (3) that it resulted in an obvious mechanical or structural change in the human body. Southern Express v. Green, 257 Va. 181 , 509 S.E.2d 836, 1999 Va. LEXIS 9 (1999); Avis Rent a Car, Inc. v. Calvin, 2000 Va. App. LEXIS 745 (Va. Ct. App. Nov. 21, 2000).

    Courts are liberal in construing the word “accident.” A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 , 1938 Va. LEXIS 287 (1938); Hopson v. Hungerford Coal Co., 187 Va. 299 , 46 S.E.2d 392, 1948 Va. LEXIS 223 (1948).

    The words “injury by accident” must be liberally construed in favor of the workman to carry out the humane and beneficent purposes of the Act. Aistrop v. Blue Diamond Coal Co., 181 Va. 287 , 24 S.E.2d 546, 1943 Va. LEXIS 179 (1943) (see Lynchburg Foundry Co. v. Irvin, 178 Va. 265 , 16 S.E.2d 646 (1941)).

    Which should be defined in a popular sense rather than a technical sense. Lynchburg Foundry Co. v. Irvin, 178 Va. 265 , 16 S.E.2d 646, 1941 Va. LEXIS 162 (1941).

    It does not have same meaning as words used in accident insurance policies. —

    The term “injury by accident” used in Workmen’s (now Workers’) Compensation Act does not have the same meaning as the words “bodily injury, or death sustained by external, violent and accidental means,” generally used in accident insurance policies. Big Jack Overall Co. v. Bray, 161 Va. 446 , 171 S.E. 686 , 1933 Va. LEXIS 335 (1933).

    Injuries not “injuries by accident.” —

    Injuries resulting from repetitive trauma, continuing mental or physical stress, or other cumulative events, as well as injuries sustained at an unknown time, are not “injuries by accident” within the meaning of this section. Morris v. Morris, 238 Va. 578 , 385 S.E.2d 858 (1989); Riley v. Eastern State Hosp., No. 1961-89-1 (Ct. of Appeals Nov. 13, 1990).

    Virginia Workers’ Compensation Commission did not err in concluding that a claimant failed to prove that he suffered a compensable injury where the claimant’s testimony showed that he repeated the same combination of movements to rotate and move 14 smart boards back and forth from sides of a room. Daggett v. Old Dominion Univ., 2018 Va. App. LEXIS 243 (Va. Ct. App. Sept. 25, 2018).

    Terms “accident” and “injury” are not synonymous. The term “accident” refers to the incident or precipitating event (the cause) that occurred at work which resulted in an “injury” (the effect). Haigh v. Matsushita Elec. Corp. of Am., 676 F. Supp. 1332, 1987 U.S. Dist. LEXIS 12113 (E.D. Va. 1987).

    “Accident” defined. —

    An accident is an event happening without any human agency, or, if happening through human agency, an event which, under the circumstances, is unusual and not expected by the person to whom it happens. It is an event which creates an effect which is not the natural or probable consequence of the means employed and is not intended, designed, or reasonably anticipated. It is a befalling; an event that takes place without one’s foresight or expectation; an undesigned, sudden, and unexpected event; a mishap resulting in injury to a person or thing. Lynchburg Foundry Co. v. Irvin, 178 Va. 265 , 16 S.E.2d 646, 1941 Va. LEXIS 162 (1941); Derby v. Swift & Co., 188 Va. 336 , 49 S.E.2d 417, 1948 Va. LEXIS 168 (1948); VEPCO v. Quann, 197 Va. 9 , 87 S.E.2d 624, 1955 Va. LEXIS 188 (1955); Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968).

    To constitute an injury by accident it is not necessary that there must be a “fall, slip or other fortuitous circumstance” nor an extraordinary occurrence in or about the work engaged in. Derby v. Swift & Co., 188 Va. 336 , 49 S.E.2d 417, 1948 Va. LEXIS 168 (1948); VEPCO v. Quann, 197 Va. 9 , 87 S.E.2d 624, 1955 Va. LEXIS 188 (1955); Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968).

    Where the effect was not the natural and probable consequence of the means employed, and was not intended or designed, the injury resulting was produced by accidental means. Hall's Bakery v. Kendrick, 176 Va. 346 , 11 S.E.2d 582, 1940 Va. LEXIS 258 (1940); Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968).

    “Mishap,” “fortuitous happening,” “untoward event.” —

    If the incident which gives rise to the injurious results complained of can be classed properly as a “mishap,” or “fortuitous” happening — an “untoward event, which is not expected or designed” — it is an accident within the meaning of the Workmen’s (now Workers’) Compensation Act. Tyree v. Commonwealth, 164 Va. 218 , 179 S.E. 297 (1935), applying the rule where a workman, while loading a truck, saw a stone, too large to be loaded, lying near the pile that he was loading, with a piece of dynamite attached to it by a sliver of shale, and believing the dynamite to be dead because of the presence of water on the rock, attempted to knock off the shale with a sprawl fork, but struck the dynamite which exploded, seriously injuring him. See also Hurd v. Hesse & Hurt, 161 Va. 800 , 172 S.E. 289 , 1934 Va. LEXIS 303 (1934).

    “Accident” may refer to result as well as cause. —

    The “by accident” portion of the requirement of this section may be satisfied by showing that an attack, which happens while employee was engaged in work activity, while perhaps not accidental as to cause, was accidental as to result. D.W. Mallory & Co. v. Phillips, 219 Va. 845 , 252 S.E.2d 319, 1979 Va. LEXIS 180 (1979).

    Unexplained accident. —

    A claimant who suffers an unexplained accident on the job and cannot recall how the accident occurred is not entitled to the presumption that the injury arose out of his employment. Claimant must prove by a preponderance of the evidence that the fall “arose out of” the employment by establishing a causal connection between his or her employment and the fall. This burden was not met where claimant has no recollection of the events leading up to his injury or the accident itself; no one saw the accident occur and no one was in the vicinity when the claimant was injured; and evidence presented did not establish the nature of the claimant’s fall or how he was injured and did not rule out the possibility that his injuries resulted from a noncompensable accident. Grand Piano & Furn. Co. v. Gray, 1997 Va. App. LEXIS 791 (Va. Ct. App. Apr. 29, 1997).

    Workers’ Compensation Commission did not err in denying the employee’s claim for benefits because the employee’s accident did not arise out of her employment only as neither her testimony nor the medical evidence established a causal connection between her employment and her injuries because the employee stated that she did not remember the cause of her accident, and she did not present any medical evidence affirmatively establishing a cause. Burney-Divens v. Cmty. Corr. Admin., 2016 Va. App. LEXIS 145 (Va. Ct. App. May 3, 2016).

    Same injury need not happen to others. —

    Whether an injury is the result of an accident does not depend on whether the same injury might happen to others. Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968).

    The causative incident need not be instantaneous in order to have occurred “suddenly” and at a particular time so as to give rise to a compensable claim. Goodyear Tire & Rubber Co. v. Harris, 35 Va. App. 162, 543 S.E.2d 619, 2001 Va. App. LEXIS 148 (2001).

    Accident must be unexpected and specific in time. —

    Two concepts are generally recognized and discussed when interpreting the “by accident” concept in Virginia. These concepts are a required degree of “unexpectedness” in the accident or injury, and a requirement of time specificity as to the occurrence of the accident or incident giving rise to the injury. Haigh v. Matsushita Elec. Corp. of Am., 676 F. Supp. 1332, 1987 U.S. Dist. LEXIS 12113 (E.D. Va. 1987).

    “Sudden” occurrence need not be unexpected. —

    Although a claimant must prove a “sudden” precipitating event that caused the injury, it is not necessary that there should be an extraordinary occurrence in or about the work engaged in; “sudden” is not used here to connote an unexpected consequence but to refer to a precipitating event that is one that immediately causes an injury, as distinguished from an injury that appears or occurs gradually. New River Castings Co. v. Woolwine, 2000 Va. App. LEXIS 802 (Va. Ct. App. Dec. 12, 2000).

    Injury must be shown to have occurred at some definite time and place. —

    The injury, to be regarded as “by accident,” must be received at a particular time and in a particular place and by a particular accident. And the accident must be something the date of which can be fixed. It is not enough that the injury shall make its appearance suddenly at a particular time and upon a particular occasion. In other words the “incident,” the act done or condition encountered, must be shown to have occurred at some reasonably definite time. Aistrop v. Blue Diamond Coal Co., 181 Va. 287 , 24 S.E.2d 546, 1943 Va. LEXIS 179 (1943); Badische Corp. v. Starks, 221 Va. 910 , 275 S.E.2d 605, 1981 Va. LEXIS 227 (1981).

    Where an employee cannot identify his injury with a movement made or action taken at a particular time at work and arising out of and in the course of employment, he cannot recover compensation. Badische Corp. v. Starks, 221 Va. 910 , 275 S.E.2d 605, 1981 Va. LEXIS 227 (1981).

    Where employee had suffered pain in her back and leg for two years, and where she suffered such pain in increasing intensity on two consecutive days but could not attribute it to any identifiable movement, incident, or event on either day, she failed to meet her burden of proof; thus, there was no evidence to support an award of compensation. Badische Corp. v. Starks, 221 Va. 910 , 275 S.E.2d 605, 1981 Va. LEXIS 227 (1981).

    Workers’ Compensation Commission erred in finding that a police officer suffered a compensable, discrete injury by accident arising out of employment because the Commission assumed, but failed to find, that the officer’s testimony established an identifiable incident with sufficient temporal precision inasmuch as the assumption that the officer sustained a non-cumulative injury during the last four hours of training was justified based on his own testimony, and there was no specific finding to that effect. City of Charlottesville v. Sclafani, 70 Va. App. 613, 830 S.E.2d 52, 2019 Va. App. LEXIS 171 (2019).

    Identifiable incident must be shown. —

    In order to show that he has suffered an “injury by accident” arising out of ordinary exertion, a claimant must prove an “identifiable incident that occurs at some reasonably definite time,” which is the cause of “an obvious sudden mechanical or structural change in the body.” Lane Co. v. Saunders, 229 Va. 196 , 326 S.E.2d 702, 1985 Va. LEXIS 192 (1985); Kraft Dairy Group, Inc. v. Bernardini, 229 Va. 253 , 329 S.E.2d 46, 1985 Va. LEXIS 200 (1985); Bradley v. Philip Morris, U.S.A., 1 Va. App. 141, 336 S.E.2d 515, 1985 Va. App. LEXIS 75 (1985); Woody v. Mark Winkler Mgt., Inc., 1 Va. App. 147, 336 S.E.2d 518, 1985 Va. App. LEXIS 76 (1985); Pendleton v. Flippo Constr. Co., 1 Va. App. 381, 339 S.E.2d 210, 1986 Va. App. LEXIS 211 (1986).

    The “injury by accident” formulation has three components: (1) an identifiable incident; (2) a sudden mechanical or structural change in the body; and (3) a causal connection between the incident and the bodily change. A claimant must satisfy each part of the “injury by accident” test. Bradley v. Philip Morris, U.S.A., 1 Va. App. 141, 336 S.E.2d 515, 1985 Va. App. LEXIS 75 (1985).

    In order to carry his burden of proving an injury by accident a claimant must prove that the cause of his injury was an identifiable incident or sudden precipitating event and that it resulted in an obvious sudden mechanical change in the body. Thus, where the full commission, in reversing the deputy commissioner, found that claimant’s injury did not meet the requirement of an identifiable incident or sudden precipitating event but instead resulted from repetitive trauma or cumulative events credible evidence supported this finding; thus it would not be disturbed on appeal. Wilhelm v. Rockydale Quarries Corp., 1993 Va. App. LEXIS 571 (Va. Ct. App. Nov. 30, 1993).

    Fire fighter’s injury was the result of an identifiable incident that occurred at a reasonably definite time where his rescue of a man with a broken leg that took 45 minutes to accomplish was an identifiable incident, the fire fighter’s subsequent disc herniation was a sudden mechanical or structural change in the body, and there was a causal connection between the incident and the bodily change. Van Buren v. Augusta Cnty., 66 Va. App. 441, 787 S.E.2d 532, 2016 Va. App. LEXIS 196 (2016).

    Under some circumstances, a claimant need not be able to pinpoint the exact moment of injury in order for it to be compensable as an “injury by accident” under the Workers’ Compensation Act. Riverside Reg'l Jail Auth. v. Dugger, 68 Va. App. 32, 802 S.E.2d 184, 2017 Va. App. LEXIS 177 (2017).

    Identifiable incident occurred when claimant stepped on a used fastener in the service bays that penetrated claimant’s shoe and the bottom of his foot, which resulted in a puncture wound; this caused an obvious and sudden mechanical or structural change in claimant’s body because the puncture wound changed the anatomy of claimant’s foot, and thus claimant proved the first and third components of an injury by accident. Farrish of Fairfax v. Faszcza, 2020 Va. App. LEXIS 173 (Va. Ct. App. June 16, 2020).

    Thus injury resulting from cumulative effect of many unidentifiable factors is not compensable. —

    An injury of gradual growth, not the result of some particular piece of work or condition encountered on a definite occasion, but caused by the cumulative effect of many acts done or many exposures to conditions prevalent in the work, no one of which can be identified as the cause of the harm, is definitely excluded from compensation. Aistrop v. Blue Diamond Coal Co., 181 Va. 287 , 24 S.E.2d 546, 1943 Va. LEXIS 179 (1943).

    A gradually incurred injury is not an “injury by accident” within the meaning of the Workers’ Compensation Act. Middlekauff v. Allstate Ins. Co., 247 Va. 150 , 439 S.E.2d 394, 10 Va. Law Rep. 785, 1994 Va. LEXIS 10 (1994).

    Repetitive trauma. —

    Injuries resulting from repetitive trauma or continuing mental stress are not “injuries by accident.” Yon v. Investors Home Mtg. Group, No. 1817-89-2 (Ct. of Appeals Oct. 16, 1990).

    The medical evidence failed to establish an identifiable incident which caused an obvious sudden mechanical or structural change in claimant’s body. Even though claimant’s pain was related to the work she performed by the cumulative exertion of her work activities and was the cause of her current condition since it is well settled that injuries resulting from repetitive trauma or other cumulative events are not “injuries by accident” within the meaning of this section. United Coupon Mfg. Corp. v. Lupo, No. 0956-89-4 (Ct. of Appeals March 13, 1990).

    Claimant must identify injury with movement made or action taken at a particular time at work. Bradley v. Philip Morris, U.S.A., 1 Va. App. 141, 336 S.E.2d 515, 1985 Va. App. LEXIS 75 (1985).

    Objective showing of incident or event required. —

    A claimant must make an objective showing of an identifiable incident or sudden precipitating event to which an injury may be related causally. Bradley v. Philip Morris, U.S.A., 1 Va. App. 141, 336 S.E.2d 515, 1985 Va. App. LEXIS 75 (1985).

    Inhalation of poisonous gases may be accident. —

    Disability or death from inhaling poisonous gases is compensable as an injury resulting from an “accident,” provided the other circumstances are such as to bring the matter within the scope of the workmen’s (now workers’) compensation laws. Aistrop v. Blue Diamond Coal Co., 181 Va. 287 , 24 S.E.2d 546, 1943 Va. LEXIS 179 (1943).

    If it occurred at a particular time and on a particular occasion. —

    Where the disability or death of the employee is due to the inhalation of poisonous gases at a particular time and on a particular occasion which can be fixed with reasonable certainty, the event is an “injury by accident.” Aistrop v. Blue Diamond Coal Co., 181 Va. 287 , 24 S.E.2d 546, 1943 Va. LEXIS 179 (1943).

    A claimant sufficiently established the occurrence of an “accident” where the claimant was required to work with a particular glue in an enclosed space over the course of a day and, that evening, experienced breathing problems that resulted in his being taken to the hospital. The claimant’s intense exposure to the special glue over the course of a single day constituted an identifiable incident even though his symptoms did not manifest themselves instantly. Tremelon v. Commercial Constr. Corp., 2000 Va. App. LEXIS 801 (Va. Ct. App. Dec. 12, 2000).

    But injury by gradual inhalation over long period may not be compensable. —

    If the death of an employee was due to the gradual inhalation of poisonous gases over a considerable period, a common-law action for damages is the appropriate remedy. Blue Diamond Coal Co. v. Aistrop, 183 Va. 23 , 31 S.E.2d 297, 1944 Va. LEXIS 126 (1944).

    Injury from unusual or unusually strenuous work. —

    The requirement that the claimant prove an identifiable incident that occurs at some reasonably definite time applies also to an employee who claims injury as a result of work that is unusual to him or unusually strenuous, repetitive or stressful. Woody v. Mark Winkler Mgt., Inc., 1 Va. App. 147, 336 S.E.2d 518, 1985 Va. App. LEXIS 76 (1985).

    Conditions of employment exposing employee to unusual hazards. —

    If the injury or death results from, or is hastened by, conditions of employment exposing the employee to hazards to a degree beyond that of the public at large, the injury or death is construed to be accidental within the meaning of this section. Byrd v. Stonega Coke & Coal Co., 182 Va. 212 , 28 S.E.2d 725, 1944 Va. LEXIS 170, limited, Carter v. Hercules Powder Co., 182 Va. 282 , 28 S.E.2d 736, 1944 Va. LEXIS 177 (1944).

    Employee’s employment exposed him to hazards over and above those to which the public is exposed where he was working within the confines of a non-air-conditioned truck, repeatedly getting into and out of a truck, emptying from 350 to 400 containers into it, and performing in temperatures which had reached almost 90 degrees. Imperial Trash Serv. v. Dotson, 18 Va. App. 600, 445 S.E.2d 716, 11 Va. Law Rep. 9, 1994 Va. App. LEXIS 436 (1994).

    Accident aggravating existing disease. —

    An accident to an employee, which sets in motion his undeveloped and dangerous physical condition with mortal consequences, is properly classable as the proximate cause of the fatality. Justice v. Panther Coal Co., Inc., 173 Va. 1 , 2 S.E.2d 333, 1939 Va. LEXIS 170 (1939); Rogers v. Williams, 196 Va. 39 , 82 S.E.2d 601, 1954 Va. LEXIS 198 (1954).

    Claimants are entitled to compensation if an accidental injury so influenced the progress of an existing disease as to cause the employee’s death, as where death resulted from latent tuberculosis which had been aggravated and “caused to flare up” as a result of a compensable trauma. Justice v. Panther Coal Co., Inc., 173 Va. 1 , 2 S.E.2d 333, 1939 Va. LEXIS 170 (1939).

    Causal connection is established when it is shown that an employee has received a compensable injury which materially aggravates or accelerates a preexisting latent disease which becomes the direct and immediate cause of death or disability. Liberty Mut. Ins. Co. v. Money, 174 Va. 50 , 4 S.E.2d 739, 1939 Va. LEXIS 140 (1939); Ellis v. Commonwealth, 182 Va. 293 , 28 S.E.2d 730, 1944 Va. LEXIS 178 (1944); Rogers v. Williams, 196 Va. 39 , 82 S.E.2d 601, 1954 Va. LEXIS 198 (1954).

    When an injury sustained in an industrial accident accelerates or aggravates a preexisting condition, . . . disability resulting therefrom is compensable under the Workers’ Compensation Act. Olsten of Richmond v. Leftwich, 230 Va. 317 , 336 S.E.2d 893, 1985 Va. LEXIS 283 (1985).

    Presence of a preexisting physical condition is immaterial if the injury is proximately caused by an accident arising out of and in the course of the employment. The fact that the accident in and of itself would not have been sufficient to cause the injury in the absence of a preexisting disease is no defense, for the employer takes the employee as he finds him. If the accident accelerates or aggravates a preexisting condition, the injured party is entitled to compensation. On the other hand, an injury due solely to the natural progress of the preexisting disease is not compensable. Pendleton v. Flippo Constr. Co., 1 Va. App. 381, 339 S.E.2d 210, 1986 Va. App. LEXIS 211 (1986).

    Exacerbation due to negligent emergency medical treatment. —

    An employee who suffered a ruptured aneurysm at work and who alleged that her injury was the aggravation, exacerbation and/or acceleration of the aneurysm due to her employer’s negligence in providing emergency medical care alleged an “accident” under the workers’ compensation act. Combs v. VEPCO, 259 Va. 503 , 525 S.E.2d 278, 2000 Va. LEXIS 38 (2000).

    Usual exertion may produce accidental injury. —

    When usual exertion results in actually breaking, herniating, or letting go with an obvious sudden mechanical or structural change in the body, whether external or internal, the injury is accidental. VEPCO v. Quann, 197 Va. 9 , 87 S.E.2d 624, 1955 Va. LEXIS 188 (1955).

    But not when combined with preexisting disease. —

    Mere exertion, which is not greater than that ordinarily incident to employment but which combines with preexisting disease to produce disability is not compensable as an “accidental injury.” Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953).

    Chronic ailment rendering claimant susceptible to injury. —

    If death is brought about by an injury due to some mishap, or accident, happening during the course of his employment, the fact that deceased had a chronic ailment which rendered him more susceptible to such injury than an ordinary person would be, will not defeat the right to compensation. Liberty Mut. Ins. Co. v. Money, 174 Va. 50 , 4 S.E.2d 739, 1939 Va. LEXIS 140 (1939).

    Injury resulting from cumulative trauma caused by physical exertions inherent in employee’s normal work is not an “injury by accident” compensable under the Workers’ Compensation Act. Kraft Dairy Group, Inc. v. Bernardini, 229 Va. 253 , 329 S.E.2d 46, 1985 Va. LEXIS 200 (1985).

    Carpal tunnel syndrome caused by traumatic injury. —

    Carpal tunnel syndrome may qualify as an “injury by accident” under this section or as an “occupational disease” under § 65.2-401 , depending upon its pathology or how it is incurred. Ogden Aviation Servs. v. Saghy, 32 Va. App. 89, 526 S.E.2d 756, 2000 Va. App. LEXIS 253 (2000).

    A claimant who testified that he felt the sudden onset of pain extending from the fingers of his right hand to his right shoulder while connecting a fuel hose to an aircraft in extremely cold weather and that he had previously experienced no numbness or other problems with his right hand and who presented medical evidence establishing a causal connection between the injury at work and his carpal tunnel syndrome was entitled to compensation. Ogden Aviation Servs. v. Saghy, 32 Va. App. 89, 526 S.E.2d 756, 2000 Va. App. LEXIS 253 (2000).

    Evidence showed sudden mechanical change and identifiable incident. —

    Credible evidence supported the Commission’s decision that claimant, who injured her knee while cleaning a doughnut-making machine, suffered a sudden mechanical change in the body, i.e., sudden pain upon the locking of her knee and that it occurred during an identifiable incident, while backing out of the machine on her hands and knees. H.N. Funkhouser & Co. v. Kirby, No. 0999-91-4 (Ct. of Appeals Oct. 22, 1991).

    Claimant’s back injury was compensable, where the injury resulted from his effort to lift a tire onto a conveyor belt and claimant was able to trace an obvious mechanical change in his body to an identifiable incident. Goodyear Tire & Rubber Co. v. Jones, No. 0957-90-3 (Ct. of Appeals Oct. 22, 1991).

    Claimant suffered a compensable injury to the claimant’s right shoulder because the employer, by stipulating that several of the claimant’s injuries sustained in a slip and fall accident at work were compensable, conceded that the claimant suffered at least one sudden mechanical or structural change to the claimant’s body. thereafter, the claimant could prove an injury was compensable by causally connecting it to the accident, even if the claimant could not demonstrate it was connected to the mechanical or structural change. Alexandria City Pub. Schs. v. Handel, 70 Va. App. 349, 827 S.E.2d 384, 2019 Va. App. LEXIS 114 (2019), vacated, 299 Va. 191 , 848 S.E.2d 816, 2020 Va. LEXIS 115 (2020), different results reached on reh'g, No. 1582-18-4, 2021 Va. App. LEXIS 78 (Va. Ct. App. May 11, 2021).

    “Sudden” structural or mechanical change proven. —

    Award of temporary total disability benefits to the employee in a workers’ compensation action was proper because the record contained sufficient evidence from which the Workers’ Compensation Commission could have found that the employee suffered a sudden structural or mechanical change in his body, specifically, neck and lower spine injuries. Family Dollar Stores, Inc. v. Presgraves, 2010 Va. App. LEXIS 491 (Va. Ct. App. Dec. 21, 2010).

    Sufficient evidence of accident. —

    The evidence was sufficient to support the commission’ finding that the claimant had been injured in an accident where the claimant experienced pain in both knees while he was on his knees for forty-five minutes pulling fabric loose from inside a machine, and where, as soon as he removed himself from the machine, the claimant reported the incident and the pain to his supervisor. Goodyear Tire & Rubber Co. v. Harris, 35 Va. App. 162, 543 S.E.2d 619, 2001 Va. App. LEXIS 148 (2001).

    Because an employee suffered an increase in symptoms and was diagnosed with sciatica after a motor vehicle accident in a company van, there was credible evidence to support a finding that the employee proved the elements of an “injury by accident.” Inner Finish Sys. v. Queen, 2005 Va. App. LEXIS 525 (Va. Ct. App. Dec. 20, 2005).

    Workers’ compensation claimant sustained an injury by accident as: (1) the claimant worked three to four hours when the claimant noticed “a lot of dust and stuff in (the claimant’s) nostrils,” and the claimant began “coughing the stuff up pretty much,” (2) the claimant continued coughing and left work early the next day, and went to a physician at the first available opportunity, and (3) the claimant’s exposure to plaster dust was “bounded by rigid temporal precision.” Hoffman v. Carter, 50 Va. App. 199, 648 S.E.2d 318, 2007 Va. App. LEXIS 298 (2007).

    Virginia Workers’ Compensation Commission did not err in relying upon the opinions of two doctors who treated the claimant to conclude that the claimant’s shoulder injury was caused by the claimant’s fall at work because the evidence did not show that the claimant failed to reveal the claimant’s past shoulder problems to the doctors. In addition, there was credible evidence to support the Commission’s finding that the claimant’s shoulder injury was caused by the fall and was not related to the preexisting condition. Hyatt Regency Crystal City & Hyatt Corp. v. Spencer, 2011 Va. App. LEXIS 23 (Va. Ct. App. Jan. 25, 2011).

    Claimant was entitled to medical benefits and temporary total disability benefits because the evidence that the claimant felt a pop in the claimant’s lower back and had an immediate and lasting sensation of pressure while lifting crates at work along with the opinion of the claimant’s treating orthopedic surgeon supported the finding that the claimant suffered an injury by accident arising out of and in the course of the claimant’s employment. Davis & Green, Inc. v. Lowery, 2014 Va. App. LEXIS 60 (Va. Ct. App. Feb. 25, 2014).

    Workers’ Compensation Commission did not err in finding that a correctional officer’s knee injury was compensable because her injury was the result of an identifiable accident occurring at a reasonably definite time; the officer did not need to point to one exact instant when the injury occurred because the injury occurred during a four-hour defensive training class and thus, was sufficiently bounded by rigid temporal precision. Riverside Reg'l Jail Auth. v. Dugger, 68 Va. App. 32, 802 S.E.2d 184, 2017 Va. App. LEXIS 177 (2017).

    Workers’ Compensation Commission did not err in finding that a correctional officer’s knee injury was compensable because her injury was the result of an identifiable accident occurring at a reasonably definite time; the officer’s injury was a structural change to her body that occurred while she was engaged in her defensive training class, which was clearly work activity, and the movements during defensive training were not repetitive in nature. Riverside Reg'l Jail Auth. v. Dugger, 68 Va. App. 32, 802 S.E.2d 184, 2017 Va. App. LEXIS 177 (2017).

    Virginia Workers’ Compensation Commission did not err by awarding medical benefits to the claimant because he proved that his injury occurred during a reasonable definite time and was a compensable injury by accident as the evidence established that he fractured his wrist on August 18, 2017, during an afternoon training session that consisted of four hours of punching drills; his wrist was not swollen at the beginning of the day’s training and he first noticed swelling in his wrist within 60 to 90 minutes after he had finished the punching drills. DMV/Commonwealth v. Bandy, 2019 Va. App. LEXIS 100 (Va. Ct. App. Apr. 30, 2019).

    Facts not showing accidental injury. —

    While claimant was engaged in painting furniture for his employer, with a small spray gun, from which the spray was released by pressure from the thumb on a button, he noticed that the end of his thumb was a little sore. A bone felon developed and a physician said that the trouble either came from a bruise or an infected abrasion. There was nothing to indicate that it came from an abrasion, and claimant himself stated that it came from a bruise. Therefore, there was no accident as that term is defined by the Workmen’s (now Workers’) Compensation Act. Hurd v. Hesse & Hurt, 161 Va. 800 , 172 S.E. 289 , 1934 Va. LEXIS 303 (1934).

    Where the evidence submitted by claimant did not show that there was an “obvious sudden mechanical or structural change” in his body, or that there was any causal connection between his work-induced exertion and the physical change which he did experience, and he presented no medical opinion to show that his injury was work-connected, he failed to sustain his burden of proving injury “by accident.” Tomko v. Michael's Plastering Co., 210 Va. 697 , 173 S.E.2d 833, 1970 Va. LEXIS 186 (1970).

    Finding of the Commission that injury of employee, who suffered an acute lumbosacral strain, involved one gradual progression of events during the day, despite employee’s contention that in picking up a shovel at the end of the day he suffered a new compensable injury or a compensable aggravation of his morning injury, and that the employee had not sustained the burden of proving that he had suffered an injury by accident that arose out of his employment would be upheld. Pendleton v. Flippo Constr. Co., 1 Va. App. 381, 339 S.E.2d 210, 1986 Va. App. LEXIS 211 (1986).

    Where a worker’s preexisting asthma was exacerbated by general environmental triggers, there was not an injury by accident and the claimed workplace exposures did not qualify as compensable injuries by accident. Deard v. Riverside Reg'l Med. Ctr., 2003 Va. App. LEXIS 429 (Va. Ct. App. Aug. 12, 2003).

    Claimant’s workers’ compensation claim relating to injury to his knee was properly denied as he failed to present evidence that he sustained injury by accident pursuant to § 65.2-101 . Given the spectrum of potential non-work-related causes of the claimant’s knee injury in evidence and the absence of any medical evidence supporting the claimant’s testimony that his knee problems were caused by the work accident, reasonable minds could conclude that the claimant had failed to satisfy his burden of proof on the issue of causation. Myers v. Madison Wood Preservers, 2012 Va. App. LEXIS 217 (Va. Ct. App. July 3, 2012).

    Workers’ Compensation Commission erred in finding that a claimant had an “injury by accident” to her right shoulder because there was no credible evidence that she “suffered an actual mechanical or structural change” in her shoulder during her workplace accident since her symptoms of limited motion and “squeaking” did not manifest until more than a year after her accident, and, even assuming, without deciding, that her new shoulder problems constituted mechanical or structural changes, it could not be concluded that they occurred suddenly during her workplace accident, and absent any showing of a close temporal relationship to her fall, her symptoms could simply reflect an injury resulting from repetitive trauma, continuing mental or physical stress, or other cumulative events rather than an injury by accident. Alexandria City Pub. Sch. v. Handel, 2021 Va. App. LEXIS 78 (Va. Ct. App. May 11, 2021).

    Virginia Workers’ Compensation Commission did not err in finding that claimant did not suffer a compensable injury by accident under Va. Code Ann. § 65.2-101 , because his version of events was not credible as the medical records indicated that claimant sustained his injury when he fell down steps; not when he struck his knee on a ladder rung. The emergency room records indicated at least a year-long history of knee pain and buckling before the work-related incident occurred—an inconsistency which claimant could not explain. Mitchell v. Weather Control, Inc., 2021 Va. App. LEXIS 179 (Va. Ct. App. Oct. 5, 2021).

    Employer’s actions committed with intent to injure employee. —

    Defendant employer’s actions committed with intent to injure employee did not constitute “accidents” under this section and employee’s suit for intentional infliction of emotional distress was not barred by the exclusivity provision of the Virginia Workers’ Compensation Act. McGreevy v. Racal-Dana Instruments, Inc., 690 F. Supp. 468, 1988 U.S. Dist. LEXIS 6655 (E.D. Va. 1988).

    C.Arising Out of and in the Course of.
    1.Generally.

    The “arising out of employment” and “course of employment” tests are different and independent tests and courts must apply them separately to each situation. County of Chesterfield v. Goyne, 26 Bankr. 47, 1982 Bankr. LEXIS 5318 (Bankr. E.D. Va. 1982).

    Employee injured on the employer’s premises is entitled to compensation if the injury occurs as the result of an activity reasonably expected to be carried on by the employee during the course of his work, be it personal or directly work related; accordingly, plaintiff would be barred from recovery only if the activity resulting in the injury was not an activity reasonably expected of an employee under the conditions of the employment. Jones v. Colonial Williamsburg Found., 8 Va. App. 432, 382 S.E.2d 300, 6 Va. Law Rep. 104, 1989 Va. App. LEXIS 91 (1989) (see also 10 Va. App. 521, 392 S.E.2d 848 (1990)).

    Virginia has adopted the “actual risk test,” which requires only that the employment expose the workman to the particular danger from which he was injured, notwithstanding the exposure of the public generally to like risks. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972); Olsten of Richmond v. Leftwich, 230 Va. 317 , 336 S.E.2d 893, 1985 Va. LEXIS 283 (1985).

    In Virginia, the “actual risk” test determines whether an injury arises out of employment. Under this test, an injury arises out of employment if the injury follows as a natural incident of the work and could have been contemplated by one familiar with the whole situation. Francisco v. O’Sullivan Indus., No. 0469-91-3 (Ct. of Appeals Oct. 22, 1991).

    Under the actual risk test, a claimant’s injury arises out of the employment if the manner in which the employer requires the work to be performed is causally related to the resulting injury. Southside Virginia Training Center v. Ellis, 33 Va. App. 824, 537 S.E.2d 35, 2000 Va. App. LEXIS 757 (2000).

    In determining whether a work-related injury is compensable and, under this test, the causative danger must be peculiar to the work, incidental to the character of the business and not independent of the master-servant relationship. The test excludes injuries which the employee would have been equally exposed to apart from the employment. Dan River, Inc. v. Giggetts, 34 Va. App. 297, 541 S.E.2d 294, 2001 Va. App. LEXIS 61 (2001).

    The mere happening of an accident at the workplace, not caused by any work-related risk or significant work related exertion, is not compensable, and a claimant must establish that the conditions of the workplace or some significant work related exertion caused the injury, such that the arising out of test excludes an injury which comes from a hazard to which the employee would have been equally exposed apart from the employment. Helfer v. Va. Dep't of Rehabilitative Servs., 2003 Va. App. LEXIS 224 (Va. Ct. App. Apr. 15, 2003).

    Accident must arise both “out of” and “in the course of” employment to be compensable. —

    Under this section, an accident resulting in injury or death of an employee must arise out of and in the course of the employment, before compensation can be awarded. Kent v. Va.-Carolina Chemical Co., 143 Va. 62 , 129 S.E. 330 , 1925 Va. LEXIS 246 (1925); Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942); Grimes v. Janney-Marshall Co., 183 Va. 317 , 32 S.E.2d 76, 1944 Va. LEXIS 156 (1944); Grand Union Co. v. Bynum, 226 Va. 140 , 307 S.E.2d 456, 1983 Va. LEXIS 279 (1983).

    An injury suffered by an employee while engaged in his master’s business within the scope of his employment proximately resulting from the negligence of fellow employees is, as to the employee, an “accident” arising out of and in the course of his employment. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    Terms “arising out of” and “in the course of” are used conjunctively, and both conditions must concur before compensation will be awarded. Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925); Sullivan v. Suffolk Peanut Co., 171 Va. 439 , 199 S.E. 504 , 1938 Va. LEXIS 296 (1938); A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 , 1938 Va. LEXIS 287 (1938); Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968); Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972); Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978); Fouts v. Anderson, 219 Va. 666 , 250 S.E.2d 746, 1979 Va. LEXIS 157 (1979).

    “Arising out of” and “in the course of” are used conjunctively and are not synonymous. Both conditions must be satisfied before compensation can be awarded. Graybeal v. Board of Supvrs., 216 Va. 77 , 216 S.E.2d 52, 1975 Va. LEXIS 251 (1975); VPI & State Univ. v. Wood, 5 Va. App. 72, 360 S.E.2d 376, 4 Va. Law Rep. 621, 1987 Va. App. LEXIS 271 (1987).

    These terms are not synonymous. Bradshaw v. Aronovitch, 170 Va. 329 , 196 S.E. 684 , 1938 Va. LEXIS 191 (1938); Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958); Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962).

    The phrases “arising out of” and “in the course of” the employment are not synonymous, and the claimant must establish both conditions by a preponderance of the evidence before compensation will be awarded. R & T Invs., Ltd. v. Johns, 228 Va. 249 , 321 S.E.2d 287, 1984 Va. LEXIS 196 (1984); Metcalf v. A.M. Express Moving Sys., 230 Va. 464 , 339 S.E.2d 177, 1986 Va. LEXIS 147 (1986); Marketing Profiles, Inc. v. Hill, 17 Va. App. 431, 437 S.E.2d 727, 10 Va. Law Rep. 613, 1993 Va. App. LEXIS 580 (1993), limited, Bernard v. Carlson Cos. - TGIF, 60 Va. App. 400, 728 S.E.2d 508, 2012 Va. App. LEXIS 236 (2012).

    “Arising out of” and “in the course of” not totally independent concepts. —

    Although “arising out of” and “in the course of” are separate and distinct concepts, the two are not totally independent; frequently proof of one will incidentally tend to establish the other. VPI & State Univ. v. Wood, 5 Va. App. 72, 360 S.E.2d 376, 4 Va. Law Rep. 621, 1987 Va. App. LEXIS 271 (1987).

    Each case is determined on its particular facts. —

    Whether an injury to an employee in an industrial business arose “out of and in the course of the employment” of the injured employee may be very difficult to determine under some circumstances, and it is practically impossible to formulate any one definition that will include every injury embraced in these words, and will exclude all injuries not embraced therein, and little help toward the correct determination of the question in a particular case is derived from the consideration of other cases involving different circumstances. Honaker & Feeney v. Hartley, 140 Va. 1 , 124 S.E. 220 , 1924 Va. LEXIS 152 (1924).

    Whether an injury is incident to or connected with a particular business, that is, whether it arises out of and in the course of the employment, depends upon the peculiar circumstances of each case. No exact rule can be formulated by which every case can be decided. Railway Express Agency v. Lewis, 156 Va. 800 , 159 S.E. 188 , 1931 Va. LEXIS 232 (1931); Sullivan v. Suffolk Peanut Co., 171 Va. 439 , 199 S.E. 504 , 1938 Va. LEXIS 296 (1938).

    Test is general character of undertaking. —

    The test is whether the general character of the undertaking in which the deceased was engaged at the time of the accident arose out of and in the course of his employment. Kent v. Va.-Carolina Chemical Co., 143 Va. 62 , 129 S.E. 330 , 1925 Va. LEXIS 246 (1925).

    Not the same test as whether servant acted within scope of employment. —

    The test for determining whether an accidental injury arose out of and in the course of the employment, within the meaning of this section, was not the same as the test for determining whether a servant acted within the scope of his employment under the doctrine of respondeat superior. Sayles v. Piccadilly Cafeterias, Inc., 242 Va. 328 , 410 S.E.2d 632, 8 Va. Law Rep. 1254, 1991 Va. LEXIS 147 (1991).

    The phrase “out of and in the course of his employment,” broadly defined, covers those accidents which befall an employee while he is discharging some duty he is authorized or directed to perform for the furtherance, directly or indirectly, of his employer’s business. Cohen v. Cohen's Dept. Store, 171 Va. 106 , 198 S.E. 476 , 1938 Va. LEXIS 261 (1938).

    The phrase “arising out of and in the course of the employment” covers those accidents which cause injury to an employee while he is discharging some duty he is authorized to perform in furtherance of his employer’s business, either directly or indirectly. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972).

    Is to be liberally construed. —

    The words “arising out of and in the course of the employment” are to be liberally construed. Bradshaw v. Aronovitch, 170 Va. 329 , 196 S.E. 684 , 1938 Va. LEXIS 191 (1938); Cohen v. Cohen's Dept. Store, 171 Va. 106 , 198 S.E. 476 , 1938 Va. LEXIS 261 (1938); Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939); Lynchburg Foundry Co. v. Irvin, 178 Va. 265 , 16 S.E.2d 646, 1941 Va. LEXIS 162 (1941); County of Chesterfield v. Goyne, 26 Bankr. 47, 1982 Bankr. LEXIS 5318 (Bankr. E.D. Va. 1982).

    The phrase “arising out of” the employment should receive a liberal construction in order to effectuate the humane and beneficent purposes of the Act. Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958); City of Richmond v. Johnson, 202 Va. 33 , 115 S.E.2d 910, 1960 Va. LEXIS 187 (1960); Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968); Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978).

    The words of the statute “arising out of and in the course of the employment” should be liberally construed to carry out the humane and beneficent purpose of the Workmen’s (now Workers’) Compensation Act; the expressions are used conjunctively and are not synonymous; both conditions must be present before compensation can be awarded; the words “arising out of” have been construed to refer to the origin or cause of the injury, and the words “in the course of” refer to the time, place and circumstances under which the accident occurred; and an accident occurs in the “course of employment” when it takes place within the period of employment, at a place where the employee may be reasonably expected to be, and while he is reasonably fulfilling the duties of his employment or is doing something which is reasonably incident thereto. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    The words “arising out of and in the course of employment” are to be liberally construed to carry out the humane and beneficent purpose of the Workmen’s (now Workers’) Compensation Act. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972).

    Voluntary act of employee causing injury. —

    If the voluntary act of an employee which causes an injury is sufficiently related to what the employee is required to do in fulfilling his contract of service, or is one in which someone in a like capacity may or must do in the interest of his employer’s business, the fact that the employee was not actually required to perform the act will not impair his right to recover compensation. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972).

    To bar an employee from the protection of workmen’s (now workers’) compensation benefits because he voluntarily acted in his employer’s interest would be to discourage constructive initiative, which is not a desirable result. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972).

    Virginia has long recognized the personal comfort doctrine, which recognizes the human need for periodic rest and refreshment; thus occasional breaks and excursions for food, drink, rest and restroom visitation are deemed to be in the course of employment; such activities benefit the employer by enhancing feasibility and desirability of employment, good physical and mental conditioning of his employees, and the cultivation of good employment relationships. Ablola v. Holland Rd. Auto Center, Ltd., 11 Va. App. 181, 397 S.E.2d 541, 7 Va. Law Rep. 648, 1990 Va. App. LEXIS 179 (1990).

    Virginia has adopted the personal comfort doctrine, under which an employee who seeks to satisfy his personal comfort, such as seeking to quench his thirst at a place provided by the employer, is within the employment. Kraf Constr. Servs., Inc. v. Ingram, 17 Va. App. 295, 437 S.E.2d 424, 10 Va. Law Rep. 539, 1993 Va. App. LEXIS 548 (1993).

    Application of personal comfort doctrine to traveling employee. —

    If the employer provides the employee a satisfactory place to satisfy his personal comfort, the employee must use that place or risk the loss of compensation; however, when the employee is traveling and no such place to satisfy the employee’s personal comfort is provided, a different rule applies, and such rule is whether the activity of quenching one’s thirst is incidental to the travel or employment or a “frolic” of one’s own. Kraf Constr. Servs., Inc. v. Ingram, 17 Va. App. 295, 437 S.E.2d 424, 10 Va. Law Rep. 539, 1993 Va. App. LEXIS 548 (1993).

    Injury while engaged in an activity of a personal nature. —

    The fact that an employee is engaged in an activity of a personal nature, in itself, is not a sufficient basis for denying compensation to an employee injured on the employer’s premises. Jones v. Colonial Williamsburg Found., 8 Va. App. 432, 382 S.E.2d 300, 6 Va. Law Rep. 104, 1989 Va. App. LEXIS 91 (1989) (see also 10 Va. App. 521, 392 S.E.2d 848 (1990)).

    Activity which was personal in nature was compensable. —

    Even though employee’s activity of throwing away trash at the time of injury was personal in nature and even though she had not reported for work, the activity on the premises which precipitated the injury was so incidental to the employment as to be expected of the employee during the course of employment. Jones v. Colonial Williamsburg Found., 8 Va. App. 432, 382 S.E.2d 300, 6 Va. Law Rep. 104, 1989 Va. App. LEXIS 91 (1989).

    Derivative injury. —

    Credible evidence in the record supported the Virginia Workers’ Compensation Commission’s finding that the claimant’s back and neck injuries were compensable consequences that arose during treatment in 2018 rather than original injuries sustained at the time of her compensable industrial accident in 2017 because the claimant described the onset of the pain she experienced during her exercises as running across her shoulders and neck, on the right side, and then down her spine into the lower part of her back, she said that the pain was “really bad in the lower part” and her back “started going out on [her]” after that, and not until she experienced these more extreme sensations in discrete parts of her back and neck did she seek medical treatment specifically for those body parts. Masonite Corp. v. Dean, 2020 Va. App. LEXIS 279 (Va. Ct. App. Nov. 10, 2020).

    Speculation. —

    Although the Workers’ Compensation Commission can draw inferences from the facts before it, the inference of a connection between the conditions of employment and the knee injury in this case fell into the realm of speculation; there was no defect with respect to the stairs on which the claimant fell, and the weight the claimant bore was not particularly heavy, but the Commission rested its decision on an inference that the claimant’s carrying of strollers established a causal connection, but this was speculative, and the evidence thus failed to establish that the accident arose out of the claimant’s employment. United Airlines, Inc. v. Taylor, 2016 Va. App. LEXIS 72 (Va. Ct. App. Mar. 15, 2016).

    Evidence was sufficient to find that employee who suffered from cryptococcal meningitis caused by massive exposure to a fungus found in dried pigeon droppings in the course of employment, which resulted in incurable imbecility, rendered him permanently unemployable; the record contained ample evidence of irreversible and severe limitations and reductions of the nonvocational quality of his life, eliminating his ability to engage in many usual cognitive processes. Mister Kleen Maintenance Co. v. Clark, 17 Va. App. 474, 438 S.E.2d 304, 10 Va. Law Rep. 652, 1993 Va. App. LEXIS 634 (1993).

    The commission found that claimant failed to prove that his disability and resulting medical treatment were caused by an injury by accident occurring at a specific time and place. The commission noted that, at most, the evidence established a non-compensable gradual development of symptoms. These findings were supported by claimant’s testimony, as well as the histories contained in the medical records, both of which suggested a gradual increase in symptoms over a period of at least three months. Krenisky v. Professional Coatings N. Am., Inc., 1997 Va. App. LEXIS 163 (Va. Ct. App. Mar. 25, 1997).

    Injury undetected because of neuropathy. —

    On the date of the injury, claimant credibly testified to driving directly home after work, and he confirmed that he did not walk over non-work areas where these used fasteners would have been lying around; he testified that he had seen used fasteners on the floor just about every day in the service bays where he worked, and because these used fasteners created a hazardous condition in the workplace as claimant performed his duties, and this hazardous condition caused his injury, it arose out of his employment. Farrish of Fairfax v. Faszcza, 2020 Va. App. LEXIS 173 (Va. Ct. App. June 16, 2020).

    Evidence sufficient. —

    Where a worker’s testimony and a doctor’s medical records and opinions proved that the worker sustained an injury by accident during her employment that became more severe when the worker bent over later in the evening, the workers’ compensation commission’s decision was supported by credible evidence. CJW Med. Ctr. & Assur. Co. v. Payne, 2003 Va. App. LEXIS 210 (Va. Ct. App. Apr. 8, 2003).

    Evidence was sufficient to establish that a fatal accident arose out of and in the course of employment, where: (1) the decedent had been told to repair a lift; (2) he was found with the necessary tools; and (3) his body was in a position that would have allowed him to perform the repair had he not been killed. These facts led to the conclusion that he was attempting to adjust the lift when the accident occurred. Va. Linen Serv. v. Wise, 2005 Va. App. LEXIS 224 (Va. Ct. App. June 7, 2005).

    There was sufficient evidence that a claimant’s injuries from a fall were attributable to a risk of employment and thus compensable. The workers’ compensation commission made specific findings based on direct and circumstantial evidence and the logical inferences drawn from that evidence, finding that the claimant was in an awkward position attempting to get out of a front-end loader while also attempting to lean in and check the brakes. City of Waynesboro v. Griffin, 51 Va. App. 308, 657 S.E.2d 782, 2008 Va. App. LEXIS 102 (2008).

    Claimant was properly denied workers’ compensation benefits because he failed to show that a tendon injury, which occurred as he stepped into a truck while at work, arose out of the course of his employment under § 65.2-101 because there was no medical or other record evidence establishing that a spasm or stepping into the truck caused the ruptured tendon. Haley v. Springs Global U.S., Inc., 54 Va. App. 607, 681 S.E.2d 62, 2009 Va. App. LEXIS 369 (2009).

    Evidence insufficient. —

    Claimant was properly denied workers’ compensation benefits where she failed to prove that she sustained a compensable injury arising in and out of her employment; evidence that the claimant was exposed only to tobacco smells, not smoke, and was also exposed to other allergens or environmental irritants on the day in question failed to support the claimant’s allegation that her exposure to tobacco smells while riding in the employer’s vehicle caused an aggravation of her pre-existing asthma condition. Fauntleroy v. Surry County Sch. Bd., 2003 Va. App. LEXIS 625 (Va. Ct. App. Dec. 9, 2003).

    Where the claimant had no memory of an accident in which his tractor/trailer ran off the road and overturned, he could not prove his injury arose out of his employment. The Virginia Workers’ Compensation Commission was correct in denying benefits. Hill v. Southern Tank Transp., Inc., 44 Va. App. 725, 607 S.E.2d 730, 2005 Va. App. LEXIS 28 (2005).

    Because the Workers’ Compensation Commission utilized an increased risk, rather than an actual risk test, hinging its award purely upon findings relating the physical characteristics of the employer’s premises to a propensity of the location itself to receive a lightning strike, and because the employee failed in her burden of proving causation, an award of benefits to said employee was erroneous. Rivanna Water & Sewer Auth. v. LaFleur, 2007 Va. App. LEXIS 458 (Va. Ct. App. Dec. 18, 2007).

    Workers’ Compensation Commission properly awarded an employee temporary total disability and medical benefits for an injury to his right knee because his injury occurred at a discreet time when he stood up from kneeling and digging, his work duties required him to work in an unusual and awkward position, credible evidence supported the Commission’s causation determination and its finding that the employee’s marketing was reasonable, in light of his education and experience, as well as the nature of his work restrictions. Dixie Constr. Co. v. Stokes, 2020 Va. App. LEXIS 71 (Va. Ct. App. Mar. 17, 2020).

    2.Arising Out of.

    “Arising out of” refers to the time, place and circumstances under which the accident takes place. By the use of these words, it was not the intention of the legislature to make the employer an insurer against all accidental injuries which might happen to the employee while in the course of the employment, but only for such injuries from or growing out of the risks peculiar to the nature of the work, in the scope of the workmen’s employment or incidental to such employment, and accidents to which the employee is exposed in a special degree by reason of such employment. Risks to which all persons similarly situated are equally exposed and not traceable in some special degree to the particular employment are excluded. Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925); Crane v. Richmond Memorial Hospital, 222 Va. 283 , 278 S.E.2d 877, 1981 Va. LEXIS 302 (1981).

    “Arising out of” refers to origin or cause of injury. Bradshaw v. Aronovitch, 170 Va. 329 , 196 S.E. 684 , 1938 Va. LEXIS 191 (1938); Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958); Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962); Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968); Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978); Fouts v. Anderson, 219 Va. 666 , 250 S.E.2d 746, 1979 Va. LEXIS 157 (1979); County of Chesterfield v. Goyne, 26 Bankr. 47, 1982 Bankr. LEXIS 5318 (Bankr. E.D. Va. 1982); R & T Invs., Ltd. v. Johns, 228 Va. 249 , 321 S.E.2d 287, 1984 Va. LEXIS 196 (1984); Winegar v. ITT, 1 Va. App. 260, 337 S.E.2d 760, 1985 Va. App. LEXIS 96 (1985); Hercules, Inc. v. Stump, 2 Va. App. 77, 341 S.E.2d 394, 1986 Va. App. LEXIS 244 (1986); VPI & State Univ. v. Wood, 5 Va. App. 72, 360 S.E.2d 376, 4 Va. Law Rep. 621, 1987 Va. App. LEXIS 271 (1987).

    The words “arising out of” refer to the origin or cause of the accident and are descriptive of its character. Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925); Grand Union Co. v. Bynum, 226 Va. 140 , 307 S.E.2d 456, 1983 Va. LEXIS 279 (1983).

    An accident arises out of the employment when the origin or cause of the injury relates to the employment. There must be a causal connection between the employee’s injury and the conditions under which the work is required to be performed. Metcalf v. A.M. Express Moving Sys., 230 Va. 464 , 339 S.E.2d 177, 1986 Va. LEXIS 147 (1986).

    An accident arising in the course of the employment is one which occurs within the period of employment, at a place where the employee may reasonably be expected to be, and while he is reasonably fulfilling the duties of his employment or is doing something which is reasonably incidental thereto. Metcalf v. A.M. Express Moving Sys., 230 Va. 464 , 339 S.E.2d 177, 1986 Va. LEXIS 147 (1986).

    Claimant in this instance was not specifically required to look for the truck which struck him while descending stairs, but was clearly responsible for “maintaining a fleet of 82 trucks, and taking care of and supervising the drivers.” Where claimant testified that he fell because he was “trying to do two work-related things at once, look out the window for the driver and walk down the stairs, the way in which claimant performed this aspect of his job increased his risk of falling on this occasion and directly contributed to cause his fall. His injury occurred because of the performance of his job duties in a particular manner.” Accordingly, the commission’s decision that the accident arose from claimant’s employment was affirmed, but because the commission did not address employer’s contention that the evidence was insufficient to prove a causal relationship between the accident and alleged injury, remand was required for resolution of that issue. Commercial Courier Express, Inc. v. Cairns, 1997 Va. App. LEXIS 159 (Va. Ct. App. Mar. 25, 1997).

    And requires causal connection between work conditions and injury. —

    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. But 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 does not arise “out of” the employment. Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939).

    The words “arising out of” mean there must be a reasonable causal connection between the employee’s work and the resultant injury or death. A risk is incidental to the employment when it belongs to or is connected with what the employee has to do in fulfilling his contract of service. Such a risk may be incidental to the employment when it is either an ordinary risk directly connected with the employment or an extraordinary risk which is only indirectly connected therewith, depending upon the special nature of the employment. Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958).

    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 workman would have been equally exposed apart from the employment. The causative danger 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. Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978).

    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. Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633 (1968); Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394 (1969); Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63 (1972); Fouts v. Anderson, 219 Va. 666 , 250 S.E.2d 746 (1979); County of Chesterfield v. Goyne, 26 Bankr. 47 (Bankr. E.D. Va. 1982); Richmond King, Inc. v. Poling, No. 0816-85 (Ct. of Appeals Jan. 8, 1986).

    A showing of causal connection is sufficient to establish that an injury arises out of the employment. Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968).

    The “arising out of” requirement refers to causation, only incidentally related to considerations of time and space, and must be satisfied by a showing of causal connection between work and injury. Graybeal v. Board of Supvrs., 216 Va. 77 , 216 S.E.2d 52, 1975 Va. LEXIS 251 (1975).

    Based upon claimant’s denial of any injury in her reports of the November 2, 1994 incident to her coworkers and supervisors and her failure to report any specific injury or trauma to her initial medical providers, the commission was entitled to conclude that claimant had not proved that her injuries were caused by the November 2, 1994, work-related incident. Bayouth v. Pizza Hut, Inc., 1997 Va. App. LEXIS 162 (Va. Ct. App. Mar. 25, 1997).

    “Arises out of” unless deviation to point of frolic. —

    So long as employee had not so deviated from the employment as to be deemed “on a frolic of his own,” employee’s accident is considered to arise out of his employment. Kraf Constr. Servs., Inc. v. Ingram, 17 Va. App. 295, 437 S.E.2d 424, 10 Va. Law Rep. 539, 1993 Va. App. LEXIS 548 (1993).

    Injury after deviation chosen by employer had ended. —

    In taking an employee to the destination he requested after work, an employer was fulfilling his agreement to provide transportation to and from work, and the injuries sustained by the employee in accident while being driven by the employer arose out of and in the course of his employment even though, after work, the employer and employee had stopped at a friend’s house to socialize and consume alcoholic beverages before resuming the trip back from work; this did not involve an employee who so materially deviated from the employment-related purposes of his trip as to constitute a frolic of his own, in that it was the employer who had chosen to deviate from the route back, and that deviation had ended when the employer and employee resumed their trip to the destination chosen by the employee. Vaughan's Landscaping & Maint. v. Dodson, 262 Va. 270 , 546 S.E.2d 437, 2001 Va. LEXIS 64 (2001).

    Claimant must show work-related exertion caused injury. —

    In order to prove the “arising out of” prong, claimant must show that the conditions of the workplace or that some significant work-related exertion caused the injury. Hayes v. Reynolds Metals Co., 1992 Va. App. LEXIS 326 (Va. Ct. App. May 19, 1992).

    Claimant did not engage in any significant exertion, her lifting of empty plastic water basin did not involve any awkward movement or position, and no condition or hazard peculiar to her workplace caused her injury; she therefore failed to prove as a matter of law that her injury arose out of her employment. Huffman v. Carilion Roanoke Mem. Hosp., 1999 Va. App. LEXIS 523 (Va. Ct. App. Sept. 14, 1999).

    Injuries did not arise out of employment. —

    An injury to the claimant’s ankle did not arise out of her employment where, at the time of the injury, the claimant was standing with both feet on the floor, slightly bent at the waist with her arms outstretched in preparation for lifting a patient, but that she had not yet lifted the patient or exerted any effort in preparation to do so. Bickell v. Lake Taylor Hospital, 1998 Va. App. LEXIS 586 (Va. Ct. App. Nov. 24, 1998).

    A claimant’s injury to her wrist allegedly caused by answering the telephone did not arise out of her employment where the evidence established that her simple act of picking up the telephone receiver did not involve any significant exertion or awkward position and that no condition or hazard peculiar to her workplace caused her injury aside from the usual act of answering the telephone. The simple act of answering the telephone under these circumstances did not constitute an actual risk of the employment. Farnia v. Prime Receivables, LLC, 2000 Va. App. LEXIS 710 (Va. Ct. App. Nov. 7, 2000).

    Claimant who drove a package pickup and delivery truck and was struck by lightning as she entered her truck after getting a package was properly denied benefits where she had proved that she sustained an injury by accident in the course of her employment, but she did not meet her burden of showing that the injuries sustained arose out of her employment; the court found that she did not prove that the employment activity exposed her to the injurious risk to a greater degree than one would be ordinarily exposed. Lucas v. Fed. Express Corp., 41 Va. App. 130, 583 S.E.2d 56, 2003 Va. App. LEXIS 381 (2003).

    Contention made by a decedent employee’s estate that the evidence failed to prove that the decedent’s injuries arose out of his employment in herding cattle was rejected, as said evidence: (1) failed to conclusively establish that the vehicle the decedent was driving had any connection to the decedent’s injuries; (2) failed to conclusively show that the cattle being herded caused the injuries; and (3) failed to show any medical reason for said injuries in which an inference could be drawn concerning causation. Estate of Helton v. Elk Garden Cattle Co., 2005 Va. App. LEXIS 136 (Va. Ct. App. Apr. 5, 2005).

    Evidence did not support the Virginia Workers’ Compensation Commission’s conclusion under § 65.2-101 that a workers’ compensation claimant’s injury, occurring when she fell as she entered her workplace, arose out of her employment as there was no evidence that the claimant tripped on a rolled up rug, as the Commission concluded; instead, the claimant testified only that she had seen a rug rolled up on prior occasions. County of Washington Soc. Servs. v. Rouse, 2007 Va. App. LEXIS 409 (Va. Ct. App. Nov. 13, 2007).

    Dismissal of a decedent’s estate administrator’s action, seeking recovery of damages for personal injury and resulting death after a co-worker assaulted the decedent by using a defibrillator on the decedent, resulting in death due to cardiac arrest and electrocution, was error, as the injury did not arise out of the employment, such that under §§ 65.2-101 and 65.2-307 , it was not within the exclusive remedy coverage of the Virginia Worker’s Compensation Act; the co-worker’s assault was purely personal on the decedent, and the employer’s workplace requirements had no causal connection with the risk of injury by assault. Hilton v. Martin, 275 Va. 176 , 654 S.E.2d 572, 2008 Va. LEXIS 18 (2008).

    Denial of temporary disability benefits to the claimant in a workers’ compensation action was appropriate because, although he argued that his injury arose out of his employment, asserting that the conditions of the patrol car parked on a 30-degree incline, the cramped interior of the patrol car, and the full uniform and gear, which weigh 25 to 30 pounds, caused him to injure his left knee when he exited the patrol car, none of the admitted medical reports mentioned any of those conditions. Maas v. Loudoun County, 2011 Va. App. LEXIS 120 (Va. Ct. App. Apr. 5, 2011).

    Virginia Workers’ Compensation Commission did not err in denying an employee benefits for injuries he sustained as a result of a spider bite he received while cleaning his work area in a storage area because the employee failed to prove by a preponderance of the evidence that his injury arose out of his employment; the employee, a forklift battery exchanger, was bitten by a spider while cleaning under the battery rack station, not while he was in the storage area, and since nothing in the record indicated the proximity of the battery rack station to the storage area, the employee did not demonstrate the necessary “critical link” between the conditions of the workplace and the spider bite. Wilson v. Ace Hardware Corp., 2011 Va. App. LEXIS 158 (Va. Ct. App. May 10, 2011).

    Virginia Workers’ Compensation Commission did not err in finding that the injuries of a workers’ compensation benefits claimant did not arise out of her employment under § 65.2-101 because the Commission considered claimant’s entire medical record related to her fall, as well as the testimony of the witnesses, including claimant’s recorded statement to employer’s representative; claimant’s recorded statement to the employer’s representative was simply additional evidence of claimant’s inability to provide a consistent explanation for how she fell. Rodrigues v. Arlington County Sch., 2012 Va. App. LEXIS 141 (Va. Ct. App. May 1, 2012).

    Virginia Workers’ Compensation Commission did not err by denying a claim for benefits because credible evidence supported the finding of the Commission that a claimant’s injury, which was sustained while the claimant was taking an agility test for field work, did not arise in the course of his employment as he was applying for field work on his own initiative and for his own advancement. Whitt v. Halliburton Energy Servs., 2012 Va. App. LEXIS 156 (Va. Ct. App. May 15, 2012).

    Commission properly found that a claimant’s knee injury did not arise out of her employment as required by § 65.2-101 because the injury occurred while the claimant was walking in a rush at a school; while the record showed that the injury occurred during the claimant’s employment, it did not establish that her injury arose from her employment. Further, nothing in the record suggested that an emergency situation was created on this particular day by the claimant’s being delayed for a few minutes from being with the autistic student in the teacher’s classroom. Gobashi v. Fairfax County Pub. Sch., 2012 Va. App. LEXIS 389 (Va. Ct. App. Dec. 4, 2012).

    Claimant did not prove that the weight of the 30 to 40 pound tray and/or the way it was held contributed to her misstep on a flight of stairs and that her injuries arose out of her employment where she testified that: (1) because the tray prevented her from seeing her feet, she had learned to count her steps so that she knew where she was on the staircase; (2) she stepped on the tenth step with the same placement of her foot as she had on the previous steps; and (3) she did not step on a foreign object or slip on anything. Dianna v. Colonial Williamsburg Co., 2013 Va. App. LEXIS 317 (Va. Ct. App. Nov. 5, 2013).

    Virginia Workers’ Compensation Commission did not err by denying the claimant workers’ compensation benefits for injuries he sustained when he fell from the bed of a pickup truck while delivering airplane parts for his employer because he failed to establish that his accident arose from the conditions of his employment, as he failed to offer an explanation for the cause of his fall. The claimant could not remember any details concerning his fall, his co-worker’s testimony failed to explain the cause of the claimant’s fall, and the record failed to establish that he fell due to any work-related duties or environmental conditions. Hersl v. United Airlines, Inc., 2014 Va. App. LEXIS 351 (Va. Ct. App. Oct. 21, 2014).

    Workers’ compensation claimant’s injury did not arise out of her employment under the actual risk test as a doorway threshold was not defective and the claimant was not at a heightened risk because of her employment as although there was a slight rise in the threshold, the rise was not uneven or irregular, the claimant had crossed the threshold before, and she believed she had raised her foot sufficiently high to have cleared the threshold; further, the claimant was not distracted as although she was having a discussion with her supervisors while crossing the threshold, she did not testify that this conversation contributed to her fall. Vick v. Hampton Rds. Transit, 2015 Va. App. LEXIS 86 (Va. Ct. App. Mar. 24, 2015).

    Virginia Workers’ Compensation Commission properly denied a police officer workers’ compensation benefits for an injury he sustained when he slipped on a stairway because the circumstantial evidence did not establish that a defect in the stairway contributed to the officer’s injury; the homeowner’s statements could not be construed as proof establishing the existence of a defect, and the officer failed to present any other evidence affirmatively establishing a defect caused him to slip. Echevarria v. City of Chesapeake, 2016 Va. App. LEXIS 269 (Va. Ct. App. Oct. 18, 2016).

    Workers’ Compensation Commission’s decision that a claimant had not proven by a preponderance of the evidence that his fall arose out of his employment was affirmed where his interrogatory answer that he tripped himself, his description of the incident to health care providers after the fall, his recorded statement to the insurance claim supervisor, and his claim forms supported the factual finding that he simply and inexplicably fell while ascending the non-defective steps. Mojares v. Rk Chevrolet, 2016 Va. App. LEXIS 318 (Va. Ct. App. Nov. 22, 2016).

    Virginia Workers’ Compensation Commission did not err in denying the claimant’s benefits claim as the claimant’s employment did not expose him to a hazard or risk that resulted in his injury because the claimant, while kneeling, reached approximately two feet into the ground and unclipped a transmitter from a meter and, while rising, he twisted to his right and felt a “pop” in his back; the claimant acknowledged that he was not in an awkward position at the time of his injury and that the relatively flat area surrounding the meter did not require him to exert any physical effort to kneel; and there were no contributing environmental factors surrounding claimant’s normal act of rising from a squatting position. Nelson v. Town of Christiansburg, 2017 Va. App. LEXIS 248 (Va. Ct. App. Oct. 3, 2017).

    Virginia Workers’ Compensation Commission did not err in denying an employee benefits because the employee failed to establish that his injuries were caused by an actual risk of his employment; credible evidence supported the Commission’s determination that the employee was injured when he merely stood from a bent position after placing an angle iron on a tarp, and as the injuries were not caused by some work condition or activity, they were not compensable. Shrewsberry v. Martinsville Mach. Works, Inc., 2018 Va. App. LEXIS 56 (Va. Ct. App. Mar. 6, 2018).

    Appellant’s injury was not caused by a work related risk or significant work related exertion and thus did not arise out of his employment, for purposes of § 65.2-101 ; he did not exert any heavy force when he pulled the plastic wrap slowly and he was not in an awkward position peculiar to his work when the injury occurred. Bowers v. Amazon.com, 2019 Va. App. LEXIS 297 (Va. Ct. App. Dec. 17, 2019).

    Claimant failed to prove by a preponderance of the evidence that her injuries arose out of her employment. The evidence presented failed to prove by a preponderance that the uneven surface of a sidewalk caused the claimant to fall. Choinski v. Va. State Univ., 2020 Va. App. LEXIS 81 (Va. Ct. App. Mar. 31, 2020).

    Record supported the Virginia Workers’ Compensation Commission’s ruling that the claimant did not prove that his injury arose out of his employment because the facts in the record surrounding how he exited the van and what work-related factors might have contributed to his injury were virtually nonexistent. The claimant testified that the manner in which he exited the van was normal, and the record did not indicate the height of the step required to exit the van or what he was carrying. Reynolds v. Falletta Enters., 2021 Va. App. LEXIS 10 (Va. Ct. App. Jan. 26, 2021).

    Accident at workplace not caused by work-related risk not compensable. —

    The mere happening of an accident at the workplace, not caused by any work-related risk or significant work-related exertion, is not compensable. Hayes v. Reynolds Metals Co., 1992 Va. App. LEXIS 326 (Va. Ct. App. May 19, 1992).

    Causal relationship may exist despite exposure of general public to same hazard. —

    An accident arises out of the employment if there is a causal connection between the claimant’s injury and the conditions under which the employer requires the work to be performed. The mere fact that the hazard is one to which the general public likewise is exposed is not, however, conclusive against the existence of such causal relationship. R & T Invs., Ltd. v. Johns, 228 Va. 249 , 321 S.E.2d 287, 1984 Va. LEXIS 196 (1984).

    Causation is an essential element which must be proven by a claimant in order to receive an award of compensation for an injury by accident under the Virginia Workers’ Compensation Act. Amp, Inc. v. Ruebush, 10 Va. App. 270, 391 S.E.2d 879, 6 Va. Law Rep. 2321, 1990 Va. App. LEXIS 85 (1990).

    Causation established by medical expert witness. —

    Credible evidence supported the Virginia Workers’ Compensation Commission’s decision that a claimant’s back injury was causally related to the claimant’s accident that occurred at work because the expert opinion of the treating orthopedic surgeon established a causal connection between the accident and the follow-up medical treatment and surgery. Davis & Green, Inc. v. Lowery, 2014 Va. App. LEXIS 60 (Va. Ct. App. Feb. 25, 2014).

    Causation. —

    Virginia Workers’ Compensation Commission properly found that a claimant’s knee injury was caused by the October 28, 2009, work accident based on: (1) the claimant’s immediate complaints of knee pain and irregularities revealed by the examination after the accident; (2) the initial treating physicians’ notations of an acute knee injury; (3) a doctor’s review of the claimant’s new and old x-rays and his opinion that the claimant suffered from a patellar fracture resulting from the work-related fall that had not properly healed; and (4) the independent medical examiner’s agreement that the original x-rays showed irregularities and acknowledgment of the possibility of a patellar fracture. Giant Food LLC & Indem. Ins. Co. of N. Am. v. Wu, 2013 Va. App. LEXIS 69 (Va. Ct. App. Mar. 5, 2013).

    Workers’ Compensation Commission did not err in entering a supplemental award for medical benefits because the timing of an employee’s hearing loss coincided with her work-related accident and the testimony of the employee and her physicians provided credible evidence from which the Commission could determine that the employee’s hearing loss was causally related to her work-related accident. Sykes Enters. v. Cox, 2014 Va. App. LEXIS 73 (Va. Ct. App. Mar. 11, 2014).

    Workers’ compensation commission did not err in finding that the claimant had failed to establish that her injury arose out of her employment, as the claimant was never able to explain why she began to fall and never testified that she began to fall because of a wet kitchen floor, and the commission was entitled to infer that the cause of her loss of balance was simply not explained by the record. Sanchez-Castro v. Arlington County Sch., 2014 Va. App. LEXIS 353 (Va. Ct. App. Oct. 14, 2014).

    Photographs showed that the fastener’s location in claimant’s shoe was consistent with the puncture wound in his foot, and claimant’s duties required him to visit the service bays daily, where fasteners and other debris were on the floor; because credible evidence showed a causal connection between the incident, stepping on the fastener, and the bodily change, the puncture wound in claimant’s foot, claimant satisfied the final component of injury by accident, causation. Farrish of Fairfax v. Faszcza, 2020 Va. App. LEXIS 173 (Va. Ct. App. June 16, 2020).

    Virginia Workers’ Compensation Commission did not err in finding that the claimant’s seizures were not compensable as they were not causally related to a workplace injury because the medical diagnostic tests related to the claimant’s seizures did not establish any causal connection between his workplace injury and his seizures; and no unequivocal medical opinion established a causal link between his workplace injury and his seizures. Sibai v. Sterling Jewelers, 2020 Va. App. LEXIS 316 (Va. Ct. App. Dec. 29, 2020).

    Because the Virginia Workers’ Compensation Commission found that the claimant’s seizures were not compensable as they were not causally related to his workplace injury, the claimant was not entitled to temporary total disability benefits in connection with the left shoulder injury he sustained when he fell down the stairs during a seizure. Sibai v. Sterling Jewelers, 2020 Va. App. LEXIS 316 (Va. Ct. App. Dec. 29, 2020).

    Credible evidence supported the Workers’ Compensation Commission’s findings that claimant sustained a compensable neck injury; causation was shown, as the treating physicians’ records contained notes that claimant’s neck was injured in her workplace injury fall. Although claimant might have had a prior diagnosis of neck problems, there was no evidence she had previously received treatment for a neck condition. Richmond Pub. Sch. v. Coy, 2021 Va. App. LEXIS 163 (Va. Ct. App. Aug. 31, 2021).

    Being greeted by clap on back. —

    Injury to police officer from being clapped on back was caused by personal greeting of one officer to another and did not arise from an actual risk connected with employment, and therefore claimant failed to prove that his injury arose out of his employment. Johnson v. County of Henrico Police, 2000 Va. App. LEXIS 18 (Va. Ct. App. Jan. 18, 2000).

    Being struck by lightning that passed through telephone switchboard. —

    Employee who claimed that she was struck by lightning that passed through a telephone switchboard she was required to use to perform her job was not eligible for disability compensation and medical benefits under the Virginia Workers’ Compensation Act because her job did not increase the risk that she would be struck. Va. Empl. Comm'n v. Hale, 43 Va. App. 379, 598 S.E.2d 327, 2004 Va. App. LEXIS 304 (2004).

    Injury received while bending and picking up. —

    Injuries resulting from simple acts of bending or turning, absent a contributing factor from the workplace, are not compensable. In this case, the claimant merely bent over to pick up a virtually weightless object. He was not in a confined space or awkward position. Therefore, the injury did not occur out of the employment. Colosimo v. Virginia Truck Ctr., Inc., 1997 Va. App. LEXIS 127 (Va. Ct. App. Mar. 18, 1997).

    An employee whose back went out as he was standing up after bending over to place a tray on a cart during the course of his employment was not entitled to compensation for his back injury since the action of bending was neither unusual, awkward, nor something that the employee was required to do on a repetitive basis and because merely bending over is a risk to which the general public is equally exposed. Southside Virginia Training Center v. Ellis, 33 Va. App. 824, 537 S.E.2d 35, 2000 Va. App. LEXIS 757 (2000).

    Where a workers’ compensation claimant who was employed as a security officer testified that the claimant suffered a back injury when the claimant bent over to clean a hubcap on a car during an employer-sponsored fundraising car wash, credible evidence supported the finding of the Virginia Workers’ Compensation Commission that the claimant’s injury was caused merely by bending over and not by work-related exertion or by working in an awkward position, and that the injury, therefore, did not arise out of the claimant’s employment. Crews v. Gateway 2000, 2003 Va. App. LEXIS 84 (Va. Ct. App. Feb. 19, 2003).

    Res judicata bars relitigation of causation in industrial accident. —

    The issue of causation in cases involving an industrial accident, however, is not an issue subject to change and should, therefore, ordinarily be barred from relitigation by the doctrine of res judicata once a final judgment has been entered. Amp, Inc. v. Ruebush, 10 Va. App. 270, 391 S.E.2d 879, 6 Va. Law Rep. 2321, 1990 Va. App. LEXIS 85 (1990).

    Standard of proof. —

    To recover benefits, the claimant must establish by a preponderance of the evidence that he suffered an injury by accident “arising out of and in the course of his employment,” and that the conditions of the workplace caused the injury. Falls Church Constr. Corp. v. Valle, 21 Va. App. 351, 464 S.E.2d 517, 1995 Va. App. LEXIS 898 (1995).

    Workers’ compensation claimant failed to meet her burden of proof that her fall from a platform while changing a gas price number sign was causally related to her job as a cashier; her unqualified admission that she did not know how or why she fell from the platform, coupled with her slender factual description of the conditions at the time of the fall, left the commission unpersuaded as to the causal connection between her injury and the work that she was employed to perform. Sutton v. Speedy's Petroleum, Inc., 2008 Va. App. LEXIS 50 (Va. Ct. App. Jan. 29, 2008).

    In a case in which an employee was returning from smoking a cigarette during her morning break in her employer’s parking lot and she hit a ball hitch attached to a pickup truck, causing her to fall to the ground, she unsuccessfully appealed the Virginia Workers’ Compensation Commission’s denial of her claim for benefits for injuries. While it was undisputed that the employee’s injury occurred in the course of her employment, she failed to prove by a preponderance of the evidence that her injury arose out of her employment. Angelo v. Stihl, Inc., 2009 Va. App. LEXIS 476 (Va. Ct. App. Oct. 27, 2009).

    Injuries arose out of employment. —

    Credible evidence proved that, at the time worker was injured in automobile accident, his travel on the highway directly linking Richmond where his headquarters were located and Milford place where he was to complete an assignment was travel which he was authorized and obligated to perform; therefore, the hazards of highway travel became necessary incidents of his employment, and showed that his injuries arose out of employment. Marketing Profiles, Inc. v. Hill, 17 Va. App. 431, 437 S.E.2d 727, 10 Va. Law Rep. 613, 1993 Va. App. LEXIS 580 (1993), limited, Bernard v. Carlson Cos. - TGIF, 60 Va. App. 400, 728 S.E.2d 508, 2012 Va. App. LEXIS 236 (2012).

    Credible evidence proved that employee’s employment duties required his presence on the highway and that his injuries thereon arose out of his employment; the accident occurred while employee was on a mission for his employer that required his presence on the road where he was subject to risks associated with the highway. He was traveling to the Fredericksburg office by the most direct route, and there was no deviation from his mission. Moreover, employee’s description of the accident provides credible evidence to support the commission’s conclusion that employee’s injuries were caused by a risk of the street occasioned by his employment. His testimony established that an oncoming vehicle veered into his lane of travel, causing him to lose control of his vehicle. Independent Life & Accident Ins. Co. v. Johnson, 1994 Va. App. LEXIS 520 (Va. Ct. App. Aug. 2, 1994).

    Because correctional officer’s job responsibilities caused him to watch the tower guards rather than the steps, how he performed his job provided the “critical link” between the conditions of the workplace and the injury, and therefore, his injury arose out of his employment. Marion Correctional Treatment Ctr. v. Henderson, 20 Va. App. 477, 458 S.E.2d 301, 1995 Va. App. LEXIS 502 (1995).

    Claimant proved that the sudden “zig-zag” movement he made to avoid a collision with the cleaning people was incidental to his work, therefore, his knee injury arose out of his employment. Teagle & Little, Inc. v. Balchunis, 1995 Va. App. LEXIS 955 (Va. Ct. App. July 25, 1995).

    The employee responded to his employer’s request by walking to her office to determine what job she needed done. At that point and continuing, the tasks the employee performed were either required by his employment or were reasonably incidental thereto. As such, his injury arose in the course of his employment. Therefore, the commission’s determination that the employee’s injury by accident arose out of and in the course of his employment was supported by credible evidence. Stratford & Monticello Square Apts. v. Sharp, 1996 Va. App. LEXIS 226 (Va. Ct. App. Apr. 2, 1996).

    Where claimant’s work involved operating knitting machines, and in order to reload the yarn on the bottom-most creels of a machine, claimant was required to perform a deep knee-bend to reach their location two inches above the floor, and where the operation of the knitting machines required claimant to perform these deep knee-bends approximately 200 times each twelve hour shift, the commission did not err when it concluded that claimant’s injury, a torn medial meniscus, arose out of her employment. Furthermore, the injury was not a cumulative trauma caused by a repetitive motion. Bassett-Walker, Inc. v. Wyatt, 26 Va. App. 87, 493 S.E.2d 384, 1997 Va. App. LEXIS 713 (1997).

    Although salesman’s diabetic condition may have caused his automobile accident, the requirement that he routinely travel by automobile to meet with customers subjected him to the risk of injury by accident and increased the dangerous effects of the injury that he received, and thus his injury arose out of his employment. Royster Clark, Inc. v. Bays, 1999 Va. App. LEXIS 674 (Va. Ct. App. Dec. 14, 1999).

    An employee who suffered a ruptured aneurysm over her lunch break while participating in an aerobics class sponsored by the employer and who alleged that her injury was the aggravation, exacerbation and/or acceleration of the aneurysm due to her employer’s negligence in providing emergency medical care alleged an injury arising out of her employment. Combs v. VEPCO, 259 Va. 503 , 525 S.E.2d 278, 2000 Va. LEXIS 38 (2000).

    Back injury suffered by a convenience store manager when straightening up after having been in an awkward, kneeling position for five minutes attempting to clear a paper jam in a computer printer was a compensable injury arising out of and in the course of the manager’s employment. Fas Mart, Inc. v. Fox, 2001 Va. App. LEXIS 658 (Va. Ct. App. Dec. 4, 2001).

    Where a workers’ compensation claimant’s back injury occurred while the claimant, a shuttle bus driver, was leaning over a passenger in a wheelchair in order to unbuckle the straps that secured the wheelchair, the Virginia Workers’ Compensation Commission properly found that the back injury arose out of the claimant’s employment within the meaning of § 65.2-101 of the Virginia Workers’ Compensation Act, as the record indicated that the injury occurred while the claimant was performing a task necessary to the job and claimant was in an awkward position attributable to the passenger’s unique circumstances. Jaunt, Inc. v. Clement, 2003 Va. App. LEXIS 20 (Va. Ct. App. Jan. 21, 2003).

    Where an employee suffered an injury to her knee, because her foot did not naturally follow the turn of her upper body due to a two-inch thick rubber mat she was standing on which produced some unmeasured degree of friction between itself and the employee’s foot, the injury to her knee arose out of the scope of her employment; further, the employee explained that she had never had any problems with her knees, legs, or feet, and that she wore the same tennis shoes she ordinarily wore on the job when the injury occurred. Teleflex Auto. Mfg. Corp. v. Honaker, 2004 Va. App. LEXIS 170 (Va. Ct. App. Apr. 13, 2004).

    Where a kennel employee was struck by cars while crossing a highway in an attempt to retrieve an escaped dog, it was not error to find that the injury arose out of the employee’s employment, because: (1) it was reasonable to find that it was among the employee’s duties to attempt to retrieve loosed animals, even if the animal left the premises and crossed the highway since supervisors had instructed employees to participate in animal retrieval tasks that required crossing the highway on a previous occasion; and (2) the incident was not unexplained. Town & Country Animal Hosp. v. Deardorff, 2008 Va. App. LEXIS 278 (Va. Ct. App. June 10, 2008).

    Virginia Workers’ Compensation Commission did not err in finding that a workers’ compensation claimant’s injury arose out of her employment because the Commission properly applied the “actual risk test” and could properly infer from the facts that but for the claimant’s job duties and the physical obstacles confronting her, she could have avoided injury since the claimant’s performance of her job increased the risk of injury by diverting attention from the danger of an approaching vehicle; the court of appeals could not find that nothing in the claimant’s work environment contributed to her injury. Green Hand Nursery, Inc. v. Loveless, 55 Va. App. 134, 684 S.E.2d 818, 2009 Va. App. LEXIS 498 (2009).

    Finding in favor of the employee in a workers’ compensation action was appropriate because the employee’s moving the cases of beer was an activity “arising out of” her employment. Additionally, even if the activity was not required by the employer, it was not prohibited by the employer and was in furtherance of the employer’s interest. Food Lion, LLC v. Otey, 2011 Va. App. LEXIS 181 (Va. Ct. App. May 24, 2011).

    Worker’s Compensation Commission properly concluded that an employee’s injuries arose out of his employment under § 65.2-101 as the evidence established more than simply an injury that came from a hazard to which the employee would have been equally exposed apart from the employment. Specifically, the evidence showed that the claimant was required to load heavy merchandise in vehicles for as many as 30 customers each day, that the specific manner in which the customers’ vehicles were positioned for loading required the employee to give directions to customers while they backed their cars up to the curbside loading area, and that the employee was struck by the vehicle of the very same customer who purchased the television that the employee was preparing to load. Sears Roebuck & Co. v. Martin, 2011 Va. App. LEXIS 162 (Va. Ct. App. May 10, 2011).

    Award of workers’ compensation benefits to the employee, a nurse, was appropriate because the test was not whether the actual call on her cell phone while she was driving was from the employer, but whether the injury could fairly be traced to the employment as a contributing proximate cause. Her injuries arose out of employment. Wythe County Cmty. Hosp. v. Turpin, 2011 Va. App. LEXIS 299 (Va. Ct. App. Oct. 4, 2011).

    Virginia Workers’ Compensation Commission (Commission) properly found that the claimant’s injury arose out of her employment under § 65.2-101 where the claimant fell because her purse was caught on a hook located on a merchandise shelf in a grocery store aisle; the Commission’s finding that the hook was peculiar to the claimant’s grocery store workplace and was not common to the neighborhood was entitled to deference under subsection A of § 65.2-706 . Giant Food LLC & Indem. Ins. Co. of N. Am. v. Wu, 2013 Va. App. LEXIS 69 (Va. Ct. App. Mar. 5, 2013).

    While a workers’ compensation claimant had no recollection of the accident or its cause, circumstantial evidence proved that his accident and injury arose out of his employment as: (1) logging was a dangerous enterprise; (2) before the accident, the grabbers on a skidder were not working properly; (3) the claimant had been operating the skidder earlier in the morning; and (4) when a co-worker approached the machine after the accident, he saw that the claimant was unconscious, slumped over the steering wheel, and that a tree had penetrated the back window opening of the skidder. Va. Tree Harvesters, Inc. v. Shelton, 62 Va. App. 524, 749 S.E.2d 556, 2013 Va. App. LEXIS 325 (2013).

    Credible evidence supported the Workers’ Compensation Commission’s finding that the metal stripping that was in a doorway was defective and caused the claimant’s workplace accident and subsequent injuries; the Commission, which awarded medical benefits to the claimant, did not err when it determined that the claimant’s injuries arose out of her employment as required by this section. VCU Health Sys. Authority-Wc & Vcu Health Sys. Auth. v. Booth, 2014 Va. App. LEXIS 340 (Va. Ct. App. Oct. 14, 2014).

    Claimant’s description of her accident met the “arising out of” standard under this section where, while working at a drive-thru window, she bent, jerked, and twisted to catch a bag of french fries in order to advance the employer’s business. Gene Forbes Enters. v. Cooper, 2015 Va. App. LEXIS 195 (Va. Ct. App. June 9, 2015).

    Credible evidence supported the Workers’ Compensation Commission’s findings that an employee’s injuries arose out of an actual risk of his employment because when he was injured he was clearing the employer’s property, and the process was an act of manual labor that required the use of a company-owned forklift; the clearing was on the employer’s property, from where he operated his business, required manual labor, involved the use of company machinery, and was done for a business purpose. McCluster v. Baltazar, 2017 Va. App. LEXIS 308 (Va. Ct. App. Dec. 5, 2017).

    Workers’ Compensation Commission properly affirmed a deputy commissioner’s award to an employee for temporary total disability benefits for injury to her left knee and ankle after she slipped on a grassy slope while walking from an abutting parking lot to the school where she worked because the treating physician opined that the fall aggravated her underlying knee condition “and/or” caused the need for the knee surgery, and the record contained more than ample credible evidence to support the finding that the employee’s accident caused an injury to her left knee and that the employer did not communicate to the employee that she was not supposed to take the course she took between the parking lot and the employer’s property. Quest for Excellence Learning v. Newsom, 2021 Va. App. LEXIS 124 (Va. Ct. App. July 20, 2021).

    Workers’ Compensation Commission did not err in finding that claimant’s injuries arose out of his employment; while closing the shop as part of his regular duties and stepping under the quickly closing bay door, his left foot dragged on an incline and he tripped and fell. In moving quickly to avoid being locked out, claimant’s movement was awkward. The slope was substantial enough to contribute to his fall, and the Commission did not err in finding that stepping sideways over the elevation was a work-related risk. Magic City Ford Lincoln Isuzu Trucks v. Kerr, 2021 Va. App. LEXIS 160 (Va. Ct. App. Aug. 31, 2021).

    Injury arose out of peculiar conditions of employment. —

    Virginia Workers’ Compensation Commission applied the appropriate standard of causation to the case, finding the injury arose out of and in the course of the peculiar conditions of the employee’s employment. The Commission’s finding that the employee’s work, in the heat, standing on the road, without food or water, resulted in the heatstroke and heart attack, was based on credible evidence. Kjellstrom & Lee, Inc. v. Saunders, 42 Va. App. 673, 594 S.E.2d 281, 2004 Va. App. LEXIS 126 (2004).

    Workers’ Compensation Commission erred in denying a workers’ compensation claimant’s claim for benefits as the claimant proved by a preponderance of the evidence that his injury arose out of his employment under § 65.2-101 , in that, in the unique circumstances of the case, the claimant’s action in sliding down from a raised chair for his feet to reach the ground to accomplish his job-related tasks was not an action that he would have been equally exposed to apart from the conditions of his employment. The undisputed evidence showed that the claimant had to contort his body to slide down from the raised chair before his feet would reach the ground eight inches below each time that the doorbell to the infirmary rang. Dovell v. Coffeewood Corr. Center, 2012 Va. App. LEXIS 17 (Va. Ct. App. Jan. 24, 2012).

    Virginia Workers’ Compensation Commission did not err in finding that the claimant suffered a compensable injury that arose out of her employment because the claimant’s employment required her to maneuver around a water stack after closing out the register for the day; as she was doing so, her left foot caught the corner of the water stack, resulting in the injury; and the Commission was entitled to conclude that the water stack, around which the claimant was required to maneuver as a part of her employment, was a workplace hazard peculiar to the claimant’s workplace and not common to the neighborhood. Dollar Tree Stores, Inc. v. Wilson, 64 Va. App. 103, 765 S.E.2d 151, 2014 Va. App. LEXIS 395 (2014).

    Claimant was entitled to workers’ compensation benefits for injuries resulting from a spider bite which the claimant sustained at work because the claimant’s injury arose out of the claimant’s employment as credible evidence demonstrated a causative danger that was peculiar to the claimant’s workplace and both a physical and temporal proximity between a peculiar or unusual workplace condition-construction work in a boiler room below the claimant’s office suite causing a proliferation of spiders in the office suite-and the claimant’s injury. James Madison Univ. v. Housden, 2020 Va. App. LEXIS 63 (Va. Ct. App. Mar. 10, 2020).

    Claimant’s injury arose out of her employment and was compensable under the Workers’ Compensation Act as she was injured when she was placing an elderly woman from the residential facility where she worked into a car; the manner in which the claimant was required to perform the task was sufficiently awkward; and the injury to the claimant’s back was caused by exertion on an occasion that was peculiar to her employment. CJ Designs Inc. v. Williams, 2021 Va. App. LEXIS 97 (Va. Ct. App. June 15, 2021).

    Heat stroke arose out of employment. —

    Virginia Workers’ Compensation Commission did not err in finding that the claimant’s heat stroke arose out his employment working as a temporary laborer for the employer who had contracted him to work on the trash collection company’s trash truck; competent evidence showed that the heat stroke occurred because the claimant worked a long day which was hot and humid, that he walked alongside the truck or rode on it for most of the day in conditions that provided no shade, and that the long garbage collection route did not offer any shade, either. Labor Finders of Va., Inc. v. Baldivieso, 2005 Va. App. LEXIS 51 (Va. Ct. App. Feb. 8, 2005).

    Presence of ice. —

    Claimant failed to present sufficient evidence from which the Workers’ Compensation Commission could infer that ice was present on a walk-in freezer floor on which she slipped. Because the claimant did not provide sufficient evidence concerning her fall or the condition of the walk-in freezer floor, the Commission did not err in concluding that the claimant’s injury did not arise out of her employment. Lewis v. Covenant Holdings Grp., LLC, 2018 Va. App. LEXIS 153 (Va. Ct. App. June 5, 2018).

    Professional football players. —

    Professional football player’s injuries were includable in the definition of “injury” because the player’s conditions of employment exposed him to hazards beyond that of the public at large. Pro-Football, Inc. v. Uhlenhake, 37 Va. App. 407, 558 S.E.2d 571, 2002 Va. App. LEXIS 46 (2002), aff'd in part, 265 Va. 1 , 574 S.E.2d 288, 2003 Va. LEXIS 17 (2003).

    Claims arising from occupational diseases pursued more than once. —

    Unlike claims based on injury by accident, claims arising from an occupational disease may be pursued more than once when based on different medical evidence establishing the disease. Amp, Inc. v. Ruebush, 10 Va. App. 270, 391 S.E.2d 879, 6 Va. Law Rep. 2321, 1990 Va. App. LEXIS 85 (1990).

    To be compensable, injury must grow out of risks particular to the nature of the work. Risks to which all persons similarly situated are equally exposed and not traceable to some special degree to the particular employment are excluded. Hercules, Inc. v. Stump, 2 Va. App. 77, 341 S.E.2d 394, 1986 Va. App. LEXIS 244 (1986).

    Meter reader failed to prove as a matter of law that his back injury arose out of his employment, where he did not engage in any significant exertion, his simple act of picking up a three-pound handheld computer and turning to exit truck did not involve any awkward position, and no condition or hazard peculiar to his workplace caused his injury. Crawford v. Virginia Elec. & Power, 1999 Va. App. LEXIS 555 (Va. Ct. App. Oct. 5, 1999).

    The injury does not have to result from an unusual or defective condition; rather, it must be caused by conditions which are particularly related to or associated with the work or work environment. Hercules, Inc. v. Stump, 2 Va. App. 77, 341 S.E.2d 394, 1986 Va. App. LEXIS 244 (1986).

    Risk not shared by general public required under “actual risk” test. —

    To be compensated under the “actual risk” test, the claimant’s injury must arise from a risk not shared by the general public. Hill City Trucking, Inc. v. Christian, 5 Va. App. 106, 360 S.E.2d 867, 4 Va. Law Rep. 688, 1987 Va. App. LEXIS 223 (1987), different results reached on reh'g, 7 Va. App. 78, 371 S.E.2d 575, 5 Va. Law Rep. 271, 1988 Va. App. LEXIS 95 (1988).

    Under the “actual risk” 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 worker 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. Hill City Trucking, Inc. v. Christian, 5 Va. App. 106, 360 S.E.2d 867, 4 Va. Law Rep. 688, 1987 Va. App. LEXIS 223 (1987), different results reached on reh'g, 7 Va. App. 78, 371 S.E.2d 575, 5 Va. Law Rep. 271, 1988 Va. App. LEXIS 95 (1988).

    An injury does not arise out of the employment when it cannot fairly be traced to the employment as a contributing proximate cause and 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. Southside Virginia Training Center v. Ellis, 33 Va. App. 824, 537 S.E.2d 35, 2000 Va. App. LEXIS 757 (2000).

    Under the actual risk test, the employee must establish that he was at greater risk of injury as a result of his employment than the general public and must prove a causal connection between the manner in which the employer required the work to be performed and the resulting injury. STG, Inc. v. Tooks, 2001 Va. App. LEXIS 329 (Va. Ct. App. June 12, 2001).

    If there is a causal relationship between the injury and the workers’ compensation claimant’s work responsibilities, the risk may indeed be “common to the neighborhood,” and a denial of benefits because the risk is “common to the neighborhood” presupposes the risk is not peculiar to the claimant’s work; the former is simply an alternative way of requiring causation between the injury and the claimant’s work, and if the injury can fairly be traced to the employment as a contributing proximate cause, it matters not that the danger is common to the neighborhood. Green Hand Nursery, Inc. v. Loveless, 55 Va. App. 134, 684 S.E.2d 818, 2009 Va. App. LEXIS 498 (2009).

    “Positional risk” doctrine not adopted in Virginia. —

    Virginia has refused to embrace the “positional risk” doctrine under which an injury arises out of the employment if it would not have occurred but for the fact that the conditions and obligations of the employment placed claimant in the position where he was injured. Hill City Trucking, Inc. v. Christian, 5 Va. App. 106, 360 S.E.2d 867, 4 Va. Law Rep. 688, 1987 Va. App. LEXIS 223 (1987), different results reached on reh'g, 7 Va. App. 78, 371 S.E.2d 575, 5 Va. Law Rep. 271, 1988 Va. App. LEXIS 95 (1988).

    Presumption injury “arose out of” employment limited in death cases. —

    The presumption that an injury “arose out of” employment was limited in its application to death cases. Pinkerton's, Inc. v. Helmes, 242 Va. 378 , 410 S.E.2d 646, 8 Va. Law Rep. 1314, 1991 Va. LEXIS 150 (1991).

    In this case, the cause of employee’s accident was unknown. As the commission noted, plaintiffs could not point to any evidence which indicated that his fall was caused by a risk of his employment. Therefore, only if plaintiffs were entitled to a presumption that employee’s injuries arose out of his employment would they be entitled to workers’ compensation benefits; the presumption does not apply to a case such as this one, where employee was not found dead at the scene of the accident, but rather died approximately one month later. Warlitner v. McDonald’s McCopco No. 05161/McDonald’s Corp., No. 2958-96-1 (Ct. of Appeals Mar. 25, 1997).

    Where a decedent was killed in a motorcycle accident, the presumption that his death arose out of his employment for purposes of § 65.2-101 did not apply where the decedent’s widow testified equivocally that the decedent was riding his motorcycle on a work errand after Sunday dinner but there was no evidence to corroborate the assertion that the decedent was delivering paper work to his bookkeeper, and further, the decedent’s body was found on a public highway that was not at or near his work place. Clifton v. Clifton Cable Contr., LLC, 54 Va. App. 532, 680 S.E.2d 348, 2009 Va. App. LEXIS 361 (2009).

    Recreational activity arises out of employment if accepted and normal activity. —

    An injury sustained as a result of recreational activity arises out of employment only when the activity is an accepted and normal activity within the employment. Mullins v. Westmoreland Coal Co., 10 Va. App. 304, 391 S.E.2d 609, 6 Va. Law Rep. 2356, 1990 Va. App. LEXIS 84 (1990).

    Previously experienced back pain was immaterial. —

    Where claimant experienced a sudden onset of pain in her back as a result of pulling a cart, the fact that she had previously experienced back pain was immaterial in light of the fact that there was sufficient evidence to show that she sustained an injury at a specific time, arising out of a specific incident, which proximately caused her disability. Canon Va., Inc. v. Pendleton, No. 0602-90-1 (Ct. of Appeals Oct. 2, 1990).

    3.In the Course of.

    “In the course of” refers to time, place, and circumstances under which injury occurred. Bradshaw v. Aronovitch, 170 Va. 329 , 196 S.E. 684 , 1938 Va. LEXIS 191 (1938); Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925); Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958); Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962); Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978); Fouts v. Anderson, 219 Va. 666 , 250 S.E.2d 746, 1979 Va. LEXIS 157 (1979); Grand Union Co. v. Bynum, 226 Va. 140 , 307 S.E.2d 456, 1983 Va. LEXIS 279 (1983); R & T Invs., Ltd. v. Johns, 228 Va. 249 , 321 S.E.2d 287, 1984 Va. LEXIS 196 (1984); VPI & State Univ. v. Wood, 5 Va. App. 72, 360 S.E.2d 376, 4 Va. Law Rep. 621, 1987 Va. App. LEXIS 271 (1987).

    Person who claimed benefits under the Workers’ Compensation Act had to prove an injury by accident arising out of and in the course of the employment; “in the course of” referred to the time, place, and circumstances under which the accident occurred. Boys & Girls Club of Va. v. Marshall, 37 Va. App. 83, 554 S.E.2d 104, 2001 Va. App. LEXIS 590 (2001).

    Evidence proved that worker’s injury occurred “in the course of the employment” because at the time the accident occurred, he was returning to Richmond from the photography assignment, that assignment was an integral part of his employment duties, and he was injured on a highway that was the shortest and most direct route between his employer’s headquarters and the place where he performed his assigned duties. Marketing Profiles, Inc. v. Hill, 17 Va. App. 431, 437 S.E.2d 727, 10 Va. Law Rep. 613, 1993 Va. App. LEXIS 580 (1993), limited, Bernard v. Carlson Cos. - TGIF, 60 Va. App. 400, 728 S.E.2d 508, 2012 Va. App. LEXIS 236 (2012).

    Injury in course of employment shown. —

    An employee who suffered a ruptured aneurysm over her lunch break while participating in an aerobics class sponsored by the employer and who alleged that her injury was the aggravation, exacerbation and/or acceleration of the aneurysm due to her employer’s negligence in providing emergency medical care alleged an injury suffered in the course of her employment. Combs v. VEPCO, 259 Va. 503 , 525 S.E.2d 278, 2000 Va. LEXIS 38 (2000).

    Award to the employee of compensation benefits related to a fall at work was appropriate because it could have been found that her fall was caused in part by a combination of the “higher than a regular step” distance from the dumpster level to the loading dock, the configuration of the loading dock, and her distraction by the child for whom she was searching. Further, the employee was not on a frolic and detour when she was injured, she testified that she injured her left shoulder, and her medical history and treatment after the emergency room visit also supported the finding that she injured her left shoulder. Paul's Bakery, Inc. v. Murphy, 2010 Va. App. LEXIS 345 (Va. Ct. App. Aug. 24, 2010).

    It was not error to find an employee’s injury arose out of the employee’s employment, and was compensable, because the unusual height of a platform from which the employee stepped was a risk peculiar to the employee’s employment and contributed to the employee’s injury, as the step’s unusual height caused the employee to step down off the platform in an awkward manner and injure the employee’s knee. GP Big Island, LLC v. Creasey, 2014 Va. App. LEXIS 382 (Va. Ct. App. Nov. 18, 2014).

    Credible evidence supported the findings that an employee’s injuries were in the course of his employment because the accident occurred on the employer’s property at a place where the employee was authorized and required to be; because a clearing was for the mutual benefit of the employer and employee, required the use of company property, and occurred while the parties were acting in their employer-employee capacity, the employee’s actions were a responsibility of or incidental to employment. McCluster v. Baltazar, 2017 Va. App. LEXIS 308 (Va. Ct. App. Dec. 5, 2017).

    Employee’s escorting coworker did not occur in course of employment. —

    Where no evidence in the record reflected that employee’s presence on the street was part of the duties required by his job or that his employer derived any benefit from his accompaniment of coworker, and where the record revealed that employee was neither required to nor directed to escort coworker, and was not performing any service related to his work as an associate attorney at the time of his injury, the Commission did not err in finding that employee’s injury did not occur in the course of his employment. Hawks v. Hazel & Thomas, P.C., No. 0833-92-4 (Ct. of Appeals Dec. 1, 1992).

    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 thereto. Bradshaw v. Aronovitch, 170 Va. 329 , 196 S.E. 684 , 1938 Va. LEXIS 191 (1938); Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939); Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958); Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962); R & T Invs., Ltd. v. Johns, 228 Va. 249 , 321 S.E.2d 287, 1984 Va. LEXIS 196 (1984); Briley v. Farm Fresh, Inc., 240 Va. 194 , 396 S.E.2d 835, 1990 Va. LEXIS 119 (1990).

    An injury occurs in the course of employment when it takes place within the period of employment, at a place where the employee may be reasonably expected to be, and while he is fulfilling the duties of his employment or is doing something which is reasonably incidental thereto. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972); Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978).

    The “course of” requirement refers to continuity of time, space and circumstances, only incidentally related to causation. This requirement must be satisfied by a showing of an unbroken course beginning with work and ending with injury under such circumstances that the beginning and the end are connected parts of a single work-related incident. Graybeal v. Board of Supvrs., 216 Va. 77 , 216 S.E.2d 52, 1975 Va. LEXIS 251 (1975).

    The “course of employment” requirement refers to continuity of time, space, and circumstances, only incidentally related to causation. County of Chesterfield v. Goyne, 26 Bankr. 47, 1982 Bankr. LEXIS 5318 (Bankr. E.D. Va. 1982).

    Accident in public parking lot not in course of employment. —

    Worker’s Compensation Commission properly ruled that a worker was not entitled to medical benefits for a fall suffered in a parking lot, as the store which employed the worker did not exercise any control over the public parking lot, and thus the accident did not occur in the course of the worker’s employment. Newberry v. Peebles Dep't Store & Am. & Foreign Ins. Co., 2005 Va. App. LEXIS 398 (Va. Ct. App. Oct. 11, 2005).

    When risk incidental to employment. —

    A risk is incidental to the employment when it belongs to or is connected with what the employee has to do in fulfilling his contract of service. Reserve Life Ins. Co. v. Hosey, 208 Va. 568 , 159 S.E.2d 633, 1968 Va. LEXIS 149 (1968).

    Where causative danger is peculiar to the work and incidental to character of the business the injury is compensable. Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958).

    The causative risk must be peculiar to the work and incidental to the character of the business and not independent of the relation of master and servant. Fouts v. Anderson, 219 Va. 666 , 250 S.E.2d 746, 1979 Va. LEXIS 157 (1979).

    The causative danger 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. Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962).

    But not where employee incurs danger not required by his position. —

    When an employee incurs dangers of his own choosing which are altogether outside of any reasonable requirement of his position, the risk arising from such action is not incident to and does not arise out of the employment. Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962).

    Required duty or voluntary act of employee. —

    As the Virginia Workers’ Compensation Commission’s order was silent on whether the claimant’s act of climbing a ladder to remove a smoke detector battery occurred in the course of claimant’s employment because it was one of claimant’s required job duties, or because it was a voluntary act that was reasonably incidental to the performance of her required job duties, it could not be said that the agreed order adjudicated ladder climbing as a required condition of the claimant’s pre-injury job; thus, the Commission did not err when it did not preclude the employer from arguing that claimant’s pre-injury job tasks excluded climbing ladders. Hayes v. Nobility Invs., LLC, 2019 Va. App. LEXIS 103 (Va. Ct. App. Apr. 30, 2019).

    Since claimant’s voluntary act of turning her body slightly to the right to reach for an orange during a break involved no awkward position, extraordinary or unusual exertion, or other hazardous circumstances peculiar to her workplace, her claim could not sustain under the statute. Peck v. Tultex Corp., 1996 Va. App. LEXIS 102 (Va. Ct. App. Feb. 13, 1996).

    Act essential to personal comfort and convenience of employee. —

    An injury sustained by an employee while engaged in the performance of an act essential to his personal comfort and convenience, but ultimately for the benefit of the employer, is compensable as arising out of and in the course of employment. Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958).

    Where employment creates necessity for travel. —

    If the work of the employee creates the necessity for travel, he is in the course of his employment, though he is serving at the same time some purpose of his own. If, however, the work has had no part in creating the necessity for travel, if the journey would have gone forward though the business errand had been dropped, and would have been canceled upon failure of the private purpose, though the business errand was undone, the travel is then personal, and personal the risk. Butler v. Nolde Bros., 189 Va. 932 , 55 S.E.2d 36, 1949 Va. LEXIS 229 (1949).

    When an employee is required to travel away from the employer’s premises to perform his work and the employer furnishes transportation to the employee, the course of one’s employment is usually expanded to include travel to and from the work site and the activities reasonably incidental thereto. Kraf Constr. Servs., Inc. v. Ingram, 17 Va. App. 295, 437 S.E.2d 424, 10 Va. Law Rep. 539, 1993 Va. App. LEXIS 548 (1993).

    Course of employment travel injury shown. —

    Where employee’s testimony and that of his supervisor established that, at the time of the accident, employee was traveling to Fredericksburg for the employer’s sales meeting where he was expected to turn in the premium money he had collected that week; this meeting and the duties attached to it were integral parts of his employment; and he was injured on a highway that was the most direct route between his home base and the employer’s office in Fredericksburg, the place where he was to perform his assigned duties, at the time of the accident, he was on his employer’s mission and thus, credible evidence proved that employee’s injury occurred in the course of his employment. Independent Life & Accident Ins. Co. v. Johnson, 1994 Va. App. LEXIS 520 (Va. Ct. App. Aug. 2, 1994).

    Where a master is liable for some negligent act of a servant done about the master’s business he is also liable to the servant in damages for an injury then suffered by him, for such an injury would have arisen out of and in the course of his employment. Taylor v. Robertson Chevrolet Co., 177 Va. 289 , 13 S.E.2d 326, 1941 Va. LEXIS 216 (1941).

    Multiple employers. —

    Commission did not err in finding that, at the time he was injured, claimant was not employed by trucking company where he worked as a dispatcher, but by sole proprietorship which he operated and which leased truck to trucking company. Clinchfield Coal Co. v. Coleman, 1999 Va. App. LEXIS 662 (Va. Ct. App. Dec. 7, 1999).

    Mere inability to recall the events surrounding an accident was not sufficient cause for application of the presumption that the accident “arose in the course of employment.” Pinkerton's, Inc. v. Helmes, 242 Va. 378 , 410 S.E.2d 646, 8 Va. Law Rep. 1314, 1991 Va. LEXIS 150 (1991).

    D.Time and Place of Accident.

    Injury must occur at place where employee is reasonably expected to be. —

    In order for an injury to be compensable, it must have occurred at a place where from the nature of his work the employee was reasonably expected to be. Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939).

    Where the plaintiff was injured at a place where she was reasonably expected to be while engaged in an activity reasonably incidental to her employment by defendant, her injury was covered under this section. Briley v. Farm Fresh, Inc., 240 Va. 194 , 396 S.E.2d 835, 1990 Va. LEXIS 119 (1990).

    At or reasonably near premises where he is to work. —

    A workman who receives an injury while at a place on, or reasonably near, the premises where he is to work, or at a place to which his employment requires him to go while doing something incident to or connected with his employment, or which is reasonably necessary for, and preparatory to, the beginning of his work, or while doing something reasonably connected with his employment, or incident thereto, after his actual labors in his employment are completed for the day, or for any particular period, may be allowed compensation for such injury. Cohen v. Cohen's Dept. Store, 171 Va. 106 , 198 S.E. 476 , 1938 Va. LEXIS 261 (1938).

    There is no such thing as “instantaneous exit” immediately after an employee punches a time clock. Manifestly an employee has a reasonable time after quitting work in which to absent himself from the premises of his employer. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    There occurs no “instantaneous exit” from a place of employment immediately upon termination of work. Briley v. Farm Fresh, Inc., 240 Va. 194 , 396 S.E.2d 835, 1990 Va. LEXIS 119 (1990).

    An employee has a reasonable time after concluding work to absent herself from the employer’s premises. Briley v. Farm Fresh, Inc., 240 Va. 194 , 396 S.E.2d 835, 1990 Va. LEXIS 119 (1990).

    Identifiable incident on sudden precipitating event. —

    Workers’ compensation claimant did not meet his burden of proving that the cause of his injury was an identifiable incident or sudden precipitating event and that it resulted in an obvious sudden mechanical or structural change in the body because he stated various dates to various people about when and how his injury occurred. Hash v. Motivation Coal Co., 2003 Va. App. LEXIS 86 (Va. Ct. App. Feb. 25, 2003).

    Employment includes reasonable margin of time and space. —

    Employment includes not only the actual doing of the work, but a reasonable margin of time and space necessary to be used in passing to and from the place where the work is to be done. If the employee be injured while passing, with the express or implied consent of the employer, to and from his work by a way over the employer’s premises, or over those of another in such proximity and relation as to be in practical effect a part of the employer’s premises, the injury is one arising out of and in the course of the employment as much as though it had happened while the employee was engaged in his work at the place of its performance. In other words, the employment may begin in point of time before the work is entered upon and in point of space before the place where the work is to be done is reached. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    The fact that the accident occurred shortly after the claimant had left her immediate place of work is not conclusive. A reasonable length of time must be given an employee to separate himself or herself from the place of work. The employment contemplated her entry upon and departure from the place of work as much as it contemplated her working there, and must include a reasonable interval of time for that purpose. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    Temporal precision established. —

    Evidence supported the commission’s factual finding that claimant’s injury occurred during the post-lunch hours of training, and thus the injury was sufficiently bounded with rigid temporal precision to establish a compensable injury; after lunch, during the final training scenario of the day, claimant experienced a “tweak” when picked up by members of the SWAT team, and he had no doubt that it was the incident that led to the arm and shoulder problems he began experiencing after the training. City of Charlottesville v. Sclafani, 2020 Va. App. LEXIS 135 (Va. Ct. App. May 5, 2020), aff'd in part, rev'd, 300 Va. 212 , 862 S.E.2d 101, 2021 Va. LEXIS 93 (2021).

    Accident occurring out of working hours. —

    The fact that the accident occurred outside of regular working hours is wholly immaterial, as this section by its terms embraces all injuries by accident arising out of and in the course of the employment, whether within or without particular hours. Honaker & Feeney v. Hartley, 140 Va. 1 , 124 S.E. 220 , 1924 Va. LEXIS 152 (1924).

    Whether the injury occurred outside of regular working hours is immaterial so long as it arose “out of and in the course of the employment.” The statute does not confine injuries which it embraces to those which arise out of and in the course of employment during regular working hours. Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962).

    Compensation is not confined to injuries occurring only during working hours. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972).

    The fact that the employee’s employment for the day had ended, in itself, was no bar to compensation for his death so long as an employment relationship existed during the trip that exposed decedent to his fatal injury. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972).

    Date of injury. —

    Workers’ compensation claimant failed to sustain the claimant’s burden of proving the claimant suffered a compensable injury by accident on February 24, 2007, under § 65.2-101 as the Virginia Workers’ Compensation Commission offered a rationale for its reversal of a deputy commissioner’s finding that a workers’ compensation claimant was credible as the claimant was unable to explain the medical records indicating that the claimant suffered an injury before January 15, 2007; the claimant testified that the claimant did not have back injuries before February 24, 2007. Karban v. Universal Fiber Sys., LLC, 2010 Va. App. LEXIS 274 (Va. Ct. App. July 13, 2010).

    Reasonably definite time shown. —

    Claimant’s injury occurred at a reasonably definite time, at 4:00 p.m. on August 30, 2016, and thus he satisfied the second component of an injury by accident; he testified that he was in employer’s service bays that day at 4:00 p.m., and the only place he could have encountered used fasteners on the floor was in those bays. The Commission found his testimony credible and requiring him to provide the precise time the used fastener punctured his foot would fault him for having neuropathy and yield a ridiculous and unjust result. Farrish of Fairfax v. Faszcza, 2020 Va. App. LEXIS 173 (Va. Ct. App. June 16, 2020).

    Claimant’s injury occurred in the course of his employment; he stepped on the used fastener during work hours at 4:00 p.m. on August 30, 2016, as he followed up on vehicles receiving maintenance in the service bays of employer’s premises, and it was claimant’s job to oversee the technicians and their work, and the technicians worked in the service bays. Farrish of Fairfax v. Faszcza, 2020 Va. App. LEXIS 173 (Va. Ct. App. June 16, 2020).

    Claimant could not identify the visit in which he stepped on a used fastener due to his neuropathy, but this inability to identify the moment the injury occurred did not preclude a finding that an identifiable incident occurred. Farrish of Fairfax v. Faszcza, 2020 Va. App. LEXIS 173 (Va. Ct. App. June 16, 2020).

    Public road between two portions of employer’s premises. —

    One category in which compensation is almost always awarded is that in which the employee travels along or across a public road between two portions of his employer’s premises, whether going or coming, or pursuing his active duties. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    Parking lot owned or maintained by employer. —

    Virginia is among a majority of states that now consider parking lots owned by the employer or maintained by the employer for its employees part of the “premises,” whether within or separated from company premises. Hunton & Williams v. Gilmer, 20 Va. App. 603, 460 S.E.2d 235, 12 Va. Law Rep. 47, 1995 Va. App. LEXIS 629 (1995).

    The parking lot rule is one of the exceptions to the rule that bars compensation for injuries not on the employer’s premises. This exception, unlike others, is based on the range of risk of the employment, not the rule of respondeat superior. This is because the employer does not necessarily control the employee during the critical period, nor is the employee being paid wages during this time. Hunton & Williams v. Gilmer, 20 Va. App. 603, 460 S.E.2d 235, 12 Va. Law Rep. 47, 1995 Va. App. LEXIS 629 (1995).

    No evidence disclosed control by employer over parking area. —

    Where no evidence showed that employees were required to park in parking garage or that employee sustained her injury in an area of the parking lot reserved for her company only, no evidence disclosed any control or authority by employer over the area in which employee parked. Hunton & Williams v. Gilmer, 20 Va. App. 603, 460 S.E.2d 235, 12 Va. Law Rep. 47, 1995 Va. App. LEXIS 629 (1995).

    Going to and from parking lot in order to reach and leave her immediate working area was a necessary incident to the claimant’s employment. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    The claimant parked her automobile on the premises of her employer in a parking area designated and maintained for employees in her classification to use. It is reasonably inferable from the record that the parking area was maintained by the employer for the mutual benefit of the employer and the employees. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    Where large numbers of employees drive automobiles to their places of employment and provision is made for parking on the employer’s premises, it is clear that the employment itself has created conditions in which the risk of automobile-connected injuries is different in kind and possibly greater in degree than that confronted by the public at large. The risk may be increased by a large number of automobiles, concentrated in a confined space, coming into and going out of the lot at approximately the same times, operated by employees who may be preoccupied with thoughts of work to be begun, or exhausted from work completed and anxious to get to their respective homes or other places of relaxation and refreshment. This would seem to be the kind of hazard from which the Workmen’s (now Workers’) Compensation Act was designed to protect employees. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    Returning from smoking during on-premises lunch break. —

    Injuries sustained by an employee on the employer’s premises when returning to work from a designated meal break arise out of and in the course of the employee’s employment and the same rule applies when the employee is returning from an area where he had gone to smoke cigarettes during a part of his lunch break. Cadmus Magazines v. Williams, 30 Va. App. 129, 515 S.E.2d 797, 1999 Va. App. LEXIS 399 (1999).

    Return to workplace to give colleague a ride. —

    A hospital employee’s injury did not occur in the course of her employment where the employee had successfully exited the hospital at the conclusion of her workday and successfully traversed the employer’s parking lot to her vehicle but, instead of exiting the premises, returned to the emergency room entrance to give a ride to a colleague where she fell and sustained an injury; the employee’s return to the emergency room was a personal errand and a personal favor and there was no evidence that the employer encouraged ride-sharing or carpooling or anticipated personal favors by its employees or that the employer benefited from such activities. Norfolk Community Hosp. v. Smith, 33 Va. App. 1, 531 S.E.2d 576, 2000 Va. App. LEXIS 535 (2000).

    Fact of injury in parking lot alone not conclusive. —

    The mere fact that an injury occurs on a parking lot provided by an employer for his employees does not necessarily make it arise out of and in the course of employment. Fouts v. Anderson, 219 Va. 666 , 250 S.E.2d 746, 1979 Va. LEXIS 157 (1979).

    Where an employee had completed his workday when he left his employer’s parking lot, and his reentry into the parking lot was not related to or in any way connected with his employment, the employee incurred the risk of injury while he was solely on a mission for his own convenience. Thus, the employee’s injury was not one “arising out of” and did not occur “in the course of” his employment, and was not compensable under the Act. Fouts v. Anderson, 219 Va. 666 , 250 S.E.2d 746, 1979 Va. LEXIS 157 (1979).

    Employee of store called out to sidewalk. —

    If an employee of a store is called out of the store to the sidewalk upon some direct or indirect business mission connected therewith, or if he is upon the sidewalk for some incidental purpose indirectly connected with his employment and is injured, in either case the injury is compensable. Cohen v. Cohen's Dept. Store, 171 Va. 106 , 198 S.E. 476 , 1938 Va. LEXIS 261 (1938).

    Employee gathering area. —

    Although claimant was injured during a break, the accident occurred on employer’s premises in an area where employees were permitted to gather during break periods. As such, employer was responsible for the condition and use of the area and the resulting dangerous circumstances inherent in crowding on steps in front of a principal entrance to the workplace. Thus, the causative danger was both incidental to the character of the workplace and dependent on the master-servant relationship. Maida Dev. Co. v. Hayslett, 1995 Va. App. LEXIS 603 (Va. Ct. App. July 25, 1995).

    The fact that employer provided a designated location for employees to gather during their breaks did not relieve it of the responsibility to provide safe conditions in other areas of the workplace where employees were known and permitted to congregate. Maida Dev. Co. v. Hayslett, 1995 Va. App. LEXIS 603 (Va. Ct. App. July 25, 1995).

    E.Public Streets.

    Injuries in public streets generally. —

    In order to entitle the claimant to compensation for injuries in the public streets, there must be some special risk incident to the particular employment which imposes some greater danger upon the employee than is imposed upon other persons actually using the streets. The test, however, is not that other persons are exposed to similar risks, but rather that the employment exposes the workman to the particular danger in the street. Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925); Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254, 1967 Va. LEXIS 128 (1967).

    There are many classes of employees whose duties to their employers require their presence upon the public streets, either frequently or continuously, and accidental injuries to them on the streets have been frequently held to be compensable. Among these are salesmen, truck drivers, messengers, solicitors, etc., who by the very nature of their employment are exposed to the hazards of the streets to a greater degree than the general public. Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925).

    An employee whose duties require him to be on the street is covered from hazards incident to street travel, on the principle that such risks are incident to the nature of the employment and employees engaged in that kind of work are necessarily exposed thereto. Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939).

    If his employment status placed the employee on the highway and an accident occurred, such accidental injury arose out of and in the course of his employment. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972).

    Two-prong test for establishing compensable public street injury. —

    To establish being part of the class of employees protected from accidental injuries upon the public streets, claimant must establish by a preponderance of the evidence: (1) that his or her duties to the employer require his or her presence upon the public streets; and (2) that his or her injury arose from an actual risk of that presence upon the streets. Sentara Leigh Hosp. v. Nichols, 13 Va. App. 630, 414 S.E.2d 426, 8 Va. Law Rep. 2030, 1992 Va. App. LEXIS 53 (1992).

    Alternative recovery route for establishing compensable public street injury. —

    If an employee does not prove that he or she is within a class of employees whose duties require their presence or travel upon the public streets to be entitled to compensation for injuries from an automobile accident, then he or she must prove that the duties of the particular employment in question required the employee’s travel or presence upon the public streets and, thus, exposed the employee to the actual risk of that presence or travel. Sentara Leigh Hosp. v. Nichols, 13 Va. App. 630, 414 S.E.2d 426, 8 Va. Law Rep. 2030, 1992 Va. App. LEXIS 53 (1992).

    “Actual risk test” in “street cases”. —

    See Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254, 1967 Va. LEXIS 128 (1967).

    Under the actual street-risk rule if the employment occasions the employee’s use of the street, the risks of the street are the risks of the employment. Marketing Profiles, Inc. v. Hill, 17 Va. App. 431, 437 S.E.2d 727, 10 Va. Law Rep. 613, 1993 Va. App. LEXIS 580 (1993), limited, Bernard v. Carlson Cos. - TGIF, 60 Va. App. 400, 728 S.E.2d 508, 2012 Va. App. LEXIS 236 (2012).

    Exposure to greater risk from presence on street need not be shown. —

    Under the “actual risk” test, it is not necessary that the employee show that his presence on the street or highway where his injuries are suffered exposes him to an increased hazard peculiar to the work and not common to the public generally. The test is not that other persons are exposed to similar risks, but rather that the employment exposes the worker to the particular danger in the street. Park Oil Co. v. Parham, 1 Va. App. 166, 336 S.E.2d 531, 1985 Va. App. LEXIS 79 (1985).

    Fact of accident on public highway alone not conclusive. —

    The fact that the accident happens along a public highway, and that the danger is one to which the general public is likewise exposed, is not conclusive against the existence of causal relationship between the conditions under which the work is required to be performed and the resulting injury, unless the danger be one to which the employee, by reason of and in connection with his employment, is not subjected peculiarly or to an abnormal degree. Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978).

    Where employee truck driver died from a gunshot wound inflicted either intentionally or negligently, and there was no indication that the gun was aimed at him because of his work as a truck driver, but the evidence clearly negated any suggestion that the truck was the target of a hijacking attempt or that the assailant tried to tamper in any other way with the vehicle or its cargo, and pointed to the conclusion that the employee’s death was the result of an arbitrary and capricious act by an unknown assailant, the risk was not peculiar to the work. It could not be said that the employee’s occupation as a truck driver subjected him, to an abnormal degree, to being shot accidentally or intentionally alongside a public highway. Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978).

    Deviations or personal missions in public streets. —

    An injury is compensable where an employee whose duties require him to operate a truck upon the streets of a city and who is permitted to select what streets he will use, with the consent of his employer, deviates from a direct route to perform a personal mission, completes the mission, starts to the point of delivery designated by his employer, and is injured before reaching his destination or a street in the direct course thereto. In the instant case the employee had accomplished the personal enterprise and was on the street for the sole benefit of his employer. Railway Express Agency v. Lewis, 156 Va. 800 , 159 S.E. 188 , 1931 Va. LEXIS 232 (1931).

    Compensation was denied for injuries suffered by claimant in an automobile accident, where the manager of defendant company had instructed truck drivers, including claimant, to travel by a certain route from which claimant had deviated at the time of the accident. Grimes v. Janney-Marshall Co., 183 Va. 317 , 32 S.E.2d 76, 1944 Va. LEXIS 156 (1944).

    The passenger representative and tour conductor for a steamboat company, whose duties were to look after the wants and comforts of the passengers and who started on foot to the nearest liquor store to procure whiskey for passengers at their request, was denied compensation for an injury received when run over by a train while he was walking across a trestle, where the shortest route to the liquor store was along a road and not across the trestle. Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939).

    Where a widow equivocally testified that a decedent was riding his motorcycle on a work errand after Sunday dinner but there was no evidence to corroborate the assertion that the decedent was delivering paper work to his bookkeeper, the widow failed to prove that the decedent’s death, which occurred as a result of an accident on a public highway, arose out of or in course of his employment under § 65.2-101 . Clifton v. Clifton Cable Contr., LLC, 54 Va. App. 532, 680 S.E.2d 348, 2009 Va. App. LEXIS 361 (2009).

    Home care nurse in route to patient’s home. —

    It may well be that many home care nurses, because of the duties of their employment, are required to travel upon the public streets and, thus, come within the protection of the “street case” principles. Nothing, however, establishes that all home care nurses come within such a class of employees. Consequently, individual claimant has the burden of proving by a preponderance of the evidence that the duties of his or her employment required travel upon the public streets. Sentara Leigh Hosp. v. Nichols, 13 Va. App. 630, 414 S.E.2d 426, 8 Va. Law Rep. 2030, 1992 Va. App. LEXIS 53 (1992).

    F.Going to or Returning From Place of Employment.

    Generally, injuries received going to or from work are not compensable. —

    The general rule is that an employee going to or from his place of work is not engaged in performing any service growing out of and incidental to his employment. Kent v. Va.-Carolina Chemical Co., 143 Va. 62 , 129 S.E. 330 , 1925 Va. LEXIS 246 (1925) (see Monumental Motor Tours v. Eaton, 184 Va. 311 , 35 S.E.2d 105 (1945); LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809 (1970); GATX Tank Erection Co. v. Gnewuch, 221 Va. 600 , 272 S.E.2d 200 (1980)).

    Subject to limited exceptions, injuries sustained by employees having fixed hours and places of employment off the employer’s premises while going to or from work, are not within the “course of employment” and are therefore not compensable under the Workers’ Compensation Act. Grand Union Co. v. Bynum, 226 Va. 140 , 307 S.E.2d 456, 1983 Va. LEXIS 279 (1983).

    An employee going to or from the place where his work is to be performed is not engaged in performing any service growing out of and incidental to his employment. Therefore, any injury received while going to or from work generally is not compensable. Kendrick v. Nationwide Homes, Inc., 4 Va. App. 189, 355 S.E.2d 347, 3 Va. Law Rep. 2220, 1987 Va. App. LEXIS 179 (1987).

    When a worker was allowed to use his employer’s van while the worker’s vehicle was being repaired and was injured while using the van to drive to work, he was not entitled to workers’ compensation because: (1) the employer’s agreement that the worker could use the van was gratuitous and not contractual; (2) the worker’s usage of the van was to be for a limited period while the worker’s car was being repaired and was not a custom incidental to the employment contract; and (3) the worker’s use of the van was a favor to the worker which was of no benefit to the employer. Marshall v. Craft Forklift, Inc., 41 Va. App. 777, 589 S.E.2d 456, 2003 Va. App. LEXIS 636 (2003).

    But there are certain exceptions to this rule. A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 , 1938 Va. LEXIS 287 (1938).

    As to special rule, limited in application to a typical situation such as employees having no fixed hours and places of employment. Grand Union Co. v. Bynum, 226 Va. 140 , 307 S.E.2d 456, 1983 Va. LEXIS 279 (1983).

    Exceptions enumerated. —

    The cases indicate that there are three exceptions to this general rule, and only three: (1) Where in going to and from work the means of transportation is provided by the employer or the time consumed is paid for or included in the wages; (2) Where the way used is the sole and exclusive way of ingress and egress, with no other way, or where the way of ingress and egress is constructed by the employer; (3) Where the employee on his way to or from work is still charged with some duty or task in connection with his employment. Kent v. Va.-Carolina Chemical Co., 143 Va. 62 , 129 S.E. 330 , 1925 Va. LEXIS 246 (1925); GATX Tank Erection Co. v. Gnewuch, 221 Va. 600 , 272 S.E.2d 200, 1980 Va. LEXIS 280 (1980).

    The second exception enumerated does not apply where an employee was killed on his way home from his place of employment fifteen minutes after leaving the place, when pursuing a route of his own choice, there being other available ones. And this is true notwithstanding the fact that the way used was the most practical one and was used constantly over a period of years with the knowledge of the employer. Kent v. Va.-Carolina Chemical Co., 143 Va. 62 , 129 S.E. 330 , 1925 Va. LEXIS 246 (1925).

    One of the recognized exceptions to the rule is where the employee is still charged with some task or duty relating to his employment while going to or from his place of work. Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962).

    Most of the decisions applying the first exception enumerated have been based upon agreements, express or implied, that the employer will furnish the worker free transportation to and from his work. LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970).

    There is an exception to the general rule where the employee on his way to or from work is still charged with some duty or task in connection with his employment. LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970).

    If an employee sustains an injury while passing, with the express or implied consent of the employer, to or from his work over the employer’s premises, or over those of another in such proximity and relation as to be in practical effect a part of the employer’s premises, the injury is as causally related to the employment as if it had been sustained while the employee was engaged in work at the place of its performance. Stone v. Keister's Mkt. & Grill, 34 Va. App. 174, 538 S.E.2d 364, 2000 Va. App. LEXIS 833 (2000).

    Where the payment of six dollars per day is not reimbursement of travel expense, but is additional compensation to attract skilled workers to remote jobsite, the first exception defined in Kent v. Virginia-Carolina Chem. Co., 143 Va. 62 , 129 S.E. 330 (1925), to the general rule that an employee going to and from work is not engaged in any service growing out of an incident to his employment does not apply. GATX Tank Erection Co. v. Gnewuch, 221 Va. 600 , 272 S.E.2d 200, 1980 Va. LEXIS 280 (1980).

    “Sole and exclusive” route. —

    A road, or segment of one, is the “sole and exclusive” route whenever it is the only way for all employees to get to and from the place of employment. GATX Tank Erection Co. v. Gnewuch, 221 Va. 600 , 272 S.E.2d 200, 1980 Va. LEXIS 280 (1980).

    Where an employee is injured as a result of a special hazard, e.g., a railroad crossing existing near the employer’s premises, on the sole and exclusive route, the injury is comprehensible. A special hazard refers to some extraordinary danger at a particular location, but it does not mean that the risk to the employee is different from that to which the general public would be exposed at the same location. GATX Tank Erection Co. v. Gnewuch, 221 Va. 600 , 272 S.E.2d 200, 1980 Va. LEXIS 280 (1980).

    Injury occurring on area in which employer had no right of passage. —

    Employee’s injury was not compensable under § 65.2-101 where there was no evidence that the employee’s fall, which occurred as she was leaving her employer’s building, occurred on a walkway, a sidewalk, or other area where the employer had right of passage, and instead, the evidence showed that the fall occurred on a grassy area that was not a walkway or other area of ingress and egress where her employer had a right of passage. Gaston v. Black, 2009 Va. App. LEXIS 358 (Va. Ct. App. Aug. 11, 2009).

    Where means of transportation is provided by employer. —

    Where it was the duty of an employee to take a car furnished him by his employer to a garage on his own premises for the night, and while returning to his home one evening with the car, the employee was killed in a collision with another car, defendant claimed that the employee intended to use the car to take his wife to the theatre that night. But even if the employee intended to use the car for this purpose, the appropriation of the car for his own private ends would not have begun until the employee actually started for the theatre; so long as he was proceeding to his home with the car he was performing a service for his employer in the regular course of his employment. Fleischman Co. v. Marshall, 149 Va. 254 , 141 S.E. 139 , 1928 Va. LEXIS 364 (1928).

    An employee while on his way to work is not in the course of his employment. But where the worker is employed to work at a certain place, and as a part of his contract of employment there is an agreement that his employer shall furnish him free transportation to or from his work, the period of service continues during the time of transportation, and if an injury occurs during the course of transportation it is held to have arisen out of and in the course of the employment. Scott v. Willis, 150 Va. 260 , 142 S.E. 400 , 1928 Va. LEXIS 311 (1928).

    When the employee is furnished transportation to or from his work by the employer and is accidentally injured during the course of travel, the injury arises out of and in the course of his employment and is compensable under the Act. Lucas v. Biller, 204 Va. 309 , 130 S.E.2d 582, 1963 Va. LEXIS 149 (1963).

    A worker going to or from work is covered by the Workmen’s (now Workers’) Compensation Act where the transportation is furnished by custom to the extent that it is incidental to and part of the contract of employment; or when it is the result of a continued practice in the course of the employer’s business which is beneficial to both the employer and the employee. LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970).

    An award of compensation for injuries to an employee incurred while being transported from his home to work by his employer was upheld as an exception to the “going to or from” rule, the means of transportation being provided by the employer, where the employer and his son customarily operated company-owned trucks in the business and in traveling to and from work, claimant, who was a close friend of the son, and almost daily they would pick up claimant and transport him to and from work. Boyd's Roofing Co. v. Lewis, 1 Va. App. 93, 335 S.E.2d 281, 1985 Va. App. LEXIS 68 (1985).

    Car salesman driving demonstrator vehicle to work. —

    An exception to the “going and coming” rule applied where the claimant, a car salesman who was involved in an accident while driving a demonstrator vehicle to work, was charged with at least three tasks by his employer in his travel to work: (1) He was required to get the car to the employer’s premises each work day because his use agreement with the employer expressly required him to have the demo available to show to customers during business hours; (2) he was required to display the dealer emblem and sales stickers on the car; and (3) he was required to show the car to any potential buyers, even off the employer’s premises; under these circumstances, the employee was engaged in the performance of duties which benefited his employer as he drove the demo to work on the day of the accident. Templeton Oldsmobile Dodge v. Dyer, 2000 Va. App. LEXIS 290 (Va. Ct. App. Apr. 18, 2000).

    Transportation furnished by employer must be beneficial to employer. —

    An employee furnished transportation by his employer, absent express or implied agreement or custom incidental to the employment contract, is not covered by the Workmen’s (now Workers’) Compensation Act unless such transportation is beneficial to the employer. LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970).

    Where free transportation was merely a favor to the employee which provided no benefit to his employer, injuries received by the employee en route were not compensable under the Workmen’s (now Workers’) Compensation Act. LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970).

    Employer must have duty to transport. —

    An employee making use of transportation customarily and gratuitously furnished by the employer, in the absence of an express provision for same, is not acting in the course of his employment unless a duty to transport can be implied from the attendant circumstances in the contract of hiring. This duty may be implied where it is shown that the transportation was provided as incident to procuring the services of an employee whose home is a great distance from the place of work. It may also be implied where the transportation provided by the employer is shown to have been a necessary incident to the employment because it was the only practical means by which the employee could travel to and from the place of work. At any rate, it must be shown that the transportation so furnished was a necessary incident of the employment rather than a mere favor not in furtherance of the employer’s business. Bristow v. Cross, 210 Va. 718 , 173 S.E.2d 815, 1970 Va. LEXIS 191 (1970).

    Resumption of transportation from work after stop to socialize. —

    Where an employer was fulfilling his agreement to provide an employee with transportation to and from work at the time of the motor vehicle accident in which the employee was injured, the employee’s injuries arose out of and in the course of his employment and he was entitled to benefits; the fact that, in the course of this trip, the employer had chosen to stop at a friend’s house to socialize and that the employer and employee had consumed alcoholic beverages prior to returning to the employer’s vehicle and resuming their return trip from work did not alter this conclusion. Vaughan's Landscaping & Maint. v. Dodson, 262 Va. 270 , 546 S.E.2d 437, 2001 Va. LEXIS 64 (2001).

    Public parking area. —

    An employee who was struck by a car while crossing the street from her place of work to the parking lot where her car was parked was not entitled to benefits where the parking lot was neither owned nor maintained by her employer, employees were not required to park there but could park any place they chose, the employer did not pay for employees’ parking or designate parking spaces for employees and the lot was not used exclusively by employees. Stone v. Keister's Mkt. & Grill, 34 Va. App. 174, 538 S.E.2d 364, 2000 Va. App. LEXIS 833 (2000).

    Mall parking lot. —

    Commission properly found that claimant’s slip and fall accident in a mall parking lot did not arise out of or in the course of his employment; there were other entrances he could have used and the lot was shared by employer and others and not owned by employer, and thus the area where claimant parked was not part of employer’s extended premises. Langford v. Dish Network & Indem. Ins. Co. of N. Am., 2020 Va. App. LEXIS 154 (Va. Ct. App. May 19, 2020).

    An employee required to go to outside places to work and to return to the employer’s office to report is at all such times acting in the course of his employment, and is entitled to compensation if injured by accident at such time. Taylor v. Robertson Chevrolet Co., 177 Va. 289 , 13 S.E.2d 326, 1941 Va. LEXIS 216 (1941); Kraf Constr. Servs., Inc. v. Ingram, 17 Va. App. 295, 437 S.E.2d 424, 10 Va. Law Rep. 539, 1993 Va. App. LEXIS 548 (1993).

    Employee required to attend off-premises meeting. —

    Employee who was killed while crossing a street on his way to meet with supervisor for purpose of traveling together to attend an off-premises meeting, was within the scope of his employment where employer required attendance at the meeting. Harbin v. Jamestown Village Joint Venture, 16 Va. App. 190, 428 S.E.2d 754, 9 Va. Law Rep. 1129, 1993 Va. App. LEXIS 79 (1993).

    Special errand rule inapplicable. —

    A police officer was not on a special errand while traveling to work so as to be entitled to compensation for injuries sustained in a motor vehicle accident where the officer was not under any supervisor’s order to report to work early and had not sought permission to do so from his supervisor but had unilaterally elected to comply with a magistrate’s request to appear at the magistrate’s office an hour before the officer’s scheduled shift began. Slemmons v. Prince William County Police Dep't, 2001 Va. App. LEXIS 238 (Va. Ct. App. May 8, 2001).

    “Going and coming” rule inapplicable. —

    The instant case did not fall within the parameters of the “going and coming” rule. Employee was traveling a direct route from his home base of business to another business site. He was not merely leaving his home to travel to a regular workplace. By traveling to Fredericksburg on Fridays to deliver the premium money to employer and to attend the sales meeting, he was engaged in performing a service incidental to his employment. Independent Life & Accident Ins. Co. v. Johnson, 1994 Va. App. LEXIS 520 (Va. Ct. App. Aug. 2, 1994).

    Going to and from lunch. —

    Thus injuries received by the employees off the premises of the employer in going to and from lunch do not arise out of or in the course of their employment. The risk of going to lunch is not a risk incident to the employment, but is rather an incident of life generally. Taylor v. Binswanger & Co., 130 Va. 545 , 107 S.E. 649 , 1921 Va. LEXIS 173 (1921); Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925) (see also Life Ins. Co. v. Wood, 7 Va. L. Reg. (n.s.) 827 (1922)).

    So an accident which occurred to a claimant on the street, either while going for a lunch at an appointed lunch hour or while going out on the street away from the place of employment for a cup of coffee when there was no appointed hour therefor, was not incidental to the claimant’s employment as night watchman in a store. Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925).

    Travel allowance. —

    An employee’s injuries incurred in an automobile accident while driving home from work were not covered by an insurance policy which exempted benefits for injuries incurred from or in the course of employment, where the employee was given a travel allowance which was payable from his home when he left in the morning until when he got back at night. Provident Life & Accident Ins. Co. v. Barnard, 236 Va. 41 , 372 S.E.2d 369, 5 Va. Law Rep. 479, 1988 Va. LEXIS 111 (1988).

    G.Falls.

    Proof that the employee fell on the employer’s premises adds nothing and answers nothing, when the inquiry is, did the injury arise out of the employment. It simply helps prove the “in the course of” prongs of the compensability test. Maida Dev. Co. v. Hayslett, 1995 Va. App. LEXIS 603 (Va. Ct. App. July 25, 1995).

    Fall on steps did not arise out of employment. —

    Although the commission concluded that a condition of the employment caused a claimant’s injury, nothing in the record supported that conclusion. The commission’s analysis that because the claimant’s heel got caught in the riser of a step, the injury was caused by a condition of her employment was rejected and, because the commission found no defect in the steps and because nothing in the record supported the commission’s holding that the injury occurred as the result of a condition of the employment, the injury did not arise out of the employment and the claimant was not entitled to workers’ compensation benefits. County of Buchanan Sch. Bd. v. Horton, 35 Va. App. 26, 542 S.E.2d 783, 2001 Va. App. LEXIS 96 (2001).

    In order for a fall on stairs to be compensable, there must either be a defect in the stairs or the claimant must have fallen as a result of a condition of the employment. County of Buchanan Sch. Bd. v. Horton, 35 Va. App. 26, 542 S.E.2d 783, 2001 Va. App. LEXIS 96 (2001).

    The fall must be a risk arising out of the employment. —

    Claimant’s injury from a fall while discussing work-related matters with a supervisor occurred in the course of employment, but the record failed to support the Virginia Workers’ Compensation Commission’s finding that the injury resulted from an actual risk arising out of the claimant’s employment. TBC Corp. v. Stephens, 49 Va. App. 650, 644 S.E.2d 84, 2007 Va. App. LEXIS 181 (2007).

    Because a worker who fell from a roof while inspecting the roof was put at risk of falling by his job duty, which required him to look for the source of a leak, his injury was by accident arising out of and in the course of the employment. It could reasonably be inferred that his job duty was the reason why he was not looking at his feet when he slipped. G. C. Constr., L.L.C. v. Cruz, 2012 Va. App. LEXIS 62 (Va. Ct. App. Mar. 6, 2012).

    Claimant, who tripped and fell while walking through the threshold of a copy room, was not entitled to benefits because the claimant failed to prove that the claimant’s accident arose out of the claimant’s employment in that the claimant’s tripping accident occurred in the course of, but did not arise out of, the claimant’s employment as a social worker for a public school district. Jennings v. Richmond Pub. Schs., 2012 Va. App. LEXIS 212 (Va. Ct. App. June 26, 2012).

    Grate stairway. —

    Virginia Workers’ Compensation Commission properly found that a claimant proved she sustained an injury by accident arising out of her employment where she was injured on a grate stairway that was not a common work risk. Nottoway Corr. Center/ Va. v. Bradner, 2003 Va. App. LEXIS 283 (Va. Ct. App. May 6, 2003).

    Injuries arose out of employment. —

    Where slip and fall was caused by wet condition of employer’s premises evidence proved that injury arose out of employment. Chandler v. ARA Food Servs., Inc., 1995 Va. App. LEXIS 346 (Va. Ct. App. Apr. 11, 1995).

    Claimant was entitled to receive workers’ compensation benefits for death of employee, claimant’s husband, which “arose out of” employee’s employment with employer while employee worked on a roofing project for it, as a preponderance of the evidence showed employee’s death arose out of head and chest injuries related to fall, and non-expert circumstantial evidence, including fact that people heard ladder being displaced, loose gravel from roof was found around employee, and employee did not complain about employee’s health prior to the fall, supported finding the “arising out of” element of the workers’ compensation claim. K & G Abatement Co. v. Keil, 38 Va. App. 744, 568 S.E.2d 416, 2002 Va. App. LEXIS 494 (2002).

    Virginia Workers’ Compensation Commission properly inferred that a claimant’s injuries arose out of his employment, even though the claimant did not recall his actual fall, where: (1) the claimant was near the top of a ladder, (2) his duties required him to stretch half the length of his body away from the ladder to apply tar, (3) he was unable to hold on to the ladder for support because he had a bucket of tar in one hand and a glove to apply the tar on the other, and (4) prior to his fall, he was to one side stretching out half his body from the ladder. Basement Waterproofing & Drainage v. Beland, 43 Va. App. 352, 597 S.E.2d 286, 2004 Va. App. LEXIS 278 (2004).

    Where a claimant alleged he aggravated a pre-existing back condition when he fell at his home office, though the treating physicians made no definitive statement as to causation, the Virginia Workers’ Compensation Commission properly considered the claimant’s testimony in determining that his injury was caused by the fall. B & H Constr., Inc. v. Baker, 2006 Va. App. LEXIS 153 (Va. Ct. App. Apr. 25, 2006).

    Workers’ compensation claimant’s injury arose out of the claimant’s employment, since the claimant fell on a wheelchair ramp while the claimant was returning to a car after assisting a patient in a wheelchair up the ramp, as: (1) there was a defect in the wheelchair ramp in that a person standing on the sidewalk/curb and looking down at the ramp might perceive the sides of the ramp as being level with the curb; (2) the defect caused the claimant’s fall and the resultant injury; (3) the photographic evidence supported the claimant’s assertion that she was unable to tell, in approaching the ramp from the rear, that the sides of the ramp sloped down to the pavement; and (4) a “rational mind” could find, upon consideration of the totality of the circumstances, that a causal connection existed between the conditions under which the claimant’s work was required to be performed and the claimant’s injury. Nurses 4 You, Inc. v. Ferris, 49 Va. App. 332, 641 S.E.2d 129, 2007 Va. App. LEXIS 59 (2007).

    Peculiar to employment. —

    Credible evidence established a causal connection between the conditions of a claimant’s employment and her fall and supported the commission’s award of benefits where the commission found that the condition of a loading ramp and the significant angle of the ramp caused or contributed to cause the claimant to fall and fracture her leg; the ramp was steep and had grit or dirt on its surface and these conditions constituted a risk peculiar to the claimant’s employment. Short Stop, Inc. v. Hammond, 2001 Va. App. LEXIS 124 (Va. Ct. App. Mar. 13, 2001).

    Application of actual risk test required. —

    Virginia Workers’ Compensation Commission erred in failing to apply the actual risk test to determine whether the claimant’s injury, occurring when she tripped over the door threshold as she entered her place of employment, arose out of her employment under § 65.2-101 . The commission should have made findings regarding whether the claimant’s risk of injury was peculiar to her job and not one to which the general public was equally exposed and regarding whether the threshold was defective, requiring an increased decree of attentiveness to negotiate. Dominion Va. Power v. Pulley, 2011 Va. App. LEXIS 191 (Va. Ct. App. June 7, 2011).

    Steps. —

    The mere fact that the presence of steps explains, at least in part, the fall does not support a finding that the injury arises from the employment. Where the steps are not unusual and no other condition of the employment contributes to the fall, the injury is not compensable. Steps are a risk of everyday life which may, depending on the specific facts of the case, be transformed into a risk peculiar to the workplace. Maida Dev. Co. v. Hayslett, 1995 Va. App. LEXIS 603 (Va. Ct. App. July 25, 1995).

    An employee’s claim for injuries sustained as a result of falling on steps in the workplace is compensable if he establishes either that the stairs were defective or that there was a causal connection between the way in which the work was required to be performed and the resulting injury. STG, Inc. v. Tooks, 2001 Va. App. LEXIS 329 (Va. Ct. App. June 12, 2001).

    An employee was not entitled to benefits for injuries sustained as a result of falling on steps in the workplace where the employee presented no evidence that the steps were defective or that some condition of the employment caused him to fall. STG, Inc. v. Tooks, 2001 Va. App. LEXIS 329 (Va. Ct. App. June 12, 2001).

    The Commission properly rejected a claim for benefits arising out of injuries a claimant sustained when he slipped and fell while descending some steps where the claimant presented no evidence that a condition peculiar to his employment caused him to slip and fall. The claimant simply testified that he slipped and fell, and although his application for benefits alleged various defects in the steps, he neither testified about those conditions nor presented evidence that they caused him to fall. Carroll v. Roland Vaults, Ltd., 2001 Va. App. LEXIS 314 (Va. Ct. App. June 5, 2001).

    Fall while stocking shelves. —

    Injuries to claimant resulting from fall were compensable, where claimant was standing on a milk crate, increasing the severity of the claimant’s injury over and above that which she would have sustained if she had been at floor level at the time of the fall, claimant was in a vault or refrigerator, enclosed with walls, she was not furnished with an appropriate ladder, had to stand on a milk crate in order to reach the shelving, and at the time this event occurred she had several one-half gallon milk cartons under her arm and was reaching up to place them upon the shelves. Southland Corp. v. Parson, 1 Va. App. 281, 338 S.E.2d 162, 1985 Va. App. LEXIS 100 (1985).

    Woodsman falling outside bunkhouse door. —

    Where a woodsman was injured when he fell outside the bunkhouse door of his employer’s lumber camp, the employment relationship caused the employee to be at the place he was at the time of the accident and thus exposed him to the hazard or risk of the happening of the accident and the circumstance that the accident and injury occurred outside of regular working hours was wholly immaterial. Lucas v. Lucas, 212 Va. 561 , 186 S.E.2d 63, 1972 Va. LEXIS 208 (1972).

    Fall held to result from existing medical problems. —

    Where not only did the evidence prove another cause of the accident (an idiopathic fall) in that claimant suffered from hypertension, medication for which caused weakness and dizziness, and an inner ear disorder marked by attacks of dizziness, but the circumstances surrounding the fall negated any inference that the fall arose out of the employment, in that claimant was walking on a level floor free from obstruction, she did not prove that her employment was either the origin or the cause of the fall. Winegar v. ITT, 1 Va. App. 260, 337 S.E.2d 760, 1985 Va. App. LEXIS 96 (1985).

    Where the evidence of claimant’s intoxication, which was contained in the hospital records, provided an explanation for his fall, the commission did not err in refusing to apply the unexplained fall presumption and in finding that his fall did not arise out of his employment. Lamberton v. Safeway Stores, Inc., No. 0972-86-2 (Ct. of Appeals May 20, 1987).

    Inexplicable fall. —

    Where claimant was walking on a flat, level surface in a well-lighted area, the circumstances did not show that the fall resulted from any condition peculiar to the work environment, or any physical condition afflicting claimant; rather, she inexplicably wound up on the floor, injured but conscious. The court concludes that the circumstances of the present case are not such that the only rational inference to be drawn is that the fall arose out of claimant’s employment. Memorial Hosp. v. Hairston, 2 Va. App. 677, 347 S.E.2d 527, 3 Va. Law Rep. 281, 1986 Va. App. LEXIS 320 (1986).

    In a workers’ compensation case involving an injury at a construction site, there was ample evidence in the record supporting a finding that the claimant’s injuries arose out of his employment, although the claimant did not remember falling, because the claimant’s fall from height was a result of the work environment, and the fall caused injuries. Liberty Mut. Ins. Corp. v. Herndon, 59 Va. App. 544, 721 S.E.2d 32, 2012 Va. App. LEXIS 36 (2012).

    Cause of fall. —

    Worker’s testimony and medical records substantiating her continuing complaints of ongoing knee pain, and a doctor’s opinion, supported the Workers’ Compensation Commission finding that a fall was caused, in part, by a compensable knee injury as well as a noncompensable injury. Trellis Cafe Rest. & Grill v. Dano, 2003 Va. App. LEXIS 376 (Va. Ct. App. July 1, 2003).

    Returning from breakfast to carry out instructions. —

    A woodsman was injured while returning to his employer’s bunkhouse, immediately after eating his breakfast at his employer’s boardinghouse, by slipping on a boardwalk, provided by his employer, near the door of the bunkhouse. The employer’s foreman had temporarily left the work and had instructed the woodsman to keep the time of the men during his absence, and also to notify the men at the bunkhouse, following breakfast, of where they were to work that day. The injury arose out of and in the course of the employment of the injured employee, within the meaning of the Workmen’s (now Workers’) Compensation Act. Honaker & Feeney v. Hartley, 140 Va. 1 , 124 S.E. 220 , 1924 Va. LEXIS 152 (1924).

    Falling off workplace steps. —

    Condition of the workplace which contributed to claimant’s fall was not merely the unusual nature of the steps per se, but the steps as a gathering place for employees on break. By gathering on the steps, the employees obstructed normal traffic into and out of the building. The inference of the commission that the number of employees gathered on the steps, combined with the necessity for claimant to stand and give way to a limited space, caused her to lose her balance and fall off the unprotected side of the steps is one apparent to the rational mind. Maida Dev. Co. v. Hayslett, 1995 Va. App. LEXIS 603 (Va. Ct. App. July 25, 1995).

    H.Heart Disease.

    Heart attacks. —

    There is no exception to the “injury by accident” test which permits a different analysis in the heart attack cases. The requirement of showing “injury by accident” applies equally to claims resulting from heart attacks. Woody v. Mark Winkler Mgt., Inc., 1 Va. App. 147, 336 S.E.2d 518, 1985 Va. App. LEXIS 76 (1985).

    In Virginia, the requirement of showing injury by accident applies equally to claims resulting from heart attacks. Wilhelm v. Rockydale Quarries Corp., 1993 Va. App. LEXIS 571 (Va. Ct. App. Nov. 30, 1993).

    Heart attack must “arise out of” employment to be compensable. —

    The “arising out of” portion of the requirement of this section is essentially a problem of causation. In solution of this problem, a claimant seeking compensation for a heart attack suffered while at work must prove that the work activity caused or contributed to cause the heart attack. D.W. Mallory & Co. v. Phillips, 219 Va. 845 , 252 S.E.2d 319, 1979 Va. LEXIS 180 (1979).

    And burden generally on claimant to prove causal connection. —

    Except for the fact that the General Assembly in former § 65.1-47.1 (now § 65.2-402 ) has provided fire fighters and law-enforcement officers a rebuttable presumption that a causal connection exists between work activity and heart disease, where compensation benefits are sought for heart attack suffered by employee while at work, the burden is on the claimant to prove that the accident falls within the statutory definition of compensable injury as injury by accident arising out of employment. D.W. Mallory & Co. v. Phillips, 219 Va. 845 , 252 S.E.2d 319, 1979 Va. LEXIS 180 (1979).

    Determination in case of preexisting heart disease. —

    In an action for compensation benefits filed by the widow of an employee who suffered a fatal heart attack while at work, where the employee suffered from a preexisting heart disease, the causation problem is complicated by the difficulty in determining whether the heart attack is merely a natural coincidence of the disease or a result of work activity. In this type of situation, common knowledge and experience are inadequate to resolve the problem; indeed, even among medical authorities, substantial disagreement exists concerning the relationship between work activity and a heart attack in a person with a preexisting heart disease. By necessity, therefore, the Commission must look to the medical evidence in the particular case to determine whether the necessary causal connection between work activity and a heart attack has been established. If any credible evidence supports the Commission’s finding that work activity has or has not caused or contributed to cause the heart attack in a particular case, the finding is conclusive and binding upon the Supreme Court. On the other hand, if no credible evidence supports the Commission’s finding, that court is not bound thereby. D.W. Mallory & Co. v. Phillips, 219 Va. 845 , 252 S.E.2d 319, 1979 Va. LEXIS 180 (1979).

    Heart attack caused by stress over period of weeks. —

    Where claimant’s heart attack was related causally to physical and emotional stresses which had accumulated over a three-week period, it was not an identifiable incident that occurred at some reasonably definite time. Woody v. Mark Winkler Mgt., Inc., 1 Va. App. 147, 336 S.E.2d 518, 1985 Va. App. LEXIS 76 (1985).

    Evidence did not establish a causal connection between claimant’s heart attack and the work he was performing at the time it occurred, where claimant, who had a history of chronic heart disease, felt severe pain in his chest while lifting a bag, and was later diagnosed at a hospital as having suffered a heart attack. Aragon Corp. of Am. v. Escobar, No. 1712-89-4 (Ct. of Appeals Oct. 16, 1990).

    The denial of dependent benefits to the decedent’s wife in a workers’ compensation action was proper because the death presumption was inapplicable and there was credible evidence to support a finding that the decedent died of a cardiac arrest entirely unrelated to heat exposure. Although the expert medical opinions were in conflict as to whether heat exposure played a role in the decedent’s demise, credible evidence supported the finding that it did not and that the death resulted solely from decedent’s preexisting coronary artery disease. Puller v. Fairfax Sch. Bd., 2011 Va. App. LEXIS 379 (Va. Ct. App. Dec. 6, 2011).

    I.Psychological Injury.

    Psychiatric treatment not compensable. —

    Psychiatric treatment of claimant after she had injured her back in a compensable industrial accident was not compensable, where claimant failed to carry her burden of proving that the psychiatric treatment was causally related to her back injury. Moretto v. Farm Fresh #197, No. 0908-91-1 (Ct. of Appeals Oct. 22, 1991).

    Purely psychological disability resulting from disagreements over managerial decisions and conflict with supervisory personnel that cause stressful consequences ordinarily are not compensable. Teasley v. Montgomery Ward & Company, Inc., 14 Va. App. 45, 415 S.E.2d 596, 8 Va. Law Rep. 2327, 1992 Va. App. LEXIS 77 (1992).

    Recovery for mental ailments without physical injury. —

    The Virginia Supreme Court long ago explicitly held that recovery under the Workers’ Compensation Act may be had as a result of mental ailments unaccompanied by physical injury. Haigh v. Matsushita Elec. Corp. of Am., 676 F. Supp. 1332, 1987 U.S. Dist. LEXIS 12113 (E.D. Va. 1987).

    Psychological injury. —

    Where a psychological injury is at issue, the fact that the condition manifests itself symptomatically at a time later than that at which the causative incident occurred is of no moment, provided that circumstances show an identifiable incident occurring at a reasonably definite time which causes the emotional injury. Hercules, Inc. v. Gunther, 13 Va. App. 357, 412 S.E.2d 185, 8 Va. Law Rep. 1507, 1991 Va. App. LEXIS 314 (1991).

    To be compensable as an injury by accident, a purely psychological injury must be causally related to a physical injury or be causally related to an obvious sudden shock or fright arising in the course of employment. Mitzelfelt v. Mt. Clinton Church of God, 1993 Va. App. LEXIS 643 (Va. Ct. App. Dec. 28, 1993).

    Use of the conjunctive “and” expresses the intent of the General Assembly that in order to be compensable, an injury must satisfy both criteria; to be compensable, a psychological injury as with a physical injury, must arise out of the employment while the triggering event of a sudden shock or fright causing the injury must occur in the course of employment. Hess v. Va. State Police, 68 Va. App. 190, 806 S.E.2d 413, 2017 Va. App. LEXIS 280 (2017).

    Conflicts with supervisory personnel that cause stressful consequences which result in purely psychological disability are ordinarily not compensable as an injury by accident. Mitzelfelt v. Mt. Clinton Church of God, 1993 Va. App. LEXIS 643 (Va. Ct. App. Dec. 28, 1993).

    Psychological disability from work disagreements not compensable. —

    Psychological disability resulting from conflicts with supervisory personnel and disagreements over management decisions do not constitute an injury by accident. Teasley v. Montgomery Ward & Company, Inc., 14 Va. App. 45, 415 S.E.2d 596, 8 Va. Law Rep. 2327, 1992 Va. App. LEXIS 77 (1992).

    Post traumatic stress disorder. —

    Workers’ Compensation Commission award of compensation benefits was upheld where credible evidence supported the commission’s finding that the claimant’s post traumatic stress disorder was causally related to an obvious sudden shock or fright which he sustained in the course of his employment, and that he suffered a compensable “injury by accident” within the meaning of former § 65.1-7. Hercules, Inc. v. Gunther, 13 Va. App. 357, 412 S.E.2d 185, 8 Va. Law Rep. 1507, 1991 Va. App. LEXIS 314 (1991).

    Post traumatic stress disorder (PTSD), may be compensable as an “injury by accident” or as an “occupational disease,” depending on how it develops; when based upon a single physical injury or obvious sudden shock or fright, PTSD may be considered an injury by accident, when it is suffered as a result of ongoing stress, it qualifies as a disease. Mottram v. Fairfax County Fire & Rescue, 35 Va. App. 85, 542 S.E.2d 811, 2001 Va. App. LEXIS 102 (2001), aff'd in part and rev'd in part, 263 Va. 365 , 559 S.E.2d 698, 2002 Va. LEXIS 45 (2002).

    Whether a Virginia state trooper’s post-traumatic stress disorder resulted from a sudden fright or shock and thus, occurred in the course of employment, was a factual determination made by the Virginia Workers’ Compensation Commission, and since evidence supported that determination, it was not further reviewable on appeal; the trooper’s traumatic experience was not a sudden or unexpected shock or fright for a state trooper who received fatal accident and crash scene reconstruction training. Hess v. Va. State Police, 68 Va. App. 190, 806 S.E.2d 413, 2017 Va. App. LEXIS 280 (2017).

    No recovery for emotional distress. —

    In accordance with the application of current Virginia law, the Virginia Workers’ Compensation Act precludes plaintiff from recovering for emotional distress in this forum. Haigh v. Matsushita Elec. Corp. of Am., 676 F. Supp. 1332, 1987 U.S. Dist. LEXIS 12113 (E.D. Va. 1987).

    Where claimant alleged a gradually incurred injury caused by cumulative events, specifically, she alleged a “pattern of abusive behavior,” continuing over an extended period of time, and she stated that this conduct caused her severe emotional distress, and further, her pleadings did not allege an injury that can be construed as resulting from an obvious sudden mechanical or structural change in her body, therefore, claimant had not alleged such an “injury by accident” within the purview of the Workers’ Compensation Act. Middlekauff v. Allstate Ins. Co., 247 Va. 150 , 439 S.E.2d 394, 10 Va. Law Rep. 785, 1994 Va. LEXIS 10 (1994).

    Racial discrimination allegations. —

    Claims of race discrimination have never been considered to fall within the generic term “industrial accidents.” Thus, common-law remedies are still available for such claims. Teasley v. Montgomery Ward & Company, Inc., 14 Va. App. 45, 415 S.E.2d 596, 8 Va. Law Rep. 2327, 1992 Va. App. LEXIS 77 (1992).

    Injuries as result of harassment and sex discrimination. —

    Injuries suffered by employee as a result of alleged harassment and sex discrimination were the result of an accident arising out of and in the course of her employment, and therefore, her exclusive remedy was the Virginia Workers’ Compensation Act. Haddon v. Metropolitan Life Ins. Co., 239 Va. 397 , 389 S.E.2d 712, 6 Va. Law Rep. 1613, 1990 Va. LEXIS 30 (1990).

    J.Assault/Murder.

    Murder may be an accident. A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 , 1938 Va. LEXIS 287 (1938); Hopson v. Hungerford Coal Co., 187 Va. 299 , 46 S.E.2d 392, 1948 Va. LEXIS 223 (1948).

    If the assault is personal to the employee and not directed against him as an employee or because of his employment, the injury does not arise out of his employment. Richmond Newspapers, Inc. v. Hazelwood, 249 Va. 369 , 457 S.E.2d 56, 1995 Va. LEXIS 47 (1995).

    To be entitled to an award arising from an assault, a claimant must establish that the assault was directed against him as an employee, or because of his employment. Smithfield Packing Co. v. Carlton, 29 Va. App. 176, 510 S.E.2d 740, 1999 Va. App. LEXIS 133 (1999).

    A showing that the probability of assault was augmented because of the peculiar character of the claimant’s job supplies the requisite causal connection. Smithfield Packing Co. v. Carlton, 29 Va. App. 176, 510 S.E.2d 740, 1999 Va. App. LEXIS 133 (1999).

    Willful assault may be “accident.” —

    Although the injury is the result of the willful and intentional assault of either a fellow employee or a third person, this fact does not prevent the injury from being accidental within the meaning of the Act. Continental Life Ins. Co. v. Gough, 161 Va. 755 , 172 S.E. 264 , 1934 Va. LEXIS 298 (1934) (see A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 (1938)).

    The term “injury by accident” includes those injuries which result from a willful and intentional assault by a third party on an employee. County of Chesterfield v. Goyne, 26 Bankr. 47, 1982 Bankr. LEXIS 5318 (Bankr. E.D. Va. 1982).

    Assault by third party. —

    The mere fact that the employee sustains injury from an assault made upon him by a third party does not entitle him to compensation; he must go further and prove that the assault was directed against him as an employee, or because of his employment; that is, that it arose out of as well as in the course of his employment. Continental Life Ins. Co. v. Gough, 161 Va. 755 , 172 S.E. 264 , 1934 Va. LEXIS 298 (1934); A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 , 1938 Va. LEXIS 287 (1938); Hopson v. Hungerford Coal Co., 187 Va. 299 , 46 S.E.2d 392, 1948 Va. LEXIS 223 (1948).

    Where at the time of an assault, claimant was performing the duties of his employment in a place he was required to be and was using means of transportation for which the cost was paid by his employer, even if the motive for the assault was to deprive him of this means of transportation, the assault was not personal to the employee, but arose out of the employment. Continental Life Ins. Co. v. Gough, 161 Va. 755 , 172 S.E. 264 , 1934 Va. LEXIS 298 (1934).

    An assaulted claimant must show that the assault was aimed at him as an employee in order to recover. To allow recovery absent such evidence would require the adoption of the positional risk doctrine which Virginia has not adopted. Virginia has, instead, adopted the “actual risk” test. Park Oil Co. v. Parham, 1 Va. App. 166, 336 S.E.2d 531, 1985 Va. App. LEXIS 79 (1985).

    Fight with coworker. —

    While the employee, who suffered a shoulder injury, successfully established that a fight between himself and a co-employee was not personal in nature, but related to employer’s business, the employee failed to prove that he was not responsible for the fight; thus, the employee was not entitled to recover workers’ compensation benefits because his injury did not “arise out of” his employment. Stillwell v. Lewis Tree Serv., 47 Va. App. 471, 624 S.E.2d 681, 2006 Va. App. LEXIS 32 (2006).

    Employee killed by contract killer. —

    Where employee was not murdered in the course of a robbery but was possibly killed by a contract killer, his death did not arise out of his employment. Goggin v. United Ins. Co., No. 0127-89-2 (Ct. of Appeals Jan. 16, 1990).

    Revengeful attack on Commonwealth’s attorney. —

    A case which involves neither the usual employer-employee relationship nor a typical industrial accident, but rather involves a Commonwealth’s attorney charged with the duty of exercising his authority in different places, including his home, and at various times, including evening hours, requires a different definition of “in the course of.” Graybeal v. Board of Supvrs., 216 Va. 77 , 216 S.E.2d 52, 1975 Va. LEXIS 251 (1975).

    “Arising” means “originating,” where the Commonwealth’s attorney’s nighttime injury from exploding bomb placed on the top of his family car no less arose in the course of his employment than if he had been shot by his revenge-seeking assailant in the courtroom immediately following the murder trial, or if he had been injured by a bomb triggered to explode in his office upon his return from the courtroom. Graybeal v. Board of Supvrs., 216 Va. 77 , 216 S.E.2d 52, 1975 Va. LEXIS 251 (1975).

    Where the course from prosecution to desire-for-revenge to injury of a Commonwealth’s attorney was unbroken, constituting a single work-connected incident, the Commission’s denial of compensation was reversed and the case remanded for the award to the claimant of appropriate compensation. Graybeal v. Board of Supvrs., 216 Va. 77 , 216 S.E.2d 52, 1975 Va. LEXIS 251 (1975).

    The risk of suffering a physical attack on account of terminating a subordinate’s employment is an ordinary risk incidental to a superior’s employment. County of Chesterfield v. Goyne, 26 Bankr. 47, 1982 Bankr. LEXIS 5318 (Bankr. E.D. Va. 1982).

    Where employee is aggressor. —

    Compensation is generally denied where a laborer suffers injuries from an assault, when the claimant is himself in fault as the aggressor; this because, in such cases, the proximate cause of the injury is not the employment, but the fault of the claimant. Farmers' Mfg. Co. v. Warfel, 144 Va. 98 , 131 S.E. 240 , 1926 Va. LEXIS 232 (1926).

    Stabbing related to work conditions. —

    Evidence supported the conclusion that claimant’s injury was caused by her ordering the men out of the store, which exposed her to the risk of bodily harm. In complying with employer’s instructions to move altercations between customers outside of the store, claimant exposed herself to an actual risk of injury, which flowed from her employment as a rational consequence. In other words, her stabbing injury was causally connected to the conditions under which she was required to work. Southland Corp. v. Curtis, 1995 Va. App. LEXIS 114 (Va. Ct. App. Feb. 14, 1995).

    Hockey player. —

    Where the workers’ compensation claimant, a professional hockey player, was injured in a fight that the claimant was ordered by the claimant’s coach to instigate, the injury arose out of the claimant’s employment pursuant to § 65.2-101 , as expert testimony supported the finding that fighting was an integral part of hockey, and at the time of the injury, the claimant was performing a task that the claimant was employed to perform. Norfolk Admirals v. Jones, 2005 Va. App. LEXIS 443 (Va. Ct. App. Nov. 1, 2005).

    Shooting of bartender at restaurant with homosexual clientele. —

    Where assailants attacked the restaurant because of its homosexual clientele, and in doing so, shot claimant, who was working as a bartender, claimant’s injury had its origin in a risk connected with his employment, and it flowed from his employment as a rational consequence. Therefore, the commission did not err in finding that claimant proved an injury by accident arising out of his employment. Bull Ring, Inc. v. Keppel, 1995 Va. App. LEXIS 105 (Va. Ct. App. Feb. 7, 1995).

    Tractor trailer driver negotiating turn triggering furious attack by motorcyclist. —

    Where furious attack on claimant was triggered by claimant’s need to occupy part of two lanes to negotiate a turn in a tractor trailer and the difficulty in seeing a small object such as a motorcycle on the right side, impersonal circumstances directly attributable to the duties of his employment, it clearly satisfied the “arising out of” prong of compensability. Smithfield Packing Co. v. Carlton, 29 Va. App. 176, 510 S.E.2d 740, 1999 Va. App. LEXIS 133 (1999).

    Goosing injury did not arise out of employment. —

    Where evidence showed clearly that the goosing in pressroom was of a personal nature and not directed against the recipients as employees or in furtherance of the employer’s business, injury, suffered as a result of the goosing, did not arise out of his employment. Richmond Newspapers, Inc. v. Hazelwood, 249 Va. 369 , 457 S.E.2d 56, 1995 Va. LEXIS 47 (1995).

    Pressroom goosing. —

    Assault was personal to employee where there was evidence that gooser goosed fellow workers because he considered them his friends. Indeed, friendship seems to have been the motivation for the pressroom goosing, as an assistant in the pressroom testified that he did not know “of anybody that had goosed anybody that didn’t consider them a friend.” Richmond Newspapers, Inc. v. Hazelwood, 249 Va. 369 , 457 S.E.2d 56, 1995 Va. LEXIS 47 (1995).

    Injury arising from horseplay between employees. —

    Employee who was the innocent victim of horseplay by co-employees when they threw ice at him, whereupon he suffered an injury, was entitled to workers’ compensation benefits under § 65.2-101 , as the injury resulted from an accident in the course of and arising out of his employment; as horseplay rather than an assault was involved, no causal connection between the injury and the work required by the employer was required to be shown. Simms v. Ruby Tuesday, Inc., 281 Va. 114 , 704 S.E.2d 359, 2011 Va. LEXIS 17 (2011).

    Injury from assault by coemployee. —

    In a case in which a former co-worker stabbed the claimant while he was working, the Workers’ Compensation Commission erred in finding that the claimant failed to prove that the injury arose out of a risk of employment because, even though the claimant knew the co-worker, the assault could still have arisen out of his employment as long as random assaults were a risk of the job, and there was no evidence the co-worker’s motives were personal; and the Commission could consider other evidence than motive to satisfy the requirement that the injury arose from a risk of employment where the co-worker’s motive was unknowable. King v. DTH Contract Servs., 69 Va. App. 703, 823 S.E.2d 6, 2019 Va. App. LEXIS 26 (2019).

    K.Disobeying Instructions.

    Fall from truck while disobeying instructions. —

    A helper on a soft drink truck left the truck cab to get a bottle of soft drink from the body of the truck. He was cautioned by the driver to wait until the truck was stopped, but disregarded the suggestion or warning and, in the effort to get the bottle, fell from the truck and was killed. While deceased was permitted to satisfy his thirst with soft drinks from the truck, he had been admonished on previous occasions that it was dangerous for him to try to procure a bottle while the truck was in motion. It was held that the accident arose out of and in the course of employment of the deceased. Bradshaw v. Aronovitch, 170 Va. 329 , 196 S.E. 684 , 1938 Va. LEXIS 191 (1938).

    Operating machine in violation of orders. —

    The employee was employed as a filling station attendant. A front-end loader purchased by the employer in connection with his separate hauling and grading business was delivered to the station pending its removal to a job site. In violation of orders to leave the machine alone the employee used it to take trash from the filling station to the dump, a task usually performed by one of the employer’s truck drivers and a function for which the loader was not designed. The employee was not familiar with the operation of the machine, lost control of it and was seriously injured when it turned over. But since in operating the machine the employee was in a place where he was not reasonably expected to be and not engaged in the fulfillment of his duties, the Commission erred in finding the injury arose out of and in the course of his employment and the award in his favor was reversed. Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962).

    The testimony of witnesses, as well as a co-worker’s written statement, constituted credible evidence to support the commission’s factual finding that claimant reached into the machine to remove dirty, wet cotton, while the machine was running, in violation of employer’s safety rules; by deliberately reaching into the machine while it was in operation, claimant violated employer’s known safety rules. Therefore, the commission did not err in ruling that claimant was barred from receiving any benefits under the Workers’ Compensation Act. Ogburn v. Southside Gin, Inc., 1997 Va. App. LEXIS 161 (Va. Ct. App. Mar. 25, 1997).

    Ignoring doctor’s orders. —

    Employee’s injuries were not compensable where the employee’s injury was the expected result of an activity that violated the doctor’s specific restrictions following an earlier compensable injury; the employee’s choice to ignore the doctor’s orders was not an injury by accident under the Act. Carpet Palace, Inc. v. Salehi, 26 Va. App. 357, 494 S.E.2d 870, 1998 Va. App. LEXIS 22 (1998).

    L.Illustrative Cases.

    The plaintiff was precluded by the Act’s exclusive remedies provision under § 65.2-307 , from seeking redress in court for her personal injuries which were sustained when her employer fired her and forcibly removed her from the place of employment. Sutter v. First Union Nat'l Bank, 932 F. Supp. 753, 1996 U.S. Dist. LEXIS 10985 (E.D. Va. 1996).

    Police officer acted in course of employment. —

    In concluding her affairs at the courthouse as the arresting officer in a drunk driving case, police officer acted in the course of her employment. Thore v. Chesterfield County Board of Supervisors, 10 Va. App. 327, 391 S.E.2d 882, 6 Va. Law Rep. 2371, 1990 Va. App. LEXIS 81 (1990).

    Injury during bank robbery. —

    The claimant was injured in an accident “arising out of” her employment, where, as part of her duties, she was required regularly to handle and carry large sums of money in cash to a bank and was injured during a robbery of that bank which occurred while she was at the bank to deposit cash for her employer. The claimant’s regular presence in a branch bank, an environment that is prone to the violence of robbery, exposed her to a special risk of assault. R & T Invs., Ltd. v. Johns, 228 Va. 249 , 321 S.E.2d 287, 1984 Va. LEXIS 196 (1984).

    Truck driver shot during late night robbery failed to show that robbery arose out of his employment. —

    Truck driver who was shot after being stopped by robbers late at night while driving for his employer satisfied the third requirement of this section, in course of employment, because he was injured while fulfilling the duties of his employment; but he did not satisfy the second requirement that the injury arise out of his employment since he was unable to offer any evidence indicating that the assault could be traced to his employment as a truck driver and he did not demonstrate that driving the truck was a contributing proximate cause to the assault or that the assault was a hazard to which he would not have been exposed apart from the employment, since the same tragedy could have happened to anyone driving on the interstate highway at 3:00 a.m. Hill City Trucking, Inc. v. Christan, 238 Va. 735 , 385 S.E.2d 377, 6 Va. Law Rep. 840, 1989 Va. LEXIS 156 (1989).

    Truck driver who was shot in the course of his employment failed to prove that the unexplained assault upon him arose out of his employment, where the assailant made no attempt to rob him or to steal his truck or its contents. Metcalf v. A.M. Express Moving Sys., 230 Va. 464 , 339 S.E.2d 177, 1986 Va. LEXIS 147 (1986).

    Compensable new injury. —

    Where the pain from the injury was in a different location than that which he had previously experienced, and an MRI revealed new objective findings, thus, evidence supported the commission’s finding that the accident caused a new injury and was not an aggravation of an old injury. First Team Auto v. Saylor, 1993 Va. App. LEXIS 612 (Va. Ct. App. Dec. 7, 1993).

    Decedent did not suffer identifiable compensable injury. —

    Where Workers’ Compensation Commission denied benefits after claimant’s husband suffered from sudden cardiac arrest while he was exposed to radar waves at work and died, claimant failed to establish that the husband suffered an identifiable compensable injury because claimant’s alleged identifiable incident, three weeks of exposure for six to eight hours per workday, was an example of repeated exposures over weeks, not a single, definite occasion of exposure. Johnson v. Gen. Dynamics Corp., 2022 Va. App. LEXIS 61 (Va. Ct. App. Mar. 8, 2022).

    which required claimant, when he stepped down, to take a longer than normal step, causing his leg to give way and resulting in an acute strain to his lower back, the steps and puddle of water were hazards peculiar to claimant’s work environment at the time, and his injury arose out of a condition of the employment. Klate Holt Co. v. Hamilton, No. 0479-89-1 (Ct. of Appeals April 10, 1990).

    Traveling salesman injured in car accident. —

    Employee, a wastewater treatment sewer salesman, who was injured in car accident while driving on highway when his car ran off the road was entitled to compensation benefits for his injury was caused by an accident associated with a risk connected with his employment as a traveling salesman; the road conditions were “fine” and there were no cars seen near his vehicle prior to the accident; his automobile veered off the highway without being struck and without him applying his brakes to avoid going into the ditch and hitting the guardrail. Vaden Co. v. Keiser, 1994 Va. App. LEXIS 24 (Va. Ct. App. Jan. 25, 1994).

    Truck driver staying in hotel while waiting to pick up cargo. —

    A truck driver had delivered a cargo to a city in another state, and on orders from his employer waited there to pick up another cargo. He fell to his death from the window of his hotel room, there being no circumstances to indicate suicide. The Commission properly awarded compensation to his wife and children. The presumption was that the death arose out of and in the course of the employment. Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958).

    Professional athlete injured in an out-of-state game. —

    Injured professional athlete presented sufficient evidence of an injury through team reports prepared by his employer establishing that the athlete injured his knee while at work for the team in a game played in Pittsburgh, a doctor’s report confirming that the incident caused the athlete’s knee injury, and the athlete’s testimony that he injured his knee during the game. Pro-Football Inc. v. Paul, 39 Va. App. 1, 569 S.E.2d 66, 2002 Va. App. LEXIS 540 (2002).

    Injury while starting truck in preparation for work held not in course of employment. —

    A worker was employed to remove snow from the streets by means of a snow plow attached to a truck owned by him, and for this work was paid by the hour. After eating lunch the worker went out to start his truck, preliminary to beginning the work of removing the snow, and while attempting to start the truck was injured. The accident did not arise in the course of the worker’s employment. Staats v. Town of Vienna, 167 Va. 37 , 187 S.E. 485 , 1936 Va. LEXIS 272 (1936).

    Injury received while performing preliminary task assigned after arriving at work early. —

    Where plaintiff had arrived at the scene of his employment early and was performing a preliminary task assigned to him, an injury accidentally inflicted upon him by defendant, a fellow employee, was properly held to have arisen out of and in the course of plaintiff’s employment. Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962).

    Employee’s injury sustained at a trash receptacle on employer’s premises was compensable, even though employee had not yet clocked in and the trash receptacle was a few steps out of the way of employee’s normal path to work. Jones v. Colonial Williamsburg Found., 10 Va. App. 521, 392 S.E.2d 848, 6 Va. Law Rep. 2790, 1990 Va. App. LEXIS 121 (1990).

    While attending meeting at which employer expected employee to be. —

    The employer held meetings once a week and at these meetings a lecturer employed by the employer made certain talks with the object of increasing efficiency. The employee received no extra compensation for the time consumed in attendance at these lectures. It appeared that all employees were notified thereof and were expected to be in attendance thereat. The employee while attending one of these lectures was struck by a falling electric fixture in the rear of the store, while awaiting the arrival of the lecturer. The accident arose out of and in the course of the employee’s employment, and the employee was precluded from bringing the common-law action against her master. Garris v. Peoples Drug Stores, 162 Va. 428 , 174 S.E. 665 , 1934 Va. LEXIS 259 (1934).

    Injury occurring while running a business errand for employer. —

    Employee’s injury arose out of and in the course of her employment where she was injured when hot steam spewed into her automobile when she was driving to pick up paychecks for her employer. Luskins, Inc. v. Neal, 1993 Va. App. LEXIS 526 (Va. Ct. App. Nov. 9, 1993).

    Graduate research assistant’s travel from professional conference site to campsite by bicycle, even though her intended purpose after arrival was employment related, was not reasonably fulfilling the duties of employment or performing functions reasonably incidental to her employment. Accordingly, since her injuries, which were caused by being struck by a hit and run vehicle while riding her bicycle, did not occur in the course of her employment, the Commission’s award was reversed. VPI & State Univ. v. Wood, 5 Va. App. 72, 360 S.E.2d 376, 4 Va. Law Rep. 621, 1987 Va. App. LEXIS 271 (1987).

    Injury received while en route to doctor’s office for treatment of compensable injury. —

    An employee who suffers a compensable injury may be awarded compensation for additional injuries suffered in an automobile accident occurring while the employee is en route from his place of employment to a doctor’s office for further treatment of the original injury. Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254, 1967 Va. LEXIS 128 (1967) (commented on in 53 Va. L. Rev. 1763 (1967)).

    The requirement of former § 65.1-88 (now § 65.2-603 ) that the employer furnish and the employee accept medical attention is read into the employment contract between them. When the employer directs or authorizes the employee to seek medical attention for a work-connected injury and the employee follows such direction or authorization, they are but fulfilling the reciprocal obligations of the Act and their contract. To say that an additional injury, suffered by an employee while fulfilling such an obligation, is not also work-connected has little support in modern legal authority and even less in logic. Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254, 1967 Va. LEXIS 128 (1967) (citing Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843 (1953) and commented on in 53 Va. L. Rev. 1763 (1967)).

    Home care nurse en route to patient’s home. —

    Accident which occurred while claimant, who worked as a home care nurse, was en route from her home to a patient’s home, did not arise out of and in the course of her employment. Sentara Leigh Hospital v. Nichols, 12 Va. App. 841, 407 S.E.2d 334, 8 Va. Law Rep. 224, 1991 Va. App. LEXIS 161 (1991).

    Work related risk or work related exertion did not cause injury. —

    Where employer sustained an acute lumbosacral strain while working on a shower stall within the scope of his employment as a plumber, the evidence was insufficient to show that the strain arose out of the employment, since the claimant failed to show that the conditions of the workplace or that some significant work related exertion caused the injury. Plumb Rite Plumbing Service v. Barbour, 8 Va. App. 482, 382 S.E.2d 305, 6 Va. Law Rep. 111, 1989 Va. App. LEXIS 100 (1989).

    Claimant’s injury resulting from the mere act of squatting was not compensable, where she experienced pain in her knee when she squatted to pick up debris during an assembly-line break after being directed by her supervisor to begin sweeping. Francisco v. O’Sullivan Indus., No. 0469-91-3 (Ct. of Appeals Oct. 22, 1991).

    A claimant was entitled to benefits for a back injury where the evidence established that the claimant was working in a crouched position, arranging forty-pound water bottles and that, after completing this activity, the claimant straightened up from the squatting position and felt a burning sensation in his lower back toward his hip area. International Paper Co. v. Dehart, 2000 Va. App. LEXIS 340 (Va. Ct. App. May 9, 2000).

    Worker seeking workers’ compensation needed to show that workplace conditions or some significant work related exertion caused the injury; a decision of the Virginia Workers’ Compensation Commission denying compensation was affirmed where a worker was injured while squatting to unlock a drawer. Coates v. Gap, Inc., 2003 Va. App. LEXIS 584 (Va. Ct. App. Nov. 12, 2003).

    Injury caused by shoes worn during employment. —

    Claimant was employed as a core maker for a manufacturer of metal pipe, and while engaged in his work wore shoes with a metal guard or tip to prevent injury to his toes. At the time of the alleged accident he was stooping to get sand in connection with his work when he felt a painful or pinching sensation in the front of his right foot. He cut off the offending part of the shoe and submitted to medical treatment, but the sore place became progressively worse and because of a hardening of the arteries it became necessary to amputate the foot. The injury arose out of and in the course of the employment of the claimant. Lynchburg Foundry Co. v. Irvin, 178 Va. 265 , 16 S.E.2d 646, 1941 Va. LEXIS 162 (1941).

    Worker attempting to cross picket line. —

    A worker who had been to lunch during the noon hour, who found himself involved in a strike, who was told that he could not go back to work, and who was injured in an attempt to pass a picket, would have been injured in the course of his employment. A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 , 1938 Va. LEXIS 287 (1938).

    Partnership employee performing personal services for one partner. —

    Where employee of partnership, who was employed to work at a service station and to do such other work as the partners directed him to do at their homes and elsewhere, was injured while cleaning the cellar floor in the home of one of the partners, the accidental injuries arose out of and in the course of the employment. Arrington v. Murray, 182 Va. 1 , 28 S.E.2d 19, 1943 Va. LEXIS 123 (1943).

    Detour too slight to be of moment. —

    Claimant’s duties as an automobile salesman had kept him downtown interviewing a prospect until it was nearly time for him to report to his employer’s warehouse for floor duty. Detained in his efforts as a salesman, he telephoned his wife and asked that supper be put a little forward that he might reach the warehouse on time. Claimant’s home was within one block of the warehouse. Immediately after supper, he left his home and near it slipped on the sidewalk, fell and was hurt. The injury arose out of and in the course of claimant’s employment, since his stopping for supper at home was purely incidental and the detour was too slight to be of moment. Taylor v. Robertson Chevrolet Co., 177 Va. 289 , 13 S.E.2d 326, 1941 Va. LEXIS 216 (1941).

    Quenching one’s thirst in a conventional manner at a place the employee is expected to be is considered incidental to the employment and, thus, cannot be considered a frolic of the employee’s own. Kraf Constr. Servs., Inc. v. Ingram, 17 Va. App. 295, 437 S.E.2d 424, 10 Va. Law Rep. 539, 1993 Va. App. LEXIS 548 (1993).

    While riding to work with employer’s representative. —

    Where the employee and other workers met at the home of the employer’s representative, who drove them to work, and this was the customary practice which not only gave the employees free transportation but benefited the employer by assuring their presence on the job, injuries received during the course of transportation were held compensable. LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970).

    Where the employee’s supervisor, as he had frequently done with other tardy newscarriers, went to the home of a boy who had overslept and drove him to work, the carrier’s injuries received en route were held to be compensable as he came under his supervisor’s control and was about his employer’s business when he accepted the free ride. The benefit derived by the employer from such transportation is obvious. LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970).

    Where the employee was permitted to ride in employer’s truck for his personal convenience in returning home for the weekend, and was not instructed to do any work at destination, injuries received en route were not compensable. LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970).

    Fact that entrance into facility required crossing railroad track not sufficient to include crossing in zone of employment. —

    Estate of employee who was killed on his way home from work when a train struck his automobile while crossing the right-of-way adjoining his employer’s business was properly denied award, where the claimant’s evidence did not prove that the employer constructed the crossing or acted in a manner sufficient to include the crossing in the zone of employment. The mere fact that the main entrance into a facility requires one to cross a railroad track which is contiguous to the employer’s property is not sufficient to make that crossing a part of the employer’s premises. Kendrick v. Nationwide Homes, Inc., 4 Va. App. 189, 355 S.E.2d 347, 3 Va. Law Rep. 2220, 1987 Va. App. LEXIS 179 (1987).

    Injury received while lifting. —

    There was credible evidence to support the Commission’s finding that the claimant established a compensable injury by industrial accident, and that the Commission properly applied the applicable law, where the claimant complained of the weight of the beam at the time of the lifting incident, he complained of back pain to two co-workers who corroborated his statement, he consistently attributed his back injury to the lifting incident, the lifting occurred at work and was part of his job as a mill wright, and his treating physician stated that gradually increasing pain was a very common sequence of events in cases of herniated discs and conclusively related the injury to the lifting incident. McFeely Hardwoods & Lumber v. Miller, 4 Va. App. 334, 358 S.E.2d 178, 4 Va. Law Rep. 1, 1987 Va. App. LEXIS 186 (1987).

    Workers’ Compensation Commission’s finding that a claimant sustained an injury by accident under § 65.2-101 was proper. While the claimant had answered on a chiropractic form that she had not experienced a sudden injury and that she had experienced an injury without obvious cause, these statements did not defeat her claim; instead, the Commission was free to interpret this isolated testimony in light of the claimant’s testimony as a whole, including the claimant’s testimony that, while she was lifting a patient onto the toilet, she “felt something pull” in her back at the time. E. Shore Cmty. Servs. Bd. v. Robinson, 2010 Va. App. LEXIS 477 (Va. Ct. App. Dec. 14, 2010).

    Injury received while bending and picking up. —

    Claimant did not engage in any significant exertion, her action of bending did not involve any awkward position, nor did any condition peculiar to her workplace cause her injury. Although she was performing a work related activity when the injury occurred, no condition of the workplace or additional exertion necessitated by work, aside from the usual act of bending and picking up a not heavy item, caused the injury. Therefore, claimant’s injury did not arise out of her employment. Cox v. Wade’s #43/Cox v. Wade's #43/Wade's Supermarket, Inc., 1994 Va. App. LEXIS 556 (Va. Ct. App. Aug. 23, 1994).

    Injury received while twisting in chair. —

    Where claimant’s injury was caused solely by twisting in his chair at work, the conditions of the work place had nothing to do with the injury he sustained, and the injury therefore was not compensable. Timmons v. Airborne Freight Corp., 1995 Va. App. LEXIS 450 (Va. Ct. App. May 16, 1995).

    Striking elbow on door jamb. —

    Claimant, who was preparing to give an injection to a patient suffering an anaphylactic reaction, was walking down the hall while reading the patient’s chart. He reached up to rub his head and because his attention was focused on the chart, he failed to see a door jamb. He struck his elbow on the jamb, causing his knuckle to injure his eye. Resulting injury was compensable because walking while reading a chart was a hazard created by the circumstances of the job. Russell County Medical Ctr. v. Chaney, 1995 Va. App. LEXIS 432 (Va. Ct. App. May 9, 1995).

    Employee who was working 30 feet above the ground in a fully extended position as he reached down to attach his lanyard to a safety line and first felt a numbness in his hand suffered an injury by accident, even if the accident would not have been sufficient to cause the injury in the absence of employee’s preexisting condition. Kemp v. Tidewater Kiewit, 7 Va. App. 360, 373 S.E.2d 725, 5 Va. Law Rep. 838, 1988 Va. App. LEXIS 122 (1988).

    Plumber’s helper sustained a compensable injury when he twisted his knee while digging a ditch, even though he could not relate the exact date of accident, since he had informed his immediate supervisor shortly after the accident. Kane Plumbing, Inc. v. Small, 7 Va. App. 132, 371 S.E.2d 828, 5 Va. Law Rep. 220, 1988 Va. App. LEXIS 88 (1988).

    Claimant’s injury arose out of her employment, where she knocked a bottle of glass cleaner from a window ledge, “turned and stooped quickly” to catch it with a sudden movement, and, as a result, injured her knee. Southside Boys Club, Inc. v. Gordon, No. 0537-90-1 (Ct. of Appeals Sept. 25, 1990).

    Accidental discharge of firearm. —

    Where a deputy high constable of the City of Richmond was accidentally shot while in the course of employment by a fellow deputy who was cleaning a firearm customarily carried by the deputies, the accident arose out of the employment. City of Richmond v. Johnson, 202 Va. 33 , 115 S.E.2d 910, 1960 Va. LEXIS 187 (1960).

    Injury to service station employee by driver who intended only to frighten. —

    Where a customer at a service station gunned his vehicle, only aiming to frighten, but caused an injury to an employee, the injury was compensable, the case being analogous to the horseplay cases in which a nonparticipant in the act was injured during the course of his employment. Park Oil Co. v. Parham, 1 Va. App. 166, 336 S.E.2d 531, 1985 Va. App. LEXIS 79 (1985).

    Mutual horseplay. —

    Where co-workers mutually participated in horseplay the resulting injury is not an “injury by accident” as contemplated by this section. Dublin Garment Co. v. Jones, 2 Va. App. 165, 342 S.E.2d 638, 1986 Va. App. LEXIS 255 (1986).

    Unilateral act analogous to horseplay. —

    Where the injury arises from the unilateral act of a co-worker upon a nonparticipating claimant, the motivation being in the spirit of a playful act which is analogous to “horseplay,” it is an “injury by accident” insofar as the claimant is concerned. Dublin Garment Co. v. Jones, 2 Va. App. 165, 342 S.E.2d 638, 1986 Va. App. LEXIS 255 (1986).

    Claimant’s playing “two on two” basketball was not an accepted and normal activity at the place of employment; therefore, claimant’s injury did not arise out of his employment. Mullins v. Westmoreland Coal Co., 10 Va. App. 304, 391 S.E.2d 609, 6 Va. Law Rep. 2356, 1990 Va. App. LEXIS 84 (1990).

    Employee’s activity in working on his personal car, on his employer’s premises and during his hours of employment, during a lull in his work obligations, with his employer’s authorization, fell within the scope of his employment, and that the injury which he suffered in performing that work arose out of and in the course of his employment and is compensable. Ablola v. Holland Rd. Auto Center, Ltd., 11 Va. App. 181, 397 S.E.2d 541, 7 Va. Law Rep. 648, 1990 Va. App. LEXIS 179 (1990).

    Severe intoxication. —

    An employee may abandon his employment by reaching an advanced state of intoxication which renders the employee incapable of engaging in his duties. This result is not based upon a special statutory defense of intoxication. Rather, a severely intoxicated employee has removed himself from the scope of his employment. Any injuries thereafter suffered are not “in the course of” the employment. The rule does not apply, however, where an intoxicated employee continues actively to perform his duties. American Safety Razor Company v. Hunter, 2 Va. App. 258, 343 S.E.2d 461, 1986 Va. App. LEXIS 266 (1986).

    Employer sponsored party. —

    On the facts, employer sponsored party was so closely connected and associated with the employment in purpose, time, location, and function that the fatal injury sustained by employee in exiting into parking lot arose out of and in the course of her employment. Kum Ja Kim v. Sportswear, 10 Va. App. 460, 393 S.E.2d 418, 6 Va. Law Rep. 2728, 1990 Va. App. LEXIS 115 (1990).

    Aircraft refueler’s neck injury. —

    Where claimant’s job involved connecting fuel hoses to commercial aircraft and observing the fuel gauges in the underside of the aircraft’s wing to determine when the aircraft was completely fueled, and on day of injury claimant looked directly overhead in an unusual or awkward position at the gauge of the aircraft he was refueling and heard a pop in his neck, the injury to his neck was caused by exertion on that occasion that was peculiar to his employment and thereby arose out of his employment. Ogden Allied Aviation Servs. v. Shuck, 18 Va. App. 756, 446 S.E.2d 898, 11 Va. Law Rep. 93, 1994 Va. App. LEXIS 533 (1994).

    Horse trainer bitten by dog. —

    Employee did not sustain an injury by an accident that arose out of her employment where nothing about the nature or character of her work, i.e., the care and training of horses, reasonably could have exposed or subjected her to the danger of being bitten by a co-worker’s pet dog. It simply was not apparent to a rational mind, in the circumstances of this case, that a causal connection existed between the conditions of employee’s required work and her injury. Lipsey v. Case, 248 Va. 59 , 445 S.E.2d 105, 10 Va. Law Rep. 1460, 1994 Va. LEXIS 79 (1994).

    Surveyor bitten by dog. —

    Commission did not err in finding that claimant’s evidence did not prove that he sustained an injury by accident that arose out of his employment. There was nothing about the character or nature of his work as a surveyor that reasonably could have exposed or subjected him to the danger of being bitten by a pet dog. Holmes v. R. Kenneth Weeks Eng'rs, 1995 Va. App. LEXIS 484 (Va. Ct. App. June 6, 1995).

    School employee bitten by dog. —

    Employee’s injury from dog bite arose out of her employment; although contact with dog was not part of employee’s regular work duties, her contact was in direct response to repeated instructions of her supervisor for her to meet his dog. Prince William County Sch. Bd. v. Fogarty, 1999 Va. App. LEXIS 513 (Va. Ct. App. Aug. 31, 1999).

    Produce clerk picking up strawberry. —

    In bending over to pick up a strawberry, produce clerk was not in an unusual position or exerting more than usual while performing a job-related task. Ruddick Corp. v. Robertson, 1995 Va. App. LEXIS 506 (Va. Ct. App. June 13, 1995).

    Employee returning from random drug screening. —

    No evidence in the record proved that a particular risk associated with the claimant’s work caused her injury. There was nothing unusual about the car or its door, and the claimant, who was returning from a routine random drug screening for employer, was not performing any significant work-related activity when she hit her head on the door frame. Nothing about the manner in which she was doing her job or any condition of the workplace caused her injury or constituted a risk of injury to the claimant. Therefore, the commission erred by concluding that the injury was compensable. City of Norfolk v. Vaughan, 1995 Va. App. LEXIS 561 (Va. Ct. App. July 5, 1995).

    National Guard member killed returning for second day of inactive duty. —

    Dependents of enlisted member of National Guard killed in traffic accident on public highway when returning to base from home for second day of inactive duty training could not recover workers’ compensation death benefits because deceased was not performing any task of employment at time of his death and therefore death did not arise out of and in the course of employment. Carlson v. Department of Military Affairs, 26 Va. App. 600, 496 S.E.2d 107, 1998 Va. App. LEXIS 91 (1998).

    Chilblains. —

    Employee’s chilblains resulting from a single exposure to cold temperature on a definite occasion during the performance of a specific piece of work was an “identifiable incident,” and therefore, a compensable injury by accident. Southern Express v. Green, 257 Va. 181 , 509 S.E.2d 836, 1999 Va. LEXIS 9 (1999).

    Bending down to lace work boots. —

    Where evidence showed that claimant did not engage in any significant exertion—his action of bending down to lace his work boots did not involve any awkward position, nor did any condition peculiar to his workplace cause his injury, and although claimant was performing a work-related activity when the injury occurred, no condition of the workplace and additional exertion necessitated by work, aside from the usual act of bending to lace his boots and straightening back up, caused the injury, the appellate court was unable to find that claimant proved as a matter of law that his injury arose out of his employment. Cobb v. Westmoreland Coal Co., 1995 Va. App. LEXIS 120 (Va. Ct. App. Feb. 14, 1995).

    Claim failed. —

    Where a former employee allegedly was fired in retaliation for reporting illegal pharmacy practices, had the employee pled that the employee’s heart attack was the final result of repetitive stress or cumulative events, as opposed to a discrete event, the employee’s personal injury claim may not have been barred by the Virginia Workers’ Compensation Act, but the employee’s own complaint did not support this argument; also, the employee’s allegation was insufficient to state a claim. Weidman v. Exxon Mobil Corp., 776 F.3d 214, 2015 U.S. App. LEXIS 276 (4th Cir. 2015), cert. denied, 576 U.S. 1036, 135 S. Ct. 2868, 192 L. Ed. 2d 897, 2015 U.S. LEXIS 4167 (2015), dismissed, No. 1:13-cv-501, 2016 U.S. Dist. LEXIS 98059 (E.D. Va. July 26, 2016).

    M.Evidence and Procedure.

    Burden of proof. —

    In order to carry his burden of proving an injury by accident, a claimant must prove that the cause of his injury was an identifiable incident or sudden precipitating event and that it resulted in an obvious sudden mechanical or structural change in the body. Morris v. Morris, 238 Va. 578 , 385 S.E.2d 858, 6 Va. Law Rep. 756, 1989 Va. LEXIS 175 (1989).

    Claimant must prove causal connection between accident and disability, etc. —

    Claimant must prove causal connection between accident and disability which he claims resulted therefrom. This proof must go beyond conjecture. If the evidence shows that it is just as probable that the disability resulted from a cause which is not compensable, as it is that it resulted from one which is compensable, the claimant has not sustained the burden of proof. Southall v. Eldridge Reams, Inc., 198 Va. 545 , 95 S.E.2d 145, 1956 Va. LEXIS 240 (1956).

    Workers’ Compensation Commission erred in granting an EMT benefits for head and brain injuries that resulted after he lost consciousness while assisting with a lumbar puncture procedure because the EMT failed to testify that the light-headedness occurred during each of the 6-12 times he had assisted in a lumbar puncture procedure, the medical records relied upon by the Commission, at most, established a correlation between the EMT’s observation of the procedure and his loss of consciousness, the medical records did not establish what caused the episode, and no credible evidence existed in the record to support a finding that the EMT’s injuries were caused by a non-physical or emotional factor. Lynchburg Gen. Hosp. v. Foster, 2018 Va. App. LEXIS 90 (Va. Ct. App. Apr. 10, 2018).

    But proof beyond a reasonable doubt is not required. —

    While the burden is on the claimant to prove causal connection between the accident and death, proof beyond a reasonable doubt is not required, a preponderance of the evidence being all that is necessary. Rogers v. Williams, 196 Va. 39 , 82 S.E.2d 601, 1954 Va. LEXIS 198 (1954).

    Finding of Commission may be based on circumstantial evidence. —

    A finding by the Commission that an injury is compensable may be established by circumstantial evidence, and in some cases claims are presumed to be within the meaning of the Act. Sullivan v. Suffolk Peanut Co., 171 Va. 439 , 199 S.E. 504 , 1938 Va. LEXIS 296 (1938).

    And court may presume that accident was compensable. —

    Where an employee is found dead as the result of an accident at his place of work or nearby, where his duties may have called him during the hours of his work, and there is no evidence offered to show what caused the death or to show that he was not engaged in his master’s business at the time, the court will indulge the presumption that the relation of master and servant existed at the time of the accident, and that it arose out of and in the course of his employment. Sullivan v. Suffolk Peanut Co., 171 Va. 439 , 199 S.E. 504 , 1938 Va. LEXIS 296 (1938); Southern Motor Lines Co. v. Alvis, 200 Va. 168 , 104 S.E.2d 735, 1958 Va. LEXIS 172 (1958).

    Presumption held not applicable. Butler v. Nolde Bros., 189 Va. 932 , 55 S.E.2d 36, 1949 Va. LEXIS 229 (1949).

    In absence of contrary or conflicting evidence. —

    In workmen’s (now workers’) compensation cases, where liability is imposed on the employer on presumptive evidence to the effect that the death arose out of the employment, there must be an absence of contrary or conflicting evidence on the point and the circumstances which form the basis of the presumption must be of such strength that the only rational inference to be drawn is that death arose out of and in the course of the employment. Hopson v. Hungerford Coal Co., 187 Va. 299 , 46 S.E.2d 392, 1948 Va. LEXIS 223 (1948).

    But burden of proof is on claimant. —

    In cases under the Workmen’s (now Workers’) Compensation Act, the burden of supplying evidence from which the inference can be legitimately drawn that the injury arose out of and in the course of the employment, rests upon the claimant. Sullivan v. Suffolk Peanut Co., 171 Va. 439 , 199 S.E. 504 , 1938 Va. LEXIS 296 (1938).

    The burden is upon the claimant to prove by a preponderance of the evidence that the accident arose out of and in the course of his employment. Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939); Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962); Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978); Hercules, Inc. v. Stump, 2 Va. App. 77, 341 S.E.2d 394, 1986 Va. App. LEXIS 244 (1986).

    The claimant bears the burden of proof in establishing the fact that his injuries resulted from an accident. That his disability may be due to, or aggravated by, accidental injury is not sufficient. There must be more than a possibility or a mere speculation. Humphries v. Newport News Shipbuilding & Dry Dock Co., 183 Va. 466 , 32 S.E.2d 689, 1945 Va. LEXIS 193 (1945).

    The claimant has the burden to establish a causal relationship between an industrial accident and injury and when the claimant, who is in a position of being able to explain the occurrence, fails to present evidence which establishes that the injury arose out of the employment the claim for compensation must be denied. Memorial Hosp. v. Hairston, 2 Va. App. 677, 347 S.E.2d 527, 3 Va. Law Rep. 281, 1986 Va. App. LEXIS 320 (1986).

    Where the commission reviewed all available medical records and a preponderance of the evidence did not establish that a worker’s numb foot was caused by a work-related accident, the worker did not sustain her burden of proving that the numbness arose out of or in the course of her employment. Milbourne-Bush v. Gateway, Inc., 2003 Va. App. LEXIS 225 (Va. Ct. App. Apr. 15, 2003).

    Judicial review regarding injury by accident. —

    Unless an appellate court can say as a matter of law that a workers’ compensation claimant sustained the claimant’s burden of proving an “injury by accident,” the findings of the Virginia Workers’ Compensation Commission to the contrary on that issue are binding and conclusive upon the appellate court. Helfer v. Va. Dep't of Rehabilitative Servs., 2003 Va. App. LEXIS 224 (Va. Ct. App. Apr. 15, 2003).

    Weight afforded treating physician testimony. —

    While the opinion of the treating physician is entitled to great weight, the law does not require that the treating physician’s opinion be accepted over that of others. Quant v. Salvation Army, Inc., 1995 Va. App. LEXIS 583 (Va. Ct. App. July 18, 1995).

    Payments and filing of reports did not toll statute of limitations. —

    When the first report of accident is filed, and when, there is no evidence of fraud or act by employer reasonably calculated to induce the employee from filing a claim with the commission, voluntary payments of compensation benefits and filing of medical reports and records do not operate to toll the limitation. Barnes v. B T R Dunlop, Inc., 1994 Va. App. LEXIS 512 (Va. Ct. App. July 26, 1994).

    Where claimant presented no evidence of any identifiable incident occurring on that day resulting in an obvious sudden mechanical or structural change in his body, the fact-finder could only speculate whether claimant’s hernia arose from a work-related cause, a cause entirely outside the employment, or a combination of causes. Accordingly, the decision of the Commission was reversed, its award is vacated, and final judgment was entered for employer. P & M Constr. Co. v. Heims, No. 0277-85 (Ct. of Appeals Dec. 13, 1985).

    When injuries may have resulted from one of two causes, for one of which the employer is responsible and for the other of which it is not responsible, the claimant must fail if his evidence does not show that the damage was produced by the former cause. And he must also fail if it is just as probable that damages were caused by the one as by the other, since claimant is bound to make out his case by the preponderance of evidence. A.N. Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 , 1938 Va. LEXIS 287 (1938); Hopson v. Hungerford Coal Co., 187 Va. 299 , 46 S.E.2d 393 (1948).

    “Just as probable” rule means merely that “a claimant must prove his case by a preponderance of the evidence.” Smith v. Fieldcrest Mills, Inc., 224 Va. 24 , 294 S.E.2d 805, 1982 Va. LEXIS 267 (1982).

    The “just as probable” rule denies compensation for failure of a claimant to sustain the burden of proof where it is just as probable that the disability resulted from a work-related cause as from a non-work-related cause. Shelton v. Ennis Bus. Forms, Inc., 1 Va. App. 53, 334 S.E.2d 297, 1985 Va. App. LEXIS 59 (1985).

    Proof of the causal connection between the industrial accident and the disabling condition underlying the employee’s application must go beyond the realm of conjecture. If it is just as likely that the disabling condition resulted from a cause which is not compensable as it is that it resulted from an accident covered by the Workers’ Compensation Act, the employee has failed to establish the requisite causal connection. Possibility is not enough. Evidence that disability “may be due” to an industrial accident is not sufficient. Watts v. Woodrow Wilson Rehabilitation Center, No. 0495-85 (Ct. of Appeals Dec. 10, 1985); Richmond King, Inc. v. Poling, No. 0816-85 (Ct. of Appeals Jan. 8, 1986).

    “Two causes” rule refers to the case where a disability has two causes: one related to the employment and one unrelated. Under this rule, full benefits will be allowed when it is shown that the employment is a contributing factor to the disability. Smith v. Fieldcrest Mills, Inc., 224 Va. 24 , 294 S.E.2d 805, 1982 Va. LEXIS 267 (1982).

    Under the “two causes” rule if a disability has two causes, one related to employment and one unrelated, benefits are allowed. Shelton v. Ennis Bus. Forms, Inc., 1 Va. App. 53, 334 S.E.2d 297, 1985 Va. App. LEXIS 59 (1985).

    Questions of law and fact. —

    Whether under a given state of facts and circumstances an employee has suffered an accident, within the meaning of the Workmen’s (now Workers’) Compensation Act, is a mixed question of law and fact, which is properly reviewable by the Supreme Court. Norfolk & Wash. Steamboat Co. v. Holladay, 174 Va. 152 , 5 S.E.2d 486, 1939 Va. LEXIS 149 (1939); Derby v. Swift & Co., 188 Va. 336 , 49 S.E.2d 417, 1948 Va. LEXIS 168 (1948); Baggett Transp. Co. v. Dillon, 219 Va. 633 , 248 S.E.2d 819, 1978 Va. LEXIS 224 (1978).

    In action to recover for the wrongful death of an employee in a coal mine, whether decedent died as a result of gradual inhalation of poisonous gas over a period of from eight days or more, or whether his death was caused by the sudden inhalation of a quantity of gas at the particular time and on the particular occasion of his death, was a question of fact for the jury. Blue Diamond Coal Co. v. Aistrop, 183 Va. 23 , 31 S.E.2d 297, 1944 Va. LEXIS 126 (1944) (see also Blue Diamond Coal Co. v. Aistrop, 181 Va. 287 , 24 S.E.2d 546 (1943)).

    Medical evidence not conclusive. —

    Medical evidence is not necessarily conclusive in a proceeding before the Virginia Workers’ Compensation Commission, but is subject to the Commission’s consideration and weighing. Helfer v. Va. Dep't of Rehabilitative Servs., 2003 Va. App. LEXIS 224 (Va. Ct. App. Apr. 15, 2003).

    Medical records did not support claim. —

    Virginia Workers’ Compensation Commission did not err in finding that the claimant did not suffer a compensable injury by accident to his left ear, nose, face, or neck because the Commission considered the claimant’s medical records and found that they did not support his testimony about any neck, nose, left ear, or facial injuries as his initial post-accident medical records from the emergency room did not indicate any complaints of such injuries. Sibai v. Sterling Jewelers, 2020 Va. App. LEXIS 316 (Va. Ct. App. Dec. 29, 2020).

    Coronary occlusion following accidental injury. —

    Where an employee suffered an injury to his back while lifting a board to a scaffold, and five days later suffered a coronary occlusion and died a month thereafter of heart trouble, the finding of the Commission that there was no causal connection between the death and the injury was one of fact, based on credible evidence, and was therefore binding on appeal. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958).

    Denial of compensation not res judicata in subsequent action. —

    A denial of an award of compensation, on the ground that the injury did not arise out of and in the course of the employment, is not res judicata in the employee’s subsequent action at law to recover damages of the employer. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    Commission erred in deciding that employee had to prove significant exertion caused injury; employee’s evidence proved that the causative danger had its origin in a risk connected with the employment and flowed from that source as a rational consequence. That the activity was usual, did not require exertion, and was not foreseen or expected, was irrelevant. Grove v. Allied Signal, 15 Va. App. 17, 421 S.E.2d 32, 9 Va. Law Rep. 162, 1992 Va. App. LEXIS 230 (1992).

    Where the commission was confronted with the conflicting accounts of how and when claimant’s knee injury was sustained, it was for the commission to decide the weight to be given these accounts and the credibility of the witnesses. The commission may consider medical histories as party admissions and as impeachment of the claimant’s testimony. Bowers v. TRW, Inc., 1996 Va. App. LEXIS 272 (Va. Ct. App. Apr. 16, 1996).

    Proffer should have been permitted. —

    Deputy commissioner erroneously refused to allow claimant to proffer evidence that purportedly would have shown that employer, at the time of claimant’s injury, was operating his business at the same volume that he had in 1986 and 1987, and thereby within the statutory definition of employer, at which time he regularly employed three or more employees. The claimant had the right to proffer her evidence, or avouch for the record what her evidence would have been because, without a proffer, it could not be ascertained on appeal whether the evidence she sought to introduce was relevant and material. Smith v. Mike Hylton t/a M.H. Stables, 14 Va. App. 354, 416 S.E.2d 712, 8 Va. Law Rep. 2859, 1992 Va. App. LEXIS 128 (1992).

    Commission review on record proper. —

    Claimant’s third party recovery created a change in the conditions under which he was awarded compensation; it affected his right to compensation and the amount and duration of it. Thus, the Workers’ Compensation Commission properly reviewed such change on record, without additional evidence and without oral argument. Eghbal v. Boston Coach Corp., 23 Va. App. 634, 478 S.E.2d 732, 1996 Va. App. LEXIS 787 (1996).

    Appellate review. —

    While the fund did not explicitly argue in its written statement that a church was not the claimant’s employer, it was the only logical conclusion one could draw from the fund’s argument, and there was sufficient argument to place the issue before the Workers’ Compensation Commission for determination; thus, it was unreasonable for the Commission to have found that the fund waived its argument that the church was not the claimant’s employer. Uninsured Employer's Fund v. Jeffreys, 2016 Va. App. LEXIS 136 (Va. Ct. App. Apr. 26, 2016).

    Sufficiency of evidence. —

    Claimant established a compensable injury by accident because the claimant testified that, when the claimant lifted a trunk from a truck at work, the claimant felt a sharp pain in the claimant’s lower back. Furthermore, the inconsistencies in the claimant’s descriptions of the accident were minor. Smith v. Dominion Tech. Solutions, 2015 Va. App. LEXIS 24 (Va. Ct. App. Jan. 27, 2015).

    CIRCUIT COURT OPINIONS

    Personal acts of other employees. —

    Defendants’ demurrers to three women employees’ claims for assault and battery, intentional infliction of emotional distress, and negligent retention, against two male employees and their employer were overruled as the claims were not barred by the exclusive remedy provisions of the Virginia Workers’ Compensation Act, § 65.2-101 et seq., since the men admitted that their purpose was to get the women to succumb to their sexual advances; the assaults and other actions were of a personal nature, directed at the women as women, rather than as employees, and did not arise out of their employment, and the injuries were not compensable injuries by accident within the meaning of the Act. Padilla v. Silver Diner, 63 Va. Cir. 50, 2003 Va. Cir. LEXIS 169 (Virginia Beach June 10, 2003).

    Alleged assault by a manager on an employee was directed at the employee as an employee in that the manager was expressing dissatisfaction with quality and work performance of employees. The manager’s actions were in furtherance of the employer’s business to the extent that the actions involved the manager’s management style in addressing what the manager perceived as the shortcomings of employees and the inability of the employee to perform a task as the manager directed. Morgan v. Brophy, 107 Va. Cir. 164, 2021 Va. Cir. LEXIS 93 (Chesapeake Jan. 28, 2021).

    Exclusive remedy. —

    Employer’s plea in bar to employee’s complaint alleging claims for negligence, negligent misrepresentation, intentional tort, and fraudulent misrepresentation related to the employee’s sickness that occurred after the employer informed the employee the employer’s office building would be fumigated, was granted, as the employee’s claim for injury resulting from chemical exposure was an injury by accident that arose out of and in the course of her employment with the employer; accordingly, the employee’s sole and exclusive remedy was under the Virginia Workers’ Compensation Act, § 65.2-101 et seq., since that Act provided, in § 65.2-307 , that an employee’s sole and exclusive remedy under those circumstances was under the Act. Murhutta v. Planning Sys., 61 Va. Cir. 340, 2003 Va. Cir. LEXIS 53 (Fairfax County Mar. 19, 2003).

    Implied contract for hire established. —

    Where a pre-existing relationship between a subcontractor and his son created an expectation that the son was to be compensated for the work he did, the son was his father’s statutory employee under an implied contract of hire on the day of injury; thus, he was barred from bringing a personal injury claim against the contractor, as his exclusive remedy was provided by the Virginia Workers’ Compensation Act. Goff v. Robert Hauser Homes, Inc., 63 Va. Cir. 297, 2003 Va. Cir. LEXIS 355 (Charlottesville Oct. 15, 2003).

    Assault personal to employee. —

    Employee’s claims against a general manager and an employer were not barred by the exclusivity provision because no conditions under which the employer required the employee’s work to be done contributed to the injury; the manager’s decision to take his frustration out on a fellow employee by assaulting her was entirely his own, and prior testimony that the manager chose to vent his frustration at the employee further demonstrated that the assault was directed at the employee personally. Morgan v. Brophy, 94 Va. Cir. 301, 2016 Va. Cir. LEXIS 147 (Chesapeake Sept. 27, 2016).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Income to Be Included:

    Employee working to repay monetary debt to employer considered to work under a contract of hire; determination of contract of hire based on whether employee works in exchange for something of value, such as forgiveness of monetary debt. Bostic v. Brenda Smith Farms, Inc., VWC File No. 211-48-59 (June 19, 2003).

    Claimant’s average weekly wage should not include allowance for t-shirts provided by employer because claimant did not derive economic benefit from t-shirts, when evidence showed that claimant more often than not wore other, non-employer t-shirts to work. Dodson v. Kloke Transfer, VWC File No. 204-19-67 (June 12, 2003).

    Whether or not in the form of money, all compensation received by the worker in addition to his regular wage must be considered in computing his average weekly wage, Examples:.

    Overtime —.Smith v. Standard Oil, 22 O.I.C. 244 (1940).

    Meals —.Harless v. Rutherford Freight Lines, Inc., 22 O.I.C. 119 (1940).

    Meals —.Harless v. Rutherford Freight Lines, Inc., 22 O.I.C. 119 (1940).

    Board —.Baker v. Jones, 3 O.I.C. 629 (1921); Smith v. Hotel Burton, 9 O.I.C. 283 (1927).

    Expense Account —.Church v. Motor Freight Corp., 18 O.I.C. 3.

    Tips —.Hairston v. Commonwealth Club, 18 O.I.C. 271 (1936); Hinshaw v. Richmond Hotels, 20 O.I.C. 345 (1938); Chesapeake Bay Seafood House v. Clements, 14 Va. App. 143, 415 S.E.2d 864, 8 Va. Law Rep. 2470, 1992 Va. App. LEXIS 90 (1992).

    Vacation Pay —.Treadway v. Blue Diamond Coal Co., 26 O.I.C. 248 (1944); Cooke v. Lawrence Motor Co., Inc., 45 O.I.C. 44 (1963).

    A bonus may be considered in determining average weekly wage where the payment was made pursuant to an employee-employer relationship. Nachod v. Public Storage Space, Inc., 62 O.I.C. 334 (1983); Treadway v. Blue Diamond Coal Co., 26 O.I.C. 248 (1944).

    Perquisites:

    In determining the value of perquisites, the deputy commissioner was entitled to rely on the claimant’s testimony. Adams v. Commonwealth of Va./Dept of Conservation & Recreation, VWC File 205-98-35 (Jan. 24, 2006).

    On June 9, 2005, the Commission rescinded the schedule of perquisites in favor of evidence of the value of perquisites to be submitted on a case by case basis.

    Income Not Included:

    Retirement Income:

    Retirement benefits are not earnings for the purpose of establishing an average weekly wage. They do not represent earnings from employment. If the decedent had been employed at the time of his death, retirement income would not have been includable for purposes of establishing an average weekly wage. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Rental Income:

    Claimant’s real estate ownership and rental income do not pertain to earned income under the Act. Vaught v. Gen. Elec. Co., 52 O.I.C. 271 (1970).

    Savings and Profit Sharing:

    Interest in savings and profit sharing plan not included as part of the average weekly wage. Kistler v. McDonald’s Corporation, 58 O.I.C. 205 (1979) (see also Boyd v. Air Conditioning Supplies, 64 O.I.C. 56 (1985) (profit sharing not included)).

    Federal tax law allows and requires an owner-employee of an S-corporation to be paid wages for services rendered to the corporation, which wages are reported on a W-2 tax form. Any remaining net earnings of the corporation are reported on a “K-1” tax form, whether or not such earnings are actually distributed. K-1 earnings should not be included in calculating a claimant’s average weekly wage, because the earnings of an S-corporation depend not only upon the efforts of the owners, but also upon the contribution of other employees and the utilization of capital. Thus, K-1 earnings are an inappropriate measure of an owner-employee’s average weekly wage. The Commission held that a claimant’s W-2 tax form reasonably reflected his wages, while the additional K-1 income reflected the value of his capital investment in the business. Davis v. Davis Auto Service, 78 O.W.C. 25 (1999).

    Fringe Benefits:

    The value of the claimant’s per diem may be included in the calculation of the claimant’s average weekly wage where it was paid regardless of the actual expenses and the employee was not required to account for how it was spent, unless the evidence shows that actual expenses were equivalent to the allowance. Smith v. McKee Foods Corporation, JCN VA02000010291 (Oct. 15, 2012).

    Value of employer’s contributions to Union Health and Welfare Fund should not be included in the employee’s average weekly wage. Hillyard v. Giant Food, Inc., 60 O.I.C. 206 (1981).

    The premium for health and hospitalization insurance paid by an employer is neither wages, allowances or payment in lieu of wages and therefore is not included in calculating an employee’s average weekly wage. Gajan v. Bradlick Company, 4 Va. App. 213, 355 S.E.2d 899 (1987); Boggs v. Equitable Construction Co., Inc., 59 O.I.C. 23 (1980), (fringe benefits for medical and life insurance not included); Boggs v. Equitable Construction Company, 60 O.I.C. 45 (1981), (employer paid Blue Cross/Blue Shield and term life insurance payments not included).

    A per diem for meals based on hours away from home rather than actual expenses was included in computing the average weekly wage of a flight attendant because it was an economic gain to the employee as part of the employment contract and was paid in lieu of wages. A fringe benefit such as reduced airfare for relative may not be included in the computation of the average weekly wage. Seabrook v. American Airlines, Inc., 68 O.I.C. 3 (1989). (Affirmed by Court of Appeals on 3/20/90).

    Computing Average Weekly Wage:

    General:

    Employee’s average weekly wage correctly based on 52-week pre-injury earnings, despite intention to retire shortly after accident; employee, a circus performer, informed employer of intention to seek other employment at end of current contract period, but suffered workplace injury before contract expired; Commission found that average weekly wage properly based on pre-injury earnings, despite fact she may have decided to retire, as injury, and not voluntary retirement, diminished ability to earn pre-injury wages. Krochkina v. Ringling Bros. Barnum & Bailey Combined, VWC File No. 211-46-02 (Jan. 20, 2004).

    The purpose “for calculating the average weekly wage is to approximate the economic loss suffered by an employee or his beneficiaries.” To achieve this purpose, Code § 65.2-101 “gives the Commission discretion in the methods to be used to determine the average weekly wage the employee was earning in the employment in which he was working at the time of the injury.” Nelson v. Adecco Employment Service, 78 O.W.C. 263 (1999).

    Where the claimant was employed in three separate jobs by the employer, and received only one paycheck for her aggregated earnings in all or any of the jobs, her average weekly wage is calculated from the sum of all earnings with that employer, despite the fact that she was performing only one of the jobs during the summer when she was injured. Watson v. City of Danville School Board, 78 O.W.C. 94 (1999).

    The credible testimony of the claimant is sufficient to establish his average weekly wage where the employer failed to produce payroll records despite a Commission request. Gibson v. Conley and F. Richard Wilton, Jr., Inc., 74 O.W.C. 132 (1995).

    The party arguing that actual wages do not accurately reflect average earnings has the burden to present wage data of other workers similarly employed. Honorkiewicz v. Capital Masonry Corporation, 74 O.W.C. 104 (1995).

    Even though the parties entered into an agreement regarding average weekly wage and an award was entered, the Commission has jurisdiction to consider whether the average weekly wage should be amended because the claimant was illegally paid at a rate lower than that required by law. The burden is on the claimant to show by clear and convincing evidence that he was paid at less than the legal rate. Curtis v. Allard Trucking Company, 74 O.W.C. 208 (1995).

    An employee will not be bound by his allegation of a lower average weekly wage when pay records establish a higher figure. Avrine v. Gulliver’s Movers, Inc., 71 O.W.C. 8 (1992).

    The Commission declined to amend the claimant’s average weekly wage based on allegations that the employer violated the Federal Fair Labor Standards Act and did not pay him the overtime that was due. The Commission did leave open a subsequent application by the claimant to amend, if his average weekly wage was increased as a result of a Fair Labor Standards action the claimant was litigating in another forum. O’Neill v. Infrared Testing, Inc., 76 O.W.C. 245 (1997).

    Average weekly wage is the average dollar weekly wage. Beauchamp v. Cummins & Hart, 59 O.I.C. 16 (1980).

    The average weekly wage is determined on the date of the injury and not on the date of disability. Therefore, the compensation rate for subsequent periods of disability would remain constant without regard to any post-accident wage increase received by the employee. Green v. Nottoway Correctional Center, 13 Va. App. 301, 411 S.E.2d 231, 8 Va. Law Rep. 1450, 1991 Va. App. LEXIS 299 (1991).

    The purpose of weekly death benefits, based on the decedent’s average weekly wage, is to replace the wages lost to the dependents as a result of the death. No indemnity benefits should be awarded if the decedent had no income for the 52 weeks preceding the communication of the diagnosis of an occupational heart disease. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Where there was a complete absence of earnings during the 52 weeks preceding death or communication of a diagnosis of an occupational heart disease, there are no earnings upon which an average weekly wage can be established to award weekly compensation benefits to statutory beneficiaries. The Commissioner distinguished Roller v. Basic Construction Company, 238 Va. 321 , 384 S.E.2d 323 (1989), as a case applying a statutory amendment to Code § 65.2-406 (C) pertinent only to asbestosis claims. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Where a claimant worked for the employer for seven months, it was appropriate to use the wages earned during this time period to formulate a fair average weekly wage. Wages from previous employment or benefits paid under the Davis/Baker Act cannot be considered. Jespersen v. Atlantic Welding & Fabricating, Inc., 73 O.W.C. 18 (1994).

    The determination of the average weekly wage is designed to approximate the actual lost earnings of the employee, and a training wage should not be included in the calculation. Berry v. Hoffman Beverage Co., Inc., 75 O.W.C. 283 (1996).

    When a claimant is promoted prior to the work injury, the average weekly wage is based on the higher earnings in the new position. Fleshman v. Checkers Check Cashing, 74 O.W.C. 148 (1995).

    Where period of claimant’s employment has been too short to serve as basis for equitable determination of his average weekly wage, the wages of three other employees doing same grade and character of work may be used. Childress v. Panther Coal Co., Inc., 22 O.I.C. 190 (1940).

    Minimum compensation rate applicable where no earnings yet in commission sales work. Richards v. Crime Control, Inc., 54 O.I.C. 314 (1972).

    Average weekly wage determined equitably where decedent had been paid varying small amounts for prior occasional jobs and was killed on first day he enjoyed “employee” status. Hogan v. C.E. Kidd Lumber Company, 60 O.I.C. 208 (1981).

    In determining the average weekly wage for a circus performer, it was appropriate to use the earnings attributed to periods of work covered by the contract rather than individual days worked. Hernandez v. Ringling Brothers/Barnum and Bailey Combined Shows Inc., 73 O.W.C. 20 (1994).

    The claimant worked for the employer only four weeks before his work accident. He alleged that his work hours were reduced because of inclimate weather, and evidence showed that he had been hired to perform 40 hours of work each week, with some overtime. The Commission held that the average weekly wage should be determined by multiplying the claimant’s hourly rate times 40 hours per week, which was consistent with the intent of the parties at the time of hire. Johnson v. Webb Mechanical, Inc., 76 O.W.C. 165 (1997).

    The claimant was employed by Dinwiddie County School Board in two separate jobs, as a teacher’s aide and as a school bus driver. She worked for separate departments and separate supervisors, and was paid from separate bookkeeping accounts. Her primary mission as a teacher’s aide was to help students with their lessons and to assist the students with their daily activities at school. Her primary mission as a school bus driver was to provide transportation. The claimant argued that her mission in both employments was to help students. The Commission held that the “primary” mission cannot be so broadly defined so as to constitute similar employment, but found that wages should still be combined because both employments were with the same employer. Cole v. Dinwiddie County School Board, 76 O.W.C. 480 (1997).

    In the absence of evidence to the contrary, a normal work week in the construction industry is forty hours. Maywalt v. Virginia Construction Company, 63 O.I.C. 229 (1984).

    The claimant had a sporadic work history with the temporary agency and did not follow through with any of her three previous assignments, all of which promised 40-hour week positions. Instead, she either left the position, was removed from the position, or did not show up for work. The Commission held that the claimant’s average weekly wage should be based upon her actual earnings, that these earnings most nearly approximated the amount she would be earning but for her work accident, and to find that the claimant was entitled to an amount equivalent to what she would have earned had she worked a 40-hour week would be too speculative on the facts here. Nelson v. Adecco Employment Service, 78 O.W.C. 263 (1999).

    The average weekly wage for an employee who contracts mesothelioma is determined by the wages earned during the fifty-two weeks in which he was last actually exposed to asbestos rather than his average weekly wage on the date of the communication and diagnosis. C & P Tel. Co. v. Williams, 10 Va. App. 516, 392 S.E.2d 846, 6 Va. Law Rep. 2775, 1990 Va. App. LEXIS 119 (1990).

    The employer is entitled to a credit for the claimant’s earnings in other pre-injury employment which continued after the industrial accident. Compensation benefits are based on two-thirds of this partial wage loss even though this rate would entitle the claimant to greater compensation benefits than his actual Guard earnings. Wade v. Virginia Military Affairs, 70 O.I.C. 1 (1991).

    Labor Management Duties:

    Payments made to an employee by a union for carrying out required labor management duties are not part of the employee/employer contract for performance of services and, therefore, not to be included in computing the average weekly wage. Goad v. Lynchburg Foundry Company, 15 Va. App. 710, 427 S.E. 215 (1993); 71 O.W.C. 5 (1992).

    Labor management duties, including mediation of disputes, is dissimilar work from that of a shell-machine operator and, therefore not included in computing the average weekly wage. Goad v. Lynchburg Foundry Company, 15 Va. App. 710, 427 S.E. 215 (1993); 71 O.W.C. 5 (1992).

    Seasonal Workers:

    The average weekly wage of a seasonal worker is based on the number of weeks actually worked if the employee continues actively to seek employment. However, the average of earnings over a fifty-two week period will be used if the employee limits the number of weeks worked in order to qualify for Social Security benefits. Yager v. Noah P. Turner Landscaping, Inc., 68 O.I.C. 7 (1989).

    The average weekly wage of a school bus driver, who worked only 42.2 weeks in a year and did not work during the remaining weeks of the year, should be calculated by dividing her annual income by 52 weeks. Otherwise, the compensation rate based on earnings over 42.2 weeks would exceed her income from working as a school bus driver over 12 months. Such a result would not approximate the claimant’s loss of income from her job and would unfairly award her higher earnings than a comparable [permanent] co-worker who suffered a similar injury. Scott v. City of Virginia Beach School Board, 78 O.W.C. 199 (1999).

    Code provision for the use of “other method of computing average weekly wage” was used in determining wages of a part-time seasonal worker killed at the commencement of the peak employment period. Ennis v. Virginia Tank Lines, 64 O.I.C. 130 (1985).

    Appropriate to use earnings of like employee for determining a seasonal worker’s average weekly wage. Brown v. American Tobacco Co., 50 O.I.C. 50 (1968).

    Where an injury results from a second dissimilar seasonal position causing incapacity for the claimant’s primary employment, the Commission has the discretion to determine an average weekly wage based on the actual earnings from the seasonal employment. The average weekly wage is not zero merely because incapacity occurred during a period when the seasonal work is normally unavailable. Hinkle v. City of Covington, 65 O.I.C. 28 (1986).

    Sole Proprietor:

    The average weekly wage of a claimant, who after his injury started a sole proprietorship, is based on the net taxable income reported by the business for Federal Income Tax purposes. This includes allowable expenses (depreciation and interest) as well as any draw or salary paid to or on behalf of the claimant. Holcombe v. Meredith Construction Company, Inc., 73 O.W.C. 31 (1994). [Note: this overrules Semones v. The New Jersey Zinc Co., 68 O.I.C. (1989)].

    The claimant’s wages are determined from his profit and loss statement which would include an allowance for depreciation without regard to whether a specific fund was established. A concurring opinion noted several methods for calculating depreciation under federal law and limited the exclusion for depreciation to the straight line procedure. Accelerated depreciation would not be permitted. Holcombe v. Meredith Construction Company, Inc., 73 O.W.C. 31 (1994). [Note: this overrules Semones v. The New Jersey Zinc Co., 68 O.I.C. (1989)].

    Waitress:

    The amount on which the employee, a waitress, paid taxes constituted the most accurate approximation of her average week earnings. Chesapeake Bay Seafood House v. Clements, 14 Va. App. 143, 415 S.Ed.2d 864 (1992).

    Similar Employment:

    It is immaterial whether the mistake in the average weekly wage is mutual or unilateral. The incorrect average weekly wage was noted on the Pre-Hearing Statement and the average weekly wage did not resemble either the wages earned or the combined wages from similar employment. Both employments were substantially similar and should be combined. Smith v. Health Horizons, JCN VA02000011358 (Sept. 22, 2014).

    Workers’ compensation is designed to place the economic burden of work-related injuries on industry and, more specifically, the employer. The rationale that the costs of work-related injuries should not expand beyond “similar employment” is to prevent the costs from being borne out of proportion to an industry’s payroll. Also, a low risk industry should not bear the costs of a high risk injury when the employer is not a part of the high risk injury. Cole v. Dinwiddie County School Board, 76 O.W.C. 480 (1997), aff’d, 258 Va. 430 , 520 S.E.2d 650 (1999).

    Where an employee is performing similar services for more than one employer his combined earnings are used in computing his average weekly wage, whether the employments are joint or concurrent. Hawthorne v. Thalhimer Bros., Inc., 32 O.I.C. 35 (1950); O’Neal v. Lexington Telephone Co., 24 O.I.C. 708 (1942); Cottrell v. Hawthorne Aviation, Inc., 56 O.I.C. 71 (1975) (affd. on review).

    Where the claimant has two jobs with the same employer, the burden on the employer is not out of proportion to either its payroll or the risks of the industry. The exposure is directly related to the employer’s payroll and the number of its employees, without regard to the types of jobs being performed. The employer is not assuming a risk of wages being paid by another employer or the risks of another industry. Since the employer is the same, the wages earned in both jobs should be combined. Cole v. Dinwiddie County School Board, 76 O.W.C. 480 (1997).

    The employee was hired to perform repair work on used cars for resale, but he was also required to perform substantial plumbing work for the employer. The employee also worked as a plumbing and heating mechanic for another employer, and he was required in that employment to perform repair work on company vehicles. Where there is a significant overlap of duties, the employee may include earnings from both employers to calculate his average weekly wage. Edmonds v. Creedle Sales Co., Inc., 75 O.W.C. 160 (1996).

    The wages of an employee may be combined with income earned as an independent contractor for the purpose of determining the average weekly wage if the nature of the work is similar. Metropolitan Cleaning Corp. v. Crawley, 14 Va. App. 261, 416 S.E.2d 35, 8 Va. Law Rep. 2570, 1992 Va. App. LEXIS 112 (1992).

    Where all of the claimant’s job duties and skills in one job are utilized in a second job with a wider scope of employment, the Commission focuses on the “primary mission” of the employee in both jobs. This analysis provides a more rational basis for determining whether two employments are so related as to conclude they are substantially similar. The claimant performed computer data entry services in both of the positions she sought to combine for purposes of her average weekly wage. However, the Commission found that the primary mission of her work for the employer was abstracting personnel files, while the primary mission of her work for the second employer was assisting in the commercial shipping of packages. These jobs were not substantially similar, and they were not combined. Tate v. United Parcel Service of America, VWC File No. 198-42-59 (July 12, 2002).

    The Commission found the claimant’s work for the employer as a part-time counselor of abused and neglected children, and her full-time work as a juvenile probation and parole officer were substantially similar, and her weekly wages in each position were combined to determine her pre-injury average weekly wage. The claimant performed many of the same duties in each employment, and the primary mission of each job was the same — to supervise and monitor children with special needs and difficulties. Diehl v. VPSAC, Inc., VWC File No. 208-39-57 (December 19, 2002).

    Position with a cleaning crew and as a house cleaner. McNeil v. First Virginia Banks, Inc., 9 Va. App. 342, 381 S.E.2d 357 (1989); 67 O.I.C. 1 (1988).

    Examples: .

    Self-employed driver and driver pulling another’s trailer. James v. August Trucking Company, 73 O.W.C. 25 (1994).

    Roofer and framing carpenter. Jenkins v. ADTCO, 69 O.I.C. 2 (1990).

    Emergency medical technician and orthopedic attendant. Balson v. York County Fire Department, 69 O.I.C. 4 (1990).

    Emergency room registration clerk and accounts receivable specialist for Lab Corp. Caton v. Fauquier Hospital, 76 O.W.C. 346 (1997).

    Part-time counselor for abused and neglected children and Juvenile probation and parole officer. Diehl v. VPSAC, Inc., VWC File No. 208-39-57 (December 19, 2002).

    Dissimilar Employment:

    Employments dissimilar where claimant’s primary job mission as a lot associate for employer was to provide customer service in a retail store while his primary job mission as an event service attendant for second employer was to prepare and clean rooms before and after events at a hotel. Kpognon v. Home Depot USA, JCN VA00001243590 (Sept. 15, 2017).

    The claimant who was injured while driving a truck during the summer was not entitled to have the wages from her school bus driving job included in her average weekly wage because the employment was not similar since it was not concurrent. While payment for the claimant’s school bus driving was made over a twelve-month period, her contract was for ten months of work and did not include the summer when her work injury occurred driving a truck. Adkison v. H & H Industries, VWC File No. 225-11-41 (June 15, 2007).

    If the work for two or more employers is not of same character the wage received only from the employer in whose service worker was at time of injury will be considered. Graham v. Gloucester Furn. Corp., 169 Va. 505 , 194 S.E.2d 814 (1938); Canady v. Trinity Memorial Gardens, Inc., 55 O.I.C. 76 (1973); Wills v. Green, 56 O.I.C. 340 (1975); Harris v. Safeway Stores, Inc., 49 O.I.C. 140 (1967); Hulvey v. Bernstein, 36 O.I.C. 319 (1954); Washington v. Potts & Kidder, 7 O.I.C. 244 (1925); Thompson v. Herbert, 4 O.I.C. 310 (1922).

    Wages earned in dissimilar concurrent employment may not be combined for the purpose of establishing the applicable weekly wage. Hudson v. Arthur Treacher, 2 Va. App. 323, 343 S.E.2d 97, 1986 Va. App. LEXIS 275 (1986).

    The “dissimilar employment rule” is applicable in determining an employee’s average weekly wage both before the injury and his post-injury earning ability. City of Fairfax v. Massey, 11 Va. App. 238, 397 S.E.2d 679, 7 Va. Law Rep. 669, 1990 Va. App. LEXIS 188 (1990).

    Rights of the parties are established by the law and the facts as they exist on the date of the accident. Wages earned in the employment in which injured are only wages to be considered, unless work in other employment is similar. Johnson v. Philip Morris, 57 O.I.C. 198 (1977).

    Increased earnings received from an ability to work extra hours at a second pre-injury dissimilar job should be included in calculating the average weekly wage for the purposes of determining the rate of temporary partial disability. City of Fairfax v. Massey, 11 Va. App. 680, 401 S.E.2d 439, 7 Va. Law Rep. 1578, 1991 Va. App. LEXIS 24 (1991).

    Combined earnings of two jobs at dairy, including overtime are be used but not earnings from driving a cab. Gaines v. Curles Neck Dairy, 49 O.I.C. 117 (1967).

    Part time work as a restaurant manager is not sufficiently similar to the claimant’s full time employment as an accountant to combine the incomes in determining average weekly wage. Sleiman v. Chesapeake City Finance, 74 O.W.C. 66 (1995).

    A member of the Virginia National Guard injured in the course of his duties is entitled to the maximum compensation rate. Earnings as a part-time custodian and as a counselor are dissimilar from the Guard duties and may not be included in determining the average weekly wage. Wade v. Virginia Military Affairs, 70 O.I.C. 1 (1991).

    Income from a position as an independent contractor performing painting jobs may not be included in determining the claimant’s average weekly wage. O’Dell v. Benzo Paint Company, 73 O.W.C. 28 (1994).

    Where all of the claimant’s job duties and skills in one job are utilized in a second job with a wider scope of employment, the Commission focuses on the “primary mission” of the employee in both jobs. This analysis provides a more rational basis for determining whether two employments are so related as to conclude they are substantially similar. The claimant performed computer data entry services in both of the positions she sought to combine for purposes of her average weekly wage. However, the Commission found that the primary mission of her work for the employer was abstracting personnel files, while the primary mission of her work for the second employer was assisting in the commercial shipping of packages. These jobs were not substantially similar, and they were not combined. Tate v. United Parcel Service of America, VWC File No. 198-42-59 (July 12, 2002).

    Amending the Average Weekly Wage:

    It is immaterial whether the mistake in the average weekly wage is mutual or unilateral. The incorrect average weekly wage was noted on the Pre-Hearing Statement and the average weekly wage did not resemble either the wages earned or the combined wages from similar employment. Both employments were substantially similar and should be combined. Smith v. Health Horizons, JCN VA02000011358 (Sept. 22, 2014).

    Claimant guilty of laches by waiting five years before bringing error in average weekly wage to the Commission’s attention after initially stipulating to incorrect average weekly wage to the prejudice of employer. Steere v. Richmond Products Corp., VWC File No. 186-45-69 (June 15, 2004).

    The Commission has the authority to amend an incorrect average weekly wage based on a mutual mistake of fact as requested by the employer. Honorkiewicz v. Capital Masonry Corporation, 74 O.W.C. 104 (1995).

    After the appeal period has expired, average weekly wage corrections should be made only when there is clear and convincing evidence of [1] misrepresentation, fraud or imposition; [2] a calculation error, or [3] an actual mutual mistake of fact. Campbell v. Commercial Steel Erections, 64 O.I.C. 78 (1985).

    The Commission will correct an average weekly wage which is clearly not computed in accordance with § 65.1-6 (now § 65.2-101 ) but only if such error is promptly brought to the Commission’s attention. Beard v. Virginia Roofing Corp., 65 O.I.C. 35 (1986).

    In the absence of evidence of mistake, fraud, misrepresentation or imposition, a request to amend an average weekly wage six months after the award was entered is untimely. Spencer v. Commonwealth of Va. Dept. of State Police, 70 O.I.C. 4 (1991).

    In allowing an amendment to an average weekly wage the Commission looks not only at the timeliness of the request but at all the circumstances including the knowledge the claimant had of a mistake, the availability of information to substantiate the mistake, and any inequity reformation may have had on the employer. Based on a finding that the widow was unaware of her husband’s actual earnings and that the carrier failed to calculate the average weekly wage in accordance with the provisions of § 65.2-101 , an amendment was allowed five years after entry of the award. Kuebbeler v. Atlantic Research Corp., 71 O.W.C. 10 (1992).

    An award will be amended retroactively if an insurance carrier incorrectly calculated the average weekly wage resulting in either an underpayment for which additional compensation is owed or an overpayment for which a credit is due. Linton v. Norfolk Dredging Company, 69 O.I.C. 1 (1990).

    Having found that claimant had convincingly established an error as to pre-injury average weekly wage, Commission vacated its previous award and directed insurance carrier to recompute employee’s compensation entitlement on all prior awards and to make future payments based on the corrected average weekly wage. Kaeser v. Centrex Corporation, 60 O.I.C. 255 (1981).

    Agreed upon average weekly wage based on mutual mistake of fact may be amended. Robinson v. O. W. Ball, Jr., Lumber Co., 56 O.I.C. 267 (1975) (review opinion); Cain v. Morris, Newman, et al., 58 O.I.C. 45 (1978); Deel v. Goodyear Tire & Rubber Co., 58 O.I.C. 87 (1978).

    Even though the parties entered into an agreement regarding average weekly wage and an award was entered, the Commission ha jurisdiction to consider whether the average weekly wage should be amended because the claimant was illegally paid at a rate lower than that required by law. The burden is on the claimant show by clear and convincing evidence that he was paid at less than the legal rate. Curtis v. Allard Trucking Company, 74 O.W.C. 208 (1995).

    When a claimant fails to mention a similar second employment at the time an original Memorandum of Agreement is executed, the Agreement cannot subsequently be set aside for the purpose of using the combined earnings in determining the average weekly wage. Norman v. Prince William County Schools, 63 O.I.C. 248 (1984).

    AWARD.

    The receipt of permanent partial disability benefits pursuant to an Award is “compensation” and therefore tolls the statute of limitations under section 65.2-708 (A). Phillips v. Hubbell Lighting, Inc., JCN 212-91-89 (Aug. 18, 2011).

    CHANGE IN CONDITION.

    A change in condition is one that flows from a progression, deterioration or aggravation of the injury sustained in the original industrial accident. McBride v. Va. Dept. of Transportation, 76 O.W.C. 227 (1997).

    The claimant’s credible testimony, corroborated by co-workers, established that he remained symptomatic following a work accident, but attempted to continue working for financial reasons. A subsequent lifting incident in the claimant’s backyard aggravated but did not cause the claimant’s back problems, and the Commission held that the back problems were related to the work accident. Eccard v. Southside Community Hospital, 77 O.W.C. 54 (1998).

    The 1991 amendment added to the language of § 65.2-101 “Change in condition” the reference to awards that had been “suspended,” and employees thereafter were required to prove continuing disability as well as a “cure” of an earlier refusal in order to have benefits reinstated. Perrigan v. Clinchfield Coal Co., 75 O.W.C. 324 (1996); Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    In 1991, the General Assembly amended the definition of “change in condition” to include “any change in the conditions under which compensation was awarded, suspended, or terminated.” The Commission later held that this amendment effectively vitiated the distinction between suspended and terminated, and claimants thereafter were obliged to prove continuing disability, through marketing efforts, in order to have compensation benefits reinstated. Goddard v. Albrite Engine Works, 78 O.W.C. 256 (1999).

    Section 65.2-510.1 provides that compensation benefits for wage loss shall be suspended whenever a partially disabled employee is imprisoned in a jail. Once suspended, a resumption of benefits is not automatic or self-executing upon release from incarceration. The claimant is required to prove that he is entitled to a resumption of benefits. Goddard v. Albrite Engine Works, 78 O.W.C. 256 (1999).

    The requirement that an Employer’s Application For Hearing must be under oath is in Rule 1.4(B)(2). By the terms of that Rule, it only applies to a change in condition application filed by an employer under § 65.2-708 . Nuttall v. Autozone, 79 O.W.C. 195 (2000).

    Where an Employer’s Application For Hearing is filed pursuant to § 65.2-712 , the requirements of Rule 1.4(A) apply. However, the application need not be submitted under oath, as is required by Rule 1.4(B) for applications submitted under § 65.2-708 . Nuttal v. Autozone, 79 O.W.C. 195 (2000).

    See notes to § 65.2-708 .

    REQUIRED NUMBER OF EMPLOYEES.

    General:

    The Commission has jurisdiction if the employer regularly has in service three or more employees in the Commonwealth. Employees working exclusively outside Virginia are not included for determining jurisdiction. Parker v. Carriage Lamp Cleaners, 70 O.I.C. 9 (1991).

    It is the employer’s burden to prove it had regularly in service less than three employees in the same business within the Commonwealth and therefore is not subject to the Workers’ Compensation Act. Johnson v. M S Carriers, 77 O.W.C. 104 (1998).

    A person cannot be an employee under the Act if the alleged employer has regularly in service less than three employees in the same business within the Commonwealth. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    Section 65.2-101(2)(h) requires only that the employer have three or more employees “regularly in service” to be within the jurisdiction of the Act. Temporary fluctuations in the number of employees do not enable an employer to avoid jurisdiction. The controlling member must be determined in light of the employer’s established mode of business. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Both full-time and part-time employees who are regularly employed to carry out the trade or business of the employer must be counted in determining the number of employees “regularly in service” with the employer. Any person hired by the employer to work in the usual course of the employer’s business is an “employee” under the Act, regardless of how often or for how long he may be employed. The number of employees regularly in service of the employer is the number “used to carry out the established mode of performing the work of the business . . . even though the work may be recurrent instead of constant.” In determining whether the employer has three or more employees regularly in service, the Commission focuses on “the character of the business” rather than “the character of the employment relationship.” Johnson v. M S Carriers, 77 O.W.C. 104 (1998).

    In determining whether the minimum number of employees exists to invoke the Workers’ Compensation Act, the Commission counts the total number of persons employed on the job by the contractor and all subcontractors. Smith Construction v. Weber, 3 Va. App. 379, 350 S.E.2d 213 (1986); Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Incorporated subcontractors, who are considered employees under the Act, count as statutory employees of the general contractor. Velonza v. Pandell Builders, Inc., 75 O.W.C. 172 (1996).

    A volunteer charitable organization that has three or more regular employees is an employer under the Act. Williams v. Warren Association for Retarded Citizens, Inc., 70 O.I.C. 18 (1991).

    Members of a corporation’s board of directors are included as employees under the Act, whether or not they receive a salary. Williams v. Warren Association for Retarded Citizens, Inc., 70 O.I.C. 18 (1991).

    Officers of a corporation, whether paid or unpaid are considered employees of the corporation. While an unpaid corporate officer is not entitled to an award for wage loss, an award may be entered for medical benefits. Sorrells v. Cliffside Service Center, 69 O.I.C. 6 (1990).

    Employees of a prime contractor’s real estate business are not counted as employees of his construction business, where there a clear and complete separation of the two businesses. Velonza v. Pandell Builders, Inc., 75 O.W.C. 172 (1996).

    When an employer has the requisite number of employees to bring him within the jurisdiction of the Virginia Workers’ Compensation Act, the existence of an action at law pending in another Court does not preclude the Commission from exercising its jurisdiction nor does it limit that of the other forum. Estate of Larry Gene Higgins v. Roanoke Electric Steel Corporation, 65 O.I.C. 13 (1986).

    It is proper to allow a proffer relating to the number of employees in previous years where the issue was whether the employer had a sufficient number of employees to be under the Act. Until such a proffer is offered, the Deputy Commissioner cannot determine if the evidence is relevant. A refusal of a proffer frustrates the appellate review process. Smith v. Mike Hylton t/a M.H. Stables, 14 Va. App. 354, 416 S.E.2d 712, 8 Va. Law Rep. 2859, 1992 Va. App. LEXIS 128 (1992).

    Where records filed with the Commission indicate that witnesses were mistaken as to the number of employees that worked for the employer, the Commission remanded the case to cross examine the employees on the question of jurisdiction. Ruiz v. Abbotts Upholstery, 75 O.W.C. 213 (1996).

    The Commission looks to the established mode in which the employer does business to determine if it had regularly in service fewer than three employees. The employer amusement park employed over fifteen people during its operational season, but employed fewer than three during the off-season. The Commission found that the employer’s established mode of business was to operate an amusement park during the appropriate seasons, regularly employing more than three workers. The Commission held that the claimant’s status as a covered employee should not fluctuate merely because it occurred at the end of the season when the number of employees on the payroll dropped below the statutory minimum. Cornelius v. 15th Street Amusement Park, L.L.C., VWC File No. 203-03-83 (June 26, 2002).

    “Regularly” Defined:

    Any person hired by the employer to work in the usual course of the employer’s business is an “employee” under the Act, regardless of how often or for how long he may be employed. With the exception of farm and horticultural businesses, both full-time and part-time employees who are regularly employed to carry out the trade or business of the employer must be counted in determining the number of employees “regularly in service.” Pineda v. Brothers, 78 O.W.C. 1 (1999).

    “Regularly” as used in the statute is not synonymous with constant. An employer cannot oscillate between coverage and exemption as his force exceeds or falls below the minimum from time to time. Cannady v. McRae Co., 57 O.I.C. 74 (1977); Jewell v. Steel Erectors, Inc., 46 O.I.C. 123 (1964); James v. White’s Grill, 44 O.I.C. 148 (1962).

    The number of employees regularly in service of the employer is the number used to carry out the established mode of performing the work of the business, even though the work may be recurrent instead of constant. In determining whether the employer has three or more employees regularly in service, the Commission focuses on “the character of the business” rather than “the character of the employment relationship.” Pineda v. Brothers, 78 O.W.C. 1 (1999).

    Workers obtained through a temporary employment agency over a period of eight months were employees “regularly in service” of the employer so as to bring it within the jurisdiction of the Act. Mayfield v. Scott Dixon t/a American Retrofit Management and Armada Hoffler Construction Co., 74 O.W.C. 11 (1995).

    The payroll records of the seasonal landscaping business indicated that the employer had fewer than three employees on some weeks during the work season, but the employer had three or more employees in service for the majority of that time, and the employer always had three or more employees when the claimant worked. The Commission found that this evidence established that the employer regularly employed three or more persons, and that it was subject to the jurisdiction of the Act. Pineda v. Brothers, 78 O.W.C. 1 (1999).

    An employer who does not regularly have in service three or more employees does not come within the Virginia Workers’ Compensation Act even if on the date of the accident three or more people were employed. Walker v. W. E. Williams, 68 O.I.C. 19 (1989).

    Truck drivers “regularly in service” implies more than work merely involving occasional pick-ups and drop-offs or merely driving through Virginia. Johnson v. M S Carriers, 77 O.W.C. 104 (1998).

    That some or all employees may work part-time is immaterial in determining jurisdiction under the Act. Burkhardt v. Whippich, 55 O.I.C. 57 (1973).

    The Commission looks to the established mode in which the employer does business to determine if it had regularly in service fewer than three employees. The employer amusement park employed over fifteen people during its operational season, but employed fewer than three during the off-season. The Commission found that the employer’s established mode of business was to operate an amusement park during the appropriate seasons, regularly employing more than three workers. The Commission held that the claimant’s status as a covered employee should not fluctuate merely because it occurred at the end of the season when the number of employees on the payroll dropped below the statutory minimum. Cornelius v. 15th Street Amusement Park, L.L.C., VWC File No. 203-03-83 (June 26, 2002).

    Charities/Churches:

    There is no exception in the Workers’ Compensation Act for charitable or religious organizations. King v. Community of Hope, Inc., 63 O.I.C. 203 (1984).

    A volunteer charitable organization that has three or more regular employees is an employer under the Act. Williams v. Warren Association for Retarded Citizens, Inc., 70 O.I.C. 18 (1991).

    EMPLOYEE.

    Note: Also see “Employer” below.

    General:

    Whether a claimant is an “employee” at the time of his injuries is governed by common law principles, and the most important indicator is whether the employer exercised control over the worker or whether the employer merely contracted for an end result. The question of what is meant by “control” depends upon the particular facts of each case. “Employees” work in many different contexts. Some “employees” work at remote locations or at home, without direct supervision. Some “employees” are professionals exercising independent judgment in decision-making. Some “employees” control their own work hours. “Employees” may be temporary or part-time. Some are paid on a “piece work” or commission basis, while others receive wages or a salary. Claros v. G & S Construction, Inc., 78 O.W.C. 153 (1999).

    Contract of Hire:

    Employee working to repay monetary debt to employer considered to work under a contract of hire; determination of contract of hire based on whether employee works in exchange for something of value, such as forgiveness of monetary debt. Bostic v. Brenda Smith Farms, Inc., VWC File No. 211-48-59 (June 19, 2003).

    Volunteer firefighter injured while attending training supplied by county; county not considered employer because not “using the service” of claimant at time of accident nor had it adopted resolution electing workers’ compensation coverage; county also not special employer because claimant not performing any service for county at time of accident. Catlett v. Caroline County Fire & Rescue, VWC File No. 206-13-68 (May 13, 2003).

    “Contract of hire” is not defined in Act. Charlottesville Music Center v. McCray, 215 Va. 31 , 205 S.E.2d 674, 1974 Va. LEXIS 227 (1974).

    The claimant has the burden to prove that he is an employee subject to the control of the employer, that he is under a contract of hire that provides an agreed remuneration for services rendered, and that the work being performed is in the business, trade, occupation, or profession of the employer. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    The Commission generally looks at four factors in deciding whether a claimant is an employee or independent contractor: the authority to select and engage the employee, the obligation to pay wages, the power of dismissal, and power of control of the employee’s actions. Where the claimant’s uncontradicted testimony established that the employer paid him by the hour and had recently given him a pay raise; directed him where and when to work; and provided transportation, equipment, meals, and lodging for out of town work, the Commission found that he was an employee. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    While it is not essential to the establishment of an employment relationship that wages be paid, there must be an implied or written contract of hire and some control exercised by the employer over an employee. The employer’s wife who received no salary, was omitted from the workers’ compensation policy and listed as a housewife for income tax purposes, was not an employee. G. Johnson v. Overhead Doors/Loyd D. Johnson, Sr., 68 O.I.C. 26 (1989).

    Where the relationship between a claimant and a business owner is one of reciprocal gratitude that is terminable at will with no specific employment obligations or relationship between service and compensation and no control over the performance of any work by the claimant, there is no contract of hire and no employee/employer relationship. Behrensen v. Whitaker, 10 Va. App. 364, 392 S.E.2d 508, 6 Va. Law Rep. 2457, 1990 Va. App. LEXIS 99 (1990).

    Part-time assistant County Registrar injured at polling place held to be employee of Board of Elections. O’Connor v. Arlington County Electoral Board and/or State Board of Election, 60 O.I.C. 333 (1981).

    An employee of a mere owner on a residence under construction, which is not being built as part of the owner’s trade or business, is not an employee covered by the Virginia Workers’ Compensation Act. Hartley v. Garland E. Pugh Mech. Contr., 76 O.W.C. 129 (1997).

    Hired by Unauthorized Person:

    Where a regular employee, not already authorized to act as agent of employer for purpose of hiring additional employees, engages the services of another to assist him in his duties and pays him himself, the question as to whether the principal employer is liable under the Act to such third person depends upon whether he has knowledge of such employment and consents thereto. This knowledge may be actual or imputed and the consent may be express or implied. Nolde Bros. v. Chalkley, 184 Va. 553 , 35 S.E.2d 827 (1947); Futrell v. Holland’s Auto Service, 28 O.I.C. 709 (1946); Murray v. Home Brewing Co., 20 O.I.C. 139 (1939).

    Unauthorized Helper:

    A person helping an employee but who was not hired by the employer or an authorized agent, is not an employee, though an emergency situation may authorize an employee to hire a helper. Brizendine v. Amherst County School Board, 37 O.I.C. 2 (1955); Blackburn v. Stone Mountain Bottling Co., 31 O.I.C. 158, 229 (1949) (appeal denied).

    A person learning to operate employer’s equipment in hope of future employment was not an employee. Gilliam v. Moore, 46 O.I.C. 9 (1964) (appeal denied).

    Janitor voluntarily working on inoperative elevator while visiting co-worker in another building was not an employee. Robinson v. Hampton Institute, 52 O.I.C. 215 (1970).

    Minors:

    Minors are specifically included under the Act. Kenney v. Pancake Kitchens, 48 O.I.C. 147 (1966) (appeal denied by Virginia Supreme Court; cert. denied by Supreme Court).

    A minor employed in violation of the labor law is employee entitled to benefits under the Act. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947); Humphries v. Boxley Bros. Co., 146 Va. 91 , 135 S.E. 890 , 1926 Va. LEXIS 314 (1926).

    Thirteen-year-old was an employee where employer took to work site and showed how to clean and store bricks used in the defendant’s business. Bean v. I.P.K. Excavating Co., 49 O.I.C. 20 (1967).

    Fifteen-year-old boy helping friend who voluntarily worked without promise or expectation of payment was not an employee. Charlottesville Music Center v. McCray, 215 Va. 31 , 205 S.E.2d 674, 1974 Va. LEXIS 227 (1974).

    Employee sui juris: fifteen years old when injured, now 19 1/2 years old. Thompson v. Stewart Buick Inc., 51 O.I.C. 271 (1969).

    Family Members:

    Where employer is husband of wife partially dependent on deceased employee-son, wife can maintain action as Act makes no exception because of family relationship between employer and employee. Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    If employer is dependent wife of deceased employee-husband, no action can be brought by dependent wife-claimant against wife-employer as same person cannot be both beneficiary and employer. Miller v. Miller, 33 O.I.C. 518 (1951); 34 O.I.C. 173 (1952).

    There is no employer-employee relationship between the corporation and the individual where the wife of a principal stockholder of a corporation assisted her husband with the corporate bookkeeping but received no pay, had duties assigned her, and the corporation had no control over her. Carter v. Carter, 49 O.I.C. 58 (1967); Setliff v. Lewis, 42 O.I.C. 118 (1960).

    Where the wife is an officer of the corporation of which her husband is president, she is an employee. Clary v. Clary Timber Sales, Inc., 55 O.I.C. 95 (1973).

    While the assignment of tasks by parent to child is commendable, it does not constitute employer-employee relationship where eleven-year-old son of employer is given tasks at store. Clare v. Clare, 50 O.I.C. 87 (1968).

    Pre-employment Testing/Trainees:

    Employee injured during pre-employment training did not prove existence of employment relationship with employer; employer invited employee to attend training camp, successful completion of which would lead to offer of employment; no completed contract of hire shown until all prerequisites to employment, including successful completion of training camp, became final. Saldana v. Asset Protection Team, VWC File No. 204-46-10 (Dec. 11, 2003).

    Compensation benefits were denied to a claimant who fell during a pre-employment test because there was no contract of hire or other agreement that he would be paid during the try-out period. Scott v. Windsor Tree Service, 70 O.I.C. 5 (1991).

    Injured during training period for sales, claimant had status of employee. Richards v. Crime Control, Inc., 54 O.I.C. 314 (1972).

    In awarding benefits to a claimant who was injured while demonstrating her ability to operate a dry cleaning press, the Commission found that she was an employee rather than a volunteer since there was an implied agreement that she would receive the minimum wage for her efforts. Girdy v. Quick & Easy One Hour Cleaners, 68 O.I.C. 29 (1989). (Affirmed by the unpublished Court of Appeals opinion of 11/6/90).

    Student Nurses:

    A person who performs a service for the public and a hospital as a student nurse for pecuniary gain to the hospital is an employee of the hospital. Thomas v. University of Va. Hospital, 34 O.I.C. 650 (1952).

    Student nurse held not to be an employee of hospital. Lawson v. Petersburg Gen. Hospital, 49 O.I.C. 181 (1967).

    Military:

    An enlisted member of National Guard during period of active service does not cease being an employee of the State while on recreational pass. Globe Indem. Co. v. Forrest, 165 Va. 267 , 182 S.E. 215 , 1935 Va. LEXIS 295 (1935).

    Corporate Officers:

    A Virginia Limited Liability Company does not have officers for the purposes of the definition of “employee” contained in § 65.2-101 . An LLC is composed of one or more members who are the owners and who may pursuant to the articles of organization or an operating agreement elect to have a manager(s). Managers so elected or appointed are automatically employees for the purposes of the Act. Where there is only one member, § 65.2-101 n provides that by notifying the LLC’s insurer he/she may elect to be an employee under the Act. Jones v. Slade, LLC, Clifton Slade & Slade’s Park, VWC File No. 226-66-62 (Oct. 17, 2007).

    Members of a corporation’s board of directors are included as employees under the Act, whether or not they receive a salary. Williams v. Warren Association for Retarded Citizens, Inc., 70 O.I.C. 18 (1991).

    Officers of a corporation are considered employees in determining whether an employer is under the Act. Spurlock v. Lineberry, 70 O.I.C. 22 (1991).

    Payment of a salary to a corporate officer is not an essential element in determining whether an officer is an employee of the corporation. Sink v. R. N. Chiles & Sons, Inc., 62 O.I.C. 414 (1983) (see also Polozzi v. Custom Travel & Designs, Inc., 68 O.I.C. 100 (1989)).

    Officers of a corporation, whether paid or unpaid, are considered employees of the corporation. While an unpaid corporate officer is not entitled to an award for wage loss, an award may be entered for medical benefits. Sorrells v. Cliffside Service Center, 69 O.I.C. 6 (1990).

    Director of dissolved corporation operated business as sole proprietor and thus was barred from compensation. Nofs v. Marj’s Metal Co., Inc., 58 O.I.C. 257 (1979).

    Prisoners:

    A prisoner injured while in Virginia’s corrections system is not an employee covered by the Virginia Workers’ Compensation Act. Singleton v. Haynesville Correctional Center, 76 O.W.C. 1 (1997).

    A prisoner who was injured while working on a road crew under an agreement between the Department of Corrections and the Department of Transportation was not an employee under the Workers’ Compensation Act. Woodward v. Commonwealth of Va./Dept. of Corrections, 249 Va. 21 , 452 S.E.2d 656 (1995); 71 O.W.C. 24 (1992).

    A prisoner sentenced to hard labor gang is not employee of Commonwealth of Virginia nor of Department of Highways. Stanley v. Dept. of Highways, 52 O.I.C. 244 (1970).

    Prisoner on work release program injured while working for private employer is employee entitled to compensation. Lawrence v. Prestwick, Inc., 56 O.I.C. 196 (1974).

    Loaned Employee:

    Employee who was hired by staffing company to work for engineering firm, where he was injured, considered employee of engineering firm; employee worked at firm for several months, without regular contact with staffing company, and firm exercised exclusive control over employee’s daily activities; engineering firm considered special employer. Price v. Reliance Staffing Serv., VWC File No. 211-70-30 (Dec. 8, 2003).

    The Act is silent as to the status of a loaned employee. It is his special master at the time of accident, and not his general master, as those terms are defined at common law, who is liable for compensation. An employee becomes the servant of a special master when the latter acquires the right to control and direct the former in his work, even though the wages continue to be paid by the regular employer. Ideal Steam Laundry v. Williams, 153 Va. 176 , 149 S.E. 479 , 1929 Va. LEXIS 254 (1929).

    The Supreme Court of Virginia has set forth several factors to consider in deciding whether a person is a borrowed servant: (1) who has control over the employee and the work he is performing; (2) whether the work performed is that of the borrowing employer; (3) was there an agreement between the original employer and the borrowing employer; (4) did the employee acquiesce in the new work situation; (5) did the original employer terminate its relationship with the employee; (6) who is responsible for furnishing the work place, work tools, and working conditions; (7) the length of the employment and whether it implied acquiescence by the employee; (8) who had the right to discharge the employee; and (9) who was required to pay the employee. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    In Virginia, the “special employer” rule is used to determine which of two employers is liable for compensation benefits to an injured employee. The rule was borrowed from the common law relating to master-servant relationships to resolve dual employer situations in the workers’ compensation context. The hallmark of the rule is control. McClellan v. H.L. Yoh Company, 77 O.W.C. 141 (1998).

    Where special master has the right and power to direct, control or dismiss one who has been assigned to him by another, the special master is the employer under the Act, even though the regular employer selected him, pays him and can also dismiss him. Beasley v. Sweeney, 44 O.I.C. 11 (1962); Rogers v. Vanguard Const. Corp. et al., 56 O.I.C. 272 (1974) (writ denied).

    To determine whether a party is a special employer, the Commission examines four elements of the master-servant relationship: (1) selection and hiring of the servant; (2) payment of his or her wages; (3) power of dismissal; and (4) power of control of the servant’s actions. The most significant factor is the extent of control over the employee. McClellan v. H.L. Yoh Company, 77 O.W.C. 141 (1998).

    In order for the regular employer to be relieved there must be some indication, express or implied, of consent of the employee to his becoming the servant of the special master. Ideal Steam Laundry v. Williams, 153 Va. 176 , 149 S.E.2d 479 (1929); Critcher v. McGuire Lumber & Supply Co., 55 O.I.C. 111 (1973).

    The claimant is not the actual or borrowed employee of a contractor, where the contractor does not control the means or methods of work alleged to have been performed. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    The “special employer” doctrine provides that the loaned employee must look to his or her special employer for indemnity for injuries suffered while performing the special employer’s work. McClellan v. H.L. Yoh Company, 77 O.W.C. 141 (1998).

    There is an important distinction between lending an employee to another and giving orders to employee to do some work for a third party. In the latter case he and not the person for whom the work is being done at time of accident will be liable under the Act. Arrington v. Murray, 182 Va. 1 , 28 S.E.2d 19 (1943); Alexandria v. McClary, 167 Va. 199 , 188 S.E. 158 (1936); Borrer v. Plumly Lumber Corp., 27 O.I.C. 649 (1945).

    VPI & SU was the decedent’s special master at the time of his death and, therefore, solely responsible for the payment of workers’ compensation benefits to his dependents. VPI & State Univ. v. Frye, 6 Va. App. 589, 371 S.E.2d 34, 5 Va. Law Rep. 154, 1988 Va. App. LEXIS 85 (1988).

    When an official of corporation instructs worker not to check out but to come with him to perform a job off the premises, an accident during such job arises out of and in the course of his employment with the corporation (cutting grass at home of officer of corporation). Wiggins v. Davenport-Lewis Chevrolet Corp., 45 O.I.C. 249 (1963).

    Employee injured while working at employer’s cabin as directed was employee of business. Simmons v. Mitchell, 50 O.I.C. 303 (1968).

    The claimant who was working an undercover assignment to identify drug abusers was an employee of Wackenhut and not an employee subject to a special master. Anderson v. Wackenhut, 66 O.I.C. 35 (1987).

    Joint Employee:

    As provided in § 65.1-80 (now § 65.2-529 ), where the employee for whose injury or death compensation is payable was at the time of injury in the joint service of two or more employers, subject to the Act, such employers must contribute to payment of compensation in proportion to the part of employee’s aggregate wage paid by each. Shaffer v. Davenport-Lewis Chevrolet Corp., 41 O.I.C. 125, 127 (1959); Strolher v. American Railway Express Co., 3 O.I.C. 41 (1921).

    In applying this rule it is immaterial that one employer pays entire wage and bills the other for his agreed share. Allen v. Darling & Son, 24 O.I.C. 297 (1942); Mauck v. Shenandoah Valley Corp., 14 O.I.C. 283 (1932).

    The fact that one person contributes more to the compensation of a worker than another does not prevent the contributor of the smaller amount from being the employer. Hawthorne v. Thalhimer Bros., Inc., 32 O.I.C. 35 (1950).

    Where claimant’s employment was secured through the Division of Elementary & Special Education, his salary paid, supervision and control exercised and salary determined by that State Agency, it was held the County School Board was merely the agent of the State for purpose of issuing salary checks and he was an employee of the State. Yates v. School Board of Roanoke County, 44 O.I.C. 291 (1962).

    Casual Employees:

    The provision of this section excluding casual employees from the Act must be read together with § 65.1-4 (now § 65.2-101 ). The test is the nature of employment, not nature of the contract. Horne v. Clinchfield Coal Co., 53 O.I.C. 144 (1971).

    “Casual employees” are not covered by the Act. Employment “is casual when not permanent nor periodically regular, but occasional, or by chance and not in the usual course of the employer’s trade or business.” Waggle v. Lang, 75 O.W.C. 33 (1996).

    Employment cannot be said to be casual where it is in usual course of trade, business or occupation of employer, even though worker is engaged only for performance of a single casual task. Hoffer Bros. v. Smith, 148 Va. 220 , 138 S.E. 474 (1927) (unloading furniture for retail furniture store); Rogers v. Rusco Window Co. of Roanoke, Inc., 54 O.I.C. 324 (1972) (temporary employment unloading boxes of siding).

    Where the employment is not permanent or periodically regular, but occasional, or by chance, and not in usual course of employer’s trade or business the employee is a casual one and does not come under the Act. Board of Supervisors v. Boaz, 176 Va. 126 , 10 S.E.2d 498 (1940) (repairing window of courthouse). See also Bennett v. Peerless Wallcoverings, Inc., 59 O.I.C. 22 (1980).

    An employee cannot be said to be casual when his work is in the usual trade, business, or occupation of the employer, even though the worker may be engaged only for the performance of a single casual task. Deaton v. Isaac Allen, 62 O.I.C. 155 (1983).

    Since the employer was in the trade, business and occupation of regularly moving furniture in Virginia and had three or more employees in the State, the claimant who was hired to unload furniture was an employee rather than a casual employee or independent contractor. Settles v. Craddock Moving & Storage Co., 16 Va. App. 1, 427 S.E.2d 428 (1993); 71 O.W.C. 31 (1992).

    As long as there is anticipated some continuity of employment, worker is not a casual employee merely because he is not employed in a permanent capacity. Seasonal employers are not exempted from the insurance requirements of the Act. Montross v. Wm. Melvin t/a Barnacle Bill’s Bait & Tackle, 68 O.I.C. 22 (1989).

    Definitions of “casual employee” and “employee regularly in service,” discussed. Dearing v. Krantz, 54 O.I.C. 79 (1972).

    Where poultry processing company was in constant state of physical expansion, they made construction a part of their business and claimant was not a casual employee. Baker v. Marval Poultry Co., Inc., 55 O.I.C. 22 (1973).

    Farm Labor/Domestic Servants:

    The employer, who engaged in the horticultural or farming business, was subject to the Workers’ Compensation Act based on a finding that there were regularly in service more than two full time employees. Garcia-Espinal v. Cundiff, 71 O.W.C. 27 (1992).

    Horticultural work involves cultivating fruits, vegetables, flowers, and plants; and plowing, tilling, or fertilizing in preparation for raising crops or plants. A landscaping business that performs work such as mowing grass, mulching, and edging trees is not a farm or horticultural business. Pineda v. Brothers, 78 O.W.C. 1 (1999).

    As used in § 65.1-28 (now § 65.2-101 ) the term “full-time” imports a sense of permanence coupled with a commitment between the employer and employee whereby the latter’s normal employment capacity is essentially utilized. The term “full time employee” refers to a specific person whose employment satisfies the definition of full-time. It does not define an aggregation of part-time employees. Lynch v. Thomas E. Lee & Sons, 12 Va. App. 933, 406 S.E.2d 423, 8 Va. Law Rep. 300, 1991 Va. App. LEXIS 177 (1991) (see also Lynch v. Lee, 19 Va. App. 230, 450 S.E.2d 391 (1994)).

    A farm worker is not covered as an “employee” within the meaning of the Virginia Workers’ Compensation Act “unless the employer regularly has in service more than two full-time employees.” “Full-time employment” refers to a sense of permanence and a commitment between the employer and employee whereby the employee’s normal employment capacity is essentially utilized. Cosgrove v. Sowers, 79 O.W.C. 63 (2000).

    “Full-time” does not include workers hired only for the harvest season. Ferguson v. Bowman, 57 O.I.C. 120 (1976).

    The claimant and another employee each worked approximately 91 hours per week for the employer, and each received a salary, housing provisions, vacation time, and sick leave. By comparison, the other workers generally worked less than 40 hours per week each, and they were paid by the hour and received no benefits. Evidence showed that these other workers had fluctuating schedules with varying hours and irregular responsibilities, depending upon available jobs. They also attended school full-time, and it was thus impossible for the employer to utilize them in a full-employment capacity. The Commission held that the employer had only two full-time employees, and that the Commission therefore lacked jurisdiction over this employer. Cosgrove v. Sowers, 79 O.W.C. 63 (2000).

    At the time of the accident, two workers for the employer were considered by the Commission to be employees only for an indefinite period of time, since both planned to attend college. One of the workers thereafter obtained another job with a construction company, demonstrating that he was uncommitted to the employer. The other worker committed to the employer after the accident instead of attending college, at which time he became a full-time employee with benefits. These facts illustrated for the Commission that only the claimant and one other employee worked full-time for the employer at the time of the accident, and that the Commission did not have jurisdiction over industrial injury at the time of the accident. Cosgrove v. Sowers, 79 O.W.C. 63 (2000).

    Claimant, a fruit picker from Jamaica, who was assigned by Growers Association to work for Tomblin who paid him, furnished transportation to and from living quarters and, in effect, paid for his housing was an employee of Tomblin and not the Association. Brown v. Tomblin, 54 O.I.C. 38 (1972).

    Domestic Servants are exempted from coverage of the Act. Hux v. Trust for Benefit of Jean Roche, 59 O.I.C. 143 (1980).

    Also see cases under topic “regularly” above.

    Independent Contractors:

    Claimant was employee, not independent contractor, where employer controlled claimant’s work by furnishing him with materials and some tools, provided transportation, assigned claimant to particular projects, inspected claimant’s work, had authority to dismiss claimant if work was unsatisfactory, and intended to obtain workers’ compensation coverage for the period at issue. Thomas v. Gooding Constr. Co., VWC File No. 217-20-23 (March 31, 2005).

    An independent contractor is personally covered as an employee only if he, the statutory employer, and the workers’ compensation carrier all agree in writing to include the independent contractor within the coverage. Reynolds v. Yellow Cab Co., 75 O.W.C. 76 (1996).

    Workers’ compensation insurance purchased to cover employees of subcontractors does not require that coverage be extended to the subcontractors themselves. McDonough v. Wisco Aluminum Corp., 75 O.W.C. 263 (1996).

    Where workers’ compensation insurance coverage is obtained through an alleged statutory employer and paid by the claimant, the evidence is sufficient to prove only that employees of the claimant were covered. Whitlock v. Whitlock Mechanical, 75 O.W.C. 350 (1996).

    Where the claimant does not prove that the alleged statutory employer exercises control over his work, but merely obtains contracts for the claimant from time to time, his evidence is insufficient to prove that he is an employee. Whitlock v. Whitlock Mechanical, 75 O.W.C. 350 (1996).

    Employees of Independent Contractors:

    The claimant was found to be an employee of an independent contractor, who did not have requisite number of employees to bring him under the Act. It was also found that he was not a statutory employee of the co-defendant at whose place of business the work was being performed because the work was not part of the co-defendant’s trade, business or occupation. Sylvia v. Graveley Construction Company, 63 O.I.C. 346 (1984).

    In determining whether the minimum number of employees exists to invoke the Workers’ Compensation Act, the Commission counts the total number of persons employed on the job by the contractor and all subcontractors. Smith v. Weber, 3 Va. App. 379, 350 S.E.2d 213, 3 Va. Law Rep. 1114, 1986 Va. App. LEXIS 372 (1986).

    Except as provided in § 65.1-29 (now § 65.2-302 ) an employee of an independent contractor is not an employee of the person contracting with the independent contractor. The person contracting with the independent contractor may be liable to employees of independent contractor under § 65.1-29 (now § 65.2-302 ), where the independent contractor is performing work which is part of the trade, business or occupation of the employer. All persons (except independent contractors themselves) engaged in performing a part of the trade, business or occupation of another are that person’s statutory employees for compensation purposes. The sole factual issue is whether the work being done by claimant was a part of the trade, business or occupation of defendant corporation. Winder v. Va.-Carolina Veneer Corp., 45 O.I.C. 251 (1963); McCoy v. Mims, 219 Va. 616 , 248 S.E.2d 817, 1978 Va. LEXIS 221 (1978).

    Employee of an independent contractor may sue another independent contractor at law. Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37, 1957 Va. LEXIS 205 (1957).

    Employers are not relieved from liability for their own negligence which causes injury to employees of independent contractors engaged in performance of work for employers outside the scope of the latter’s occupation. Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37, 1957 Va. LEXIS 205 (1957).

    Examples:

    A worker must provide a service in the usual course of trade, business, or profession of the employer to be an employee under the Act. It is not enough that the service provided has some incidental business benefit to the employer. Montross v. Wm. Melvin t/a Barnacle Bill’s Bait & Tackle, 68 O.I.C. 22 (1989).

    Where the employee is hired after responding to a newspaper advertisement, and his term of employment is indefinite and for a salaried income; and where the employee is assigned no single task or project and works with other employees or specialists hired by the employer to complete his assigned work; and where the employer retains the right to terminate the employment at will, an employer-employee relationship is established. Sidam v. Manjac Construction Co., 76 O.W.C. 19 (1997).

    Employees of a business who were hired only to perform work that was not part of the regular or permanent operations of that business are not employees defined and covered by the Act. Waggle v. Lang, 75 O.W.C. 33 (1996).

    The claimant, a mechanic who was paid by commission, was found to be an employee based on evidence that labor charges, warranty terms, dispatching, and twenty-four hour call were mandated by the employer. Nielsen v. Jim’s Home Auto, 71 O.W.C. 37 (1992).

    Despite evidence of a signed contract to the contrary, a claimant working for a courier service was held to be an employee. Walker v. Road Runner Express, 62 O.I.C. 472 (1983).

    The fact that the claimant was paid by piece work rather than by the hour has no bearing on whether there is an employee-employer relationship, where these other indices of control are present. Claros v. G & S Construction, Inc., 78 O.W.C. 153 (1999).

    Despite a signed agreement indicating that the claimant was an independent contractor, the Commission found him to be an employee because of the degree of control exercised by the employer. Sampson v. C & C Trucking, Inc., 71 O.W.C. 41 (1992).

    Since he was not under the direction and control of the lessee of the truck at the time of the accident, the claimant was held to be an employee of the uninsured lessor of the truck. Strange v. Kinsmen Trucking, Inc. and/or Warren Trucking Compa, 62 O.I.C. 436 (1983).

    The driver of a tractor-trailer unit was held to be an employee of the equipment owner because of the existence of the element control. Spence v. Ferris, 64 O.I.C. 296 (1985).

    Truck driver for laundry was an employee. Palmer v. White Way Laundry, Inc., 48 O.I.C. 180 (1966).

    Dance choreographer under control of play director-producer was an employee. Hepburn v. Resseguie and/or National Dinner Theatres Inc., 54 O.I.C. 174 (1972).

    Hairdressers and shampoo person were employees. Burkhardt v. Whippich, 55 O.I.C. 57 (1973).

    Claimant, who was hired by dairy farm owner to improve farm buildings, was held to be an employee. Good v. Paul C. Edmunds, Jr. t/a Blue Ribbon Dairy Farm, 57 O.I.C. 138 (1976).

    Newspaper route carrier found to be an employee. Hann v. Times-Dispatch Pub. Co., 166 Va. 102 , 184 S.E. 183 , 1936 Va. LEXIS 169 (1936).

    Election poll worker, working on the average of two days per year, held to be employee of Lynchburg. Huffman v. Electoral Board of City of Lynchburg, 57 O.I.C. 182 (1977).

    Helicopter pilot was employee. Cottrell v. Hauthorne Aviation, Inc., 56 O.I.C. 71 (1975).

    Pilot on charter flight for another company was an employee. Delp v. Mountain Empire Flying Service, 56 O.I.C. 94 (1975).

    Window washer was an employee. Gower v. Williamsburg Village Associates, 57 O.I.C. 140 (1977).

    Persons performing electrical work, plumbing and masonry work also worked regularly as carpenters or laborers were employees. Kennedy v. Wilson, 55 O.I.C. 207 (1973).

    The fact that an employee accepts overtime on-call work with the employer does not change his status, where his work duties when responding to such calls remain the same. Sidam v. Manjac Construction Co., 76 O.W.C. 19 (1997).

    Physician found to be employee of hospital and not independent contractor. Hernandez v. The Alexandria Hospital, 57 O.I.C. 172 (1977).

    Clean-up worker was employee. Marcey v. Ray Burnette Volkswagen, Inc., 57 O.I.C. 235 (1977).

    Compensation awarded claimant who was officially requested by county sheriff to assist in subduing outbreak at night football game and who was injured during melee. McGhee v. Louisa County, 57 O.I.C. 243 (1977).

    Employee of contractor may be a statutory employee of owner. Where the owner undertakes to perform work with its own employees, such owner in fact makes such work part of his trade, business or occupation. Allen v. Sage, 47 O.I.C. 1 (1965).

    The Commission looks to the established mode in which the employer does business to determine if it had regularly in service fewer than three employees. The employer amusement park employed over fifteen people during its operational season, but employed fewer than three during the off-season. The Commission found that the employer’s established mode of business was to operate an amusement park during the appropriate seasons, regularly employing more than three workers. The Commission held that the claimant’s status as a covered employee should not fluctuate merely because it occurred at the end of the season when the number of employees on the payroll dropped below the statutory minimum. Cornelius v. 15th Street Amusement Park, L.L.C., VWC File No. 203-03-83 (June 26, 2002).

    EMPLOYER.

    General:

    Volunteer firefighter injured while attending training supplied by county; county not considered employer because not “using the service” of claimant at time of accident nor had it adopted resolution electing workers’ compensation coverage; county also not special employer because claimant not performing any service for county at time of accident. Catlett v. Caroline County Fire & Rescue, VWC File No. 206-13-68 (May 13, 2003).

    An “all-states” endorsement carried by an employer on its workers’ compensation policy does not subject the employer to Virginia jurisdiction. Johnson v. M S Carriers, 77 O.W.C. 104 (1998).

    Except as provided in § 65.1-29 to § 65.1-34 (now § 65.2-302 ), where a person engages another to perform work which is part of his trade, business or occupation or where a contractor or subcontractor subcontracts a part of the work which he has contracted to do for another, an employer within the intent of the Act is one between whom there exist with the injured or deceased worker a master and servant relationship, as is defined at common law. Craig v. Moran, 51 O.I.C. 64 (1969); Johnson v. Purdy Timber Co., Inc., 50 O.I.C. 205 (1968).

    A builder constructing his own personal residence is still subject to the Workers’ Compensation Act as an owner, so long as such work is part of his trade, business, occupation, or profession. Hartley v. Garland E. Pugh Mech. Contr., 76 O.W.C. 129 (1997).

    While restoration and remodeling were essential to the establishment of a bed and breakfast inn, such activities were not part of the regular or permanent operations of that business, or activities that employees of the bed and breakfast inn would normally be expected to perform. The question of what constitutes part of the trade, business, or occupation of an employer is not whether the activity is useful, necessary, or even absolutely indispensable to the employer’s business, since, after all, this could be said of practically any repair, construction or transportation service. The test is whether the indispensable activity is, in that business, normally carried on through employees rather than independent contractors. What a business does on a day-to-day basis provides a reasonably reliable indicator of its trade, business, or occupation. Waggle v. Lang, 75 O.W.C. 33 (1996).

    Four elements usually exist: authority to select and engage, obligation to pay wages, power of dismissal, and power of control of the servant’s action. The power of control is the most significant element, the existence of the first three elements is not essential. The test is: the location of the power to control and direct the servant in the performance of his work. Phillips v. Brinkley, 194 Va. 62 , 72 S.E.2d 339, 1952 Va. LEXIS 207 (1952); Coker v. Gunter, 191 Va. 747 , 63 S.E.2d 15, 1951 Va. LEXIS 133 (1951); Brown v. Fox, 189 Va. 509 , 54 S.E.2d 109, 1949 Va. LEXIS 193 (1949); Crowder v. Haymaker, 164 Va. 77 , 178 S.E. 803 , 1935 Va. LEXIS 179 (1935).

    A foreign country is not an “employer” under the Act. The Commission does not have jurisdiction to hear the claim of an employee working for the Federal Republic of Germany at its Arlington, Virginia, office. Lenassi v. Federal Republic of Germany, 70 O.I.C. 11 (1991).

    Claimant was employer and not an employee; any rights he has against coal company for including himself on payroll report for workers’ compensation coverage must be adjudicated in forum other than Commission. Rife v. Jewell Coal & Coke Co., 53 O.I.C. 291 (1971).

    A mere owner of an anticipated residence, not engaged in his trade or business, is not an employer subject to the Virginia Workers’ Compensation Act. Hartley v. Garland E. Pugh Mech. Contr., 76 O.W.C. 129 (1997).

    Ownership of rental property as an investment is not a trade, business, or occupation that subjects an attorney to workers’ compensation claims. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    Assuming ownership of rental real estate could be considered a business of an attorney, construction of an addition to the attorney’s personal residence was not part of that business. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    Sole Proprietor:

    A sole proprietor’s election to be covered for workers’ compensation purposes by his own policy of insurance was established by the inclusion of his salary in the total payroll and counting himself in the total number of employees. Marshall v. F. & M. Custom Builders, 62 O.I.C. 295 (1983).

    There is no distinction between a self-employed person who voluntarily places himself under the Act and an employee of an employer who comes within the purview of the Act by operation of law except as to certain requirements regarding notice being given to the carrier. Therefore, a self-employed person who receives a communication of an occupational disease may pursue the claim against the employer where he was last injuriously exposed, i.e., himself and his insurance carrier. Fuller v. Ray Fuller Trucking, 71 O.W.C. 176 (1992).

    A sole proprietor who elects to be covered by his own workers’ compensation insurance policy must give notice of an injury to the insurance carrier who then provides a panel of physicians to the injured employee. Any change in physicians must also be authorized by the insurance carrier. Crawford v. O.A. Crawford Heating & Air Conditioning, 67 O.I.C. 7 (1988).

    Although notice to an insurance agent may satisfy the notice requirement of the Act under certain circumstances, the claimant in this case neither told the agent that his accident was work related nor gave the agent information from which a person could conclude that the accident was work related, and the Commission held that notice subsequently given was untimely. Marchiafava v. Lance Marchiafava, Inc., 76 O.W.C. 124 (1997).

    Mere inclusion of the claimant’s name as the “named insured” on a policy of workers’ compensation insurance is an insufficient basis to claim that he is an “employee” under the Act. A sole proprietor is not considered an “employee” without a voluntary election by the proprietor to come within the coverage of the Act. Where the policy of insurance was apparently purchased by the proprietor to satisfy his own liability to the employees of uninsured subcontractors, and there was no evidence that the insurer was put on notice of the alleged election, the policy language was insufficient to establish that he was an “employee.” Parrish v. Media One, VWC File No. 199-09-41 (May 8, 2001).

    Partners:

    A partner cannot be an employee of the partnership. Weisz v. Anne Lee Candy Shop, 55 O.I.C. 372 (1973); Carey v. Self & Self, 45 O.I.C. 25 (1963); Fleming v. Fleming Bros. Coal Co., 30 O.I.C. 377 (1948); Berry v. Fray Berry Construction Co., 58 O.I.C. 21 (1979).

    Joint venturers, even though in same management, cannot be employees. Carter v. Rowletts, 35 O.I.C. 482 (1953); 36 O.I.C. 80 (1954); Smith v. Smith, 35 O.I.C. 366 (1953); Hevener v. Highland Mutual Telephone Co., 32 O.I.C. 403 (1950); Gilbert v. Burgess, 17 O.I.C. 249 (1935); Osier v. Sentinel Security, 57 O.I.C. 278 (1976).

    Although there is no generally accepted definition of joint venture, it is said to exist “when two or more persons combine in a joint business enterprise for their mutual benefit, with an express or implied understanding or agreement that they are to share in the profits or losses of the enterprise, and that each is to have a voice in its control or management.” Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    Where an attorney used a contractor to build an addition to his personal residence, the Commission held that this did not amount to an enterprise in which profits and losses would be generated, and the relationship of the attorney and the contractor was not one of joint adventurers. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    When partnership is dissolved the obligations of partnership are not terminated. Echols v. Drs. Riley & Natvig, 56 O.I.C. 102 (1974).

    Independent Contractors:

    Claimant hired to perform carpentry and framing held to be independent contractor. “[A] client that hires an independent contractor retains the right to require the work be performed according to industry and governmental standards. The client determines if the end result is suitable for its needs. If the client finds the work lacking, it may end the business relationship and find another independent contractor to accomplish its goals. By doing so, the client acts as any other consumer in the marketplace, and this does not change the nature of the relationship into one of employer and employee.” Petrone v. Best Bid, Inc., JCNVA02000016244 (Jan. 22, 2015).

    Persons occupying the status of contractors and subcontractors are not employees. See Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37 (1957), for a discussion of cases .

    An employer who uses independent contractors rather than employees is excused from numerous legal, tax and insurance obligations. However, the mere intention to label workers as “independent contractors,” even a mutual intention, is not enough to avoid these obligations. The employer must give up substantial control over the contractor’s work activities, while the basic decisions are often left to the contractor. The independent contractor relationship is frequently characterized by a lack of continuity and exclusivity. Claros v. G & S Construction, Inc., 78 O.W.C. 153 (1999).

    An employer often hires experienced employees who do not require direct supervision and instruction, and it is the right of the employer to exercise control over the conduct of the worker, even though it is only held in reverse, that determines whether the worker is an employee or an independent contractor. Sidam v. Manjac Construction Co., 76 O.W.C. 19 (1997).

    Whether a person is an excellent craftsman, exercising independent judgment in the means of carrying out the work, is not determinative of independent contractor status. Other factors must be considered. Employees may include individuals of high skill as well as moderate or low skills. Computer programmers, accountants, lawyers, and doctors may qualify as “employees” if they are involved in an employment relationship. Many professional employees work unsupervised, supervise others, and exercise independent judgment. Stone v. Broad Run Builders, Inc., VWC File No. 196-99-02 (June 7, 2001).

    An employer cannot merely designate or agree that the worker is an independent contractor in derogation of the actual relationship established by the facts of a particular case, and the Commission must look behind such agreement to determine the status in fact. Sidam v. Manjac Construction Co., 76 O.W.C. 19 (1997).

    In determining whether a person is an employee or an independent contractor, the Commission examines four factors: the selection and engagement of the worker; the payment of wages; the power of dismissal; and most significantly, the power of control of the employee’s actions. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997); Sidam v. Manjac Construction Co., 76 O.W.C. 19 (1997).

    An independent contractor is not an employee or statutory employee merely because he performs work in the trade, business occupation, or profession of the employer which is usually performed by employees, if the employer retains no right to control the manner in which the work is performed. Reynolds v. Yellow Cab Co., 75 O.W.C. 76 (1996).

    Fact that claimant was paid on hourly basis from which social security and federal income taxes were deducted is not controlling in determining employment status. Claimant was not employee. Hogge v. H & S Corp., 53 O.I.C. 139 (1971).

    The fact that the employer reported the claimant’s earnings on a 1099 form rather than a W-2 form does not make it just as likely that the claimant was an independent contractor. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Where the evidence tending to prove that the claimant is an independent contractor is not clear, and the power to control is retained by the alleged employer and was exercised in that relationship, the relationship will be held to be that of an employer and employee. Sidam v. Manjac Construction Co., 76 O.W.C. 19 (1997).

    An independent contractor is personally covered as an employee only if he, the statutory employer, and the workers’ compensation carrier all agree in writing to include the independent contractor within the coverage. Reynolds v. Yellow Cab Co., 75 O.W.C. 76 (1996).

    Workers’ compensation insurance purchased to cover employees of subcontractors does not require that coverage be extended to the subcontractors themselves. McDonough v. Wisco Aluminum Corp., 75 O.W.C. 263 (1996).

    Even though a percentage of the gross amount due was withheld for workers’ compensation purposes, the claimant was found to be an independent contractor and not an employee. Walsh v. Lewis G. Holt, 63 O.I.C. 364 (1984).

    Where the evidence showed that the claimant had no contract for hire, could come and go as he pleased, hire labor at his discretion, use his own tools, and work unsupervised, this did not indicate the requisite control necessary to establish an employment relationship between the claimant and the alleged employer. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    Claimant who shared proceeds of work with another, after expenses for gas and employee wages and workers’ compensation insurance were deducted, was a joint subcontractor and not an employee. A joint subcontractor cannot be the statutory employee of a general contractor. McDonough v. Wisco Aluminum Corp., 75 O.W.C. 263 (1996).

    The claimant who leased tractors to a trucking company and was injured while driving one of the leased tractors for that company was found to be an independent contractor. Bray v. U.S. Lines Trucking, Inc., 67 O.I.C. 12 (1988).

    The claimant, an owner/operator who hauled under a lease agreement, was an independent contractor inasmuch as there was no power to dictate the means and method by which his tasks were accomplished. Hamilton Trucking v. Springer, 10 Va. App. 710, 396 S.E.2d 379, 7 Va. Law Rep. 211, 1990 Va. App. LEXIS 151 (1990).

    Airplane pilot engaged in fish spotting was an independent contractor. Jacobsen v. Menhaden Co., Inc., 38 O.I.C. 129 (1956) (appeal denied).

    Claim for death benefits denied in finding that deceased was acting as an independent contractor rather than employee at the time of the helicopter crash which resulted in his death. Seals v. Tom-V Mining, Inc., 57 O.I.C. 315 (1977).

    Golf caddy under control of caddy-master at all times when not actually in service of a member is an employee of golf club. That members pay caddy directly is not determinative of employer-employee relationship. Shepperd v. Williamsburg Restoration Inc., 40 O.I.C. 133 (1958).

    Whether a person is an “employee” or an “independent contractor” is governed by common law principles. The Commission looks generally to four factors: the selection and engagement of the worker; the payment of wages; the power of dismissal; and, most significantly, the power of control. The issue of control includes factors such as which party invests in the facilities used in the work; whether the work is part of the principal’s regular business; and the permanency of the relationship. The threshold level of control necessary to find employee status is generally lower when applied to professional services than when applied to nonprofessional services. The Commission held from the facts of this case that the pastor was an employee of the local church, where the church provided all the facilities, staff, and equipment used by the pastor; where the relationship was long term and not transitory; where the pastor worked full time for the local church; where such work was an integral part of the church operation, and central to the church’s fundamental purpose; where the pastor served on the church’s governing board; and where the local church made recommendations to the parent church regarding placement and termination of the pastor’s employment. Harper v. Lomax A.M.E. Zion Church, 75 O.W.C. 109 (1996).

    Labor Brokers:

    Employee who was hired by staffing company to work for engineering firm, where he was injured, considered employee of engineering firm; employee worked at firm for several months, without regular contact with staffing company, and firm exercised exclusive control over employee’s daily activities; engineering firm considered special employer. Price v. Reliance Staffing Serv., VWC File No. 211-70-30 (Dec. 8, 2003).

    An employee service contract cannot transfer workers compensation liability to another party where the employer maintains full control over the employee. Speas v. Omega Interiors, Inc., 71 O.W.C. 21 (1992).

    See UPI v. Frye, 6 Va. App. 589, 371 S.E.2d 34 (1988); LMI Insurance v. James Foley et al., (Unpublished Court of Appeals Record # 2670-96-4 and 2671-96-4) (July 29, 1997).

    Surety:

    Where the employer defaults on his contract and his surety company becomes responsible for completion thereof, it is liable for payment of compensation to a worker of the contractor who is injured while engaged in work directed towards the performance of obligation to complete. National Surety Co. v. Rountree, 152 Va. 150 , 147 S.E. 537 , 1929 Va. LEXIS 157 (1929).

    The definition of employer includes insurer, so that notice to insurer constitutes notice to employer. Dowdy v. Giant of Va., Inc., 210 Va. 408 , 171 S.E.2d 254, 1969 Va. LEXIS 257 (1969).

    The Commonwealth, and not the particular department by which worker is employed, is the employer under the Act. Department of Game & Inland Fisheries v. Joyce, 147 Va. 89 , 136 S.E. 651 , 1927 Va. LEXIS 287 (1927); Smith v. State Hwy. Comm'n, 131 Va. 571 , 109 S.E. 312 , 1921 Va. LEXIS 47 (1921).

    When governmental entities and public utilities are involved, it is not simply what they do that defines their trade, business or occupation. What they are supposed to do is also a determinant. A governmental entity has duties, obligations, and responsibilities imposed upon it by statutes and charter provisions. Consequently, local governments’ trade, business, or occupation must be judged according to the public duties they are authorized and empowered by legislative mandate to perform. Williams v. Portsmouth Redev. & Hous. Auth., 76 O.W.C. 465 (1997).

    Acceptance and administration of a federal grant does not make all those associated with the grant employees of the local governmental entity. Each determination of whether a grant program is part of an entity’s trade, business or occupation must be done on a case-by-case basis. Williams v. Portsmouth Redev. & Hous. Auth., 76 O.W.C. 465 (1997).

    The Portsmouth Authority [PRHA] had participated for ten years in a federal grant program intended to help eliminate drug use by teenage residents. The funds were used by PRHA to provide buses to transport the teenagers to athletic events in a program administered by a volunteer worker selected by PRHA. The volunteer hired the claimant as a bus driver, subject to the approval and subsequent control of PRHA, through time sheets submitted by the volunteer supervisor. The Commission found from the long-term participation of PRHA in the federal grant program, together with its fiscal oversight and administration of the program, that the program was a function of the trade, business or occupation of PRHA, and that the claimant was therefore an employee of the governmental entity. Williams v. Portsmouth Redev. & Hous. Auth., 76 O.W.C. 465 (1997).

    A foreign country is not an “employer” under the Act. The Commission does not have jurisdiction to hear the claim of an employee working for the Federal Republic of Germany at its Arlington, Virginia, office. Lenassi v. Federal Republic of Germany, 70 O.I.C. 11 (1991).

    FILED.

    Change in condition claim filed by certified mail on last date before statute of limitations ran was timely. Wheeler v. Giant Food, Inc., No. 070, VWC File No. 203-36-16 (March 25, 2005).

    A certified letter must be posted at the United States Post Office in order to be considered “filed.” The marking of a letter as “certified mail” and placing in a mail box is considered filed only when received by the Commission. Smallwood v. Overbrook Landscaping, Inc., 70 O.I.C. 56 (1991).

    In rejecting an employer’s application for failing to pay compensation pursuant to Rule 1.4, the Commission held that a facsimile transmission is not “filed” until actually received by the Commission. Sistare v. W. Logan Rowse, 73 O.W.C. 54 (1994).

    In § 65.2-101 , the General Assembly clearly defined how a document is to be “filed” with the Commission. Properly “filing” a claim within the statute of limitations of § 65.2-601 is a jurisdictional requirement, and the Commission has no power to accept an alternate filing that is untimely. Claimant’s counsel chose to use a private delivery service to attempt to file a claim within the statue of limitations. Due to a national emergency that brought all airborne shipping to a halt, the claim was delayed in transit, arriving after the statute of limitations had run. The Commission held that the claimant chose to use an alternate delivery method at her own risk, noting that the claim would have been automatically “filed” when delivered to a local post office and placed into certified mail. Hundley v. Williamsburg Community Hospital, VWC File No. 197-64-42 (February 5, 2002).

    “Accident”:

    Injuries sustained by claimant in an elevator that travelled up and down, jerked and erratically moved for over 30 minutes were compensable injuries by accident arising out of claimant’s employment. Farmer v. Macy’s, JCN VA00001088061 (Sept. 14, 2017).

    Where a compensable work accident resulted in a fusion at L5-S1 and claimant subsequently felt a loud “pop” while sitting, the resulting disc herniation at L4-5 is a compensable consequence of the original injury rather than a new accident because the fusion resulted in a weakening at the L4-5 level. Gaskins v. W. L. McKendree & Company, Inc., VWC File No. 214-82-19 (Sept. 26, 2006).

    Employee’s injury caused by using vacuum cleaner arose out of employment; employee proved that injury was sudden and unexpected; whether work activity was “innocuous” not relevant to whether injury caused by specific, work-related physical task. Spruill v. Norfolk School Bd., VWC File No. 208-59-15 (Apr. 8, 2003).

    Layman’s use of term “accident” differs from the legal definition. Claimant’s description of events is the pertinent aspect rather than his response to inquiry of “accident” or injury. Caddy v. Sherman Construction Co., 57 O.I.C. 72 (1976).

    Where a claimant who was advised by his treating physician to avoid employment exposing him to electrical shock returns to such employment and suffers a shock, there has been no injury by accident since the subsequent difficulties were foreseen and not an accident. Miller v. Dixon Lumber Company, 67 O.I.C. 71 (1988) (see also Dobbins v. Contractors Equipment & Supply Co. (appeal denied), 58 O.I.C. 104 (1979); Bragg v. Buchanan General Hospital, Inc., 59 O.I.C. 30 (1980)).

    Because the Act does not contemplate benefits for injuries voluntarily inflicted, the Act does not allow recovery of compensation where the claimant’s disability was the expected result of an activity that violated his doctor’s specific restrictions. In this case, the treating physician did not specifically issue any work restrictions to the claimant. Rather, the physician’s comments to the claimant about changing his occupation were advisory, not prohibitory, and his continued work as an electrician did not violate any specific restrictions. Wong v. New View Electrical, Inc., 79 O.W.C. 120 (2000).

    Where a claimant suffered a back injury while doing heavy manual work in contradiction of medical restrictions imposed upon him after discharge from the hospital, his subsequent disability was the expected result of his failure to obey medical advice and not a compensable injury by accident. Ellis v. City of Norfolk, 68 O.I.C. 47 (1989).

    Compensation benefits were denied to the employee who engaged in a prohibited activity by assisting in lifting a heavy stove despite specific instructions from his supervisor to do no lifting because of a prior back injury. Sluss v. Scott Farmers Cooperative, Inc., 71 O.W.C. 133 (1992).

    An application for carpal tunnel syndrome as a result of an industrial accident, and an application for the same condition as an occupational disease are not barred by res judicata since they set forth different causes of actions derived from different circumstances, different medical diagnoses and involved different legal foundations. Wood v. Allison Apparel Marketing, Inc., 11 Va. App. 352, 398 S.E.2d 110, 7 Va. Law Rep. 1038, 1990 Va. App. LEXIS 216 (1990).

    An employee who is injured in a work-related accident, and whose injuries aggravate or exacerbate a pre-existing condition resulting in disability, is entitled to compensation. Alexander v. Russell Stover Candies, 76 O.W.C. 448 (1997).

    Although the claimant suffered a temporary increase in symptoms after a later incident, there was essentially the same degree of effusion and range of motion as before the incident, and there was no change in work restrictions or medical treatment because of that incident. The Commission held that the later incident was not a new accident, but only an aggravation of her earlier work accident. McBride v. Va. Dept. of Transportation, 76 O.W.C. 227 (1997).

    Injury by Accident.

    Also see cases under “Arising Out of and In Course of Employment” below.

    Traumatic injury suffered during the course of a multi-hour training session was a discreet and specific injury and the training session provided the necessary rigidity of temporal precision to constitute one event. Bandy v. Dept. of Motor Vehicles, JCN VA00001370700 (Nov. 2, 2018), aff’d. No. 1878-18-2 (Ct. App. of Va., April 30, 2019) (unpublished opinion); Sclafani v. City of Charlottesville, JCN VA00001340217 (Nov. 29, 2018).

    Claim held compensable where claimant felt a strain when lifting a projector and moving a desk. Case distinguishable from Lysable Transport, Inc. v. Patton, 57 Va. App. 408, 702 S.E.2d 596 (2010), because claimant did not describe feeling a strain when she either lifted the projector or lifted the desk but rather felt a strain, in the same part of her body, when she lifted both objects. Although she felt the same sensation on two occasions, injury was not the result of repetitive trauma. An identifiable incident occurred that caused an obvious sudden mechanical or structural change in her body when she lifted the projector. While lifting the desk may have exacerbated the initial injury, the initial injury nonetheless occurred. That claimant experienced severe pain several hours after the initial strain was not fatal to her case. Colyer v. Wise Co. Pub. Sch., JCN VA00001117556 (Oct. 25, 2016).

    In order to recover on a workers’ compensation claim, a claimant must prove (1) an injury by accident, (2) arising out of and (3) in the course of his employment. The burden is upon the claimant to prove the foregoing by a preponderance of the evidence. Al-Janabi v. MCI Communications Corp., 76 O.W.C. 290 (1997); Morgan v. City of Norfolk School Board, 76 O.W.C. 359 (1997); Raynor v. Va. Department of Health, 76 O.W.C. 308 (1997).

    To constitute an injury by accident, it is not necessary that there should be an extraordinary occurrence in or about the work engaged in. The evidence is sufficient to establish an injury by accident even though the degree of exertion is usual and ordinary and the employee had some predisposing physical weakness. Lynch v. Virginia Veterans Care Center, 78 O.W.C. 32 (1999).

    The claimant must prove by a preponderance of the evidence that he suffered an injury by accident. Even if the injury made its appearance suddenly, at a particular time and upon a particular occasion, the claimant still must prove that the cause of the injury was an identifiable incident or sudden precipitating event and that it resulted in an obvious sudden mechanical or structural change in the body. Al-Janabi v. MCI Communications Corp., 76 O.W.C. 290 (1997).

    A medical procedure [tuberculin injection] required by the employment clearly occurs within the scope of and arises out of the employment duties. Where, as a natural consequence of the procedure, the claimant’s skin is broken, and the foreign substance injected into his body causes an adverse reaction, the procedure constitutes an “accidental” injury, because the injection results in an unintended consequence. Dempsey v. Henrico County Fire Dept., 79 O.W.C. 202 (2000).

    An employer is liable for preventative medical treatment if the employee suffers a specific industrial accident that leads to the need for such treatment, as a result of the “accident”. However, where a tuberculin skin test merely identifies a potential need for medical treatment, and there is no evidence that the test caused the underlying condition for which such treatment is required, the employer is not liable for a six-month course of treatment to monitor liver function because of a concern that the employee had tuberculosis. Rather, the employer is responsible only for treatment, if any, of the swelling and redness directly caused by the test. Dempsey v. Henrico County Fire Dept., 79 O.W.C. 202 (2000).

    The aggravation of an old injury or pre-existing condition is not per se tantamount to a new injury. To be a new injury, the incident giving rise to the aggravation must, in itself, satisfy each of the requirements of an injury by accident. McBride v. Va. Dept. of Transportation, 76 O.W.C. 227 (1997).

    An “injury by accident” has three components: (1) an identifiable incident; (2) a sudden mechanical or structural change in the body; and (3) a causal connection between the incident and bodily change. Raynor v. Va. Department of Health, 76 O.W.C. 308 (1997).

    For there to be a compensable “injury by accident” an employee must prove that the injury was caused by “an identifiable incident or sudden precipitating event that results in an obvious, sudden mechanical or structural change in the body.” Injuries from repetitive trauma, continuing mental or physical stress, or other cumulative events, as well as injuries sustained at an unknown time do not satisfy this requirement. Morris v. Morris, 238 Va. 578 , 385 S.E.2d 858, 6 Va. Law Rep. 756, 1989 Va. LEXIS 175 (1989).

    To be compensable as an injury by accident, a purely psychological injury must be causally related to a physical injury, or to a sudden shock or fright arising in the course of employment. Owens v. Dept. of Transportation, 77 O.W.C. 257 (1998).

    Although a claimant must prove a “sudden precipitating event” that caused the injury, it is not necessary that there should be an extraordinary occurrence in or about the work engaged in. “Sudden” as used in this context means an “immediate” event that causes or precipitates an injury; “sudden” is not used here to connote an unexpected consequence. Thus, “sudden precipitating” event is one that “immediately” causes an injury, as distinguished from an injury that appears or occurs gradually. Morgan v. City of Norfolk School Board, 76 O.W.C. 359 (1997).

    The Commission held that the claimant, who merely developed a soft tissue injury or tibia plateau tear after kneeling for 20-30 minutes, without any sudden precipitating incident, or any sudden mechanical or structural change in the knee, did not prove an injury by accident. Rottier v. City of Alexandria School Board, 78 O.W.C. 232 (1999).

    The specific incident that caused the employee’s sudden mechanical or bodily change must be viewed in the aggregate, not in its component parts. Blizzard v. Super Fresh Food Markets, Inc., 75 O.W.C. 168 (1996).

    Pain does not have to be contemporaneous with the accident to be an injury by accident. Where the claimant consistently related her symptoms to the work activity, the mere fact that she did not experience pain until some hours later does not defeat the “injury by accident” claim. Dodd v. Medical Care Center, 76 O.W.C. 486 (1997).

    The claimant established an injury by accident when he experienced severe back pain simultaneously with rising from a bent over position handling a 100-pound drum of chlorine thereby aggravating a pre-existing condition. Manassas Ice & Fuel Co. v. Farrar, 13 Va. App. 227, 409 S.E.2d 824, 8 Va. Law Rep. 1100, 1991 Va. App. LEXIS 269 (1991).

    An injury by accident was established when the claimant who was carrying 70 pounds of tools, coughed and immediately felt back pain. Hartsoe v. Central Boiler, Inc., 65 O.I.C. 73 (1986).

    Benefits were awarded to an employee who lifted a 100-pound furnace, leaned over it for approximately four to five minutes to cut and fit it into place and was unable to stand up as the result of an acute lumbosacral strain. The employee’s action required unusual exertion and involved a risk of his employment specific to the nature of the job. Brown v. Caporaletti, 12 Va. App. 242, 402 S.E.2d 709, 7 Va. Law Rep. 2126, 1991 Va. App. LEXIS 70 (1991).

    Compensation benefits were awarded to an employee who felt a sharp pain upon arising after working one-half hour sitting on a stool in a bent position. Whitt v. Southeastern Virginia Training Center, 70 O.I.C. 120 (1991).

    Compensation benefits were denied to an employee who felt a slip in his back as he attempted to stand up after working for a period of time in a crouched position welding a water line. Colston v. Union Camp Corporation, 70 O.I.C. 126 (1991).

    Credible testimony of the claimant may be sufficient to establish an injury by accident unimpeached by the medical records, even if the medical histories refer only to general repetitive tasks the claimant performed when the accident occurred. Mullins v. Dickenson County Medical Center, 74 O.W.C. 176 (1995).

    The claimant injured her neck and shoulders while helping to restrain a sedated dental patient over a period of twenty minutes. The Commission held that the incident described was sufficiently discrete and precise to constitute a compensable injury by accident. Galeano v. Northern Virginia Training Center, 76 O.W.C. 191 (1997).

    The claimant and a coworker lifted a large metal table weighing about 100 pounds, and carried it approximately 50 yards. She did not feel pain until later that evening. The Commission found that the act of carrying one particular table at a specific time for a short distance constituted a specifically defined task, i.e., a discrete activity. The activity did not extend over any significant time period, and the act of carrying the table satisfied the requirement of a sufficiently identifiable incident. Dodd v. Medical Care Center, 76 O.W.C. 486 (1997).

    Burden of Proof:

    Where a physician’s statement as to causation is one of possibility, not probability, and the possibility of a causal connection does not rise to the level of an opinion to a reasonable degree of medical probability, it is insufficient to satisfy the claimant’s burden of proof. The preponderance of evidence must show that work was the cause of the disability under the more probable than not rule. Parker v. Wal-Mart Associates, Inc., JCN VA00000223428 (Aug. 31, 2011).

    Claimant’s testimony need not be corroborated, but must be credible and in accord with normal events. Walsh Constr. Co. v. London, 195 Va. 810 , 80 S.E.2d 574 (1954); Warren v. Bishop & Settle Construction Co., 57 O.I.C. 366 (1977).

    Commission has discretion to give probative weight to hearsay statements. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958).

    Where the claimant is not inherently incredible, the Commission will look to his testimony and the medical record to determine whether he has met his burden of proving that a condition of the employment caused the accident. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    Where the treating physicians identified no independent risk factors for a retinal detachment injury except for the history of accident given by the claimant, the Commission found the evidence sufficient to establish that the trauma was caused by the work related fall. Hall v. A. Bertozzi, Inc., 76 O.W.C. 415 (1997).

    A claim will not be denied simply because an employee is confused as to the exact date of the accident if the Commission is satisfied that an injury by accident occurred. Mullins v. Dominion Coal Corporation, 68 O.I.C. 43 (1989) (see also Tiller v. Alexandria Lithograph Co., 60 O.I.C. 451 (1981)).

    When claimant identified specific movement or action taken at a particular time at work, claim should not be defeated because he is unable to distinguish whether accident happened on one day or another. Davis v. Clinchfield Coal Company, 60 O.I.C. 127 (1981).

    Pain from an injury need not be contemporaneous with the incident to establish a causal connection, and a lapse of eight days between the incident and a medical report of treatment is not fatal to the claim. Akisi v. Harwood Foundation, Inc., 75 O.W.C. 298 (1996).

    If a claimant’s testimony, taken as a whole, does not make it appear clearly and unequivocally that the case is without merit, the claimant’s case is not fatally damaged. The claimant’s testimony, when viewed in its entirety established an identifiable incident at a reasonably definite time. Seven-up Bottling Company v. Moseley, 230 Va. 345 , 335 S.E.2d 272 (1985).

    The Commission relies primarily but not entirely on medical evidence in order to determine the cause of an injury. Hall v. A. Bertozzi, Inc., 76 O.W.C. 415 (1997); Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    An unequivocal medical opinion that the accident caused the injury is not necessary for the claimant to carry her burden of proof of an injury by accident. Dodd v. Medical Care Center, 76 O.W.C. 486 (1997).

    A claimant does not have to establish the identity of a specific item which struck him in the eye but must prove only that he received an injury by accident arising out of and in the course of his employment. Norfleet v. Williams, 66 O.I.C. 18 (1987).

    Foreman on construction site struck in eye by unknown object does not bear burden of proving what object directly or by ricochetting in the work environment caused injury. Garrett v. Harry M. Brown Co., 51 O.I.C. 101 (1969).

    Negligent Acts:

    Negligence by an employer or an employee is not a factor in determining entitlement to benefits under the Workers’ Compensation Act. An employer’s negligence in failing to provide a safe work place is not a basis for an award of benefits under the Act. Shumate v. Marion Diner, 70 O.I.C. 100 (1991).

    If an employee did not foresee the result of his deliberate act, even though it was an act of gross negligence or stupidity on his part, such result should be regarded as accidental. Tyree v. Commonwealth, 164 Va. 218 , 179 S.E. 297 (1935); Burkhardt v. Whippich, 55 O.I.C. 57 (1973).

    A claimant’s negligence is not a bar to recovery under the Act. Although the claimant may have selected a dangerous means to reach his destination, that does not defeat his claim. Sirk v. M. G. Apartments, 63 O.I.C. 307 (1984).

    While a claimant may be guilty of negligence in choosing a ladder too short or standing on the top rung, such action was not a bar to his claim if his action could be considered poor judgment. However, compensation was denied because the claimant’s ethanol level of .26 was found to have impaired his judgment and made him more likely to fall. Brown v. Powell’s Paint Co., Inc., 68 O.I.C. 113 (1989).

    Heart Attack:

    The evidence failed to establish an injury by accident where the claimant had a preexisting cardiovascular disease and was subject to multiple risk factors, one of which was work-related tension. Willis v. Bemiss Equipment Corporation, 65 O.I.C. 124 (1986).

    Death:

    The death presumption does not apply where a person is unable to recall the accident and dies a day later. Tweed v. Newport News Shipbuilding & Dry Dock, VWC File No. 227-87-41 (June 26, 2007).

    Based on a reasonable inference, the decedent who was discovered dead at his place of employment next to a refrigerated truck was found to have suffered an injury by accident. Stone v. Gwaltney of Smithfield, 65 O.I.C. 102 (1986).

    In denying benefits where the decedent was found dead next to his truck after mowing grass, the Commission found that the evidence failed to demonstrate a significant exertion or particular strenuous effort occurring at an identifiable time. Hall v. John T. Williams Association, Inc., 70 O.I.C. 107 (1991).

    Hearing Loss:

    The claimant, who had pre-existing hearing loss, suffered a compensable injury by accident when gunfire resulted in hearing loss. In determining claimant’s hearing loss from the accident the normal or non-material 26 decibel is subtracted from the pre-existing hearing loss. This number is then subtracted from the post-accident hearing loss. The resulting decibel loss is then compared to the chart in Rule 12 to determine the percent of hearing loss related to the compensable work accident. Macudzinski v. Omniplex World Service, Inc., VWC File No. 218-73-91 (Feb. 21, 2007).

    Psychological and Emotional Disorders:

    The claimant, who suffered shortness of breath and an acute anxiety/panic reaction after the backhoe he was operating slipped on the side of a hole causing him to fear striking exposed power lines, proved a compensable psychological injury. Berry v. City of Richmond Public Utilities, VWC File No. 226-69-44 (June 26, 2007).

    The claimant’s depression that developed from pain relating to injuries incurred in a work accident is a compensable consequence of the original injury and as such is a change of condition governed by § 65.2-708 which requires that a claim be filed within two years from the date compensation was last paid pursuant to an award. Brown v. Ruby Tuesday’s Inc., VWC File No. 215-94-55 (June 11, 2007), On remand deputy commissioner on Oct. 19, 2007 found for claimant. By March 6, 2008 review opinion the commission affirmed(On remand deputy commissioner on Oct. 19, 2007 found for claimant. By March 6, 2008 review opinion the commission affirmed).

    The common denominator for psychological injuries resulting from a sudden shock or fright, in the absence of physical injury, is that the event precipitating the sudden shock or fright is something out of the ordinary in terms of the injured employee’s work duties, something so dramatic or frightening so as to shock the conscience. Owens v. Dept. of Transportation, 77 O.W.C. 257 (1998).

    An emergency medical technician firefighter who experienced post traumatic stress disorder symptoms several days after administering medical attention to a severely injured man inside a wrecked automobile was denied compensation benefits on the basis that the sudden mechanical or structural change in the body element of an injury by accident was not established. Chesterfield County/Fire Department v. Dunn, 9 Va. App. 475, 389 S.E.2d 180, 6 Va. Law Rep. 1384, 1990 Va. App. LEXIS 31 (1990).

    Compensation benefits were awarded to an employee who after spraying insecticides into his face and eyes subsequently developed a panic attack disorder. Emotional harm following physical injury is compensable even when the physical injury does not directly cause the emotional consequence. Seneca Falls Greenhouse & Nursery v. Layton, 9 Va. App. 482, 389 S.E.2d 184, 6 Va. Law Rep. 1393, 1990 Va. App. LEXIS 32 (1990).

    Benefits were awarded to an employee who suffered a post traumatic stress disorder after sustaining a sudden shock or fright from being thrown through the air by an explosion. The principles in Burlington Mills Corp. v. Hagood, 177 Va. 204 , 13 S.E.2d 291 (1941), were relied upon to establish a compensable injury by accident. Hercules, Inc. v. Gunther, 13 Va. App. 219, 412 S.E.2d 185 (1991).

    Stroke related to collapse of building found compensable. Hopkins v. American Furniture Co., 51 O.I.C. 126 (1969).

    An incident resulting in a neurosis causing an incapacity for work is an injury, even though it is of functional origin with no visible lesion. Beverley v. Omohundro Elec. Co., 33 O.I.C. 532 (1951); Gatewood v. Gatewood, 33 O.I.C. 431 (1951).

    The claimant’s depression was cumulative in nature and did not meet the injury by accident test of a sudden giving away or herniation of the body. Turnage v. The Retreat Hospital, 68 O.I.C. 105 (1989).

    The mere fact that offensive words are spoken at work is not sufficient to constitute an accident as contemplated by the Workers’ Compensation Act unless they are of such magnitude as to place the listener in fear for personal safety or so clearly outrageous and unusual as to shock the collective conscience. Mitchell v. City of Newport News, 65 O.I.C. 126 (1986).

    Compensation benefits were denied to an employee who suffered psychiatric hospitalization after a shouting match with the supervisor upon a finding that the evidence failed to establish a sudden shock or fright or physical injury. Teasley v. Montgomery Ward & Company, Inc., 14 Va. App. 45, 415 S.E.2d 596, 8 Va. Law Rep. 2327, 1992 Va. App. LEXIS 77 (1992).

    Compensation benefits were denied to a special education teacher who suffered severe acute emotional distress during two meetings with student’s parents arranged by the principal to resolve problems. McClain v. Manassas Park City Schools, 68 O.I.C. 110 (1989).

    In denying compensation benefits to a claimant who suffered a major depression episode after termination from her employment, the Commission found that it was not unusual for managerial decisions involving evaluation, demotion, promotion, transfer, and termination of employees to cause stress or depression; however, there was no jurisdiction under the Virginia Workers’ Compensation Act. The forum for resolving such disputes involved grievance procedures and contractual remedies. Turnage v. The Retreat Hospital, 68 O.I.C. 105 (1989).

    When depression and anxiety are causally related to a traumatic on-the-job injury such as an injury incurred during a robbery, compensation may be awarded on the basis of injury by accident. Harris v. N W S Employees Federal Credit Union, 65 O.I.C. 131 (1986).

    Traumatic neurosis caused by bank robbery; defendant responsible for hospitalization and evaluations. Willier v. Arlington Trust Co., Inc., 55 O.I.C. 379 (1973).

    Robbery involved no physical impact, but shock or fright resulted in compensable disability. Huzzey v. Merrimac Motel Corp., 55 O.I.C. 187 (1973).

    Exposure To Elements:

    A worker suffering harmful consequences from an exposure to peculiar degree by reason of his work need not prove that the exposure was instantaneous. Exposure to unusual heat or cold on one occasion may cause an injury by accident under the Act. Byrd v. Stonega Coke & Coal Co., 182 Va. 212 , 28 S.E.2d 725 (1944); Watts v. Rockbridge Motor Co., Inc., 16 O.I.C. 275 (1934); Richardson v. Ratcliffe & Tanner, Inc., 8 O.I.C. 1028 (1926); Odom v. Fass, Inc., 8 O.I.C. 322 (1926).

    An employee is entitled to recover under a theory of injury by accident if his injuries, not a disease, were the immediate consequence of exposure to a greater hazard by reason of his employment than that to which he otherwise would have been exposed. Where the evidence did not show the claimant was exposed to extraordinary weather conditions, nor that his activity was distinguishable from other employees who are required to work outside, the Commission found his work did not expose him to any additional hazard or risk of injury. Bennett v. Centex-Bateson Const. Co., 76 O.W.C. 98 (1997).

    An injury caused by heat exhaustion or other weather-related conditions is generally compensable only when the environmental conditions are extraordinary. While the claimant experienced profuse sweating, and the medical records suggested he suffered from dehydration from heat and excessive sweating, he did not offer evidence of extraordinary environmental factors at work. He did not testify that the heat caused him to become dizzy and fall; there was no definitive evidence in the record regarding the weather conditions on the date of the accident; and testimony suggested that the day was neither hot nor cold. Therefore, the claimant failed to prove that his fall arose out of a risk of employment. Turner v. Turner’s Concrete Contracting, VWC File No. 194-75-07 (January 10, 2001).

    Frostbite or Cold Exposure:

    Exposure to cold or hot temperatures resulting in conditions such as frostbite or heatstroke may constitute an injury by accident. Green v. Southern Express, 76 O.W.C. 93 (1997), aff’d, Southern Express v. Green, 257 Va. 181 , 509 S.E.2d 836 (1999), affirming 26 Va. App. 439, 495 S.E.2d 500 (1998).

    Compensation was awarded to a refuse collector who suffered frostbite after working without gloves. The Commission’s findings demonstrated that the weather conditions were unusual, that the injury resulted from conditions of employment at a definite time and that the employee was exposed “to hazards to a degree beyond that of the public at large.” Robinette v. Kayo Oil Company, 210 Va. 376 , 171 S.E.2d 172 (1969) was distinguished. Grayson Refuse Service, Inc. v. Davis, No. 0250-85 (Ct. of Appeals, May 21, 1986).

    Exposure one particular afternoon to cold temperature while unloading frozen carload of coal is injury by accident. Nellum v. Phelps, 43 O.I.C. 231 (1961).

    Newspaper boy exposed to freezing weather, frostbite held compensable. Ippolito v. Richmond Newspapers, Inc., 55 O.I.C. 190 (1973).

    Compensation benefits were awarded to the claimant who suffered frostbite during extensive exposure to extreme cold temperatures. Burrell v. Washington Metropolitan Area, 71 O.W.C. 168 (1992).

    Compensation benefits were awarded to the employee who suffered a cold-induced vascular or migraine headache syndrome after hanging conduit in a freezer over a two-hour period, part of which time a blower was directed at his face. Stafford v. Richfood, Inc., 71 O.W.C. 121 (1992).

    Claimant who suffered from chilblains, a condition associated with cold exposure accompanied by dampness, during work over a period of 3 - 4 hours has proved an injury by accident. Green v. Southern Express, 76 O.W.C. 93 (1997), aff’d, Southern Express v. Green, 257 Va. 181 , 509 S.E.2d 836 (1999), affirming 26 Va. App. 439, 495 S.E.2d 500 (1998).

    The claimant suffered a compensable frostbite injury after shoveling snow for a discrete period of three hours. The fact that the claimant suffered from a preexisting diabetic heel ulcer was immaterial. The evidence established that the claimant developed frostbite due to exposure to cold, and that the frostbite injury aggravated the claimant’s preexisting diabetic neuropathy to the point of total disability. The employer is responsible for the effects of an injury that aggravates a preexisting condition, even if the condition would otherwise be considered an ordinary disease of life. Sheppard v. Richmond (City of) School Board, VWC File No. 201-40-64 (January 25, 2002).

    Heatstroke:

    Benefits were awarded to claimant who suffered from heat stroke while working under extraordinary conditions that included being outside rather than his usual location inside and performing physically demanding labor at a rapid pace on new asphalt in an area without shade. Carico v. American Truckaway Com., VWC File No. 224-79-88 (Aug. 15, 2006).

    Benefits were awarded to an employee who suffered heat exhaustion while setting tile in a shower enclosure because the risk was peculiar to the employment. Yarbrough v. R. M. Black, Inc., 71 O.W.C. 123 (1992).

    Decedent who died as a result of a heatstroke suffered an injury by accident which arose out of and in the course of his employment. Gauldin v. Asplundh Tree Expert Company, 66 O.I.C. 23 (1987).

    Exposure beyond that of public in general to risk of harm from heat may support claim, whether artificially generated or by heat of sun made more likely to cause harm by conditions of work. Byrd v. Stonega Coke & Coal Co., 182 Va. 212 , 28 S.E.2d 725 (1943); Artis v. J. Lawson Jones Constr. Co., Inc., 51 O.I.C. 11 (1969); Updike v. Commonwealth, 36 O.I.C. 151 (1954); Norris v. Sager’s Poultry, Inc., 36 O.I.C. 65 (1954); Lauria v. McShain, Inc., 25 O.I.C. 687 (1943); Johnson v. Norfolk Tidewater Terminals, Inc., 12 O.I.C. 542 (1930), 13 O.I.C. 14 (1931) (appeal denied).

    Insect Bites/Bee Stings/Animal Attacks:

    The claimant’s injury arose out of his employment when he was bitten by a snake when he reached under some steps to retrieve the key to a vacant house. Even though the general public is exposed to snakes under structures, the claimant was exposed to an increased risk of injury since his work order required him to retrieve the key and there was a risk of snakes underneath the structure. Collier v. C S S S, Inc., t/a Bug Company South (The), JCN VA01002420495 (Sept. 16, 2011).

    Claimant who was stung by a bee was not entitled to compensation benefits as the injury did not arise out of his employment. This case provides case citations for other cases in which insect bites and bee stings have been found both compensable and non-compensable, depending on the circumstances of each case. Beals v. Boxx Systems, L.L.C., VWC File No. 235-57-00 (Aug. 6, 2008) see also Williams v. Greensville Correctional Center, VWC File No. 233-92-44 (Aug. 15, 2008).

    Lightning/Windstorm/Gases:

    Benefits awarded to family of employee killed after being struck by lightning. Perdue v. Mason & Hanger Co., 23 O.I.C. 514 (1941).

    Injury as result of exposure to windstorm held compensable. Scott County School Board v. Carter (teacher), 156 Va. 815 , 159 S.E. 115 (1931); Southgate Co. v. Butler (watchman), 148 Va. 671 , 141 S.E. 928 , 9 O.I.C. 76 (1927); Stark v. Rappahannock County School Board, 11 O.I.C. 526, 539 (1929).

    It is well-established that the inhalation of fumes may constitute an injury by accident where the inhalation occurs at a particular time and on a particular occasion which can be fixed with reasonable certainty. Alexander v. Russell Stover Candies, 76 O.W.C. 448 (1997); Link v. Hoechst Celanese Corp., 76 O.W.C. 148 (1997).

    Inhalation of poisonous gases on a single occasion may produce accidental injuries. Baltimore v. Benedict Coal Corp., 182 Va. 446 , 29 S.E.2d 234 (1944); Davis v. Robinson’s Sons, 30 O.I.C. 361 (1948); Embrey v. Southern Chemical Co., 13 O.I.C. 87 (1931).

    The claimant had a history of mild asthma that was aggravated by acute exposure to bleach fumes at work. The Commission held that the acute asthma attack constituted a mechanical or structural change in the body that occurred immediately upon smelling the bleach fumes, and proved a compensable injury by accident arising out of the employment. Alexander v. Russell Stover Candies, 76 O.W.C. 448 (1997).

    Pneumonia from inhalation of fumes while working on underside of car on single occasion was compensable. Leathers v. Peck Iron & Metal Co., Inc., 52 O.I.C. 162 (1970) (see also Clark v. National Fruit Product Company, Inc., VWC File # 170- 35-5 (July 17, 1995)).

    Where the claimant experienced shortness of breath and chest pains within 15 - 20 minutes after starting work, which her treating physician unequivocally attributed to exposure to fumes at work, and which required medical care within three hours, she has proved a compensable injury by accident. Link v. Hoechst Celanese Corp., 76 O.W.C. 148 (1997).

    Welding flash injury at a particular time is by accident and not occupational disease from protracted exposure in employment. Showalter v. Shen-Mar Food Products Corp., 51 O.I.C. 244 (1969).

    Chemical burns of both feet from cement getting into shoes is accident. Du Vall v. Faller, 53 O.I.C. 88 (1971).

    Low-voltage electrocution was an accident. Perkins v. Virginia Elec. & Power Co., 45 O.I.C. 187 (1963).

    Burns on body not needed where electrical shock was triggering device that precipitated fatal heart attack. Ambrose v. Basic Constr. Co., 52 O.I.C. 7 (1970).

    Where a money bag, worn for about three years, caused a large, hard area by its constant rubbing, a secondary infection of that area caused by the rubbing is an accident. Delp v. Wiseman Co., 32 O.I.C. 10 (1950).

    An occupational disease which is an aggravation of a pre-existing disease is not compensable. Alexander v. Russell Stover Candies, 76 O.W.C. 448 (1997).

    ARISING OUT OF AND IN THE COURSE OF THE EMPLOYMENT.

    GENERAL.

    Knee injury arose out of the employment where claimant experienced a pop in his knee as he stood up after having spent 30 to 45 minutes digging and kicking a template board, a task which required him to work in an un- usual and awkward position. Stokes v. Dixie Construction Co., Inc., JCN VA00001547649 (September 12, 2019), aff’d No. 1656-19-4 (Ct. of Appeals, March 17, 2020).

    Home-based office worker showed injury occurred during course of employment; employee fell on stairs at home after walking up, and then down, stairs to confer with wife, a fellow employee, about a business-records discrepancy; accident found to occur at place where he was reasonably expected to be. Teter v. Teter’s Interstate Exxon, VWC File No. 211-47-73 (Dec. 1, 2003).

    The claimant must prove that his injury arose out of and in the course of employment. The elements “arising out of” and “in the course of” are used conjunctively and are not synonymous. Both requirements must be fulfilled. Sacra v. Builders Floor Service, Inc., 78 O.W.C. 84 (1999).

    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. The claimant bears the burden of proving by a preponderance of the evidence that her injury arose out of her employment. Cantwell v. Bldg. Service Contr. Assn. Int’l, 76 O.W.C. 261 (1997); Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997); Cooksey v. City of Richmond Emergency Comm., 76 O.W.C. 518 (1997).

    The phrase “arising out of” refers to the origin or cause of the injury. An injury arises out of the employment where there is apparent to the rational mind upon consideration of all the circumstances, a casual connection between the conditions under which the work is required to be performed and resulting injury. The claimant must show that the conditions of the workplace or some significant work related exertion caused the injury. The causative danger must be peculiar to the work, incidental to the character of the business, and not independent of the master-servant relationship. In cases where an injury does not follow as a natural incident of the work and does not result from exposure occasioned by the nature of the employment, the injury does not arise out of employment. Swartz v. Rich Products Corporation, 78 O.W.C. 245 (1999).

    To qualify for workers’ compensation benefits, an employee’s injuries must result from an event “arising out of” and “in the course of” the employment. A “critical link” must exist between the conditions of the workplace and the injury in order for the injury to qualify as “arising out of” the employment. Phansond v. Alexandria Hospital, 76 O.W.C. 379 (1997); Nichols v. Hardee’s, 76 O.W.C. 428 (1997).

    In determining whether an injury to an employee “arises out of” the employment, Virginia has adopted the “actual risk” test. Under that test, it is not necessary to show that the work causes an increased risk or exposes the employee to a different hazard than she might confront away from the workplace. The actual risk test requires only that the employment exposes the employee to the particular danger giving rise to the injury, regardless of the exposure of the general public to similar risks. An injury “arises out of” the employment if the employee shows that the employment exposed her to the particular environment that did present the risk of an accident, and that her injury was causally related to such exposure. Clarke v. Southside Virginia Community College, 75 O.W.C. 94 (1996); Lynch v. Virginia Veterans Care Center, 78 O.W.C. 32 (1999).

    To prove that the injury arose out of the employment, a claimant must establish a causal connection between the conditions under which the work is required to be performed and the resulting injury. The claimant must show that the conditions of the workplace or some significant work-related exertion caused the injury. The causative danger must be peculiar to the work, incidental to the character of the business, and not independent of the master-servant relationship. In cases where an injury does not follow as a natural incident of the work and does not result from exposure occasioned by the nature of the employment, the injury does not arise out of the employment. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997); Cooksey v. City of Richmond Emergency Comm., 76 O.W.C. 518 (1997).

    In determining whether an injury to an employee “arises out of” the employment, Virginia has adopted the “actual risk” test. That requires only that the employment expose the employee to the particular danger giving rise to the injury, regardless of the exposure of the general public to similar risks. Gibson v. Fabri Centers of America, Inc., 75 O.W.C. 372 (1996).

    Virginia has rejected the “positional risk” test in favor of the “actual risk” test. The mere happening of an accident at the workplace, not caused by any work related risk or significant work related exertion, is not compensable. Virginia has adopted the “actual risk test,” which requires only that the employment expose the workman to the particular danger from which he was injured, notwithstanding the exposure of the public generally to like risks. Cooksey v. City of Richmond Emergency Comm., 76 O.W.C. 518 (1997); Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    It is unnecessary under the “actual risk” test to show that the employee’s work causes an increased risk or exposes her to a different hazard than she might confront away from the workplace. The “actual risk” test requires only that the employment expose the employee to the particular danger from which she was injured, not withstanding the exposure of the general public generally to like risks. Andrews v. St. Mary’s Hospital, 76 O.W.C. 43 (1997).

    To prove that an injury arose out of his employment, a claimant must demonstrate that a condition of the employment either caused or contributed to the injury. Clark v. Goodyear Tire & Rubber Co., 76 O.W.C. 145 (1997).

    The claimant, a nurse practitioner, was completing histories, and writing prescriptions and charts, as she sat on a stool. Because her legs did not fit under the accompanying desk, she had to sit with her legs to the side and twist back to write on the desk. She was injured when she pushed back the stool and stood, with her arms and torso twisted. The Commission noted that merely arising from a chair is generally an ordinary, everyday event, but the particular facts in this case supported a finding that the claimant was awkwardly positioned as a result of her employment duties, and the back injury was held to be compensable. Barker v. Department of Health, 78 O.W.C. 56 (1999).

    The claimant sat down at work to eat her evening meal, and struck her right kneecap on something under the table. There was nothing unusual about the table where the claimant sat down to eat her lunch, nor was there any evidence that either the chair or the table were in any way defective. The act of sitting down did not require any awkward movement or activity that could in any way be attributed to the employment. Nothing about the manner in which she was doing her job or any condition of the workplace caused her injury or constituted a risk of injury. Accordingly, the Commission found that the claimant had failed to prove that her injury arose out of the employment. Griffin v. Chesapeake Sheriff’s Office, 79 O.W.C. 4 (2000).

    Injury sustained by a school secretary while responding to a supervisor’s request to help capture a bird that had flown into the building arose out of the employment, since it was part of her work duties to respond to requests for assistance. An injury sustained while performing duties incidental to the employment and necessary to eliminate a disruption to the work arises out of the employment, even if the activities are common to the neighborhood. Cooper v. City of Petersburg School Bd., 75 O.W.C. 60 (1996).

    An injury occurs in the course of employment when it takes place within the period of employment, at a place where the employee may be reasonably expected to be, and while fulfilling the duties of her employment or while she is doing something which is reasonably incidental thereto. Seckora v. United Insurance Co. of America, 76 O.W.C. 61 (1997); Sacra v. Builders Floor Service, Inc., 78 O.W.C. 84 (1999); Doyle v. Walker, 78 O.W.C. 89 (1999).

    Once having determined that an accident occurred during the course of employment, the “arising out of” inquiry considers whether the injury was related to a condition of the employment. Reynolds v. Food Lion, Inc., 76 O.W.C. 300 (1997).

    The claimant was descending a staircase at work while cradling 35-pound box with his left arm and holding onto a handrail with his right hand. As he stepped to the third stair, he heard a pop in his left knee. The claimant acknowledged that he descended the steps in a normal fashion and that there was no abnormality in the steps, and no foreign substance on the surface, that caused him to slip and fall. The treating physician reported that the claimant’s injury was partly due to a pre-existing degenerative condition, but that it primarily resulted from the acute accident, due to the increased risk of carrying the 35-pound box. The Commission found that the evidence established that the claimant’s injury was causally related to the act of carrying a 35-pound box down the staircase, and that the injury arose out of the employment. Swartz v. Rich Products Corporation, 78 O.W.C. 245 (1999).

    At the request of the claimant, the employer agreed to donate a box of bread dough to a church. The claimant injured his knee while carrying the box of bread down a stairway at work. The Commission held that the fact that the box of bread was intended as a charitable donation, and that the employer elected to donate it at the request of the claimant, was of no import. The Commission concluded that the box was being transported by the claimant at the direction of the employer, and that the claimant was descending the stairway in furtherance of that order, and that the injury arose out of the employment. Swartz v. Rich Products Corporation, 78 O.W.C. 245 (1999).

    Noting that a snowstorm was developing toward the end of her shift and that she lived some 20 miles from the truck stop, the claimant requested and was granted permission to stay overnight in a motel that was part of the employer’s operation. The Commission held that the claimant’s purpose in staying overnight on the employer’s premises was primarily for her own benefit, and her slip and fall accident later that evening did not arise in the course of her employment. Miller v. White’s Auto Truck Stop, Inc., 76 O.W.C. 101 (1997).

    A chance encounter with a dog while at work is not a risk of the employment, even when the employment requires outside work. An attack by a dog becomes a risk of the employment where the nature of the employment substantially increases the risk of an encounter between the employee and the dog. The employee walked to his van, parked on a residential street, and a neighborhood dog attacked him as he returned to the unfinished home in which he was painting. Because the only connection between the attack and the employee’s work was the fact that the work caused him to be at a particular location, the Commission found that the attack did not arise out of a risk of the employment. Argenbright v. Custom Painting, Inc., VWC File No. 202-33-09 (August 1, 2001).

    GOING AND COMING.

    Claimant’s injuries when struck by vehicle entering employer’s driveway where it intersected with public sidewalk on which claimant was walking to work from bus stop did not occur in the course of employment. Gonzalez v. HEI Hospitality, JCN VA02000019517 (Apr. 1, 2016).

    District Court Clerk fell on sidewalk leading to county courthouse. Building was not owned or maintained by employer but she was required to work at this location. Commission found employee fell sufficiently close to entry door of building for extended premises doctrine to apply. Andrews v. Supreme Court of Va., JCN VA00000889453 (Oct. 7, 2014).

    The general rule is that an employee going to or from his place of work is not engaged in performing any service growing out of or incidental to their employment. Therefore, injuries received going to or from work are not compensable. Meadows v. Condon Reed, Inc., 76 O.W.C. 241 (1997).

    The Virginia Supreme Court described three exceptions to the general rule denying coverage to an employee going to or from work: (1) where transportation is provided by the employer or the time consumed is paid for or included in the wages; (2) where the way used is the sole and exclusive way of ingress and egress, or where the way of ingress or egress is constructed by the employer; and (3) where the employee is charged with some duty or task in connection with his employment while on his way to or from work. Meadows v. Condon Reed, Inc., 76 O.W.C. 241 (1997); Hardy v. Nardi Contracting Group, Inc., 77 O.W.C. 162 (1998).

    As a general rule, accidents sustained while employee is going to or from work are not within the employment, unless the employer furnishes transportation or employee is paid for transportation time; the accident occurs on the sole exclusive means of ingress or egress which was constructed by the employer; or the employee while on the way to or from work is charged with some duty connected with the employment. See GATX Tank Erection Co. v. Gnewuch, 221 Va. 600 , 272 S.E.2d 200, 1980 Va. LEXIS 280 (1980); Kent v. Va.-Carolina Chemical Co., 143 Va. 62 , 129 S.E. 330 , 1925 Va. LEXIS 246 (1925).

    The claimant has the burden of proving that one of the exceptions to the general rule of going and coming applies to his claim. Meadows v. Condon Reed, Inc., 76 O.W.C. 241 (1997).

    A home health care nurse injured on the way from her home to that of a patient failed to establish that her employment required her to travel upon the public streets or that she was within one of the exceptions to the going to and from work rule. Sentara Leigh Hospital v. Nichols, 12 Va. App. 841, 407 S.E.2d 334, 8 Va. Law Rep. 224, 1991 Va. App. LEXIS 161 (1991) (en banc).

    Carlson, a Virginia National Guardsman, completed two four-hour training sessions on a Saturday, and then returned home to Fredericksburg. While returning to Fort A. P. Hill the next day with a fellow-guardsman, Carlson suffered fatal injuries in an accident with yet another guardsman. The Commission held that because no overnight accommodations were provided to Carlson and he was free to leave the post and return home at the end of the workday on Saturday, and because he was not charged with some duty of his employment at the time of his injury, the accident and injuries did not arise out of or in the course of his employment. Carlson v. Dept. of Military Affairs, 76 O.W.C. 143 (1997).

    The “going and coming” rule is irrelevant if the claimant can prove that she was injured on her way to work while passing over the property of another that was in such proximity and relation to the employer’s premises as to be, in practical effect, a part of those premises. There are two distinct lines of authority addressing this issue — the “walkway” and “parking lot rule” cases. “Walkway” cases focus on issues related to physical proximity to work, ingress and egress from the employer’s property and the reasonableness of compensability of accidents that occur within the margin of time and space used to pass to and from the workplace. The “parking lot rule” cases focus on the employer’s expectations about risk. Compensability depends on the employer’s authority and control over the location of the accident. The Commission found that the claimant suffered a compensable injury at the entrance to a public elevator that provided the only effective means of ingress and egress from the employer’s property, applying the rule in “walkway” cases. Laverdure v. RESNA, VWC File No. 205-17-05 (July 30, 2002).

    General:

    Benefits are payable if the employer furnishes transportation or includes in wages payment for time so used:. Bristow v. Cross, 210 Va. 718 , 173 S.E.2d 815 (1970); Lucas v. Biller, 204 Va. 309 , 130 S.E.2d 582 (1963); Hann v. Times-Dispatch Publishing Co., 166 Va. 102 , 184 S.E.2d 183 (1936); Russell v. Williams, 47 O.I.C. 284 (1965); Lynch v. Appalachian Power Co., 46 O.I.C. 145 (1964); Kerns v. Wilkins, 46 O.I.C. 129 (1964); Skeens v. Bailey Coal Co., 44 O.I.C. 242 (1962); Hamm v. Bailey Coal Co., 43 O.I.C. 47 (1961), appeal denied; Jenkins v. Willetts Terminal Restaurant, 37 O.I.C. 116 (1955); Whitehead v. Portsmouth Transit Co., 34 O.I.C. 482 (1952); Borek v. D.W. Alcorn Co., 56 O.I.C. 29 (1975).

    Claim may be compensable if the way used is the sole and exclusive method of ingress or egress. Gnewuch v. Gatx Tank Erection Co., 221 Va. 600 , 272 S.E.2d 200 (1980); Kent v. Va.-Carolina Chem. Co., 143 Va. 62 , 129 S.E.2d 330 (1925); Tyrrell v. City Bank & Trust Co. of Alexandria, 51 O.I.C. 279 (1969); Cooper v. Graham-White Mfg. Co., 45 O.I.C. 48 (1963).

    Employee’s injury in motor vehicle accident on way to work arose out of employment; employer had provided vehicle as benefit of employment and specifically provided for commuting to and from work; Commission found accident qualified for exception to general rule disallowing compensation for accidents going to and coming from work, as transportation was provided by employer; employer also derived benefit from employee driving company vehicle as vehicle provided advertising for company. Garrett v. Advanced Pest Control, VWC File No. 210-53-10 (Jan. 21, 2004).

    Transportation Furnished:

    An injury sustained by a workman who is provided with transportation when going to or from his work is considered as arising out of his employment when such transportation is a result of an express or implied agreement between the employer and his employee; or where the transportation is furnished by custom to the extent that it is incidental to and part of the contract of employment; or when it is a result of a continued practice in the course of the employer’s business which is beneficial to both the employer and the employee. Meadows v. Condon Reed, Inc., 76 O.W.C. 241 (1997).

    Where claimant is injured in a vehicle owned and operated by the employer while returning to work from lunch, the vehicle becomes an extension of that employer’s premises. George v. Avis Rent-A-Car, 60 O.I.C. 169 (1981).

    Where transportation after work was provided as a favor to the employee and of no benefit to the employer, the resulting injury was not the result of an injury by accident arising out of and in the course of his employment. Oliver v. Calvert-Jones Company, Inc., 60 O.I.C. 338 (1981).

    To prevail under the first exception to the going and coming rule, the claimant must prove that the transportation to and from work provided by the employer is pursuant to an express or implied agreement that the employer will furnish free transportation to the employee on a regular basis, such that it is incidental to and part of the employment contract. Where the claimant is responsible for providing her own transportation to and from work on a regular basis, and she received rides from the employer only on a few occasions, the evidence establishes transportation provided only an accommodation to the claimant and not in furtherance of the employer’s interests. Hardy v. Nardi Contracting Group, Inc., 77 O.W.C. 162 (1998).

    The claimant for almost the entire term of his 35-year employment had been provided the use of a company van for work purposes only, in which he kept his tools for use when dispatched directly to the job location from his home, or in case of emergency dispatches. The Commission held that the transportation was the result of an agreement or custom that benefited both the employer and employee, giving the employer flexibility to dispatch the employee directly from home or while in transit, and it was held irrelevant that on the occasion of the accident the claimant was going to the office and not to a remote jobsite. Meadows v. Condon Reed, Inc., 76 O.W.C. 241 (1997).

    Transportation Furnished:

    An injury sustained by a workman who is provided with transportation when going to or from his work is considered as arising out of his employment when such transportation is a result of an express or implied agreement between the employer and his employee; or where the transportation is furnished by custom to the extent that it is incidental to and part of the contract of employment; or when it is a result of a continued practice in the course of the employer’s business which is beneficial to both the employer and the employee. Meadows v. Condon Reed, Inc., 76 O.W.C. 241 (1997).

    Where claimant is injured in a vehicle owned and operated by the employer while returning to work from lunch, the vehicle becomes an extension of that employer’s premises. George v. Avis Rent-A-Car, 60 O.I.C. 169 (1981).

    Where transportation after work was provided as a favor to the employee and of no benefit to the employer, the resulting injury was not the result of an injury by accident arising out of and in the course of his employment. Oliver v. Calvert-Jones Company, Inc., 60 O.I.C. 338 (1981).

    To prevail under the first exception to the going and coming rule, the claimant must prove that the transportation to and from work provided by the employer is pursuant to an express or implied agreement that the employer will furnish free transportation to the employee on a regular basis, such that it is incidental to and part of the employment contract. Where the claimant is responsible for providing her own transportation to and from work on a regular basis, and she received rides from the employer only on a few occasions, the evidence establishes transportation provided only an accommodation to the claimant and not in furtherance of the employer’s interests. Hardy v. Nardi Contracting Group, Inc., 77 O.W.C. 162 (1998).

    The claimant for almost the entire term of his 35-year employment had been provided the use of a company van for work purposes only, in which he kept his tools for use when dispatched directly to the job location from his home, or in case of emergency dispatches. The Commission held that the transportation was the result of an agreement or custom that benefited both the employer and employee, giving the employer flexibility to dispatch the employee directly from home or while in transit, and it was held irrelevant that on the occasion of the accident the claimant was going to the office and not to a remote jobsite. Meadows v. Condon Reed, Inc., 76 O.W.C. 241 (1997).

    Transportation Cost Reimbursed:

    Where employee furnishes his own transportation but is compensated for time consumed in travel to and from the job, an accident during that travel time is compensable. Nadasi v. Eubank Co., 38 O.I.C. 83 (1956).

    Where employee furnishes his own transportation but is compensated for time consumed in travel to and from the job, an accident during that travel time is compensable. Nadasi v. Eubank Co., 38 O.I.C. 83 (1956).

    Where transportation expenses are reimbursed to the claimant, the employer in effect is providing the transportation and assumes responsibility for over-the-road injuries that occur while going to and from work. Spiroff v. Medshares Home Care, 78 O.W.C. 182 (1999).

    The employer is liable for an over-the-road work accident while the employee is going to or coming from work if it provides transportation or reimburses the employee for transportation expenses, or if it pays the employee for the time consumed in the travel. Spiroff v. Medshares Home Care, 78 O.W.C. 182 (1999).

    Where employee is reimbursed for the travel, an accident during authorized travel to employee’s home over a holiday is compensable. Bates v. Kern’s Bakery, Inc., 37 O.I.C. 91, 201 (1955).

    A daily allowance which employee may use for board and lodging at the place of work or for traveling to and from work in his personal car, does not extend the Act to cover employee while commuting. Lewhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809 (1970) 50 O.I.C. 129 (1968) Phillips v. Stone & Webster Engineering Corp., 58 O.I.C. 285 (1975).

    Transportation Time Paid:

    Benefits awarded to fireman who was injured on the way to work in response to a flood because his salary began the instant he received phone call. Reamy v. City of Richmond Fire Dept., 55 O.I.C. 290 (1973).

    Where social worker was required to furnish own automobile and to house it at her home at night, injuries received by claimant in auto accident prior to beginning of workday were compensable. Eaddy v. South-Eastern Tidewater Opportunity Project, 56 O.I.C. 100 (1975) (affd. on review); Schwartz v. White Tower, 57 O.I.C. 312 (1976).

    Claimant who was injured while going to work after being so directed by the employment agency that hires and pays employees who perform work for other business was not in the course of employment because transportation was not provided and pay did not begin until arrival at work. Doherty v. Va. Temporaries, 54 O.I.C. 103 (1972).

    Ingress and Egress:

    Accident on employer’s sole means of ingress and egress is within scope of employment whether or not owned or controlled by employer. Adams v. Westmoreland Coal Co., 60 O.I.C. 4 (1981).

    If use of exit not prohibited by employer accident may be compensable even though it is not the sole means of egress. Foust v. Dickerson Buick Corp., 47 O.I.C. 125 (1965) (appeal denied). But see Collier v. Betty B. Coal Co., 57 O.I.C. 79 (1976).

    The claimant while coming to work on the sole means of ingress and egress to the employer’s premises was injured when he swerved to avoid hitting a tractor-trailer stopped on the state-maintained road behind two trucks waiting at the gate to the workplace. In awarding benefits the Commission made a reasonable inference that the trucks were waiting to do business with the employer and therefore were a special hazard that had its origin in the employment. Adkins v. Merillat Industries, 68 O.I.C. 57 (1989).

    If employee is still charged with a duty connected with the employment when injury occurs, claim may be compensable:. Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196 (1962) (before regular work hours, but while engaged in employment duties); Jordan v. Larus & Bro. Co., Inc. (WRVA), 44 O.I.C. 151 (1962); Cruise v. Trayer’s Holiday Restaurant, 44 O.I.C. 55 (1962) (special errand rule); Nugent v. Dorsk, 42 O.I.C. 100 (1960) (after completion of duties and off employer’s premises, at private parking area); Gillespie v. Thompson, Kirby & Shay, 45 O.I.C. 93 (1963) (specifically instructed to transport scaffolding pins to job site); Foreman v. Tyree-Jones Motor Corp., 47 O.I.C. 122 (1965) (salesman en route from one prospect to another on Sunday).

    Where an employee is required to go to outside places to work, she is at all such time acting in the course of her employment, and is entitled to compensation if injured by a work-related accident at such time. Seckora v. United Insurance Co. of America, 76 O.W.C. 61 (1997).

    The claimant’s injury occurred while she was rushing into the store to complete a work-related task, turning off the store’s alarm. The claimant’s speed and manner was determined by the conditions of her employment, which allowed only 60 - 120 seconds to turn off the alarm. The Commission held that this was sufficient to establish the injury was caused by the conditions of the workplace or some significant work-related exertion. Caceres v. Kids R Us, 76 O.W.C. 312 (1997).

    The claimant testified that she made some work related phone calls at home prior to leaving for work with the employer, and that business issues were discussed with the employer on the drive to work. The Commission found that such casual work conversation was not equivalent to being specifically charged with a work related duty or task while on the way to work. Hardy v. Nardi Contracting Group, Inc., 77 O.W.C. 162 (1998).

    Parking Lot Accidents:

    The mere designation of an area for visitors and handicapped individuals does not establish employer specifically was allocated a certain portion of building’s parking lot. Instead, the evidence in the record showed that the parking lot where claimant parked was available to all tenants in the building, not only employer’s employees. Claimant did not have a particular area of parking lot where he was required or designated to park as an employee of the employer, and he did not have an assigned parking space. Winn v. Dixon Hughes Goodman LLP, JCN VA00001124345 (Nov. 29, 2016).

    The employer permitted the claimant to take an examination off the employer’s premises, paying for her time and requiring no leave. As the claimant was walking across the parking lot at the off premises location, she slipped on ice, fell, and was injured. The Commission held that the injury arose out of her employment. By permitting the claimant to travel to the off premises location to take the exam, the employer took on additional risks and lost authority and control over the risks faced by the claimant. Additionally, the employer allowed the claimant to take the exam for their mutual benefit, thus exposing her to the risk of ice on the parking lot. Goldman v. Virginia Ear Nose & Throat PLLC, JCN VA0200002359 (June 23, 2011).

    Because the employer kept a time clock and supplies at the apartment complex where the claimant worked as a housekeeper and coincidentally lived, the parking lot where she fell on the ice 15 to 20 steps away from where she was going to clock in was part of the employer’s extended premises. Duran v. Red Coats, Inc., VWC File No. 228-01-05 (March 7, 2007).

    A majority found that the claimant, a Supreme Court employee working in the Chesterfield County District Court House who slipped on the ice leaving work, did not prove that the accident occurred on her employer’s extended premises in that Chesterfield County owned the parking lot rather than her employer. She did not have an assigned parking space and was injured in an area open to the public. Schott v. Supreme Court of Virginia/Commonwealth of Va., VWC File No. 222-85-09 (June 6, 2006).

    Claimant en route to parking area fell due to sloping of paved road separating parking area from store in which she worked. There was no evidence that employer maintained or controlled the parking lot, that employees were provided specific places to park, or that claimant was in a location other than a common area used also by customers and employees of other stores. Therefore, claimant was not on the employer’s extended premises at the time of her injury. Newberry v. Peebles Dept. Store, VWC File No. 214-54-35 (Jan. 7, 2005), aff’d, Record No. 0273-05-01 (Oct. 11, 2005).

    Airport parking lot in which claimant, an air line employee, slipped and fell, was not an extension of the premises of the employer because the employer did not own, maintain, or control the parking lot, its employees did not have assigned spaces or a special section of the lot where they were required to park, and the lot was shared with other airport employees. Mirtschin v. US Airways, Inc., VWC File No. 217-56-00 (Oct. 26, 2004).

    Employee’s injury did not arise out of his employment where he was injured in a shopping center parking lot, he did not have an assigned parking space and was free to park anywhere in the lot, and the employer did not own or maintain the lot. Tapp v. Food Lion, VWC File No. 213-18-62 (Aug. 25, 2004).

    Employee was injured in parking lot partially owned by employer county, but maintained by the town and open to the general public. Since the county did not exercise control over the situs of the accident and no evidence demonstrated that the county’s employees were required to park in a particular area, injury did not arise out of employment. Floyd v. Fauquier County Community Dev., VWC File No. 213-27-56 (Feb. 12, 2004).

    Employee injured from slip on ice in parking lot on way to clocking in arose out of employment; employee worked for maintenance company under contract to maintain client worksite; employee hired to come on site, clock in, and perform assigned tasks; accident occurred on premises and not in remote location on way to or from work or otherwise unconnected with employment. Blackwell v. Bob Holtz Serv., Inc., VWC File No. 204-03-23 (June 24, 2003).

    Accidental injuries of employees in company parking lots come under Act. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394 (1969); Childress v. Tysinger Motor Co., Inc., 57 O.I.C. 71 (1976) (affd. on review) (appeal denied); O’Neil v. Northwest Airlines, Inc., 57 O.I.C. 271 (1977); Comuntzis v. Kertscher, 58 O.I.C. 73 (1979).

    Fall in company parking lot on way to work is compensable. Jones v. Marval Poultry Company, Inc., 60 O.I.C. 242 (1981).

    Compensation awarded to an employee who sustained an injury on the company parking lot during a work break. Ferrell v. Comdial Telephone System, 64 O.I.C. 137 (1985).

    The claimant ran in a parking lot to move traffic cones for a tire sale, and was injured when he tripped and fell. The evidence showed no reason to hurry, nor was there anything irregular or unusual about the parking lot. The Commission held that the claimant selected the speed and manner with which he performed his job, but it did not require that he run, and the Commission found no causal connection between the claimant’s employment and his injury. Lane v. Sears Roebuck and Company, 76 O.W.C. 218 (1997).

    “Premises” of the employer means those used for ingress and egress, regardless of ownership. Tyrrell v. City Bank & Trust Co. of Alexandria, 51 O.I.C. 279 (1969).

    Shopping mall parking lot was part of employer’s premises. Ocheltree v. Dairy Queen, 64 O.I.C. 244 (1985).

    Shopping mall parking lot was part of employer’s premises. Ocheltree v. Dairy Queen, 64 O.I.C. 244 (1985).

    Walkway in Capitol Square not premises of State agency employing claimant. Jacobs v. Com. of Va./Dept. of Accounts, 56 O.I.C. 184 (1975).

    A public sidewalk bordering the premises of the employer is part of the “extended premises” of the employer, and an accident occurring there arises in the course of employment. Wiggins v. Planters Peanuts, 76 O.W.C. 211 (1997).

    The claimant who slipped in the snow while getting into his car in a parking lot provided by the employer established an injury by accident that arose out of and in the course of the employment. Scotece v. Prudential Insurance Co., 68 O.I.C. 69 (1989).

    The claimant who slipped in the snow while getting into his car in a parking lot provided by the employer established an injury by accident that arose out of and in the course of the employment. Scotece v. Prudential Insurance Co., 68 O.I.C. 69 (1989).

    Where the evidence established that it was dark and raining, and the employee was hurrying in rain to work from her car parked in a space assigned to her by the employer, and the evidence preponderated to show that her fall was caused by the wet ground surface, the accident arose out of a risk related to the conditions of her work. Andrews v. St. Mary’s Hospital, 76 O.W.C. 43 (1997).

    The claimant, who slipped on black ice while proceeding on a direct path to work from a parking lot for which her employer arranged reasonable rates and collected the fee, was injured in an accident that arose out of and in the course of her employment. Agee v. Alexis Risk Management, 69 O.I.C. 84 (1990).

    Injuries sustained while crossing street between employer’s parking lot and work-place held compensable. Ingram v. Marval Poultry Co., Inc., 58 O.I.C. 192 (1978).

    Use of a shortcut across employer’s premises to public highway, with acquiescence of employer, is incidental to employment. Williams v. Va. Crusty Pie Co., 52 O.I.C. 288 (1970); Bolden v. Hollins College Corp., 37 O.I.C. 1 (1955).

    Injuries sustained while walking from public parking lot to place of employment not compensable. Smith v. Southern Hardware, 59 O.I.C. 282 (1980).

    Accident occurring crossing street to parking lot not owned by employer and which is not sole means of ingress and egress is not compensable. Kithas v. Brandin Iron Restaurant, 60 O.I.C. 264 (1981).

    Compensation denied where employee of county was on a public street en route home from work on private motorcycle. Wilcox v. County of Henrico, 49 O.I.C. 336 (1967).

    After an accident on public highway but car rolled onto recreation field of school where the claimant is employed does not mean injuries were sustained on premises of employer. Wilson v. Russell County School Board, 50 O.I.C. 348 (1968).

    The “going and coming” rule is irrelevant if the claimant can prove that she was injured on her way to work while passing over the property of another that was in such proximity and relation to the employer’s premises as to be, in practical effect, a part of those premises. There are two distinct lines of authority addressing this issue — the “walkway” and “parking lot rule” cases. “Walkway” cases focus on issues related to physical proximity to work, ingress and egress from the employer’s property and the reasonableness of compensability of accidents that occur within the margin of time and space used to pass to and from the workplace. The “parking lot rule” cases focus on the employer’s expectations about risk. Compensability depends on the employer’s authority and control over the location of the accident. The Commission found that the claimant suffered a compensable injury at the entrance to a public elevator that provided the only effective means of ingress and egress from the employer’s property, applying the rule in “walkway” cases. Laverdure v. RESNA, VWC File No. 205-17-05 (July 30, 2002).

    ON PREMISE INJURIES.

    Before/After Work:

    Claimant’s injuries, sustained prior to the start of her shift when a chair on which she sat to eat in a public cafeteria broke, arose out of and in the course of her employment; claimant was attending to her personal comfort in an area the employer anticipated employees would use, and her early arrival benefitted the employer. Lopez-Arias v. Shoppers Food Warehouse/Supervalu, Inc., VWC File No. VA010-0242-5770 (Dec. 3, 2010).

    Employee’s fall on icy sidewalk in front of employer’s building while arriving at work found to occur on employer’s extended premises; question of ownership of building or sidewalk not relevant to question of extended premises. Seeley v. Atlantic Rehab. Servs., Inc., VWC File No. 208-07-37 (Mar. 17, 2003).

    Activities at or near place of employment preparatory to beginning or departing from work are within the Act. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394 (1969); Sisco v. Lawson, 30 O.I.C. 33 (1948); Kelly v. Friedman-Marks Clothing Co., Inc., 27 O.I.C. 100 (1945).

    Accidental injuries occurring on the premises before or after the regular hours of work are compensable. Poindexter v. V.M.I., 51 O.I.C. 216 (1969).

    Although the claimant may have earlier performed substantial amounts of work at home, she was expected to perform her job duties and conduct business in the designated office after the company opened a business office. The Commission did not find that the claimant’s performance of some work-related tasks at home established that she was already “in the course of her employment” when she was picked up for the ride to work on the day of her accident. Hardy v. Nardi Contracting Group, Inc., 77 O.W.C. 162 (1998).

    Although the claimant may have earlier performed substantial amounts of work at home, she was expected to perform her job duties and conduct business in the designated office after the company opened a business office. The Commission did not find that the claimant’s performance of some work-related tasks at home established that she was already “in the course of her employment” when she was picked up for the ride to work on the day of her accident. Hardy v. Nardi Contracting Group, Inc., 77 O.W.C. 162 (1998).

    An injury sustained when the employee arrived at work early and was performing a preliminary task assigned to him was held compensable. Fields v. Virginia Air Conditioning & Refrigeration Services, 62 O.I.C. 167 (1983).

    The claimant was injured while playing with a child she had been asked to watch by a teacher who occasionally supervised her work activities. The injury was not in the course of the employment, since it occurred after the claimant had completed her work shift and while performing activities not expected of her or incident to the employment. McKay v. Henrico County Capital Area Training Consortium, 74 O.W.C. 72 (1995).

    Compensation benefits were awarded to the claimant who, after parking his car on an adjacent highway where employees normally park, entered the employer’s premises, walked through a paved parking lot, climbed steps to his assigned building, and twisted his knee after stepping on a rock. Wolford v. Western Temporary Services, 73 O.W.C. 89 (1994).

    Also see “Recreational” topic below.

    Lunch/Personal Comfort Break:

    The claimant’s fall sustained while she was running back to the bus she operated following a rest room break arose out of her employment even though she could not specifically identify the cause of her fall because the claimant’s rushing to keep her bus route schedule was an environmental factor contributing to her injury. Nall v. Fairfax Connector, VWC File No. VA010-0242-5138 (Feb. 5, 2010).

    A security guard who fell on a curb exiting a convenience store across the street from her assigned location was not in the course of her employment as the injury did not occur on the employer’s extended premises. The personal comfort doctrine applies only if “the employee uses the facilities furnished to [her] by the employer, or does not depart from the employer’s premises, or go to some place thereon where (s)he has no right to be.” Harris v. Atlantic Protective Services, Inc., VWC File No. 221-33-04 (June 13, 2006).

    The personal comfort doctrine was inapplicable to claimant who was injured crossing a railroad track while returning to a construction site after purchasing coffee at a convenience store during his break because the injury did not occur on the employer’s premises or extended premises. Benitez v. JV Enterprises, VWC File No. 218-10-94 (Oct. 31, 2005) (Appeal Dismissed).

    Virginia has long recognized the personal comfort doctrine, recognizing the need for periodic breaks and excursions for food, drink, rest, and restroom visitation. Reynolds v. Food Lion, Inc., 76 O.W.C. 300 (1997).

    An injury sustained by an employee while engaged in the performance of an act essential to her personal comfort and convenience, but ultimately for the benefit of the employer, is compensable. Seckora v. United Insurance Co. of America, 76 O.W.C. 61 (1997).

    Injuries suffered during a temporary pause in the work to get a drink of water, rest a few moments, answer a call of nature, or the like, are within the Act. Griffith v. Raven Red Ash Coal Co., Inc., 181 Va. 911 , 27 S.E.2d 360 (1943); Bradshaw v. Aronovitch, 170 Va. 329 , 196 S.E.2d 384 (1938); Washington v. Glisson Masonry Corp., 49 O.I.C. 329 (1967); Barile v. Hampton Motor Corp., 58 O.I.C. 11 (1979).

    Injuries suffered while on a personal comfort break are compensable only if such break is taken on the premises or extended premises of the employer, or at a place and facility designated by the employer for such purpose, or incidental to required travel outside the employer’s premises to perform work duties. Injury from motor vehicle accident while on break and en route to nearby convenience store for coffee and snacks does not arise out of or in the course of employment. Cannavino v. Kiln Creek Auto Sales, 75 O.W.C. 267 (1996).

    The claimant worked as a cashier at Food Lion. She clocked out for lunch, and went to the delicatessen area of the store to purchase food to eat in the employee lounge. The claimant was not required to eat her lunch in the employee lounge, or to purchase her food in the store. As she turned to walk away without buying anything, she slipped on a piece of meat which was on the floor. The Commission held that the claimant’s injury arose out of and in the course of her employment. Reynolds v. Food Lion, Inc., 76 O.W.C. 300 (1997).

    Where employee, taking break, leaned out window and fell, his injury was incidental to employment, such breaks being sanctioned by employer and in line with established custom. Marshall v. Richmond Broom Co., 34 O.I.C. 15 (1952); Jenkins v. Marval Poultry Co., 57 O.I.C. 192 (1977).

    Claimant’s momentary deviation from his employment to open a window, whether to let out smoke or to observe a car in the parking lot, is too insubstantial a deviation to remove him from the course of his employment. Wood v. Limitorque Corporation, 63 O.I.C. 375 (1984).

    Burns from work gloves catching fire while lighting cigarette were compensable. Price v. Miller, 51 O.I.C. 221 (1969).

    Claimant sustained leg injury when, during a lull in his work, he tried to climb a tree “to see if he could still do it.” Claimant had deviated from his regular employment, and injury did not arise out of employment. Morris v. Asplundh Tree Expert Co., 57 O.I.C. 251 (1977).

    The employee who was injured while eating lunch on site at the request of the employer in a designated area behind the premises was in the course of his employment even though he was officially off of the clock. Mileham v. Sal’s Italian Restaurant & Pizza, 70 O.I.C. 139 (1991).

    Injuries during lunch breaks on the employer’s premises may be compensable. Giddens v. Kesteren, 57 O.I.C. 131 (1976); Elliott v. Farm Fresh, 58 O.I.C. 112 (1978).

    The Commission denied benefits to an employee who suffered an eye injury from foreign matter while eating lunch in the employer’s cafeteria because the injury did not result from any risk associated with the work environment. Derricott v. City of Norfolk, 70 O.I.C. 137 (1991).

    Compensation benefits were denied to an employee who suffered burns when a hot bowl of chili heated in the employer’s microwave spilled on his arm during a lunch break because the accident did not arise out of his employment. Thornbury v. The Genie Company, 71 O.W.C. 135 (1992).

    The employee, a wheelchair-bound paraplegic, was injured when a hot beverage purchased from a vending machine in the employer’s breakroom spilled on his lap. Held, the claimant was injured by something over which the employer had control, the temperature of the liquid, which established the requisite nexus between the conditions of the employment and the employee’s injury. Davies v. Hershey Food Corp., 75 O.W.C. 341 (1996).

    Compensation was awarded when an employee was injured during her lunch break on the employer’s premises while performing an act of a personal nature, which had become part of the customary procedure with knowledge of the employer. Tinsley v. Courtland Manufacturing Company, 63 O.I.C. 351 (1984).

    Employee killed on defendant’s premises in process of leaving to secure lunch provided by employer for working overtime was under the Act. Maloyed v. Olin Mathieson Chem. Corp., 50 O.I.C. 240 (1968); Clark v. Walker Mach., 45 O.I.C. 27 (1963).

    The Commission held that the personal comfort doctrine did not apply, where the employee was injured in a traffic accident during a lunch break, away from his usual workplace. Injuries suffered while on a personal comfort break are compensable only if such break is taken on the premises or extended premises of the employer, or at a place and facility designated by the employer for such purpose, or incidental to required travel outside the employer’s premises to perform such duties. The claimant’s work schedule, including his lunch break was different because he was attending a seminar that day. However, the accident occurred away from the employer’s premises, and the employee’s lunch travel was not incidental to his duties for the employer. Tutor v. City of Norfolk Police Department, VWC File No. 197-62-99 (May 9, 2001).

    Personal Mission or Activity:

    Compensation benefits were awarded to a commissioned employee who was injured during normal work hours while working on his personal car with the employer’s consent. Ablola v. Holland Rd. Auto Center, Ltd., 11 Va. App. 181, 397 S.E.2d 541, 7 Va. Law Rep. 648, 1990 Va. App. LEXIS 179 (1990).

    Injuries sustained while repairing own car on employer’s premises after working hours were the result of a personal mission unrelated to employment. DeBruhl v. Fox Hurley, Inc., 59 O.I.C. 67 (1980) (see also Lawrence, et al. v. Williams Paving Co., Inc., 59 O.I.C. 169 (1980)).

    In awarding compensation benefits to an employee who was injured after hours while performing work for his own customers, the Commission held that the employee’s ability to supplement his wages by using the employer’s equipment and premises after hours were part of the contract for hire that allowed the employer to pay the employee reduced wages. Sanford v. Contemporary Woodcrafters, Inc., 70 O.I.C. 143 (1991).

    Conflicting evidence showed that the employee was injured while driving to her husband’s business to pick up his pay check or to advise him that she would be working late. Held, the employee deviated from her normal route for personal reasons, and the injury did not occur in the course of her employment. Gray v. Employers Resource Management Corp., 75 O.W.C. 312 (1996).

    Compensation benefits were denied to the claimant who slipped and fell while returning via an underground tunnel from making a personal doctor’s appointment in a building adjacent to her place of employment. The case was distinguished from Prince v. Pan-American World Airways, 6 Va. App. 268, 368 S.E.2d 96 (1988), in that the claimant was on a personal mission, she was not required to use the tunnel to enter her place of employment, and her job duties did not require her to go to the doctor’s building. Mays v. Humana Hospital Clinch Valley, 68 O.I.C. 94 (1989).

    Compensation benefits were awarded to the claimant, a veterinarian assistant, who was bitten by her own cat while acting in the capacity of both a customer and an employee. Scott v. Douglass Alan Houston, 68 O.I.C. 90 (1989).

    Injury by Guns:

    Accident did not arise out of employment although claimant was injured during course of his employment when he and fellow employee compared pistols and one accidentally fired. Neither employee was required to have a pistol for his job. Hamilton v. Imperial Oil Co., 48 O.I.C. 102 (1966); Fuller v. Ponce de Leon Hotel, 44 O.I.C. 100 (1962).

    Benefits denied to a night watchman not authorized to carry gun and job did not require him to be armed. Stone v. Gray Concrete Pipe Co., Inc., 50 O.I.C. 311 (1968).

    Claimant’s gunshot wound from pistol he was not authorized to carry was a personal risk and did not arise out of his employment. Harper v. Virginia Appalachian Lumber Company, 60 O.I.C. 179 (1981).

    Employee who elected to participate in Russian roulette was not under the Act. Teller v. Campbell, 54 O.I.C. 370 (1972).

    Picking Up Paycheck:

    Accidental injury sustained by employee on worksite to pick up paycheck at invitation of employer held compensable. Decatur v. American Silk Mills, Inc., 60 O.I.C. 131 (1981).

    A claimant who slipped and fell at her place of employment while waiting to receive her paycheck several hours after clocking out was not entitled to compensation benefits. McKinney v. Hardee’s, 67 O.I.C. 99 (1988).

    Since the claimant was not performing any duty for her employer when she was injured on her day off while at her place of employment to pick up her paycheck, compensation benefits were denied. Nicely v. Liberty House Nursing Home, 68 O.I.C. 103 (1989).

    Claimant, whose employment had been terminated and who chose to return to employer’s premises to pick up two checks due, was injured on the employer’s parking lot and was held not to be in the course of her employment at the time of injury. Gillespie v. Metal-Craft, Inc., 57 O.I.C. 131 (1976).

    Injury After Employment Ceases:

    Although compensation coverage is not automatically and instantaneously terminated by the firing or quitting of employee and he is within the course of his employment for a reasonable period while he winds up his affairs, injury in altercation more than five hours after leaving premises is not covered. Cobbs v. Regino’s Restaurant, 51 O.I.C. 51 (1969); Redman v. Mays (appeal denied), 58 O.I.C. 300 (1978).

    Injury sustained five minutes before leaving worksite at end of day which was to be claimant’s last on job due to his termination, held compensable. Jones v. A.P. Perry & Company, 60 O.I.C. 245 (1981).

    A former Deputy Sheriff who slipped and fell while descending the witness stand suffered an injury by accident that arose out of and in the course of her employment. Although the claimant had terminated her employment prior to the testimony, she was a public official whose actions in appearing at the trial were a reasonable conclusion of her work responsibilities. Thore v. Chesterfield County Board of Supervisors, 10 Va. App. 327, 391 S.E.2d 882, 6 Va. Law Rep. 2371, 1990 Va. App. LEXIS 81 (1990).

    OFF PREMISES INJURIES.

    Positional risk doctrine not applicable in this jurisdiction. Bowman v. Hutchens Chevrolet, 52 O.I.C. 31 (1970); Broughman v. Fiber Salvage Co., Inc., 51 O.I.C. 26 (1969) (appeal denied); Ash v. Newport News, Office of Human Affairs, 59 O.I.C. 4 (1980).

    Street Accidents:

    The claimant was driving company van on company business when an object entered the window and struck the claimant in the eye. The injury arose from an actual risk of the claimant’s presence on the streets and thus arises out of the employment. Williams v. Edward Randolph Williams/Hank Williams Painting and Landscaping, L.L.C., JCN VA02000008947 (formerly VA00000299713) (June 15, 2011).

    The claimant’s accident, where he was struck by a car while chasing after a dog, arose out of and in the course of employment because it was among the claimant’s duties to attempt to retrieve loosed animals. While the claimant could not remember how he was injured, his accident was not unexplained because there were eyewitnesses to the accident. Dearforff v. Town and Country Animal Hospital, VWC File No. 231-34-72 (Dec. 7, 2007), aff’d No. 0047-08-4 (Ct. of Appeals, June 10, 2008, unpublished).

    Claimant was unconscious at time of motor vehicle accident and could not remember the accident. The etiology of his loss of consciousness was unclear. The accident was unexplained and, therefore, not compensable. The increased risk analysis used in idiopathic fall cases is not applicable where the evidence failed to establish that symptoms that caused accident or that traffic accident itself were caused by employment-related factors. Webb v. Ruan Transport Management Systems, Inc., VWC File No. 215-99-00 (Feb. 17, 2005).

    Virginia has adopted the “actual risk test” in “street cases.” Lucas v. Lucas, 212 Va. 561 , 136 S.E.2d 63 (1972); Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254, 1967 Va. LEXIS 128 (1967); Cohen v. Cohen's Dept. Store, 171 Va. 106 , 198 S.E. 476 , 1938 Va. LEXIS 261 (1938); Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925).

    It is not necessary that the employee show that his presence on the street or highway where his additional injuries are suffered exposes him to an increased hazard peculiar to the work and not common to the public generally. Such a burden is now characterized as obsolete. Under the “actual risk test,” it is immaterial even whether the degree of exposure is increased, if in fact the employment subjected the employee to the hazards, whether continuously or infrequently. Cantwell v. Bldg. Service Contr. Assn. Int’l, 76 O.W.C. 261 (1997).

    Where employee’s duties may be performed on public streets, there must be some proof he was in the course of employment at time of accident. Chancellor v. Goodrich Co., 20 O.I.C. 265 (1938), 21 O.I.C. 6 (1939).

    Injury did not arise out of employment where, returning to office with lunch, claimant was struck by a car which jumped curb two doors from employer’s office door. Jessee v. Roberson, 60 O.I.C. 232 (1981).

    In denying compensation benefits to the decedent, who left his disabled truck in Appomattox Court House rather then wait for the repair crew and was found dead as the victim of an apparent hit-and-run incident in Powhatan County, the Commission noted that an over-the-road driver is under the Act from the time he is first dispatched until he returns home or to his point of departure and even during alternative transportation home or to his primary work site if tasks are completed at an intermediate location. However, in this case the evidence failed to establish a work-related reason for the decedent’s location so distant from his truck. Lee v. Osborne Trucking Company, Inc., 73 O.W.C. 107 (1994).

    The claimant, whose eye was injured by a particle of dust while he waited to return by the subway from a meeting, was exposed to a street hazard caused by a special risk incident to his employment. It is of no consequence that he was exposed to the same hazard as members of the general public on the same subway platform. Dayton v. Arlington County Fire Department, 69 O.I.C. 96 (1990).

    Compensation benefits were awarded to the claimant who was injured in a car accident while procuring coffee and doughnuts for coworkers. Lee v. Commonwealth of Virginia/Virginia Department of Health, 65 O.I.C. 78 (1986).

    Duties of District Manager primarily public relations; auto accident at 3 a.m. compensable. Van Houten v. Schlitz Brewing Co., 52 O.I.C. 267, 269 (1970).

    Compensation awarded to a claimant who was injured while proceeding directly back to his normal route home after deviating from that route to perform a task in connection with his employment. Payne v. Charles City County School Board, 64 O.I.C. 256 (1985).

    If purpose of trip is primarily personal to employee no compensation may be allowed. Butler v. Nolde Bros., 189 Va. 932 , 55 S.E.2d 36, 1949 Va. LEXIS 229 (1949).

    Compensation benefits were awarded to the claimant who fell off of the back of a truck because his foreman had directed him to ride on the bumper to check on construction and to look for tools. Stephens v. WARRCO, Inc., 69 O.I.C. 92 (1990).

    The claimant was required to be on the sidewalk in Chicago. She was carrying a briefcase, a three-inch three-ring binder, and a purse. A high wind that gusted just as she raised her arm to hail a cab caused her to fall and injure her left ankle and right knee. The Commission held that her employment placed the claimant on the sidewalk under these conditions, and her accident arose out of her employment. Cantwell v. Bldg. Service Contr. Assn. Int’l, 76 O.W.C. 261 (1997).

    Attendance at Meeting:

    Attendance at special business meetings is incidental to employment, and accidents at or during necessary travel to and from such meetings are in the course of employment. King v. Leonard’s T.V. Appliances, Inc., 35 O.I.C. 407 (1953), 36 O.I.C. 27 (1954) (appeal denied).

    Injury to teachers en route home from conference was compensable. Holland v. Amherst County School Board, 52 O.I.C. 142 (1970).

    Attending seminar at direction of employer; lunch hour accident was awarded. Myers v. Fairfax County Fire & Rescue Services, 55 O.I.C. 253 (1973).

    Returning home from awards dinner sponsored by employer tantamount to special errand. Rogers v. Beneficial Finance Co., 52 O.I.C. 216 (1970) (appeal denied).

    Special Mission/Personal Work for Employer:

    Employee not considered on special errand for employer at time of injury; employee routinely made bank deposits and stopped at post office for employer on way to work; employee’s injury occurred on way to work, and employee had in her possession various items, including bank documents and mail; activity not considered special errand because part of her regular routine; employee also not considered to be working at time of accident because of dual purpose doctrine because only evidence of work purpose at time of accident was possession of work documents, and accident occurred before work on public street. Vislobokova v. Tracey Corp., VWC File No. 203-37-42 (Jan. 29, 2003).

    The “special errand” rule applies if the employee is given a special assignment outside her normal duties, but upon which her wages are measured, that clearly represents a special benefit to the employer. Woodward v. Hardee’s, 75 O.W.C. 50 (1996).

    Compensation awarded to an employee, who, at the completion of his work shift, was requested by this employer to repair a furnace at a home he rented to his son. The employee suffered a severe leg injury when he slipped in the yard. Padgett v. Turpin’s Amoco Service, Inc., 63 O.I.C. 263 (1984).

    Injuries sustained while employee was trimming trees at the home of the employer were compensable. Davenport v. Frank Sheffield, Jr., t/a Fuqua & Sheffield, 62 O.I.C. 151 (1983).

    Claimant on special mission in his own car at the employer’s request was under Act when injured. Powell v. James Ricks Painting Contractor, 58 O.I.C. 293 (1979).

    Claimant was on a special mission when he was directed to take a truck home with him and was injured the next morning while investigating a problem with the ladders on the truck. Johnson v. Lambert Painting & Decorating, 59 O.I.C. 159 (1980).

    See also Robert George Woodward v. Hardee’s/Boddie Noel Enterprise, Inc. (unpublished Court of Appeals Memorandum Opinion Record # 0504-96-3) (August 13, 1996).

    The Commission held that the “special errand rule” did not apply. The rule applies if the employee is injured during a temporary, special assignment outside the employee’s normal work duties, and the assignment represents a special benefit to the employer. While the employee was attending a seminar on the day of the accident, rather than his usual duties, nothing suggested that the automobile accident during his lunch break constituted a “special errand” for the employer, making the hazards of the highway a risk of the employment. Tutor v. City of Norfolk Police Department, VWC File No. 197-62-99 (May 9, 2001).

    Personal Mission or Activity:

    Fatal injuries sustained by employee while returning to place of employment after cashing a check during lunch hour held not compensable. Smith v. Bassett Furniture Co., 57 O.I.C. 335 (1975).

    Employee shot by fellow employee while off employer’s premises en route to lunch was not compensable. Clark v. Walker Machine & Foundry Corp., 45 O.I.C. 27 (1963).

    Employee who suspended carrying out his duties and left employer’s premises temporarily on a mission of his own was not under Act. Dreyfus & Co. v. Meade, 142 Va. 567 , 129 S.E. 336 , 1925 Va. LEXIS 360 (1925).

    Deviation from Work:

    A security guard who fell on a curb exiting a convenience store across the street from her assigned location was not in the course of her employment as the injury did not occur on the employer’s extended premises. The personal comfort doctrine applies only if “the employee uses the facilities furnished to [her] by the employer, or does not depart from the employer’s premises, or go to some place thereon where (s)he has no right to be.” Harris v. Atlantic Protective Services, Inc., VWC File No. 221-33-04 (June 13, 2006).

    The personal comfort doctrine was inapplicable to claimant who was injured crossing a railroad track while returning to a construction site after purchasing coffee at a convenience store during his break because the injury did not occur on the employer’s premises or extended premises. Benitez v. JV Enterprises, VWC File No. 218-10-94 (Oct. 31, 2005) (Appeal Dismissed).

    Where duties of employee are performed off the premises of employer, if he suspends his work to accomplish a purpose wholly disconnected therewith, injuries received while so engaged are not within the Act. Grimes v. Janney-Marshall Co., 183 Va. 317 , 32 S.E.2d 76, 1944 Va. LEXIS 156 (1944).

    Where an employee is required to go to outside places to work, he is at all such time acting in the course of his employment, and is entitled to compensation if injured by accident at such time. However, an accident incurred while on such work related travel does not arise out of the employment if the employee has so deviated from his work related activities as to be deemed “on a frolic of his own.” Sacra v. Builders Floor Service, Inc., 78 O.W.C. 84 (1999).

    Unauthorized rider in delivery car would not remove claimant from scope of employment when accident occurred on direct delivery route. Jones v. Felt’s Drug Store, Inc., 48 O.I.C. 138 (1966).

    Bryan v. Highway Carriers , VWC File No. 187-70-78 (July 2, 1998) does not stand for an overly broad principle that all deviations, regardless of the reason, from a specific route are non-compensable frolics. Instead, witnesses’ credibility regarding the alleged deviation determined the outcome of Bryan. Whether an injury arises out of and in the course of the employment depends upon the peculiar circumstances of each case. No exact rule can be formulated by which every case can be decided. Doyle v. Walker, 78 O.W.C. 89 (1999).

    The continuity of his employment will not be broken by a mere trivial departure or deviation. Taylor v. Robertson Chevrolet Co., 177 Va. 289 , 13 S.E.2d 326, 1941 Va. LEXIS 216 (1941); Railway Express Agency v. Lewis, 156 Va. 800 , 159 S.E. 188 , 1931 Va. LEXIS 232 (1931).

    The claimant testified that he was trying to reach the pick-up destination, but that he was lost and needed directions. The evidence showed that the claimant was fulfilling the employer’s interests when the accident happened. There is insufficient evidence of a designated route or that the claimant deviated to reach his personal residence. The coincidence that his route was near his residence does not establish a deviation. Doyle v. Walker, 78 O.W.C. 89 (1999).

    Deviation of no consequence; claimant back on normal route occasioned by his employment. Shorter v. Wise County School Board, 51 O.I.C. 242 (1969).

    While en route to a different job site, the claimant drove towards the closest 7-11 store he was familiar with, although it was 2.2 miles in the opposite direction from the work site. He intended to buy a drink, an act clearly encompassed by the personal comfort doctrine. The claimant was not on some other purely personal errand. The Commission held that such a short deviation was not sufficient to take the claimant out of the course of his employment. Sacra v. Builders Floor Service, Inc., 78 O.W.C. 84 (1999).

    Employee is still in the course of employment where employer’s interests are being served to some extent at time of accident. Fleischman Co. v. Marshall, 149 Va. 254 , 141 S.E. 139 , 1928 Va. LEXIS 364 (1928).

    Injury at Housing Provided by Employer:

    Injuries received in attempting to prevent theft from premises while dressing in employer’s dormitory preparatory to going on duty were compensable. Robinson v. Cavalier Hotel, 49 O.I.C. 281 (1967).

    Injury sustained in living quarters where migrant workers housed was compensable. Brown v. Tomblin, 54 O.I.C. 38 (1972).

    An accident which occurred during off-duty hours in living quarters furnished by the employer was held compensable. Although use of these facilities was not required, both the employer and employee derived a substantial benefit from such an arrangement. Stapleton v. Powhatan Correctional Center, 62 O.I.C. 428 (1983).

    Living quarters not furnished as condition of employment or additional pay therefore claim not compensable. Bryant v. Tri-County Asphalt Co., Inc., 48 O.I.C. 25 (1966).

    Injuries During Business Travels:

    Employee sent to training school in New York for four weeks who was injured returning from restaurant three miles from lodging was under the Act. Eating necessary meals while traveling was part of employment. Smith v. Va. Telephone & Telegraph Co., 54 O.I.C. 347 (1972).

    Compensation awarded to a flight attendant who suffered an injury when she jammed her foot against the bed in a motel room during a layover. Petitbon v. United Airlines, 62 O.I.C. 355 (1983).

    A claimant who suffered a knee injury while extricating himself from the back seat of a car during attendance at an out of town conference was awarded compensation benefits. Elfino v. Virginia Department of Highways, 66 O.I.C. 30 (1987).

    In awarding compensation to a travel agent, who slipped and fell from a tree limb while having her picture taken during a familiarization trip paid from her own funds, the Commission found that the trip financially benefitted both the claimant and her employer. Polozzi v. Custom Travel & Designs, Inc., 68 O.I.C. 100 (1989).

    An injury received in a skiing accident was in the course of the employment but the injury did not arise out of a risk which could be fairly traced to the employment. Nachod v. Public Storage Space, Inc., 62 O.I.C. 334 (1983).

    Compensation benefits were awarded to the claimant who slipped and fell in a shower while attending an out-of-town meeting. Falls v. O’Baugh Ford Chrysler Plymouth, 73 O.W.C. 91 (1994).

    Injury At Home:

    Volunteer firefighter who was injured while responding to an accident that occurred near his home and outside of his fire department’s jurisdiction was in the course of employment because his department regularly responded to accidents outside of its jurisdiction and he responded in a manner expected of him. Dockery v. Fort Blackmore Volunteer Fire Dept., VWC File No. 230-81-10 (March 26, 2008).

    Claimant slipped in her driveway when walking from her home office, where she performed work-related duties, to her car to perform sales work for the employer. She did not describe any intervening non-work activities. Claimant showed that her injury occurred in the course of her employment by proving continuity of time, space and circumstances between her work and her injury. Miller v. Walsworth Publishing Co., VWC File No. 214-44-83 (Aug. 10, 2004).

    Home-based office worker showed injury occurred during course of employment; employee fell on stairs at home after walking up, and then down, stairs to confer with wife, a fellow employee, about a business-records discrepancy; accident found to occur at place where he was reasonably expected to be. Teter v. Teter’s Interstate Exxon, VWC File No. 211-47-73 (Dec. 1, 2003).

    A State Police Officer who slipped and fell on the ice while going to his police car after completing paper work at home was awarded compensation benefits. Ashe v. Department of State Police, 66 O.I.C. 39 (1987).

    Finding that the injury was not a result of the employment, the Commission denied benefits to a police officer, who slipped on ice and fell while leaving his home in route to inspecting his police car prior to beginning his shift. Townsend v. Department of State Police/Commonwealth of Virginia, 73 O.W.C. 95 (1994).

    Law enforcement officers who sustain accidents while off duty, although on call twenty-four hours a day, are not covered by the Act unless the officer was entrusted with a duty of the employment at the time of the accident. Stone v. Fairfax County Bd. of Sup’rs, 76 O.W.C. 109 (1997).

    Injuries received by worker at home while preparing to go to work are not compensable. Staats v. Town of Vienna, 167 Va. 37 , 187 S.E. 485 , 1936 Va. LEXIS 272 (1936).

    Employment of traveling salesman did not begin until he had entered his car to commence day’s work. Injury sustained when he fell on icy sidewalk on way from home to car held not compensable. Hughes v. Encylopedia Britannica, 57 O.I.C. 178 (1977).

    EXPOSURE TO NATURAL FORCES.

    Claimant discussing business with secretary in exterior designated smoking area was struck by ice that fell from employer’s building. The Commission held that the act of standing under ice was not an employment risk. Claimant failed to prove conditions of employment placed him at a heightened risk of being struck by ice. Reidboard v. Herndon (Town of) Public Works, VWC File No. 212-39-46 (July 21, 2004).

    If an employee is injured by some natural force, such as a hurricane, tornado, or lightning, drowns due to flooding, or is injured by falling debris during an earthquake, the event does not, by itself, fasten liability on the employer. Absent other evidence, the death or disability arises from an act of God, not from the employment. However, the claimant’s injury may still be compensable if she proves that the nature of her employment brings into existence a special or peculiar risk of exposure to the disastrous forces of nature. In this case, the employee’s delivery van was struck by lightning, causing injury. Because she failed to prove that her employment exposed her to a heightened risk of lightning injury, the Commission denied her claim. Lucas v. Federal Express Corporation, VWC File 206-96-04 (October 25, 2002).

    Professional Sports:

    Claimant’s altercation during a hockey game arose out of and in the course of his employment and constituted an “accident” under the Act. Fighting is an integral part of claimant’s job for the employer. Jones v. Norfolk Admirals, VWC File No. 212-24-49 (Dec. 10, 2004).

    Recreational Activities:

    Injuries sustained by an off-duty police detective in a motor vehicle accident while driving his un-marked police car to exercise at a gym facility owned by the employer arose out of the employment. Kelley v. Co. of Henrico, JCN VA00001046469 (Dec. 16, 2016).

    Claimant’s death while mountain biking at the employer’s annual conference did not arise out of the employment because claimant’s decision to ride the bike was entirely personal and had no reasonable relationship to either the employer’s business or the overall purpose of the conference. Short v. Lumos Networks Corp., JCN VA00001070344 (Dec. 12, 2016).

    An injury sustained as a result of recreational activity arises out of the employment only when the activity is an accepted and normal activity within the employment. An injury by accident does not include injury resulting from an employee’s voluntary participation in employer-sponsored off-duty recreational activities which are not part of the employee’s duties. Morgan v. City of Norfolk School Board, 76 O.W.C. 359 (1997).

    Whether a recreational activity is within the course of employment depends on the extent to which the employer expects or requires the employees to participate. The commission must consider whether the recreational function is so closely associated with the employment as to be considered an incident of it. Other factors to be considered are the degree to which the employer derives a benefit from the activity, the degree of sponsorship and participation by the employer, whether the activity occurs on premises associated with the employment, when the activity occurs in relation to work, and the frequency or period over which the activity has been conducted. Morgan v. City of Norfolk School Board, 76 O.W.C. 359 (1997).

    The Commission rejected the employer’s assertion that the employee was injured while participating in a “trust-fall” at a leadership conference in “off-duty recreational activities which are not part of the employee’s duties.” The employer sponsored the conference, noting that it was intended to “enhance team building and trust” at work. The employee’s supervisor attended the conference, and the “trust-fall” was one of the scheduled events. Transportation to the conference, the conference fee, as well as room and board were all provided for the employee by the employer. Finding that the activity was “so closely associated with the employment to be considered an incident of it,” the Commission found the injury compensable. Defibaugh v. Philip Morris USA, VWC File No. 200-42-75 (January 30, 2001).

    Recreational activities on the premises at a time closely related to working hours and involving some concurrent benefit to employer are incidents of employment and injuries while engaged therein arise out of and in the course of employment. Shaffer v. Tides Inn, 36 O.I.C. 425 (1954); Mabe v. Visador Co., 59 O.I.C. 178 (1980).

    Compensation benefits were denied to an employee who was injured prior to the work day while playing basketball at the employer’s premises on the basis that the activity was not an accepted and normal activity at the place of employment. Mullins v. Westmoreland Coal Co., 10 Va. App. 304, 391 S.E.2d 609, 6 Va. Law Rep. 2356, 1990 Va. App. LEXIS 84 (1990).

    Baseball teams organized to play between various stores of defendant. Injury to claimant during practice session away from employer’s premises but during normal working hours was compensable. Watson v. Giant Open Air Market, 55 O.I.C. 368 (1973).

    A minister who suffered a knee injury while participating in a weekly basketball game with fellow ministers was entitled to compensation benefits. Wilson v. First Assembly of God Church, 67 O.I.C. 93 (1988).

    Compensation benefits were denied to the claimant who suffered a knee injury while playing basketball in a high school gymnasium during a lunch break at a safety and first aid training session. The record failed to establish that the basketball game was required, expected, or benefitted the employer. Kennedy v. Clinchfield Coal Co., 68 O.I.C. 92 (1989).

    The claimant, who suffered an injury outside of working hours during a company softball game, was entitled to benefits because the accident occurred at the employer’s premises while he was performing an activity that was anticipated and supported by the employer. The employer’s sports program was an integral part of the carrying on of its business. Hughes v. Anheuser Busch Company, Inc., 69 O.I.C. 98 (1990).

    Compensation awarded where claimant sustained injury while participating in hockey game as part of his employment and the activity inured to the benefit of the employer. White v. Skateland Associates, 60 O.I.C. 137 (1981).

    Compensation benefits were awarded to a claimant who suffered a knee injury during a basketball game because his job assignment required him to socialize with fellow employees outside of the work place in order to identify drug users. Anderson v. Wackenhut, 66 O.I.C. 35 (1987).

    Compensation benefits were awarded to an employee who was killed by a motor vehicle as she exited her employer’s place of business after attending a New Year’s Eve party. The employer sponsored party was so closely connected and associated with the employment in purpose, time, location and function as to make the injury arise out of and in the course of the employment. Kum Ja Kim v. Sportswear, 10 Va. App. 460, 393 S.E.2d 418, 6 Va. Law Rep. 2728, 1990 Va. App. LEXIS 115 (1990).

    Accident which occurred at company picnic which employees were encouraged but not required to attend did not arise out of the employment. Jones v. Bank of Virginia, 60 O.I.C. 244 (1981).

    Death of city fireman from heart attack while jogging (an exercise activity which, while not mandatory, was department sponsored and approved of by the employer) held to have arisen out of and in the course of employment. Moss v. City of Alexandria, 57 O.I.C. 253 (1977); Smith v. City of Richmond Bureau of Fire, 58 O.I.C. 333 (1978).

    Voluntary Actions:

    Benefits were awarded to claimant who was injured providing emergency assistance to an office co-worker on the basis that her actions were reasonable and there was a sufficient nexus to her employment. Brewer v. Va. Employment Commission/Commonwealth of Va., VWC File No. 224-63-42 (Aug. 18, 2006) see also Laster v. Verizon Communications, VWC File No. 217-27-54 (Nov. 14, 2005) (Benefits awarded to telephone repair man who slipped on ice going down steps to direct an ambulance to a customer’s apartment).

    Employee’s injury, caused while assisting retail customer in jump-starting car, did not arise out of or in the course of employment; employer’s policy was that customer service did not include volunteering to assist customers with vehicle problems, other than providing telephone to call for help; employee not performing any direct or incidental duties at time of injury, and actions at time of injury significantly deviated from employment. Quirk v. Target, VWC File No. 213-72-58 (Apr. 23, 2004).

    Employee’s injury, which was found to result from slamming hand on hard surface in response to his anger, did not arise out of employment; employee created risk of injury as a result of his manifestation of anger; risk was product of employee’s choosing, and not of reasonable requirement of employment. Duvall v. Federal Mogul Corp., VWC File No. 211-39-67 (Dec. 18, 2003).

    Employee did not remove himself from employment by working under bridge, where he suffered injury; employer warned against standing under bridge, but did not allege violation of safety rule; although employee acted negligently, he was injured while fulfilling work duties at place reasonably near where he was expected to be. Slayton v. Cleco Corp., VWC File No. 211-29-72 (Nov. 13, 2003).

    The claimant did not have a flu injection merely as a volunteer. The claimant, a nurse practitioner, was “strongly encouraged” to undergo an annual flu injection because she routinely treated pregnant patients, and patients with diabetes, HIV-AIDS and other “high risk” conditions. The claimant established that her vaccination protected her patients, and it kept her working instead of being home sick. After the injection, the claimant suffered injurious side effects. Because the employer “strongly” encouraged the vaccination, the benefits of the vaccination primarily inured to the employer’s benefit and the claimant was not required to pay for the injection, the Commission found the injury arose out of and in the course of her employment. Eysenbach v. Old Dominion University, VWC File No. 208-70-64 (November 15, 2002).

    A claimant who suffered paresthesias as the result of blood being drawn at an employer’s sponsored health fair was not entitled to compensation benefits because she voluntarily participated without coercion from her employer and was not performing any duty incidental to her employment. Goodman v. Commonwealth of Virginia-Department of Health and Employee Relations, 67 O.I.C. 96 (1988).

    A claimant who was injured while off the clock but at the job site to assist a co-worker was acting as volunteer and not entitled to compensation benefits. Jackson v. Ratcliff Concrete Company, 8 Va. App. 592, 382 S.E.2d 494, 6 Va. Law Rep. 155, 1989 Va. App. LEXIS 108 (1989).

    Climbing a tree pursuing squirrel, employee voluntarily put himself in potentially dangerous situation not required by work assisting groundskeepers. Windell v. National Memorial Park, Inc., 52 O.I.C. 293 (1970).

    Employee who elected to go swimming on employer’s premises during lunch hour incurred dangers of his own choosing outside of requirements of employment and not incidental to employment. Jessee v. Commonwealth of Virginia Dept. of Conservation and Economic Dev., 58 O.I.C. 201 (1978).

    A claimant who was injured while acting as a “volunteer” without any apparent necessity other than humanitarianism was denied compensation. Annis v. Virginia Employment Commission, 62 O.I.C. 6 (1983).

    Though claimant was injured while assisting motorist with disabled vehicle on employer’s premises, injury did not arise out of the employment. Cuthbertson v. Beatrice Pocahontas Coal Company, 60 O.I.C. 118 (1981).

    Claimant’s injury while assisting coworker who fainted arose out of her employment. Compensation is payable for injuries sustained in the rescue of coemployees on the theory that the employer has a duty to aid its own employees in peril and that any employee is impliedly authorized to discharge this duty in an emergency. Gibson v. Fabri Centers of America, Inc., 75 O.W.C. 372 (1996).

    Employee drive-in theater manager, injured in truck accident was in actual work-duty status and not mere volunteer. Gaines v. VDT, Inc., 57 O.I.C. 126 (1977) (appeal denied).

    Where a truck driver arrived at the scene of an automobile accident and was injured while attempting rescue of the victims, his injury arose out of his employment when occasion for the rescue was presented because of nature of his employment. This is especially applicable to those whose work requires them to operate motor vehicles on streets and highways. Cash v. Barr Tire Co., Inc., 41 O.I.C. 14 (1959).

    Compensation denied for injuries sustained by off-duty firefighter summoned to neighbor’s burning house; activity held not to be in course of employment. Wray v. City of Norfolk Fire Dept., 58 O.I.C. 368 (1978).

    Horseplay:

    Claimant injured after customer grabbed him around the neck was victim of assault not horseplay. Regardless of whether assailant’s motivation is playful, amorous, vindictive or hostile, it is still an assault. Claim denied because assault was neither directed at claimant as employee nor consequence of conditions under which employer required work to be performed. Baker v. Lowe’s Home Centers, JCN VA00000990523 (Mar. 29, 2016).

    A security guard was forcefully struck by an employee of the business to which he was assigned. The resulting injury was not compensable because the incident was neither horseplay nor an assault within the Act. Wilkie v. Inter Con Security Systems, Inc., VWC File No. 228-69-45 (Sept. 17, 2007).

    Employee’s injury to hand from butcher knife not compensable; evidence showed cook’s injury resulted from swinging knives in martial arts maneuver; employee not engaged in work activity at time of injury and thus injury wholly unrelated to employment. Gunter v. Montgomery Reg’l Hosp., VWC File No. 209-32-04 (Mar. 18, 2003).

    Employees not participating, but innocently injured by pranks of other employees, are entitled to compensation. Miller v. Rujoco, Inc., 52 O.I.C. 175 (1970); Talor v. Celanese Corp. of America, 30 O.I.C. 257 (1948); Gobble v. Booher Auto Auction, Inc., 59 O.I.C. 108 (1980).

    Horseplay is an affirmative defense. Consequently the employer had the burden of establishing that the employee engaged in horseplay and the activity actually caused the injury. Simms v. Boddie Noell Enterprises, Inc., 63 O.I.C. 303 (1984).

    While the claimant’s actions were ill-considered and possibly negligent, they did not constitute “horseplay” in the sense that she created a risk beyond that of the employment. Ferrell v. Comdial Telephone, 64 O.I.C. 137 (1985).

    Compensation is granted where claimant is not engaged in horseplay and is injured while on lunch break. Hauser v. Deep Meadow Correctional Center, 60 O.I.C. 196 (1981).

    Injuries occasioned by so-called “horse play” between claimant and fellow employees, where claimant instigated or participated in the occurrence, are not compensable. Carr v. Sterling Development Corp., 51 O.I.C. 38 (1969); Henry v. Henry, 41 O.I.C. 74 (1959); Strickner v. Appalachian Wood Preservers, Inc., 35 O.I.C. 78 (1953); White v. Jones, 29 O.I.C. 167 (1947); Gragano v. Virginia Opera Association, 77 O.W.C. 127 (1998).

    Accidents that occur through the employer condoning horseplay arise out of the employment and become the responsibility of the employer. Where supervisory personnel participate in the horseplay, there is no question but that it is being condoned by the employer. Gragano v. Virginia Opera Association, 77 O.W.C. 127 (1998).

    Where another employee begins the play, if claimant thereafter freely engages therein he is not within the Act. Harris v. Thompson-Starrett Co., Inc., 26 O.I.C. 183 (1944).

    “Indian wrestling” with co-workers; not a peril of services rendered to employer nor reasonably incident thereto. Spitzer v. Intervestors, Inc., 54 O.I.C 354 (1972).

    Also see notes to § 65.2-306 .

    Assault/Murder:

    In absence of evidence that assault was motivated by claimant’s status as professor or assailant’s status as student, compensation for injuries sustained by college professor in assault by former student with mental health problems denied. Gava v. J. Sargeant Reynolds, JCN VA00001305668 (Dec. 27, 2018).

    Claimant injured after customer grabbed him around the neck was victim of assault not horseplay. Regardless of whether assailant’s motivation is playful, amorous, vindictive or hostile, it is still an assault. Claim denied because assault was neither directed at claimant as employee nor consequence of conditions under which employer required work to be performed. Baker v. Lowe’s Home Centers, JCN VA00000990523 (Mar. 29, 2016).

    A security guard was forcefully struck by an employee of the business to which he was assigned. The resulting injury was not compensable because the incident was neither horseplay nor an assault within the Act. Wilkie v. Inter Con Security Systems, Inc., VWC File No. 228-69-45 (Sept. 17, 2007).

    Generally, an employee assaulted at work is entitled to benefits if the assault was directed against the employee because of his employment. However, compensation is denied if the injured employee is the aggressor or instigator. Where the altercation would have been avoided but for the actions of the claimant, compensation is barred. The employee’s abusive and threatening words, the nature of the racial epithet used, and the threatening gestures of the employee were conduct that provoked the assault and established that he was the aggressor. Powell v. A. E. Morris Hauling, Inc., 75 O.W.C. 318 (1996).

    An employee injured as result of assault must show that the assault was directed against him as an employee or because of his employment. Gowin v. Friendly Motor Sales, Inc., 50 O.I.C. 156, 158 (1968) (appeal denied); Freeman v. Standard Furniture Co., 57 O.I.C. 125 (1976) (appeal denied); Silverman v. Metco Metals, Inc., 57 O.I.C. 329 (1977).

    If assault is result of a quarrel or a personal robbery and has no relation to work being performed by employee, the injury cannot be said to arise out of employment. Hopson v. Hungerford Coal Co., 187 Va. 299 , 46 S.E.2d 392 (1948); Campbell & Co. v. Messenger, 171 Va. 374 , 199 S.E. 511 (1938); Freeman v. Int’l. Brotherhood of Electrical Workers, 32 O.I.C. 443 (1950); Brown v. V.P.I., 32 O.I.C. 439 (1950); Torian v. Boston Durham Ice Cream Co., Inc., 32 O.I.C. 101, 239 (1950); Cole v. Dept. of Highways and Transportation, 58 O.I.C. 65 (1979).

    Compensation will be awarded, regardless of motive of assailant, if employer knew of assailant’s presence on the premises and of the likelihood of assault and took no steps to protect worker from the unusual hazard. Lynchburg Steam Bakery v. Garrett, 161 Va. 517 , 171 S.E. 493 , 1933 Va. LEXIS 343 (1933).

    The claimant began working for the employer in Kentucky. The employer provided transportation by company vehicle from the Eastern Shore to Kentucky and paid for employees to stay at the Hatfield Inn. Work was completed on March 16, 1996, but employees were allowed to stay an additional night. On the following morning, the claimant placed his gear in the company truck and went back into the hotel. The claimant returned to find that a coworker had removed the claimant’s items and placed his own gear in that location. The claimant put his own items back, and a dispute arose. The claimant turned away, and the coworker hit him in the back of the head with a carpenter’s level. The Commission concluded from this evidence that it was the usual custom for the employer to provide transportation to and from work sites in other states. Therefore, actions directly related to the ride, such as loading luggage, were part of the claimant’s work, and an altercation relating to the placement of luggage was work related. Walker v. Carolina Tool & Millwright, 78 O.W.C. 128 (1999).

    The claimant began working for the employer in Kentucky. The employer provided transportation by company vehicle from the Eastern Shore to Kentucky and paid for employees to stay at the Hatfield Inn. Work was completed on March 16, 1996, but employees were allowed to stay an additional night. On the following morning, the claimant placed his gear in the company truck and went back into the hotel. The claimant returned to find that a coworker had removed the claimant’s items and placed his own gear in that location. The claimant put his own items back, and a dispute arose. The claimant turned away, and the coworker hit him in the back of the head with a carpenter’s level. The Commission concluded from this evidence that it was the usual custom for the employer to provide transportation to and from work sites in other states. Therefore, actions directly related to the ride, such as loading luggage, were part of the claimant’s work, and an altercation relating to the placement of luggage was work related. Walker v. Carolina Tool & Millwright, 78 O.W.C. 128 (1999).

    A sexual assault on a police woman by her co-worker was personal and not directed against her as an employee or because of her employment. In addition, her employment at the central police desk did not substantially increase the risk of sexual assault. Carr v. City of Norfolk, 15 Va. App. 266, 422 S.E.2d 417, 9 Va. Law Rep. 435, 1992 Va. App. LEXIS 266 (1992).

    Compensation benefits were denied to an employee who was mugged while running errands for her employer, including making a bank deposit, because the evidence failed to establish that the injury arose out of her employment. Gamache v. Reynolds Foil Federal Credit Union, 70 O.I.C. 103 (1991).

    Compensation benefits to the claimant who was assaulted and robbed of personal money while taking trash to the dumpster outside his place of employment were denied on the basis that the assault did not arise out of his employment and was personal in nature. Khalio v. WK’s Cafe, 67 O.I.C. 89 (1988).

    The injury received by a parking lot attendant when he was knocked to the ground by a fleeing individual suspected of a crime in a nearby store was not caused by exposure to an actual risk of his employment. Carter v. Yellow Cab Company, 63 O.I.C. 57 (1984).

    Assault on a teacher on school premises held not to be an actual risk of her employment. Grimes v. Arlington County School Board, 63 O.I.C. 153 (1984).

    Stewardess injured during layover must show that the assault by a third party stranger was directed against her as an employee, even though she would not have been at that location but for her employment. Kuhn v. Eastern Airlines, Inc., 60 O.I.C. 272 (1981).

    A resident property manager, who was injured when she slipped on wet stairs while securing a laundry room after working hours and was then assaulted, was in the course of her employment. Both the employer and employee benefitted from her presence on the premises beyond the regular office hours. The assault, in an area where criminal attack could reasonably be anticipated, was a risk of the employment that arose out of and in the course of the employment. Burch-Rishel v. Canterbury Square Apartments, 69 O.I.C. 102 (1990).

    Compensation benefits were denied to an employee who was assaulted returning from dinner while attending an out of town seminar. Perkins v. Commonwealth of Virginia/VPI Extension Division, 65 O.I.C. 118 (1986).

    While finding that evidence of a non-work related motive precluded the application of the presumption to an employee who was fatally assaulted by an unknown assailant in an area of a hotel frequented by vagrants and drifters, the Court awarded benefits on a rational inference that the death arose out of and in the course of the employment. Thomas Nelson Limited Partnership v. Fritz, 11 Va. App. 269, 397 S.E.2d 891, 7 Va. Law Rep. 696, 1990 Va. App. LEXIS 190 (1990).

    When a co-worker, who had earlier been teased by his fellow employees and an assistant foreman for wearing yellow socks at work, assaulted the claimant and knocked him from the platform on which he was working to the floor, the injuries sustained in the fall were found to have arisen out of the employment. Slaughter v. Exposaic Industries, Inc., 63 O.I.C. 312 (1984).

    Assault provoked by arguments over work earlier in day; on employer’s premises after working hours, waiting for usual ride home was compensable. Posey v. Hammett Stone Co., Inc., 52 O.I.C. 198 (1970).

    Assault provoked by argument over refusal to extended credit was compensable. Gray v. East Coast Oil Corp. (appeal denied), 58 O.I.C. 154 (1979).

    Employee killed by unknown assailants after going to a private residence to recover merchandise stolen from his employer was not covered under the Act. While he was about his employer’s business with his permission, there was no evidence that the attack was a result of the work related activity. Freeman v. Standard, 57 O.I.C. 125 (1976).

    Claimant in argument with employer, evicted from premises; injury arose out of and in course of employment. Patrick v. Kings Palace, Inc., 52 O.I.C. 196 (1970).

    Rape of desk clerk in the course of her employment was not directed against her as an employee of the hotel, therefore the attack did not arise out of her employment. Bradley v. Hotel Jefferson Corporation, 60 O.I.C. 55 (1981).

    Benefits were denied to a nurse assaulted on employer’s parking lot was because she was a female and not related to work. Bowling v. Memorial Hospital, 54 O.I.C. 25 (1972).

    Compensation benefits were awarded to a bartender, who after dispersing six to ten youths from the restaurant for yelling obscenities, was later randomly shot while standing behind the bar. The Commission found that the claimant was responsible for maintaining order and that the assailants returned to attack this specific restaurant for a particular purpose. Keppel v. Bull Ring, Inc. t/a Anvil Restaurant, 73 O.W.C. 97 (1994).

    Compensation benefits were awarded to the claimant who, in conformity with training provided by the employer, was stabbed after advising two fighting customers to leave. Curtis v. The Southland Corporation, 73 O.W.C. 100 (1994).

    Where claimant was shot at work by estranged husband, accident did not arise out of the employment. Matherly v. The Southland Corporation, 60 O.I.C. 303 (1981).

    Bullet fired from unknown source, injury not caused by hazard arising out of employment. Carawan v. Creasy & Whiteed, 42 O.I.C. 25 (1960); Turner v. Burger King, 59 O.I.C. 295 (1980).

    Where claimant was the aggressor compensation will generally be denied. Meekins v. Saga Food Service, Inc., 53 O.I.C. 200 (1971); James v. Thom McAn Shoe Store, 58 O.I.C. 198 (1978); Bataineh v. King of Pita Bakery, VWC File No. 201-57-41 (July 6, 2001).

    Injuries suffered during an altercation with a co-worker are not compensable where the claimant was the aggressor. Walker v. 7 11, 74 O.W.C. 115 (1995); Bataineh v. King of Pita Bakery, VWC File No. 201-57-41 (July 6, 2001).

    Compensation was awarded upon a finding that even if the claimant were the aggressor, the disabling injuries were inflicted by the other party after the altercation had ended. Stitt v. Install, Inc., 62 O.I.C. 432 (1983).

    Person who strikes first blow not necessarily the aggressor. Daniel v. Sash, Door & Glass Corp., 51 O.I.C. 70 (1969).

    Compensation benefit awarded to Union agent shot while managing union affairs. Freeman v. International Brotherhood of Electrical Workers, 32 O.I.C. 443 (1950).

    Deceased and co-employee performing janitor service; argument arose in connection with work. Brown v. V.P.I., 32 O.I.C. 439 (1950).

    Compensable when purpose of attack was to obtain property of employer (automobile); employee also robbed. Gorwin v. Friendly Motor Sales, Inc., 50 O.I.C. 156, 158 (1968) (appeal denied).

    Death of store manager shot at closing time by men he had earlier asked to be quiet in store arose out of the employment. Walters v. Safeway Stores, Inc., 56 O.I.C. 324 (1975) (affd. on review, appeal denied).

    Evidence of argument with co-worker at work on day of murder was sufficient to find death arose out of the employment. Paytes v. A & P, 58 O.I.C. 272 (1978).

    Murder of a general district court judge while he was holding session of court by an assailant, whom he had found guilty of a speeding conviction one month earlier, found to have arisen out of the employment. Cunningham v. Commonwealth of Virginia, 57 O.I.C. 92 (1976) (affd. on review) (appeal denied).

    Murder of a general district court judge while he was holding session of court by an assailant, whom he had found guilty of a speeding conviction one month earlier, found to have arisen out of the employment. Cunningham v. Commonwealth of Virginia, 57 O.I.C. 92 (1976) (affd. on review) (appeal denied).

    Judge killed at his home by assailant disgruntled by judge’s decision was compensable. Colosanto v. City of Alexandria, 55 O.I.C. 100 (1973).

    Compensation benefits were awarded to the claimant who was killed by a gunshot wound as he drove through a high crime area from the main office to his assigned location. Whetsell v. George A. Roberson, CPA, 73 O.W.C. 102 (1994).

    Also see notes under “Presumption” below.

    Self-inflicted pistol shot not hazard arising out of employment. Henderson v. Basic Constr. Co., 47 O.I.C. 167 (1965) (appeal denied).

    Death was from a self-inflicted rifle shot and not from accidental fall while shooting pigeons at school. Henley v. William King Elementary School, 50 O.I.C. 184 (1968).

    Whether fall from roof was by accident or design is of no moment in determining compensability where duties of employment did not entail going on to roof of cupola. Stanwitz v. Leas & McVitty, Inc., 42 O.I.C. 122 (1960).

    Insect Bites:

    In order to demonstrate that her spider bite injury arose out of her employment, claimant must do more than show that insects sometimes were observed on the employer’s property. She must prove that her risk of exposure to spiders was greater than that experienced by the general public. Whittemore v. Williamsburg Landing, Inc., JCN VA00001058566 (March 14, 2017).

    Because the claimant’s work as a cook required her to wash dishes at night in the basement where spiders were previously seen in the sink, her spider bite arose out of a risk of her employment. Hobbs v. Greyston Manor, Inc., VWC File No. 228-38-38 (May 1, 2007).

    The claimant felt a sharp stinging sensation when she reached into a stack of new linens in a clean windowless room in a nursing home. The majority found that the claimant’s job as a CNA did not expose her to a greater risk of insect bites than that encountered by the general public. Barrett v. Blue Ridge Rehab Center, VWC File No. 228-84-38 (April 5, 2007).

    Stairs/Fall:

    Claimant left scene of accident and later returned and observed liquid on stairs. Evidence was sufficient to infer foreign condition was present at time of accident. Shifflett v. Pamela Marzban, DDS, PC, JCN VA00000879889 (Dec. 4, 2014).

    The claimant felt a pop in his knee as he was ascending steep scaffolding steps, which required the claimant to pull himself up with his arms while pushing off with his foot. This additional effort was necessitated by the steepness of the stairs and was a risk of his employment, even though there was no flaw or defect in the stairs. The claimant proved a causal connection between his injury and the manner in which he was required to perform his work. Shakra v. Truland Systems Corporation, JCN VA00000296644 (Aug. 2, 2011).

    The claimant was injured but conscious at the bottom of the stairs leading to the employer’s designated smoking area. He had no recollection of the event or of any significant physical problems prior to the fall. The stairs had no defect. The claimant died the next day. Evidence is insufficient to prove an idiopathic fall or to infer a risk of the employment caused the fall. Tweed v. Newport News Shipbuilding & Dry Dock, VWC File No. 227-87-41 (June 26, 2007).

    Because his work created the risk and need to rush, benefits were awarded to a courier whose knee froze or gave way as he hurried down steps in order to meet the employer’s daily deadline for delivering packages. Alexander v. Federal Express Corp., VWC File No. 224-22-90 (Aug. 22, 2006).

    Claimant’s actions in rushing down a hall to prevent a nursing home resident from leaving the building and to turn off a motion sensor were reasonably incidental to her specific duties, benefited her employer and were consistent with actions that would be expected of an employee when confronted with this situation. Crabtree v. Heritage Hall, VWC File No. 217-16-42 (Feb. 11, 2005).

    Claimant failed to establish curb over which he tripped and fell was uniquely dangerous because of a defect or the presence of a slippery substance, or that the conditions of his employment caused the fall. Morris v. Virginia Auto Glass, Inc., VWC File No. 217-44-04 (Oct. 26, 2004).

    Claimant’s work required her to traverse in an area covered by gravel, rocks, dirt and asphalt. Claimant fell when she stepped on a two-inch rock that skated out from under her. The Commission found the rock sufficiently large to be considered a condition of the employment. Winall v. Newport News Shipbuilding & Dry Dock Co., VWC File No. 216-67-35 (Oct. 22, 2004).

    Claimant’s fall from a car carrier trailer arose out of his employment where he climbed on top of the trailer to check ramps and wheel alignment, requiring him to stand on narrow metal grating. The combination of the height, narrow grating, and space between the truck and trailer was sufficient to establish that the conditions of claimant’s workplace caused or contributed to his injury. Farris v. John D. Reynolds T/A J.R. Classic Autos, VWC File No. 216-17-46 (Sept. 1, 2004).

    Employee’s injuries from fall down stairs, caused by rushing to “catch” fellow employee, held to arise out of employment; employee’s supervisor instructed employee to rush, and employee testified that she was rushing when she fell down stairs. Woodson v. Central Va. Training Ctr., VWC File No. 209-08-46 (Mar. 1, 2004).

    Employee’s injury caused by tripping over heel of fellow employee arose out of employment; employees, who worked in hospital, were walking fast to retrieve patients; fellow employee stepped in front of employee, causing employee to trip over fellow employee’s heel; injury connected to conditions under which work was to be performed and not result of merely tripping over own feet while walking. Jacob v. INOVA Mount Vernon Hosp., VWC File No. 211-34-35 (Dec. 4, 2003).

    Fall at work shown to arise out of employment when evidence established that employee, who was performing security screenings on airline passengers and fell while turning in the course of screening a passenger, tripped over a one-inch rubber strip joining a hard floor with a carpeted floor. Yousef v. Atlantic Coast Airlines, Inc., VWC File No. 211-81-31 (July 11, 2003).

    Employee’s injury caused by awkward exit from truck off ladder arose out of employment; ladder not defective or unusually high but employee’s step off ladder awkward when toe caught ladder, causing him to land on ankle awkwardly. Shortt v. Humphrey’s Enterprises, Inc., VWC File No. 208-04-35 (May 16, 2003).

    For Court of Appeals Cases involving stairs see:.Malik v. McDonalds Corp., Record No. 0399-92-4 & 0263-92-4 (September 29, 1992); Reston Homeowners Association, et al. v. Noble, Record No. 1704-92-4 (June 29, 1993); Centerville Automotive, MSS, Inc. v. Vanover, Unpublished Opinion, Record No. 1439-94-4 (February 28, 1995); Southside Virginia Training Center/Commonwealth of Virginia v. Shell, 20 App. 199, 455 S.E.2d 761 (1995); Nottoway Correctional Center/Commonwealth of Virginia v. Thompson, Unpublished Opinion, Record No. 1469-94-2 (April 11, 1995); Marion Correctional Treatment Center v. Henderson, 20 Va. App. 477, 458 S.E.2d 301 (1995); Mildred Hackney v. M P & M Coal Co., Inc., Record No. 0012-96-3 (April 30, 1996) (Unpublished Memorandum Opinion); Janette R. Ogle v. National Association of Elementary School Principals, Record No. 2708-95-4 (May 14, 1996) (Unpublished Memorandum Opinion); City of Portsmouth v. Grant, Record No. 0029-96-1 (July 2, 1996) (Unpublished Memorandum Opinion).

    In determining whether an injury while climbing a ladder arises out of the employment, the case law pertaining to ordinary steps and stairways is inapplicable, since the work risks are greatly increased with a ladder. Miller v. Canon of Virginia, Inc., 79 O.W.C. 56 (2000).

    The evidence established that the claimant was descending a staircase with a hand truck loaded with electronic equipment that had been used to complete a service call. The equipment on the hand truck shifted, and the claimant attempted to prevent it from falling. While doing so, he lost his balance and fell down the steps, sustaining injury. This is not a case where an injured employee’s fall is unexplained. Rather, the evidence inexorably leads to the conclusion that the claimant’s fall was caused by a shifting weight on the hand truck and his effort to stop the equipment from falling. The Commission found that the claimant’s fall and resulting injury were caused by a condition of his employment. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    Where the employee could not hold onto a stairway railing and stop her fall because she was carrying supplies related to her work, her injuries arise out of her employment. Emerson v. Econo Clean Janitorial Service, Inc., 76 O.W.C. 32 (1997).

    Compensation benefits were denied an employee who felt a pain in her right leg while carrying cleaning supplies up steps. The evidence failed to establish that the claimant slipped, tripped or fell or that the cleaning supplies or steps contributed to her injury. Elliott v. Holiday Inn — 39th Street, 69 O.I.C. 108 (1990).

    Employee descending two-story scaffold carrying a tripod and a carpenter’s level twisted knee when his foot caught on a handrail post. Held, the injury arose out of the employment. Hurst v. Protec Construction Service, Inc., 77 O.W.C. 6 (1998).

    The mere fact that a step is different from other steps, standing alone, does not render it a causative danger peculiar to the work and not common to the neighborhood. Cooksey v. City of Richmond Emergency Comm., 76 O.W.C. 518 (1997).

    Compensation was awarded to a claimant who fell down stairs after her heel caught in rubber matting on the step. Larson v. Signet Bank, 74 O.W.C. 119 (1995).

    As the claimant stepped aside to allow arriving workers to pass, he stepped half on the concrete walk and half on recessed dirt. Because grass had grown up above the concrete, he could not see that drop down from the concrete. As a result, he twisted his ankle and fell, injuring his shoulder as he grabbed onto a post. The Commission held that a condition of the workplace contributed to the accident. Clark v. Goodyear Tire & Rubber Co., 76 O.W.C. 145 (1997).

    Compensation benefits were awarded to an employee who suffered injury when he fell from a wall onto a stairwell while tying his shoe. Mileham v. Sal’s Italian Restaurant & Pizza, 70 O.I.C. 139 (1991).

    In awarding compensation benefits to a claimant who misstepped and fell while descending an elevated court room witness stand, the Commission found that an employee is exposed to a specific risk while ascending or descending steps in the course of the employment and the risk arose out of the employment. Parker v. S. J. Conner & Sons, 68 O.I.C. 86 (1989).

    The claimant fell while stepping off a raised dispatch area. She alleged that her fall was caused by her slipping on the metal strip on the edge of the step, but no evidence was elicited to indicate that the metal strip was worn, slippery, or defective in any manner, and she testified that the conditions on the date of her accident were the same as those that had been in place for several years. There was no evidence of a foreign substance on the metal strip, the step, carpeting, or the claimant’s shoes, that would have caused her to slip, nor did she attribute her fall to any defective condition of the step or the workplace. The Commission found that the claimant’s fall was caused by her inattention and distraction unrelated to her work, and that she placed her foot down near the edge of the step without realizing she was that close to the edge, and fell. This did not prove that her accident and injury arose out of the employment. Cooksey v. City of Richmond Emergency Comm., 76 O.W.C. 518 (1997).

    Compensation benefits were awarded to the claimant who misstepped and fell while backing down the stairs with a broom. Garland v. Wythe County School Board, 73 O.W.C. 81 (1994).

    In awarding compensation benefits to a teacher’s aide who while descending steps slipped on the top step and twisted her foot, the Commission noted that the act of ascending and descending stairs required concentration and an altered gait. Benefits may be awarded when the necessity of traversing different or varied surfaces in the work place in combination with inattention, diversion or negligence, caused a claimant to suffer an injury from a misstep or a slip. Wallace v. Russell County School Board, 68 O.I.C. 83 (1989).

    Compensation benefits were awarded to the claimant who while running to escape a fire ran through a fire door, rapidly turned to descend a flight of steps, and felt her knee give way as she was going down the stairs. Hairston v. J. D. Bassett Manufacturing Co., 73 O.W.C. 83 (1994).

    Although there was nothing unusual about the stairs which the claimant, a correctional officer, was descending when his foot slipped, the requirement that he look at the guard tower to see if his wave was acknowledged while on the steps provided the critical link to the employment necessary to find his case compensable. Henderson v. Commonwealth of Virginia/Marion Correctional Treatment Center, 73 O.W.C. 85 (1994).

    Compensation benefits were denied to the claimant who felt pain in his foot as he ran up the steps to make a delivery. Thompson v. Infinite Color, Inc., 73 O.W.C. 87 (1994).

    A competitive car sales environment created by the employer increased the risk of falling on stairs and directly contributed to cause the employee’s fall. Chettiar v. Checkered Flag Motor Car Co., 77 O.W.C. 15 (1998).

    The claimant, who worked at a fast food restaurant, was asked to go to an outside storage area to retrieve some cartons. Her uncontradicted testimony was sufficient to establish that there was grease on the soles of her shoes from working in the kitchen area, and that the ramp where she fell was sloped and wet from rain. The Commission held that her slip and fall was caused by the substances present on her shoes and the wet ramp, hazards peculiar to her employment, and the injury was compensable. Nichols v. Hardee’s, 76 O.W.C. 428 (1997).

    Evidence that shows the employee fell by tripping over either an elevated door sill or an adjacent mat is sufficient to prove a compensable accident. It is not necessary that the employee specifically establish one cause of her fall if she establishes one or more risks of her employment to be the cause of the fall. Turner v. Southern Virginia Mental Health Inst., 75 O.W.C. 199 (1996).

    The Commission found that the failure of the claimant to mention debris on the floor in an incident report prepared for the employer was of no consequence, since she testified credibly that too much was going on when she filled out that report, and the report did not ask what caused her to fall, only to describe what happened. Caceres v. Kids R Us, 76 O.W.C. 312 (1997).

    It is unnecessary for a claimant to positively identify the substance that causes a slip and fall. Compensation was awarded to a claimant who slipped while walking across a wet floor. Stevens v. Anheuser Busch Co., Inc., 74 O.W.C. 142 (1995).

    While it might be better from an evidentiary consideration to have a more certain identification of the substance that caused the claimant’s shoes or the floor to be slippery, that is not an essential element to prove a compensable accident. The evidence is sufficient if the Commission can reasonably infer from the record that there was a substance on the floor or the claimant’s shoes that caused the fall in the course of the claimant’s employment. Nichols v. Hardee’s, 76 O.W.C. 428 (1997).

    Compensation benefits were awarded to the claimant who, after parking his car on an adjacent highway where employees normally park, entered the employer’s premises, walked through a paved parking lot, climbed steps to his assigned building, and twisted his knee after stepping on a rock. Wolford v. Western Temporary Services, 73 O.W.C. 89 (1994).

    An idiopathic fall caused by fainting or other personal illness may be compensable if the injuries are shown to have been aggravated by, caused by, or attributed to a risk of the employment. Chambers v. Commonwealth of Virginia/Buckingham Correctional Center, 70 O.I.C. 110 (1991).

    The employee was walking across the employer’s parking lot when she heard an approaching bus and turned to make sure she was not in its path. She fell as she turned back, but did not know what caused her to fall. Held, the injury did not arise out of the employment, since there was no evidence that the distraction from the bus contributed to her fall. Kashin v. Co. of James City Bd. of Supervisors, 75 O.W.C. 344 (1996).

    The employee was walking across the employer’s parking lot when she heard an approaching bus and turned to make sure she was not in its path. She fell as she turned back, but did not know what caused her to fall. Held, the injury did not arise out of the employment, since there was no evidence that the distraction from the bus contributed to her fall. Kashin v. Co. of James City Bd. of Supervisors, 75 O.W.C. 344 (1996).

    Where “something snapped” in claimant’s leg as she walked along a level, clean, unobstructed and well-lighted hall and did not involve a slip, trip, stumble or fall there is no connection between conditions of work environment and resulting injury. Accidents resulting from risks to which all persons are equally exposed and not traceable to some degree to the particular employment are excluded from coverage under the Act. Crane v. Richmond Memorial Hospital, 222 Va. 283 , 278 S.E.2d 877, 1981 Va. LEXIS 302 (1981).

    Where a fall is witnessed, it is not totally unexplained. The witness in this case testified that the claimant’s feet slipped out from under her and caused her to become horizontal with the floor. Evidence also revealed that the claimant was walking on a tile floor, wearing paper booties that did not have good tread or traction. The Commission inferred that the logical explanation was that the booties contributed to the claimant’s fall, which established the critical link between the employment and the accident. Phansond v. Alexandria Hospital, 76 O.W.C. 379 (1997).

    Where the evidence shows that the employee slipped and fell on terrazzo floors that the employer kept well polished and clean, making them shiny and slick, and that there was a history of many falls or near falls on the slippery floors, the claimant has shown a hazard unique to the employment and her slip and fall on such floor arises out of the employment. Clarke v. Southside Virginia Community College, 75 O.W.C. 94 (1996).

    Exiting Vehicles, etc.:

    Employee’s injury caused while exiting employer’s vehicle arose out of employment; employee, an undercover police officer, injured while climbing out of low-positioned Corvette that was used in undercover work; hoisting motion from low vehicle, causing knee injury, considered unusual and awkward and formed connection between injury and employment. Motley v. Prince William County Police, VWC File No. 182-11-95 (Apr. 19, 2004).

    Employee’s injury caused by awkward exit from truck off ladder arose out of employment; ladder not defective or unusually high but employee’s step off ladder awkward when toe caught ladder, causing him to land on ankle awkwardly. Shortt v. Humphrey’s Enterprises, Inc., VWC File No. 208-04-35 (May 16, 2003).

    Injuries sustained as a result of stepping out of or into a truck in an awkward or unusual manner, or on a step which is abnormal in height or condition, arise out of the employment. Berry v. Virginia Dept. of Transportation, 79 O.W.C. 72 (2000).

    Compensation benefits were awarded to an employee who fell while descending a school bus because the steps were unusual and required a different degree of attention and exertion. Boyette v. Prince George’s County School Board, 69 O.I.C. 110 (1990).

    Where the seat of the employer’s truck was elevated approximately three feet above ground level, and the claimant had to utilize an intermediate step of about one to one and one-half feet above ground level between the cab of the truck and the ground in order to exit the truck safely, having to step down from such an elevation and in such a manner constituted a risk of employment. Berry v. Virginia Dept. of Transportation, 79 O.W.C. 72 (2000).

    Compensation benefits were awarded to the claimant whose left knee popped as he stepped from a truck to the ground while removing his right foot from a stirrup. Theriault v. Estes Express Lines, 73 O.W.C. 79 (1994).

    Idiopathic/Unexplained Falls:

    The claimant was injured but conscious at the bottom of the stairs leading to the employer’s designated smoking area. He had no recollection of the event or of any significant physical problems prior to the fall. The stairs had no defect. The claimant died the next day. Evidence is insufficient to prove an idiopathic fall or to infer a risk of the employment caused the fall. Tweed v. Newport News Shipbuilding & Dry Dock, VWC File No. 227-87-41 (June 26, 2007).

    Claimant did not remember why he fell, but immediately prior to his fall he had been standing on a roof hosing it down and had made adjustment to a ladder preparing to descend from roof. These facts established a set of risks unique to the employment, and the evidence was sufficient to support a reasonable inference that claimant fell either because his wet shoe slipped or the ladder shifted. Roupe v. Hall’s Constr. Corp., VWC File No. 218-14-72 (Jan. 12, 2005).

    In Virginia, the effects of an idiopathic fall are compensable if the employment places the employee in a position increasing the dangerous effects of such a fall, such as on a height, near machinery or sharp corners, or in a moving vehicle. Daniels v. Lantz Construction Co., 77 O.W.C. 60 (1998).

    The effects of the claimant’s idiopathic fall were found to be compensable because his employment as a construction supervisor required that he position himself one foot from the edge of a six foot drop in order to inspect a retaining wall on the opposite side of a loading dock. This elevated height constituted an added risk of the claimant’s employment, as it increased the severity of his injuries when he fell. Daniels v. Lantz Construction Co., 77 O.W.C. 60 (1998).

    For additional Court of Appeal’s cases involving stairs and idiopathic falls see Plastic Products, Inc. v. Mildred Clark Bullock, Record No. 1963-95-2 (April 16, 1996), (Unpublished Memorandum Opinion); Virginia State University v. Almeaner Gilliam, Record No. 1746-95-2 (April 2, 1996), (Unpublished Memorandum Opinion).

    For a case discussing idiopathic and unexplained falls see PYA/Monarch v. Harris, 22 Va. App. 215, 468 S.E.2d 688, 1996 Va. App. LEXIS 221 (1996).

    Employee’s injury resulting from awkward movement arose out of employment; employee bent and retrieved pans from lower shelf and arose with pans and twisted to place pans on table; Commission found employee not merely bending over but experienced symptoms during lifting and twisting motion. Davis v. Little Gen’l Store, Inc., VWC File No. 211-71-77 (Oct. 14, 2003).

    Employee’s injury found to arise out of employment when injury caused while turning at work station with feet planted on non-slip rubber mat; employee not engaged in “simple act of turning,” but while turning on mat designed to prevent slipping causing feet not to move during turn. Honaker v. Teleflex Automotive Mfg. Corp., VWC File No. 210-18-16 (June 30, 2003).

    Bending/Standing:

    Injury incurred while bending down performing a pat down of a prison inmate did not arise out of employment. Banks v. Deep Meadow Correctional Center, VWC File No. 217-80-44 (April 11, 2005).

    Employee’s injury found to arise out of employment when injury occurred while arising from sitting on floor in awkward position for 45 minutes; employee’s work required her to assume awkward position, posing risk of injury from recovering from that position. Stallard v. Appalachian Reg’l Cmty. Head Start, Inc., VWC File No. 206-69-80 (June 27, 2003).

    Employee’s injury found to arise out of employment when injury occurred while arising from sitting on floor in awkward position for 45 minutes; employee’s work required her to assume awkward position, posing risk of injury from recovering from that position. Stallard v. Appalachian Reg’l Cmty. Head Start, Inc., VWC File No. 206-69-80 (June 27, 2003).

    Compensation benefits were awarded to an employee who suffered a knee injury when he arose from a squatting position on sloping terrain. The movement required significant exertion and greater weight was placed on the injured leg. Beatley v. Metropolitan Washington Airport Authority, 69 O.I.C. 105 (1990).

    Compensation benefits were denied to a claimant whose knee gave way as he turned around on the first step of a stairway to go back to retrieve equipment. The mere act of turning without some added risk is not sufficient to bring an injury at the workplace within the context of the Act. County of Chesterfield v. Johnson, 237 Va. 180 , 376 S.E.2d 73, 5 Va. Law Rep. 1545, 1989 Va. LEXIS 14 (1989).

    Compensation benefits were denied to a claimant whose knee gave way as he turned around on the first step of a stairway to go back to retrieve equipment. The mere act of turning without some added risk is not sufficient to bring an injury at the workplace within the context of the Act. County of Chesterfield v. Johnson, 237 Va. 180 , 376 S.E.2d 73, 5 Va. Law Rep. 1545, 1989 Va. LEXIS 14 (1989).

    The evidence showed that the employee was injured as she stood and turned while rising from a chair. Held, accident did not arise out of the employment. A simple acts of walking, bending or turning, without any other contributing environmental factors, should not be considered as risks of the employment. Smith v. Halmode Apparel, 75 O.W.C. 258 (1996).

    Benefits were awarded to the employee who suffered an injury as he arose from kneeling on his left leg and pushing a beam with his right leg because the injury occurred as a risk of the employment. Thornsberry v. Tidewater Construction Corp., 71 O.W.C. 115 (1992).

    Benefits were awarded to an employee whose knee popped upon arising from working with knees flexed for five to ten minutes. The hazardous stance for a specific identifiable period was an unusual exertion incident to the work. Boehm v. Seaboard Communications, 71 O.W.C. 118 (1992).

    Compensation benefits were awarded to a housekeeping aide who, after working on her hands and knees cleaning the floor, felt pain in her back as she attempted to stand while holding a spray bottle and placing her right hand on the bed to support herself. Coates v. Mary Washington Hospital, 73 O.W.C. 66 (1994).

    A claimant who suffered a knee injury while extricating himself from the back seat of a car during attendance at an out of town conference was awarded compensation benefits. Elfino v. Virginia Department of Highways, 66 O.I.C. 30 (1987).

    A knee injury resulting from bending and lifting a pallet arises out of the employment. Jackson v. Hechinger Co., 74 O.W.C. 128 (1995).

    The Commission is not prepared to state that any single action of “bending” or “straightening up” will determine the existence or nonexistence of a compensable claim without consideration of all applicable conditions. Reed v. Commonwealth of Virginia/Norfolk State University, 64 O.I.C. 269 (1985).

    Accidents caused by mere bending are not injuries that arise out of the employment. Smith v. Wampler-Longacre, Inc., 74 O.W.C. 186 (1995) (see also Smith v. Halmode Apparel, 75 O.W.C. 258 (1996)).

    A “contortion of the body” to perform a job task is a hazard of the workplace. Davidson v. Potomac Mills Exxon, 76 O.W.C. 437 (1997).

    An accident arises out of the employment when a causal connection exists between the injury and the conditions under which the employer requires the work to be performed. A contortion of the body necessitated by the employee’s work is risk created by the workplace. The injury need not be caused by an extraordinary occurrence in or about the work performed, nor must the precipitating movement be unusual or require exertion. Shifflett v. Fleet Maintenance Service, Inc., 77 O.W.C. 202 (1998).

    An accident arises out of the employment when a causal connection exists between the injury and the conditions under which the employer requires the work to be performed. A contortion of the body necessitated by the employee’s work is risk created by the workplace. The injury need not be caused by an extraordinary occurrence in or about the work performed, nor must the precipitating movement be unusual or require exertion. Shifflett v. Fleet Maintenance Service, Inc., 77 O.W.C. 202 (1998).

    The claimant was on a creeper and working under a trailer for approximately one hour. He pushed the creeper out from under the trailer, twisted his body in an awkward manner to place one hand on the floor and one hand on the tire, and twisted and arose from the creeper with his legs crossed. The Commission held that the claimant’s action in standing from a seated position on the creeper was the end point to an injurious transaction which commenced when he pushed himself out from under the trailer after working underneath it for an hour. The common thread in such cases is that the employee was required to work in an awkward position for an extended period, which posed a risk of injury as he recovered from such position, and injuries that result from such work arise out of a risk or hazard of the employment. Shifflett v. Fleet Maintenance Service, Inc., 77 O.W.C. 202 (1998).

    Injury sustained by a claimant when she leaned over to pick up a pencil which had fallen to the floor did not arise out of her employment. Haro v. Ramada Inn, 64 O.I.C. 158 (1985).

    Compensation benefits were denied to an employee who experienced back pain as she straightened up from leaning forward across a bath tub to clean a wall. Prophet v. South Hill Ventures, 70 O.I.C. 125 (1991).

    Where the claimant bends to lift a bucket of water, pours it out while bent, and suffers a back injury while rising with the empty bucket, the work while bending constituted a hazard, and the injury while extracting herself arises out of the employment. The specific incident that caused the employee’s sudden mechanical or bodily change must be viewed in the aggregate, not in its component parts. Blizzard v. Super Fresh Food Markets, Inc., 75 O.W.C. 168 (1996).

    The claimant attempted to peer over waist-high boxes on a pallet while standing on one foot, his trunk turned towards the right, his upper body turned towards the left, and his weight on his left hand. The awkward movement produced a sudden back strain that arose out of the employment. Taylor v. Wal Mart Stores, Inc., 74 O.W.C. 156 (1995).

    The claimant attempted to peer over waist-high boxes on a pallet while standing on one foot, his trunk turned towards the right, his upper body turned towards the left, and his weight on his left hand. The awkward movement produced a sudden back strain that arose out of the employment. Taylor v. Wal Mart Stores, Inc., 74 O.W.C. 156 (1995).

    The claimant worked as a cashier at a gas station kiosk. At the time of her accident, she was performing work in an unusual or awkward position, with one foot on the ground and another on a six-inch ledge, reaching into a cart to retrieve a soda. This evidence established a causal connection between her injuries and the conditions under which the employer required her to work, and thus arose out of her employment. Davidson v. Potomac Mills Exxon, 76 O.W.C. 437 (1997).

    Compensation benefits were awarded to the claimant who forcibly pulled yarn while bent over and a minute or two later felt pain in his back while straightening up after reaching in an awkward position for a sponge. Hill v. E. I. Du Pont De Nemours & Co., 73 O.W.C. 68 (1994).

    Compensation benefits were awarded to the claimant who forcibly pulled yarn while bent over and a minute or two later felt pain in his back while straightening up after reaching in an awkward position for a sponge. Hill v. E. I. Du Pont De Nemours & Co., 73 O.W.C. 68 (1994).

    Compensation awarded to an employee who sustained an injury when she was bending over and reaching down into a box to pick up some material. Hepner v. Sancar Corporation, 64 O.I.C. 167 (1985).

    Compensation awarded to an employee who sustained an injury when she was bending over and reaching down into a box to pick up some material. Hepner v. Sancar Corporation, 64 O.I.C. 167 (1985).

    The employee suffered a back injury when, to secure items on a food cart, she tossed straps under the cart, which was approximately 12 inches above the floor. Held, the awkward physical movement in bending and tossing the straps under the cart established the causal connection between the employment and the injury. Grissom v. Alladin Food Management, 75 O.W.C. 226 (1996).

    The claimant, who suffered a knee injury when she squatted down to check the contents of a catheterized patient’s urine bag, was awarded compensation benefits. Smithers v. Lewis-Gale Hospital, 66 O.I.C. 27 (1987).

    Compensation benefits were denied to a claimant who after working for one and a half hours bent over to pick up a piece of plastic pipe and felt a sudden back pain before actually touching the pipe. The mere happening of an accident at the work place not caused by any work related risk or sufficient work related exertion was not compensable. Plumb Rite Plumbing Service v. Barbour, 8 Va. App. 482, 382 S.E.2d 305, 6 Va. Law Rep. 111, 1989 Va. App. LEXIS 100 (1989).

    In awarding benefits to the employee who was working in a crouched position several feet off of the ground repairing a two inch pipe line when he reached for an eight pound piece of pipe and felt sharp pain in his back, the Court held the work place condition constituted the “hazard” that was peculiar to the work. It was irrelevant whether the employee was reaching or had lifted the pipe, that the activity was usual and did not require exertion or that the injury was not foreseen or expected. The employee’s act of reaching for the pipe was found to be the event that satisfied both the “identifiable incident” and the “reasonable definite time” components of the injury by accident test. Grove v. Allied Signal, 15 Va. App. 17, 421 S.E.2d 32, 9 Va. Law Rep. 162, 1992 Va. App. LEXIS 230 (1992).

    Compensation benefits were awarded to an employee who, while repairing a heater over a twenty-minute period which involved kneeling, squatting, lying down and rising to a standing position on a ramp, felt pain in his knee as he stood up for the third time. Stout v. Bally’s HTCA, 73 O.W.C. 70 (1994).

    In awarding compensation benefits to an employee who experienced back pain upon arising from working in a squatting position for forty-five minutes, the Commission noted that the mere act of bending over or arising from such a position alone with resultant injury is not compensable. When stooping, bending or arising is tied in with other movements or actions required by his work, compensation may be awarded if the medical evidence supports causation. The mere fact that a employee may perform similar activities at home does not prevent an award when an injury is sustained performing the same activities at his workplace. Hastings v. City of Danville Waste Water Treatment Plant, 70 O.I.C. 128 (1991).

    In order to perform his work, the claimant had to assume a full squat, balance on his forefeet, dangle his arms below him, and use both hands to remove caulk from a pipe only a few inches off the floor. After maintaining this awkward position and performing the significant work related exertion for five to ten minutes, he felt pain accompanied by an audible “pop” as he attempted to stand. These facts establish an injury by accident arising out of the employment. Campbell v. Buffalo Air Handling, 74 O.W.C. 82 (1995).

    Compensation benefits were awarded to an employee who felt a sharp pain upon arising after working one-half hour sitting on a stool in a bent position. Whitt v. Southeastern Virginia Training Center, 70 O.I.C. 120 (1991).

    Compensation benefits were awarded to an employee who felt a sharp pain upon arising after working one-half hour sitting on a stool in a bent position. Whitt v. Southeastern Virginia Training Center, 70 O.I.C. 120 (1991).

    Compensation benefits were denied to an employee who felt a slip in his back as he attempted to stand up after working for a period of time in a crouched position welding a water line. Colston v. Union Camp Corporation, 70 O.I.C. 126 (1991).

    The claimant established an injury by accident when he experienced severe back pain simultaneously with rising from a bent over position handling a 100-pound drum of chlorine thereby aggravating a pre-existing condition. Manassas Ice & Fuel Co. v. Farrar, 13 Va. App. 227, 409 S.E.2d 824, 8 Va. Law Rep. 1100, 1991 Va. App. LEXIS 269 (1991).

    Compensation benefits were denied to the claimant, a customer service representative, who after receiving a telephone call through his headset felt a pop in his back as he twisted to the right to reach his computer. The mere act of turning in a chair is insufficient to bring the injury under the Act. Timmons v. Airborne Freight Corp., 73 O.W.C. 72 (1994).

    Lifting/Carrying:

    Compensation was awarded to the claimant, who experienced stabbing back pain requiring immediate medical attention, while picking up a box as part of her normal work duties. Russell Loungewear v. Gray, 2 Va. App. 90, 341 S.E.2d 824, 1986 Va. App. LEXIS 246 (1986).

    After lifting chain off of a tractor trailer, the employee felt a severe pain in his back as he turned to put the lid on a box. The injury arose out of the employment since the claimant was performing a job related task requiring climbing, lifting, twisting and bending, and experienced an immediate onset of pain. Roanoke Electric Steel Corporation v. Gilcrest, No. 1347-85 (Ct. of Appeals, May 29, 1986).

    The majority of the Commission held that the one continuous movement of bending forward, grasping and lifting a box, with the most severe pain while straightening with the box in her hand establishes an injury by accident while lifting. Armstead v. Philip Morris Companies, 74 O.W.C. 196 (1995).

    Compensation benefits were awarded to an employee who lifted a 100-pound furnace, leaned over it for approximately four to five minutes to cut and fit it into place and was unable to stand up as the result of an acute lumbosacral strain, because the employee’s action required unusual exertion and risks that were encountered solely due to the nature of the job. Brown v. Caporaletti, 12 Va. App. 242, 402 S.E.2d 709, 7 Va. Law Rep. 2126, 1991 Va. App. LEXIS 70 (1991).

    Compensation benefits were awarded to an employee who experienced back pain while carrying a 50-pound bag of coal dust in a crouched position through a 2 x 2 door. Brewer v. Westmoreland Coal Company, 70 O.I.C. 112 (1991).

    Compensation benefits were awarded to the employee who after carrying a 200-pound walk board, suffered back pain while performing relatively light work cutting vinyl siding. Willard v. Phillip Hughes Contractors, 70 O.I.C. 116 (1991).

    Compensation benefits were awarded to an employee who felt a sharp pain in his back as he attempted to catch a falling box. Wright v. Harrison’s Supermarket No. 1, 70 O.I.C. 254 (1991).

    In awarding compensation benefits, the Commission held that the claimant suffered a minor strain while lifting a case of drinks from the back of a pallet. The fact that the strain was minor did not mean that it was cumulative nor did the failure immediately to report the incident negate the occurrence of an injury by accident. Tyrrell v. Mid Atlantic Coca Cola, 73 O.W.C. 63 (1994).

    Hernia:

    Employee’s hernia injury found not to result from repetitive trauma; employee stated that he moved two pieces of heavy equipment at 3:30 p.m. and immediately thereafter felt pain in groin; Commission found that employee identified specific incident — moving equipment — causing bodily change — strain; evidence did not show gradual onset of pain from repetitive, strenuous work. Martin v. Goodyear Tire & Rubber Co., VWC File No. 212-22-57 (Mar. 26, 2004).

    A causal connection between the work and the hernia must be shown. The mere fact that a worker discovered the condition during the course of his work does not establish a compensable claim. Roy v. Yancey Bark & Lumber Co., Inc., 31 O.I.C. 280 (1949); Purcell v. Commonwealth, 31 O.I.C. 276 (1949); Catlett v. Sanderson & Porter, 31 O.I.C. 110 (1949); Boisseau v. Boisseau, 31 O.I.C. 97 (1949).

    To be compensable a hernia must be the result of an identifiable movement or action taken at work and arising out of and in the course of employment. Rice v. E.P. Liles Construction Corp., 60 O.I.C. 361 (1981).

    Compensation denied where the evidence failed to establish any identifiable incident occurring on a particular day which resulted in an obvious sudden mechanical or structural change in the body. P & M Construction Co., Inc. v. Heim, Court of Appeals Record #0277-85 (12/18/85).

    It is not necessary that there be an immediate protrusion or visible external knot following the accident, if there was an actual rupture of the abdominal wall such that a hernia would be apparent to a physician making an incision. Maryland Cas. Co. v. Robinson, 149 Va. 307 , 141 S.E. 225 , 1928 Va. LEXIS 367 (1928).

    Mere predisposition to a hernia, such as relaxed rings, malformation, physical weakness or congenital defect is not a bar to compensation benefits. Dixon v. Norfolk S.B. Corp., 182 Va. 185 , 28 S.E.2d 617 (1944); Turner v. Langley Field Post Exchange, 25 O.I.C. 433 (1943); Hayes v. Ford Motor Co., 17 O.I.C. 400 (1935); Moseley v. Robertson Chemical Co., 8 O.I.C. 584 (1926); Stewart v. Wilson Co., 5 O.I.C. 36 (1923).

    A hernia occurring at the site of a previous hernia that had surgically been repaired is not a pre-existing condition. Miller v. Kincheloe, 27 O.I.C. 37 (1945); Atkinson v. Burgess Lumber Co., 20 O.I.C. 166 (1938); Thorton v. Thurston Co., Inc., 18 O.I.C. 222 (1936); Ridge v. Sanitary Grocery Co., 13 O.I.C. 27 (1931).

    Other Injuries:

    Claimant’s dog bite did not arise out of his employment where, while not performing any required job duties, he approached and initiated contact with a chained dog to give him water and pet him. Markham v. C&C Cullet Supply, VWC File No. 213-72-31 (Oct. 27, 2004).

    Compensation benefits were awarded to a claimant who during her regular employment duties was required because of her height to perform an awkward maneuver to place yarn in a cart. Ellis v. Spun Fibers, Inc., 68 O.I.C. 72 (1989).

    The claimant who felt a popping in her neck as she stretched to relieve stiffness attributed to working in one position for an extended period of time was denied compensation benefits on the basis that her injury was not the result of a risk of her employment. Young v. S. L. Nusbaum Insurance Agency, 68 O.I.C. 80 (1989).

    The majority of the Commission held that the claimant’s injury, suffered as he reached into the cab of his truck from the sleeper compartment to shut off an alarm clock, did not arise out of his employment. The evidence did not show that the claimant was in an awkward position or engaged in any extraordinary or unusual exertion. Ralston v. Blizzard Trucking, 74 O.W.C. 54 (1995).

    Extensive effort required to turn a steering wheel on a metro bus made it a hazard peculiar to the work, and the back injury sustained by the driver while engaged in that activity held compensable. Foster v. Washington Metropolitan Area Transit Authority, 62 O.I.C. 172 (1983).

    The claimant was in an awkward position while pushing on the clutch of a UPS package car, which was difficult to shift into third gear. The Commission held that the conditions of the workplace contributed to the claimant’s injury. Jacobs v. United Parcel Service, 76 O.W.C. 247 (1997).

    Compensation benefits were awarded to a bus driver who felt a needle prick in his arm while adjusting a tight overhead mirror with his arm extended. D’Souza v. WMATA, 69 O.I.C. 111 (1990).

    Compensation benefits were denied to an employee who while either reaching across the cab of a truck to retrieve a key from a box in the window of the passenger door or while exiting the vehicle, felt a pop in his left knee followed by a collapse of the knee as he walked across the parking lot. Schrembs v. Casey Buick, 69 O.I.C. 114 (1990).

    Compensation was denied to the claimant whose eye became irritated while checking a computer system. The “corneal abrasion” was not an additional risk of the employment. Eddy v. Norfolk City Fire & Paramedical Services, 73 O.W.C. 74 (1994).

    Compensation benefits were denied to a surveyor who was attacked by dogs as he sketched topography on a city street. Other than his work causing him to be in the location, there was no evidence to connect the employment and the attack. Holmes v. R. Kenneth Weeks Engineers, 73 O.W.C. 77 (1994).

    Also see cases under “Injury By Accident” topic above.

    Psychiatric:

    While supervisor’s touching of claimant’s face and use of vulgar language were unexpected, unwelcome, and troubling to claimant, evidence did not establish that either the state or touching was so outrageous and unusual as to constitute a sudden shock or fright. Chisholm v. Pariser Dermatology Specialists, Ltd., JCN VA02000017447 (Feb. 11, 2015).

    Claimant, a female correctional officer, was found to have sustained a compensable injury after she was grabbed by a nude inmate in a bear hug around her arms, and the inmate later pled guilty to the charge of aggravated sexual battery. Claimant would also have been entitled to compensation for a purely psychological injury, even in the context of a prison environment, because the confrontation by a naked convicted rapist was a sudden shocking or frightening event. Shortridge v. Keen Mountain Correctional Center, JCN VA00000239081 (Feb. 7, 2013).

    Employee’s anxiety disorder not shown to be result of sudden shock or fright and thus did not arise out of employment; bus driver developed anxiety disorder after bus rear-ended; evidence did not show physical injury or emergency, hectic, or chaotic situation caused by accident; accident merely resulted in delay of bus route; psychological condition not compensable. Plese v. Chesapeake Cmty. Serv. Bd., VWC File No. 207-65-77 (Mar. 17, 2003).

    A nervous condition resulting from a sudden fright or shock may be compensable despite the lack of physical impact. However, psychological disabilities resulting from the stressful consequences of managerial decisions, or from conflicts with supervisors, are ordinarily not compensable. Akers v. Bell Atlantic, 75 O.W.C. 301 (1996).

    Compensation benefits were awarded to an employee who, after spraying insecticides into his face and eyes, subsequently developed a panic attack disorder. Emotional harm following physical injury is compensable even when the physical injury does not directly cause the emotional consequence. Seneca Falls Greenhouse & Nursery v. Layton, 9 Va. App. 482, 389 S.E.2d 184, 6 Va. Law Rep. 1393, 1990 Va. App. LEXIS 32 (1990).

    Compensation continued to an employee, who was found able to perform his pre-injury employment from a physical standpoint but who, because of a psychiatric condition related to the industrial accident, was unable to return to gainful employment. Bowers v. Earl’s Market, 63 O.I.C. 27 (1984).

    Employer found responsible for the cost of psychiatric treatment on finding that the claimant’s traumatic neurosis was causally related to her industrial accident. Gentry v. City of Richmond, 62 O.I.C. 188 (1983).

    OTHER.

    Compensable Consequence:

    It is unreasonable to conclude that degeneration of an injury, or the failure of an injury to heal, is a non-compensable consequence where it results from an employer’s failure to authorize or provide recommended medical treatment as required by the Workers’ Compensation Act. Hall v. Campbell County School Board 26, JCN VA00000189503 (Aug. 29, 2013).

    To apply the consequence of a consequence analysis to medical treatment for the initial injury would dramatically limit the medical treatment available to a claimant for his compensable injury. This would conflict with the claimant’s entitlement under the Act to reasonable and necessary medical treatment related to the compensable injury. Sychev v. S K A Construction, LLC, VWC File No. 228-36-59 (Apr. 14, 2011).

    The claimant’s depression that developed from pain relating to injuries incurred in a work accident is a compensable consequence of the original injury and as such is a change of condition governed by § 65.2-708 which requires that a claim be filed within two years from the date compensation was last paid pursuant to an award. Brown v. Ruby Tuesday’s Inc., VWC File No. 215-94-55 (June 11, 2007), On remand deputy commissioner on Oct. 19, 2007 found for claimant. By March 6, 2008 review opinion the commission affirmed.

    Dental problems that result from medication prescribed for the industrial accident are a compensable consequence and the responsibility of the employer. Martin v. Still Water, Inc., VWC File No. 152-51-72 (May 17, 2007).

    Injuries sustained in a motor vehicle accident while going to a medical appointment for the work injury are a compensable consequence of the industrial accident. Jones v. Checkered Flag Toyota, VWC File No. 220-84-93 (Jan. 26, 2007).

    Where a compensable work accident resulted in a fusion at L5-S1 and claimant subsequently felt a loud “pop” while sitting, the resulting disc herniation at L4-5 is a compensable consequence of the original injury rather than a new accident because the fusion resulted in a weakening at the L4-5 level. Gaskins v. W. L. McKendree & Company, Inc., VWC File No. 214-82-19 (Sept. 26, 2006).

    In awarding permanent total benefits it was found that the claimant’s brain injury was a compensable consequence of his work injury. While there was no physical trauma to the brain, structural changes as a result of histoplasmosis altered brainwave activity and caused a loss of brain function. Heller v. Powhatan Correctional Center/Commonwealth of Va., VWC File No. 174-73-32 (July 19, 2006).

    In awarding permanent total benefits it was found that the claimant’s brain injury was a compensable consequence of his work injury. While there was no physical trauma to the brain, structural changes as a result of histoplasmosis altered brainwave activity and caused a loss of brain function. Heller v. Powhatan Correctional Center/Commonwealth of Va., VWC File No. 174-73-32 (July 19, 2006).

    The Act does not require that a compensable consequence meet the definition of an injury by accident in order to be compensable. Where there is a direct causal connection to the original accidental injury, a subsequent problem caused by repetitive trauma may be a compensable consequence. Frazier v. Infineon Technologies, VWC File No. 218-88-98 (Feb. 6, 2006).

    Claimant’s back pain was a compensable consequence of his left knee injury where the medical evidence showed that the knee injury exacerbated the pre-existing back condition due to claimant’s altered gait and use of crutches. Mason v. Crown Cork & Seal Co., VWC File No. 201-25-94 (Sept. 8, 2004).

    Employee’s atrial fibrillation found to be compensable consequence of injury to left third finger; although medical evidence in conflict, preponderance of medical evidence showed that finger injury to employee, who suffered from heart condition, caused onset of episode of atrial fibrillation. Fuller v. Meadow Creek Wood Shop, VWC File No. 211-18-55 (Jan. 21, 2004).

    Gradually incurred compensable consequence not subject to notice and limitations provisions of § 65.2-601 ; employee gradually developed right-foot condition as a result of off-loading weight onto right foot because of original left-foot injury; claim for right foot not time-barred by § 65.2-601 but timely under § 65.2-708 . Field v. American Red Cross, VWC File No. 198-54-11 (Mar. 10, 2003).

    Where a causal relationship between an initial compensable injury and a subsequent injury is established, the doctrine of compensable consequences provides that the subsequent injury is considered to have arisen out of and in the course of the employee’s employment. Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    When primary injury arose out of and in course of employment, every natural consequence flowing from the injury likewise arises out of employment. Speight v. Gen. Tire of Norfolk, Inc., 48 O.I.C. 227 (1966).

    Where a compensable injury is a contributing cause of a subsequent injury or disability, the subsequent injury is a compensable consequence of the original injury. The employer is responsible for psychiatric treatment necessitated by a compensable industrial accident. Palmer v. City of Roanoke Emergency Services, 70 O.I.C. 147 (1991).

    An employee who developed occupational right arm epicondylitis from assembly line employment and later developed left arm symptoms while performing clerical work for a subsequent employer suffered a compensable consequence. The first employer was responsible for the payment of benefits because the over utilization of the left arm was necessary to provide relief to the injured right arm. Collins v. Allied Bendix Corporation, 69 O.I.C. 116 (1990).

    To prove a compensable consequence between an ankle injury and a shoulder condition, the evidentiary standard is a reasonable medical probability and not a reasonable degree of medical certainty. Elliott v. Blue Ridge Stone Corp., 71 O.W.C. 138 (1992).

    The employee’s bilateral carpal tunnel syndrome was found to be a compensable consequence of her industrial accident which necessitated the use of a walker or crutches. Medical evidence that the wrist condition was “probably” caused by the use of the ambulatory aids was sufficient to establish compensability. Alls v. American Balance Corp., 71 O.W.C. 141 (1992).

    For the purpose of establishing the compensability of a subsequent injury, the doctrine of compensable consequences applies to both an aggravation of a previously compensable injury and a new injury. If the subsequent injury is a new injury the provisions of § 65.1-87 (now § 65.2-601 ) are applicable with the limitations period commencing from the date of the new injury. If the subsequent injury is a change in condition the limitations period of § 65.1-99 (now § 65.2-708 ) are applicable. Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    Where an employee’s severe injury and its consequences directly caused him to become devoid of normal judgement and to be dominated by a disturbance of the mind which led to suicide, a claim by his dependents was found to be compensable. The post-injury suicide was held to be a change in condition and not a new accident. Confer v. Arban & Carosi, Inc., 63 O.I.C. 66 (1984).

    A new accident as a compensable consequence does not extend the maximum period of 500 weeks for total incapacity. Williams v. General Heating & Engineering Co., Inc., 67 O.I.C. 105 (1988).

    Where an accident at work is direct cause of a second accident en route home, the second accident is held to have arisen out of and in course of employment. Miller v. Wilson Laurel Farms, Inc., 52 O.I.C. 178 (1970); Smith v. Va.-Car. Hardware Co., 36 O.I.C. 145 (1954).

    If the second accident occurs during recreational activity not connected with employment, it is compensable where a fracture, not completely healed, is again broken at same site. Cockerille v. Va. Elec. & Power Co., 45 O.I.C. 34 (1963).

    Fractured ankle in fall at home, resulted from vertigo caused by previous skull fracture. Fleming v. Capital City Constr. Corp., 47 O.I.C. 120 (1965).

    Death from fall while using crutches and wearing leg brace necessitated by accident was compensable. Glenn v. Goodman Bros., 52 O.I.C. 110 (1970).

    Injuries are compensable when incurred in travel to and from medical appointments for industrial injury. Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254; Griffin v. Gen. Elec. Co., 49 O.I.C. 135 (1967).

    Aggravating effects of re-exposure to causative agent of dermatitis is not new accident. Hawkeye-Security Ins. Co. v. McDaniel, 210 Va. 209 , 169 S.E.2d 582; Durham v. Walker Mach. & Foundry Co., 52 O.I.C. 90 (1970); McDaniel v. Folker, 49 O.I.C. 201 (1967).

    Where second accident is not related to first, though both result in back injuries, compensation prorated between the two employers. Brunk v. Anning-Johnson Co., Inc., 48 O.I.C. 21 (1966) (appeal denied).

    Both accidents caused incapacity; both employers must pay. Freeman v. Va. Hauling Co., 49 O.I.C. 108 (1967).

    Medical sequelae of a primary injury are compensable as a compensable consequence, and the employer is liable for gastrointestinal problems resulting from medications prescribed for the work injury. Cox v. Hensel Phelps Construction Company, 74 O.W.C. 204 (1995).

    An employer is responsible for every natural consequence that flows from the injury unless it is the result of the claimant’s intervening intentional conduct. The employer is responsible for treatment of the claimant’s diabetes aggravated by epidural steroid injection treatment of the work injury. Smith v. Holdren’s, Inc., 74 O.W.C. 94 (1995).

    Where noncompensable injury aggravates condition resulting from earlier compensable injury and causes additional disability as well, employer is liable for that portion of the most recent medical treatment which can be attributed to exacerbation of the compensable injury. Smith v. Fine’s Men’s Shop, 60 O.I.C. 414 (1981).

    Presumption:

    The death presumption does not apply where a person is unable to recall the accident and dies a day later. Tweed v. Newport News Shipbuilding & Dry Dock, VWC File No. 227-87-41 (June 26, 2007).

    Presumption applied in the following cases: Long distance truck driver found in light well beneath third story window of hotel room provided by employer, met his death by accidental means, within the period of employment, at a place where he might reasonably be expected to be, and while reasonably fulfilling duties of his employment. Alvis v. Southern Motor Lines, 200 Va. 168 , 104 S.E.2d 735 (1958); Lamm v. Ocean View, etc., 57 O.I.C. 220 (1976). Service station employee. Rasnake v. Kayo Oil Co., 57 O.I.C. 298 (1976). Insurance agent. Robeson v. Metropolitan Life Insurance Co., 58 O.I.C. 307 (1979).

    Presumption applied in case of service station attendant working graveyard shift, killed while performing his duties. Jenkins v. Howser’s Esso, 54 O.I.C 185 (1972).

    The presumption that an injury “arose out of ” the employment only applies in death cases. It is inapplicable to cases where an employee because of the severity of the injuries is unable to recall the circumstances surrounding an accident. Pinkerton's, Inc. v. Helmes, 242 Va. 378 , 416 S.E.2d 646 (1991).

    The presumption in death cases that certain unexplained accidents arise out of the employment does not extend to an accidental injury case where an employee is rendered unconscious and, as a result, is unable to explain the accident. An unexplained fall is generally not compensable because the “critical link” between the employment and the accident cannot be made. Phansond v. Alexandria Hospital, 76 O.W.C. 379 (1997).

    Where employee is found unconscious as result of accidental injury at a place where his employment reasonably required him to be and death ensues before consciousness is regained, in the absence of evidence to the contrary, it will be presumed the accidental injury arose out of and in course of employment. Wills v. Rountree, 40 O.I.C. 168 (1958) (appeal denied). See also Keil v. K&G Abatement Company, VWC File No. 194-66-72 (December 19, 2001).

    There is no basis to find an unexplained accident which would give rise to the presumption that death arose out of the employment when the evidence is unclear whether a death resulted from an exertion over an extended period or from a pre-existing heart condition unrelated to specific exertion. Hall v. John T. Williams Association, Inc., 70 O.I.C. 107 (1991).

    While finding that evidence of a non-work related motive precluded the application of the presumption to an employee who was fatally assaulted by an unknown assailant in an area of a hotel frequented by vagrants and drifters, the Court awarded benefits on a rational inference that the death arose out of and in the course of the employment. Thomas Nelson Limited Partnership v. Fritz, 11 Va. App. 269, 397 S.E.2d 891, 7 Va. Law Rep. 696, 1990 Va. App. LEXIS 190 (1990).

    General:

    The claimant, a registered nurse, had a positive reaction to a tuberculin skin test, which test was required and provided by her employer. Although further tests revealed no evidence of clinical TB, her physician prescribed prophylactic treatment, and excused her from work while taking it. While the claimant proved an injury by accident (the tuberculin test and resulting reaction), there was no evidence that she received specific treatment causally related to the skin reaction. Claimant’s disability was related to preventive treatment, which was not the responsibility of the defendants. Lambert v. Livinrite Home Health Services, JCN VA00000520302 (Oct. 10, 2013).

    Intervening exacerbation of symptoms not considered new compensable injury by accident, but a compensable change in condition; employee suffered neck and shoulder strain in 1997 and suffered an exacerbation of symptoms in 2002 from lifting at work; Commission determined that 2002 exacerbation not new injury by accident; although incident shown to be sudden and identifiable, it was not shown to result in mechanical or structural change in body, but only mere increase of symptoms. Willis v. Stafford County Sch. Bd., VWC File No. 188-88-41 (Oct. 9, 2003).

    The question of causation between an incident and the injury is essentially a medical issue that is usually resolved by reference to medical reports. Burcham v. Kelly Services, Inc., 77 O.W.C. 50 (1998).

    Where incapacity or death results from a disease caused by physical injury, whether the injury does so by weakening the resistance to the extent that the worker contracts the disease or by rendering active an undeveloped or quiescent condition the incapacity will be compensated. Where an apparently healthy worker received an injury and immediately thereafter becomes incapacitated, in the absence of positive affirmative evidence tending to establish a break in the chain of causation, the conclusion will be that the incapacity resulted from the injury. Justice v. Panther Coal Co., Inc., 173 Va. 1 , 2 S.E.2d 333, 1939 Va. LEXIS 170 (1939); Bristol Builders Supply Co. v. McReynolds, 157 Va. 468 , 162 S.E. 8 , 1932 Va. LEXIS 306 (1932); Winchester Milling Co. v. Sencindiver, 148 Va. 388 , 138 S.E. 479 , 1927 Va. LEXIS 238 (1927).

    Where the attending physician does not know what caused the disability, or where it is merely possible that incapacity might have been caused by trauma, claimant has not sustained the burden of proof. Trillhaase v. Univ. of Rochester, 52 O.I.C. 256 (1970).

    When it is proven that the claimant’s employment is one of two factors contributing to his disability, full benefits will be allowed. Bergman v. L & W Drywall, 222 Va. 30 , 278 S.E.2d 801, 1981 Va. LEXIS 267 (1981).

    “Possibility” that cancer was result of accident is not enough. Scott v. Ford Motor Co., 49 O.I.C. 295 (1967).

    Where decedent’s ruptured aneurism either caused fall or resulted from fall, evidence raises mere possibility of causal connection and is not sufficient to produce compensable claim. Eaton v. Clinchfield Coal Co., 60 O.I.C. 149 (1981).

    In determining whether the incapacity for work is caused by an injury in the employment, medical testimony is important. Cataract was caused by severe blow to eye by piece of wood. Blackwell v. Miller Mfg. Co., Inc., 49 O.I.C. 23 (1967).

    Pre-existing Condition Aggravated by Accident:

    Evidence persuasively established that work accident wherein claimant injured his right hip aggravated his pre-existing psychiatric problems. Hearn v. Maryland & Virginia Milk Producers Corp., VWC File No. 208-75-26 (Dec. 21, 2004).

    When it appears an employee has received a compensable physical injury which materially aggravated or accelerated a pre-existing disease, which disease thereupon became the direct and immediate cause of disability or death, causal connection between the injury and disability has been established. Ohio Valley Construction Co. v. Jackson, 230 Va. 56 , 334 S.E.2d 554 (1985); Ellis v. Commonwealth, 182 Va. 293 , 28 S.E.2d 730 (1944); Liberty Mutual Ins. Co. v. Money, 174 Va. 50 , 4 S.E.2d 739 (1939); Justice v. Panther Coal Co., 173 Va. 1 , 2 S.E.2d 333 (1939); Berry v. Royster Guano Co., 161 Va. 442 , 171 S.E. 519 (1933); Pendleton v. Flippo Construction, Inc., 1 Va. App. 381, 389 S.E. 210 (1986); Davis v. Glebe Auto Market, 55 O.I.C. 120 (1973); Cutler v. Hoy, 57 O.I.C 98 (1976); Jenkins v. Merit Oil Corp., 59 O.I.C. 153 (1980); Smith v. The Richards Corp., 59 O.I.C. 280 (1980).

    If the exertion from employment can be shown to have actually resulted in the sudden and obvious injury to the employee regardless of a predisposing physical weakness or condition, the disability is compensable. Compensation was awarded where the claimant, who was operating a front-end loader over uneven terrain, experienced pain at a particular point in time which intensified during the day. Jewell Ridge Coal Corp. v. McGlothlin, 2 Va. App. 294, 343 S.E.2d 94, 1986 Va. App. LEXIS 271 (1986).

    Since the employer takes the employee as he finds him, it is of no moment whether he finds him predisposed to injury by disease, or predisposed to further injury as a result of a prior injury. Bragg v. Lynchburg-Westover Dairies, Inc., 49 O.I.C. 35 (1967); Everett v. Rubino & Farris, Inc., 44 O.I.C. 69 (1962).

    The fact that the worker suffered from a chronic ailment, rendering the effects of an accident more injurious than they would have been to an ordinary person, will not defeat a claim for compensation. Liberty v. Mutual Ins. Co. v. Money, 174 Va. 50 , 4 S.E.2d 739 (1939); Williams v. Coal Processing Co., 51 O.I.C. 294 (1969); Stacy v. Jake Hollow Coal Co., 41 O.I.C. 134 (1959).

    An injury by accident that materially aggravates or accelerates a pre-existing condition is compensable. While the claimant’s condition may also have been aggravated by other non-work related factors such as snow shoveling and dog walking, it is clear that the claimant’s work injury contributed to his worsened condition, his need for surgery, and his subsequent disability. Under the “two causes” rule, where disability and resulting treatment has two causes, one related to the employment and the other not, benefits will be awarded when it is proven that the employment is a contributing factor to the disability. Wong v. New View Electrical, Inc., 79 O.W.C. 120 (2000).

    The fact that the claimant had preexisting back problems is immaterial and not a sufficient defense to liability, where the claimant had not received treatment for his back since July 1992 and had been able to perform regular work until the accident. Campbell v. Buffalo Air Handling, 74 O.W.C. 82 (1995).

    If the accident accelerates or aggravates a pre-existing condition, the injured worker is entitled to compensation. On the other hand, an injury due solely to the natural progress of the pre-existing condition is not compensable. Burcham v. Kelly Services, Inc., 77 O.W.C. 50 (1998).

    Where a finding is made that minor trauma sustained at work did not aggravate or precipitate disabling complaints from pre-existing tumor, no award can be made. Piver v. City of Norfolk, 57 O.I.C. 293 (1976).

    Claimant who had a cataract extraction was awarded benefits resulting from detached retina due to work activity of lifting. Crawford v. Miles Southeastern Corp., 56 O.I.C. 79 (1975).

    Benefits awarded where hemangioma was congenital but trauma caused it to become symptomatic. Rose v. Star Band Co., Inc., 51 O.I.C. 233 (1969).

    Accident aggravated idiopathic aseptic neurosis of hip joints, contributing cause for surgery. Davis v. Glebe Auto Market, 55 O.I.C. 120 (1973).

    Back injury superimposed on pre-existing systemic lupus erythematosus and rheumatoid arthritis, death resulted from accident. Crocker v. Suffolk Oil Co., Inc., 56 O.I.C. 81 (1975) (affd on review).

    Medication for original injury aggravated gastrointestinal system, resulting in ulcer. Austin v. Prince William Answering Service, 58 O.I.C. 9 (1971).

    Medical sequelae of a primary injury are compensable as a compensable consequence, and the employer is liable for gastrointestinal problems resulting from medications prescribed for the work injury. Cox v. Hensel Phelps Construction Company, 74 O.W.C. 204 (1995).

    An employer is responsible for every natural consequence that flows from the injury unless it is the result of the claimant’s intervening intentional conduct. The employer is responsible for treatment of the claimant’s diabetes aggravated by epidural steroid injection treatment of the work injury. Smith v. Holdren’s, Inc., 74 O.W.C. 94 (1995).

    Benefits awarded where Buerger’s disease (thromboangiitis obliterans) aggravated by exposure to cold temperatures beyond exposure of general public resulting in amputation of leg. Nellum v. Phelps, 53 O.I.C. 231 (1971).

    Pre-existing Condition Caused Accident:

    Where worker’s infirmity causes the initial accident, compensation will be awarded if it appears that some aspect of employment entered the causal chain to make consequences more serious than they would otherwise be. Thus, a fall by employee into a tank of water, or down a flight of stairs is compensable, even though worker’s disease caused the fall. However, an idiopathic fall on a level floor is not compensable, unless the employment environment increases the hazard of the fall. Harris v. Jayen Co., 44 O.I.C. 115 (1962); Breeden v. Town of Culpeper, 57 O.I.C. 49 (1976); Rorrer v. Bassett Furniture Co., 37 O.I.C. 273 (1955).

    Where injuries following the fall are more severe than they might have been had worker suffered an attack at home or any other place not connected with the employment, compensation will be allowed. Tolker v. B & G Olsen, 50 O.I.C. 318, 320 (1968).

    Distinction between unexplained falls and idiopathic falls is discussed in the following cases:.Lester v. Lebanon Shell Station, 49 O.I.C. 186 (1967); Glascock v. Nash Street Associates, 49 O.I.C. 132 (1967); Solyan v. Harrison Tire Co., 44 O.I.C. 252 (1962); Akers v. Va. etc., Mills, 57 O.I.C. 1 (1975); Hill v. Boulevard Supermarket, 59 O.I.C. 125 (1980); PYA/Monarch v. Harris, 22 Va. App. 215, 468 S.E.2d 688, 1996 Va. App. LEXIS 221 (1996).

    Cause of accident may be disregarded if injuries would not have occurred except for the employment. Price v. Thalhimer Bros., Inc., 51 O.I.C. 219 (1969); Hicks v. Hercules Powder Co., 49 O.I.C. 151 (1967); Causey v. Bonnie Enterprises, Inc., 49 O.I.C. 60 (1967); Delawder v. Byrd, Inc., 45 O.I.C. 67 (1963).

    Epileptic seizures known to employer; employment required working at heights. Huntington v. Moses E.C.C.O., 47 O.I.C. 177 (1965).

    In denying benefits for the employee’s aneurysm which resulted in an auto accident, the Court held that “evidence that shows a mere possibility that the accident resulted from an employment related aggravation of an idiopathic condition does not constitute ‘credible evidence’ to support an award of compensation. The evidence failed to establish that a condition of the employment aggravated or caused the aneurysm.” Virginia Department of Transportation v. Mosebrook, 13 Va. App. 536, 413 S.E.2d 350, 8 Va. Law Rep. 1960, 1992 Va. App. LEXIS 32 (1992).

    Causal Connection Examples:

    Dental problem caused by extensive use of pain medications, including fentanyl, for back injury held causally related to original accident. Wentz v. P & J Automotive, JCN 2039868 (Jan. 28, 2019).

    Claimant’s work unloading a dairy truck was not atypically strenuous and the evidence failed to establish that the claimant’s work caused his fatal heart attack as opposed to the injury simply occurring while the work was being performed. The estate of Dinh v. Giant Food, L.L.C., VWC File No. 227-00-71 (Feb. 11, 2008).

    De Quervains Disease related to accident. Blick v. Southampton Textile Co., 52 O.I.C. 26 (1970).

    Uncommon form of hepatitis contracted during employment. Singer v. Comm. of Va. No. Va. Community College, 58 O.I.C. 326 (1979).

    Employee does not bear burden of proving exactly what caused sudden loud noise at work resulting in acoustic trauma. Wolfe v. Arlington County School Board, 55 O.I.C. 384 (1973).

    Compensation and medical benefits denied for total knee replacement where evidence failed to establish causal relationship to initial compensable ankle injury. Medical report must be filed under Rule 17 (now Rule 4.2) and is not, as alleged, a work product. Hughes v. Goodyear Tire & Rubber Co., 60 O.I.C. 219 (1981).

    Disability caused by medication for a cold, supplied by employer, taken on advice of employer’s nurse was compensable. Camp v. Miller & Rhoads, Inc., 55 O.I.C. 68, 73 (1973).

    Complications resulting from anesthesia for removal of pin from hip, causally connected with accident. Duncan v. Smith Bowman Distillery, Inc., 46 O.I.C. 74 (1964).

    In awarding benefits the Commission found disablity as a result of a splinter incident at work triggering dermatitis from the medication or reaction to materials exposed to while performing duties. Vaughn v. American Furniture Co., Inc., 53 O.I.C. 363 (1971).

    Compensation for partial disability was awarded when tetanus antitoxin for injury caused serum sickness and rheumatoid arthritis. Wilson v. Leggett’s Dept. Store, 50 O.I.C. 346 (1968).

    Where claimant was efficient, competent employee prior to accident and subsequently suffered anxiety neurosis, proximately caused by accident, which condition caused him to be unable to perform his duties, compensation was awarded. Minton v. Washington County Board of Supervisors, 40 O.I.C. 94 (1958); Evans v. City of Fredericksburg, 40 O.I.C. 46 (1958); Jordan v. Sunrise Coal Co., 57 O.I.C. 207 (1977).

    Psychiatric care for depression following traumatic amputation of both hands was compensable. Weisz v. Murry’s Steaks, Inc., 49 O.I.C. 330 (1967).

    Thrombophlebitis was found to be causes by a compensable accident in the following cases:.Watkins v. Martinsville City School Board, 46 O.I.C. 245 (1964); Vaughan v. Scott County School Board, 44 O.I.C. 267 (1962); Satterfield v. Burton Co., Inc., 41 O.I.C. 123 (1959); Moore v. Consumer Auto Services t/a Value Rent-A-Car, 58 O.I.C. 249 (1979).

    Where claimant had a pre-existing osteoarthritic condition which was aggravated by trauma and while in traction developed thrombophlebitis, this condition was brought about by type of treatment rendered for traumatic injury and therefore compensable. Stacy v. Jake Hollow Coal Co., 41 O.I.C 134 (1959).

    Hip and knee injuries compensable due to accidental fall but extended disability due to back injury is not related since medical evidence reveals prior degenerative disc disease. Spence v. City of Virginia Beach, Police-Animal Control, 60 O.I.C. 416 (1981).

    Absent evidence that unwitnessed blow to leg materially aggravated pre-existing phlebitic condition which led to fatal embolism, claim for death benefits must fail. Lucas v. Eccon Construction Company, 60 O.I.C. 292 (1981).

    MISREPRESENTATION.

    Claimant’s failure to indicate a felony conviction on application did not bar compensation because there was no causal relationship to the accident. Prince William County Service Authority v. Harper, 25 Va. App. 166, 487 S.E.2d 246, 1997 Va. App. LEXIS 441 (1997), aff'd, 256 Va. 277 , 504 S.E.2d 616, 1998 Va. LEXIS 105 (1998).

    To successfully establish the defense of fraudulent misrepresentation and bar a claim for compensation benefits, an employer must prove that (1) the employee knew that the representation was false; (2) the employer relied upon the false misrepresentation; (3) such reliance resulted in the consequent injury; and (4) there is a causal relationship between the injury in question and the false representation. Bringas v. Immer Drywall Co., Inc., 76 O.W.C. 172 (1997).

    Benefits for accident otherwise compensable will be denied if material misrepresentations as to his physical condition (back injury) are made by prospective employee to prospective employer and employment is afforded on basis of misrepresentations to detriment of employer. Hawkins v. Lane Co., 49 O.I.C 144 (1967); Alexander v. W. N. Jackson Co., 55 O.I.C. 1 (1973); Dobbins v. Contractors Equipment & Supply Co. (appeal denied), 58 O.I.C. 104 (1979); Zook v. Maline & Hyde, Inc., 58 O.I.C. 373 (1979); Bembury v. Newport News Shipbuilding & Dry Dock Co. (appeal denied), 58 O.I.C. 15 (1979); Burke v. Alfred Teves, Inc., 59 O.I.C. 43 (1980).

    The claimant’s misrepresentations related to prior claims, work restrictions, medication, and physical condition. Her accident did not involve lifting, and she was physically able to perform her job prior to the accident, when cases of beer fell on her. Any physical limitations which the claimant previously had, or from which she suffered, did not contribute to her accident, and the injuries sustained did not aggravate her preexisting condition. In this case, no causal connection between the misrepresentation and the injury was shown. Young v. Service Distributing, Inc., 77 O.W.C. 72 (1998).

    The causal connection between the misrepresentation and the subsequent accident is shown if the injury is to the same part of the body to which the misrepresentation relates, or where the misrepresentation relates to a qualification for the position. Harper v. Prince William Co. Service Auth., 75 O.W.C. 361 (1996).

    While the general rule is that a material misrepresentation must be shown to bear some causal connection with the industrial accident, a willful misrepresentation may be found where an employee failed to advise the employer of a previous conviction of a felony because State law would have precluded him from being hired as a security guard. Richards v. Central Security Bureau, Inc., 71 O.W.C. 187 (1992).

    An employee’s failure to note previous back pain as a result of a kidney problem on a job application did not bar recovery under the Workers’ Compensation Act for a subsequent back injury because the misrepresentation was not causally connected to the latter injury. Grimes v. Shenandoah Valley Press, 12 Va. App. 665, 406 S.E.2d 407, 7 Va. Law Rep. 2956, 1991 Va. App. LEXIS 143 (1991).

    Willful concealment of truth constitutes fraud just as much as willful utterance of a falsehood. Partlow v. City of Alexandria, 53 O.I.C. 247 (1971), (disease incurred in childhood concealed on application for employment); Abernathy v. Union Envelope Co., 51 O.I.C. 1 (1969), (previous injury of wrist not disclosed but questionable whether it would have resulted in denial of employment).

    The defense of misrepresentation on an employment application may be raised at the time of an original application or after an award for compensation has been entered. Wishon v. Williams Power Corporation, 69 O.I.C. 76 (1990).

    Where the employer alleges misrepresentation on an employment application, the employer is not limited to learning whether the employee had a felony conviction, but may inquire as to how they relate to the position for which the employee applied. Harper v. Prince William Co. Service Auth., 75 O.W.C. 361 (1996).

    A claimant who supplied a false social security number and misrepresented on his employment application that he was legally eligible for employment in the United States forfeited his right to receive compensation benefits. Bilbao v. Dee Shoring Company, Inc., 66 O.I.C. 53 (1987).

    Where the employee misrepresents his immigration status and provides a false social security number to the employer, which is not revealed to the employer until after the accident, the employer is absolved from providing workers’ compensation benefits. Bringas v. Immer Drywall Co., Inc., 76 O.W.C. 172 (1997).

    An employer was at his own risk when he hired an illegal alien without obtaining sufficient documentation. The claimant’s providing of a false Social Security number was not sufficient misrepresentation to defeat the claim. Ramallo v. Fisher & Stachen, Inc., 68 O.I.C. 117 (1989).

    OPINIONS OF THE ATTORNEY GENERAL

    Covid-19. —

    If a first responder becomes ill from COVID-19 from an exposure at work, it is likely a compensable illness under the Workers’ Compensation Act. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    If COVID-19 is an upper respiratory disease, it falls under the heart and lung presumption of the Act for first responders, however the statutory presumption applies only to a limited class of first responders under certain circumstances and, therefore, would not have broad applicability to all or most of the first responders whose official duties regularly place them at far greater risk of contracting COVID-19 than the general public following social distancing guidelines. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A first responder who has the benefit of a presumption, has the initial burden of producing evidence to trigger the presumption (evidence of the disease, and evidence of disability or death caused by the disease); once the presumption is triggered, the burden shifts to the employer to rebut the presumption (that the disease was not caused by the employment and that there is a non-work-related cause). See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    § 65.2-101.1. Certified mail; subsequent mail or notices may be sent by regular mail.

    Whenever in this title the Commission is required to send any mail or notice by certified mail and such mail or notice is sent certified mail, return receipt requested, then any subsequent, identical mail or notice that is sent by the Commission may be sent by regular mail.

    History. 2011, c. 566.

    § 65.2-102. Coverage of firefighters and law-enforcement officers in off-duty capacity.

    1. Notwithstanding any other provision of law, a claim for workers’ compensation benefits shall be deemed to be in the course of employment of any firefighter or law-enforcement officer who, in an off-duty capacity or outside an assigned shift or work location, undertakes any law-enforcement or rescue activity. Nothing in this section shall prohibit an employer from using any defense otherwise available under this title.
    2. For purposes of this section:“Firefighter” means all (i) salaried firefighters, including special forest wardens designated pursuant to § 10.1-1135 , emergency medical services personnel, and arson investigators and (ii) volunteer firefighters and emergency medical services personnel, if the governing body of the political subdivision in which the principal office of such volunteer fire company or volunteer emergency medical services agency is located has adopted a resolution acknowledging such volunteer fire company or volunteer emergency medical services agency as employees for purposes of this title.“Law-enforcement officer” means all (i) members of county, city, town, or authority police departments, (ii) sheriffs and deputy sheriffs, (iii) auxiliary or reserve police and auxiliary or reserve deputy sheriffs, if the governing body of the political subdivision in which the principal office of such auxiliary or reserve police and auxiliary or reserve deputy sheriff force is located has adopted a resolution acknowledging such auxiliary or reserve police and auxiliary or reserve deputy sheriffs as employees for purposes of this title, (iv) members of the State Police Officers’ Retirement System, and (v) members of the Capitol Police as described in § 30-34.2:1.

    History. 1993, c. 719; 2001, c. 330; 2008, c. 109; 2015, cc. 502, 503.

    Cross references.

    As to malicious bodily injury to law-enforcement officers, firefighters, search and rescue personnel, or emergency medical service providers, see § 18.2-51.1 . As to assault and battery of certain officers, etc., see § 18.2-57 . As to persons entitled to vote by absentee ballot, see § 24.2-700 .

    The 2001 amendments.

    The 2001 amendment by c. 330 inserted “including special forest warden designated pursuant to § 10.1-1135 ” in subsection B, in the paragraph defining “Firefighter.”

    The 2008 amendments.

    The 2008 amendment by c. 109, in subsection B, in the paragraph defining “Law-enforcement officer,” added clause (v) and made a related change.

    The 2015 amendments.

    The 2015 amendments by cc. 502 and 503 are identical, in the definition for “Firefighter” in subsection B, substituted “medical services personnel” for “technicians, lifesaving and rescue squad members,” “emergency medical services personnel” for “lifesaving or rescue squad members” and twice substituted “emergency medical services agency” for “lifesaving and rescue squad.”

    Research References.

    Virginia Forms (Matthew Bender). No. 2-1301 Juror Qualification Form.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 8.

    § 65.2-103. Coverage of members of the Virginia National Guard or Virginia Defense Force during response to orders.

    A claim for workers’ compensation benefits shall be deemed to be in the course of employment with the Virginia National Guard or Virginia Defense Force for any member thereof who, reacting to an order to report received while he is outside an assigned shift or work location, undertakes in direct obedience to a lawful military order travel by the most expeditious route to his designated place of state active duty pursuant to §§ 44-54.4, 44-75.1, and 44-78.1. Nothing in this section shall prohibit an employer from using any defense otherwise available under this title.

    History. 2005, c. 223; 2011, cc. 572, 586; 2015, c. 221.

    The 2011 amendments.

    The 2011 amendments by cc. 572 and 586 are identical, and deleted “State” preceding “Defense Force.”

    The 2015 amendments.

    The 2015 amendment by c. 221 substituted “Virginia National Guard or Virginia Defense Force” for “Virginia National Guard, Virginia Defense Force, or naval militia” in the first sentence.

    § 65.2-104. Coverage of first responders in off-duty capacity during state of emergency.

    1. Notwithstanding any other provision of law, if the Governor declares a state of emergency pursuant to the provisions of Chapter 3.2 (§ 44-146.13 et seq.) of Title 44, or any local director of emergency management with the consent of the appropriate local governing body declares an emergency pursuant to § 44-146.16, attributable to an enemy attack, sabotage or other hostile action, resource shortage, or fire, flood, earthquake or other natural cause, a claim for workers’ compensation benefits shall be deemed to be in the course of employment of any first responder who, in response to a lawful order issued pursuant to the state of emergency, travels by the most expeditious route to or from his home or other location outside an assigned shift or work location to or from that shift or work location. Nothing in this section shall prohibit an employer from using any defense otherwise available under this title.
    2. For purposes of this section, “first responder” shall include any person referenced in subdivision 1 l of the definition of “employee” in § 65.2-101 who provides emergency services, during the period that the states of emergency defined in subsection A are in effect.

    History. 2005, c. 429.

    The number of this section was assigned by the Virginia Code Commission, the number in the 2005 act having been § 65.2-103 .

    OPINIONS OF THE ATTORNEY GENERAL

    Covid-19. —

    If a first responder becomes ill from COVID-19 from an exposure at work, it is likely a compensable illness under the Workers’ Compensation Act. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    If COVID-19 is an upper respiratory disease, it falls under the heart and lung presumption of the Act for first responders, however the statutory presumption applies only to a limited class of first responders under certain circumstances and, therefore, would not have broad applicability to all or most of the first responders whose official duties regularly place them at far greater risk of contracting COVID-19 than the general public following social distancing guidelines. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A first responder who has the benefit of a presumption, has the initial burden of producing evidence to trigger the presumption (evidence of the disease, and evidence of disability or death caused by the disease); once the presumption is triggered, the burden shifts to the employer to rebut the presumption (that the disease was not caused by the employment and that there is a non-work-related cause). See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    § 65.2-105. Presumption that certain injuries arose out of and in the course of employment.

    In any claim for compensation, where the employee (i) is physically or mentally unable to testify as confirmed by competent medical evidence, (ii) dies with there being no evidence that he ever regained consciousness after the accident, (iii) dies at the accident location or nearby, or (iv) is found dead where he is reasonably expected to be as an employee, and where the factual circumstances are of sufficient strength from which the only rational inference to be drawn is that the accident arose out of and in the course of employment, it shall be presumed the accident arose out of and in the course of employment, unless such presumption is overcome by a preponderance of competent evidence to the contrary.

    History. 2011, cc. 229, 304; 2012, c. 841; 2013, c. 169; 2016, c. 358.

    The 2012 amendments.

    The 2012 amendment by c. 841 substituted “arose out of and was in the course of employment” for “was work related” twice.

    The 2013 amendments.

    The 2013 amendment by c. 169 rewrote the section.

    The 2016 amendments.

    The 2016 amendment by c. 358 inserted the (i) designation and added (ii) through (iv).

    CASE NOTES

    Applicability of presumption. —

    Statutory presumption that an injury was work related was inapplicable to an injured employee’s claim because the statute expressly provided that an employee had to be physically or mentally unable to testify for the presumption that an injury was work related to apply. However, although the employee could not remember what happened or caused the employee’s head injury in an accident at work, the employee was able to testify at a hearing. Rush v. Univ. of Va. Health Sys., 64 Va. App. 550, 769 S.E.2d 717, 2015 Va. App. LEXIS 96 (2015).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    This section is only applicable when a physical or mental condition prevents claimant from testifying under oath. No evidence was presented indicating a physical or mental condition prevented claimant from testifying or understanding the meaning of the oath. The fact that his injury prevented him from recalling how his accident occurred is not sufficient to invoke the presumption afforded by Va. § 65.2-105 . Rosales v. Morelos Constr., Inc., JCN VA02000015866 (Jan. 28, 2015).

    § 65.2-106. Criminal justice training academy trainees.

    1. Notwithstanding any other provision of law, any individual who receives training at a criminal justice training academy established pursuant to Article 5 (§ 15.2-1747 et seq.) of Chapter 17 of Title 15.2 shall not be deemed an employee of the criminal justice training academy. A criminal justice training academy shall have no liability to provide coverage or benefits under this title to any individual receiving training at the academy.
    2. The employer that arranges for an individual to be trained at a criminal justice training academy shall provide coverage and benefits under this title to the individual during the period the individual is receiving training at the academy.

    History. 2013, c. 219.

    § 65.2-107. Post-traumatic stress disorder incurred by law-enforcement officers and firefighters.

    1. As used in this section:“Firefighter” means any (i) salaried firefighter, including special forest wardens designated pursuant to § 10.1-1135 , emergency medical services personnel, and local or state fire scene investigator and (ii) volunteer firefighter and volunteer emergency medical services personnel.“In the line of duty” means any action that a law-enforcement officer or firefighter was obligated or authorized to perform by rule, regulation, written condition of employment service, or law.“Law-enforcement officer” means any (i) member of the State Police Officers’ Retirement System; (ii) member of a county, city, or town police department; (iii) sheriff or deputy sheriff; (iv) Department of Emergency Management hazardous materials officer; (v) city sergeant or deputy city sergeant of the City of Richmond; (vi) Virginia Marine Police officer; (vii) conservation police officer who is a full-time sworn member of the enforcement division of the Department of Wildlife Resources; (viii) Capitol Police officer; (ix) special agent of the Virginia Alcoholic Beverage Control Authority appointed under the provisions of Chapter 1 (§ 4.1-100 et seq.) of Title 4.1; (x) for such period that the Metropolitan Washington Airports Authority voluntarily subjects itself to the provisions of this chapter as provided in § 65.2-305 , officer of the police force established and maintained by the Metropolitan Washington Airports Authority; (xi) officer of the police force established and maintained by the Norfolk Airport Authority; (xii) sworn officer of the police force established and maintained by the Virginia Port Authority; or (xiii) campus police officer appointed under Article 3 (§ 23.1-809 et seq.) of Chapter 8 of Title 23.1 and employed by any public institution of higher education.“Mental health professional” means a board-certified psychiatrist or a psychologist licensed pursuant to Title 54.1 who has experience diagnosing and treating post-traumatic stress disorder.“Post-traumatic stress disorder” means a disorder that meets the diagnostic criteria for post-traumatic stress disorder as specified in the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.“Qualifying event” means an incident or exposure occurring in the line of duty on or after July 1, 2020:
      1. Resulting in serious bodily injury or death to any person or persons;
      2. Involving a minor who has been injured, killed, abused, or exploited;
      3. Involving an immediate threat to life of the claimant or another individual;
      4. Involving mass casualties; or
      5. Responding to crime scenes for investigation.
    2. Post-traumatic stress disorder incurred by a law-enforcement officer or firefighter is compensable under this title if:
      1. A mental health professional examines a law-enforcement officer or firefighter and diagnoses the law-enforcement officer or firefighter as suffering from post-traumatic stress disorder as a result of the individual’s undergoing a qualifying event;
      2. The post-traumatic stress disorder resulted from the law-enforcement officer’s or firefighter’s acting in the line of duty and, in the case of a firefighter, such firefighter complied with federal Occupational Safety and Health Act standards adopted pursuant to 29 C.F.R. 1910.134 and 29 C.F.R. 1910.156;
      3. The law-enforcement officer’s or firefighter’s undergoing a qualifying event was a substantial factor in causing his post-traumatic stress disorder;
      4. Such qualifying event, and not another event or source of stress, was the primary cause of the post-traumatic stress disorder; and
      5. The post-traumatic stress disorder did not result from any disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action of the law-enforcement officer or firefighter.Any such mental health professional shall comply with any workers’ compensation guidelines for approved medical providers, including guidelines on release of past or contemporaneous medical records.
    3. Notwithstanding any provision of this title, workers’ compensation benefits for any law-enforcement officer or firefighter payable pursuant to this section shall (i) include any combination of medical treatment prescribed by a board-certified psychiatrist or a licensed psychologist, temporary total incapacity benefits under § 65.2-500 , and temporary partial incapacity benefits under § 65.2-502 and (ii) be provided for a maximum of 52 weeks from the date of diagnosis. No medical treatment, temporary total incapacity benefits under § 65.2-500 , or temporary partial incapacity benefits under § 65.2-502 shall be awarded beyond four years from the date of the qualifying event that formed the basis for the claim for benefits under this section. The weekly benefits received by a law-enforcement officer or a firefighter pursuant to § 65.2-500 or 65.2-502, when combined with other benefits, including contributory and noncontributory retirement benefits, Social Security benefits, and benefits under a long-term or short-term disability plan, but not including payments for medical care, shall not exceed the average weekly wage paid to such law-enforcement officer or firefighter.
    4. No later than January 1, 2021, each employer of law-enforcement officers or firefighters shall (i) make peer support available to such law-enforcement officers and firefighters and (ii) refer a law-enforcement officer or firefighter seeking mental health care services to a mental health professional.
    5. Each fire basic training program conducted or administered by the Department of Fire Programs or a municipal fire department in the Commonwealth shall provide, in consultation with the Department of Behavioral Health and Developmental Services, resilience and self-care technique training for any individual who begins basic training as a firefighter on or after July 1, 2021.

    History. 2020, cc. 1206, 1262.

    Editor’s note.

    At the direction of the Virginia Code Commission, “Department of Wildlife Resources” was substituted for “Department of Game and Inland Fisheries” in subsection A to conform to Acts 2020, c. 958.

    Chapter 2. Virginia Workers’ Compensation Commission.

    § 65.2-200. Industrial Commission continued as the Virginia Workers’ Compensation Commission; number, election and terms of members; vacancies; Chairman; members to devote entire time to office.

    1. The Industrial Commission of Virginia is continued and shall hereafter be known as the Virginia Workers’ Compensation Commission. All powers and duties conferred and imposed upon the Industrial Commission by any other law are hereby conferred upon and vested in the Virginia Workers’ Compensation Commission.
    2. The Commission shall consist of three members, one of whom shall be chosen by the joint vote of the two houses of the General Assembly convened in an even-numbered year, and who shall serve for terms of six years.
    3. Whenever a vacancy in the Commission occurs or exists when the General Assembly is in session, the General Assembly shall elect a successor for the unexpired term. If the General Assembly is not in session, the Governor shall forthwith appoint pro tempore a qualified person to fill the vacancy for a term ending thirty days after the commencement of the next session of the General Assembly, and the General Assembly shall elect a successor for the unexpired term.
    4. Not more than one member of the Commission shall be a person who on account of his previous vocation, employment or affiliation shall be classified as a representative of employers, and not more than one such appointee shall be a person who on account of his previous vocation, employment or affiliation shall be classed as a representative of employees. The Commission thus composed shall elect one of its number chairman for a term of three years commencing on July 1, 1979, and each succeeding three years thereafter. Each member of the Commission shall devote his entire time to the duties of his office and shall not hold any position of trust or profit or engage in any occupation or business interfering or inconsistent with his duties as such member.

    History. Code 1950, § 65-9; 1954, c. 233; 1968, c. 660, § 65.1-10; 1971, Ex. Sess., c. 70; 1979, c. 459; 1991, c. 355; 2006, c. 838.

    The 2006 amendments.

    The 2006 amendment by c. 838, in subsection B, deleted “during the month of January of each regular session of the General Assembly” following “General Assembly”; and deleted “from the first day of February next succeeding election” following “six years.”

    Law Review.

    For essay, “The Court of Appeals of Virginia Celebrates Thirty Years of Service to the Commonwealth,” see 50 U. Rich. L. Rev. 217 (2015).

    CASE NOTES

    Failure to have full commission hear the review. —

    Decision reviewing the award of benefits to a claimant was reversed on appeal as the Virginia Workers’ Compensation Commission lacked authority to review the employer’s appeal of that decision as a result of having only two out of three statutorily required Commissioners hear the review due to a vacancy existing on the Commission. The employer had not waived the issued since it had raised the same in a motion to reconsider or vacate the decision. Hitt Constr. v. Pratt, 53 Va. App. 422, 672 S.E.2d 904, 2009 Va. App. LEXIS 76 (2009).

    Matter was not heard before a properly constituted full Virginia Workers’ Compensation Commission because only two of the three statutorily authorized commissioners decided it; because the Commission’s authority is a matter of legislative prerogative, the Commission is bound by the plain meaning of the words in the Workers’ Compensation Act, and § 17.1-327 , which fail to provide the authority to recall or designate a retired commissioner to serve in a review proceeding. Layne v. Crist Elec. Contr., Inc., 62 Va. App. 632, 751 S.E.2d 679, 2013 Va. App. LEXIS 371 (2013).

    Composition of review panel. —

    Employer failed to support its contention that there was no employer representative because there was no evidence pertaining to the previous vocation, employment or affiliation of the Chief Deputy Virginia Workers’ Compensation Commissioner to determine whether or not he acted as an “employer” representative. McCluster v. Baltazar, 2017 Va. App. LEXIS 308 (Va. Ct. App. Dec. 5, 2017).

    Composition of the Virginia Workers’ Compensation Commission review panel was proper because the mechanism provided in subsection D of § 65.2-705 , was triggered since one commissioner was absent, and thus, the chairman appointed a deputy commissioner to the review panel, which consisted of two commissioners and one deputy commissioner; because a majority of commissioners existed, a quorum was achieved, and the review panel was authorized to take judicial, legislative, and discretionary action. McCluster v. Baltazar, 2017 Va. App. LEXIS 308 (Va. Ct. App. Dec. 5, 2017).

    Prior affiliation of a deputy commissioner appointed to serve on a review panel is irrelevant as to whether the panel was properly constituted. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Language of both subsection D of § 65.2-705 and subsection D of § 65.2-200 is clear and unambiguous. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Under the plain language of subsection D of § 65.2-705 , the statute only requires that when a retired member is recalled to serve on a review panel, they must occupy “the seat,” i.e., be of the same classification as the commission member they are replacing; as this portion of the statute plainly refers only to “retired members” of the commission, it does not compel the conclusion that a deputy commissioner, serving by appointment on a review panel, must be of a certain affiliation. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Workers’ Compensation Commission properly found that the composition of the review panel did not contravene the statutory requirement because the chairman of the commission correctly appointed a deputy commissioner to participate in the panel in light of a commissioner’s absence; the deputy commissioner was not and had never been a “retired member” of the commission, and thus, his background as either an employee or employer representative was irrelevant. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    § 65.2-201. General duties and powers of the Commission.

    1. It shall be the duty of the Commission to administer this title and adjudicate issues and controversies relating thereto. In all matters within the jurisdiction of the Commission, it shall have the power of a court of record to administer oath, to compel the attendance of witnesses and the production of documents, to punish for contempt, to appoint guardians pursuant to Part C (§ 64.2-1700 et seq.) of Subtitle IV of Title 64.2, and to enforce compliance with its lawful orders and awards. The Commission shall make rules and regulations for carrying out the provisions of this title.
    2. The Commission may appoint deputies, bailiffs, and such other personnel as it may deem necessary for the purpose of carrying out the provisions of this title.
    3. The Commission or any member thereof or any person deputized by it may for the purposes of this title subpoena witnesses, administer or cause to be administered oaths, and examine or cause to be examined such parts of the books and records of the parties to a proceeding as relate to questions in dispute arising in instances in which the Commission has power to award compensation. This authority shall extend to requests from like agencies of other states who honor similar requests from the Commission.
    4. The Commission shall publish and, upon request, furnish free of charge, such blank forms and literature as it shall deem requisite to facilitate or promote the efficient administration of this title. The Commission shall publish a workers’ compensation guide for employees which informs an injured employee of his rights under this title. If the Commission receives notice of an accident, it shall provide a workers’ compensation guide to the employee.
    5. A majority of the commissioners, including any deputy commissioner appointed or retired commissioner recalled pursuant to subsection D of § 65.2-705 , shall constitute a quorum for the exercise of judicial, legislative, and discretionary functions of the Commission, whether there is a vacancy in the Commission or not, but a quorum shall not be necessary for the exercise of its administrative functions.
    6. The Commission shall tabulate the accident reports received from employers in accordance with § 65.2-900 and shall publish the same in the annual report of the Commission and as often as it may deem advisable, in such detailed or aggregate form as it may deem best. The name of the employer or employee shall not appear in such publications, and the employers’ reports shall be private records of the Commission and shall not be open for public inspection except for the inspection by the parties directly involved, and only to the extent of such interest. These reports shall not be used as evidence against any employer in any suit at law brought by any employee for the recovery of damages.

    History. Code 1950, §§ 65-10, 65-14, 65-16, 65-19; 1952, c. 14; 1962, c. 339; 1968, c. 660, §§ 65.1-11, 65.1-18, 65.1-22; 1983, c. 102; 1991, c. 355; 2004, c. 178; 2012, c. 588; 2018, c. 250.

    Cross references.

    As to this chapter being exempt from the hearing officer requirements of the Administrative Process Act, see § 2.2-4024 .

    Editor’s note.

    At the direction of the Virginia Code Commission, the reference to “Title 31” was changed to “Part C ( § 64.2-1700 et seq.) of Subtitle IV of Title 64.2” to conform to the recodification of Title 64.1 by Acts 2012, c. 614, effective October 1, 2012.

    Acts 2020, c. 549, cl. 1 provides: “That the Virginia Workers’ Compensation Commission shall engage an independent and reputable national research organization with expertise in workers’ compensation policy to conduct an analysis to (i) develop options for covering workers’ injuries caused by repetitive motion through the Virginia workers’ compensation system and (ii) summarize key policy considerations associated with modifying the Code of Virginia to cover injuries caused by repetitive motion. The analysis shall take into consideration (a) the annual number of injuries caused by repetitive motion to workers in Virginia and other states; (b) other states’ evidentiary requirements for claiming workers’ compensation benefits for such injuries; (c) necessary changes to Virginia’s statutory provisions; and (d) impacts on workers, employers, and insurers. The Virginia Workers’ Compensation Commission shall ensure that the proposed options and policy considerations be submitted to the Chairmen of the House Committee on Appropriations and the Senate Committee on Finance and Appropriations by November 30, 2020.”

    The 2004 amendments.

    The 2004 amendment by c. 178 inserted the present second sentence in subsection A.

    The 2012 amendments.

    The 2012 amendment by c. 588 added subsection E and redesignated former subsection E as F.

    The 2018 amendments.

    The 2018 amendment by c. 250 inserted “including any deputy commissioner appointed or retired commissioner recalled pursuant to subsection D of § 65.2-705 ” in subsection E.

    Research References.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 1 Courts. § 1.08 Workers’ Compensation Commission; Chapter 41 Rules of Procedure, § 41.05 Rules of the Virginia Workers’ Compensation Commission. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 15, 57.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-18 or prior law.

    The Commission has the power to enter awards granting or denying benefits under the Workers’ Compensation Act and dictating the terms under which those benefits will be paid as long as those terms do not conflict with the requirements of the Act. Rusty's Welding Serv., Inc. v. Gibson, 29 Va. App. 119, 510 S.E.2d 255, 1999 Va. App. LEXIS 67 (1999).

    Duty of Commission. —

    Workers’ Compensation Commission erred in applying a per se prejudice standard to find that the employer’s filing of an accident report involving the claim of the claimant, which was made more than two years after the claimant’s accident and outside the statute of limitations, tolled the statute of limitations which otherwise would have barred the claimant’s application for benefits. Rather, it should have applied an actual prejudice standard because the evidence showed that it fulfilled its duty of notifying the claimant in an earlier case that she only had a certain amount of time to file a claim, and, thus, in the present case the claimant may have been aware that she only had a certain amount of time to file a claim, which would undercut her argument that she did not know that she had to file a workers’ compensation claim within two years. Hall v. Winn-Dixie Stores, Inc., 41 Va. App. 835, 589 S.E.2d 484, 2003 Va. App. LEXIS 642 (2003).

    Virginia Workers’ Commission’s authority under the statute to administer this title and to make rules and regulations for carrying out the provisions of this title, cannot be enlarged to include the administration of provisions that are not expressly set forth in Title 65.2 or the power to recall or designate a retired commissioner to serve in review proceedings by rule or regulatory proceeding; the General Assembly did not confer that authority on the Commission, and none can be presumed. Layne v. Crist Elec. Contr., Inc., 62 Va. App. 632, 751 S.E.2d 679, 2013 Va. App. LEXIS 371 (2013).

    Authority of Commission. —

    Even if the Virginia Workers’ Compensation Commission incorrectly used the term “law of the case” in the second review opinion, there was no reversible error as the Commission had the authority to limit or permit reconsideration of any issues it had already decided when it reviewed the case again after remanding the matter to a deputy commissioner, and the ruling in the second review opinion merely reflected the practical reality that the Commission generally did not review the determinations it had already made. Meidan, Inc. v. Leavell, 62 Va. App. 436, 749 S.E.2d 201, 2013 Va. App. LEXIS 291 (2013).

    Making and enforcing rules. —

    Commission has power to make and enforce rules not inconsistent with the Workers’ Compensation Act, to further the Act’s provisions. Turpin v. Fairfax County Sch. Bd., 1999 Va. App. LEXIS 614 (Va. Ct. App. Nov. 2, 1999).

    Notice of rule passed under this section. —

    Employer and insurance carrier held charged with notice of rule of Commission passed pursuant to this section. Parker v. Manchester Bd. & Paper Co., 201 Va. 328 , 111 S.E.2d 453, 1959 Va. LEXIS 230 (1959).

    Rules may not be inconsistent with act. —

    As an administrative agency, the commission has been delegated authority to make rules and regulations for carrying out the provisions of the workers’ compensation act but that authority does not permit the commission to adopt rules that are inconsistent with the act. Brown v. United Airlines, Inc., 34 Va. App. 273, 540 S.E.2d 521, 2001 Va. App. LEXIS 49 (2001).

    Inapplicability of Administrative Process Act. —

    Where the Workers’ Compensation Commission merely implemented an expedited procedure to determine the continuing award or denial of claimant’s benefits, the Commission was acting in a quasi-judicial function and, therefore, was not subject to the Virginia Administrative Process Act. Williams v. VEPCO, 18 Va. App. 569, 445 S.E.2d 693, 10 Va. Law Rep. 1598, 1994 Va. App. LEXIS 398 (1994).

    Deputy may be appointed to sit with commissioners. —

    The Commission acted under the authority granted to it by § 65.2-203 when it appointed a deputy to sit with two members of the Commission to review the termination of an award. Clinch Valley Med. Ctr. v. Hayes, 34 Va. App. 183, 538 S.E.2d 369, 2000 Va. App. LEXIS 835 (2000).

    Failure to have full commission hear review. —

    Decision reviewing the award of benefits to a claimant was reversed on appeal as the Virginia Workers’ Compensation Commission lacked authority to review the employer’s appeal of that decision as a result of having only two out of three statutorily required Commissioners hear the review due to a vacancy existing on the Commission. The employer had not waived the issued since it had raised the same in a motion to reconsider or vacate the decision. Hitt Constr. v. Pratt, 53 Va. App. 422, 672 S.E.2d 904, 2009 Va. App. LEXIS 76 (2009).

    Matter was not heard before a properly constituted full Virginia Workers’ Compensation Commission because only two of the three statutorily authorized commissioners decided it; because the Commission’s authority is a matter of legislative prerogative, the Commission is bound by the plain meaning of the words in the Workers’ Compensation Act, and § 17.1-327 , which fail to provide the authority to recall or designate a retired commissioner to serve in a review proceeding. Layne v. Crist Elec. Contr., Inc., 62 Va. App. 632, 751 S.E.2d 679, 2013 Va. App. LEXIS 371 (2013).

    Composition of review panel. —

    Composition of the Virginia Workers’ Compensation Commission review panel was proper because the mechanism provided in subsection D of § 65.2-705 , was triggered since one commissioner was absent, and thus, the chairman appointed a deputy commissioner to the review panel, which consisted of two commissioners and one deputy commissioner; because a majority of commissioners existed, a quorum was achieved, and the review panel was authorized to take judicial, legislative, and discretionary action. McCluster v. Baltazar, 2017 Va. App. LEXIS 308 (Va. Ct. App. Dec. 5, 2017).

    Hearsay statements are admissible in evidence before Commission. —

    The Commission is not governed in its decisions by common-law rules of evidence, and hearsay statements are properly admissible in evidence before it. The Commission has the discretion to give probative weight to hearsay statements in arriving at its findings of facts. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958).

    And probative weight of hearsay evidence is for Commission to determine. —

    Hearsay evidence is admissible under this section. It follows that the Commission may give it some probative weight, and it is for the Commission, and not for the court, to determine what probative weight, if any, they should give to it in arriving at the findings of fact. The court could not interfere with the exercise of such discretion without usurping powers which are conferred by this section on the Commission, since the Commission is the sole tribunal provided to ascertain the facts. American Furn. Co. v. Graves, 141 Va. 1 , 126 S.E. 213 , 1925 Va. LEXIS 386 (1925).

    The Commission’s award was conclusive and not appealable where hearsay evidence was supported by other competent evidence to sustain its findings that deceased was engaged in his employment when he sustained the accident causing an abrasion which caused his death. American Furn. Co. v. Graves, 141 Va. 1 , 126 S.E. 213 , 1925 Va. LEXIS 386 (1925).

    Commission may consult medical treatises. —

    Under the broad provisions of the Workmen’s (now Workers’) Compensation Act, the Commission is authorized to consult medical treatises. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958).

    And consider extracts from medical journals and unsworn statements of medical experts. —

    There was no merit in the contention that the Commission erred in admitting and considering unsworn statements of medical experts and extracts from medical journals, where the written opinions of physicians were submitted by both parties to the action, and the record did not show that claimant objected to the introduction of testimony at any stage in this proceeding, or asked the privilege of cross-examining the doctors. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958).

    Rule as to after-discovered evidence. —

    The rule of the Commission dealing with after-discovered evidence is the same as that required by the courts of Virginia. Nicholson v. Clinchfield Coal Corp., 154 Va. 401 , 153 S.E. 805 , 1930 Va. LEXIS 222 (1930).

    Workers’ Compensation Commission erred in allowing the claimant to introduce evidence as to his average weekly wage after the original hearing on his case had ended and after the extended time for presenting evidence had passed, as the Workers’ Compensation Commission was not permitted to accept evidence after those two periods had passed; while a claimant could file a motion to re-open the record, the claimant filed no such motion and the motion would not likely have been granted because the average weekly wage evidence did not qualify as evidence that could not have been obtained prior to the hearing through the exercise of reasonable diligence. Gwaltney of Portsmouth v. Scales, 2005 Va. App. LEXIS 474 (Va. Ct. App. Nov. 22, 2005).

    No error occurred when the state workers’ compensation commission denied the employer’s motion to reconsider and/or vacate the workers’ compensation commission’s decision, on the ground of mootness, that affirmed the deputy commissioner’s findings that the employer was responsible for a pain clinic evaluation for the claimant; at the time that the issue was heard on the merits, there was an actual controversy between the parties and the employer’s attempt after the hearing on the merits to submit medical records to establish mootness had to fail because the records were not “after-discovered evidence” that reasonably could not have been obtained prior to the relevant hearing. Wal-Mart Assocs., Inc. v. Jones, 2007 Va. App. LEXIS 49 (Va. Ct. App. Feb. 13, 2007).

    Rule against postponement. —

    The rule of the Commission that no postponement will be granted unless it appears that, without fault of the party asking for it, material and irreparable injury may occur, and parties are required to make every preparation possible to appear at the time and place of hearing, is reasonable. Nicholson v. Clinchfield Coal Corp., 154 Va. 401 , 153 S.E. 805 , 1930 Va. LEXIS 222 (1930).

    Jurisdiction. —

    Language of 10 U.S.C.S. § 1095 clearly provided that the United States could institute and prosecute legal proceedings against a third party payer to enforce a right of the United States under that section, and defendant insurers had provided no reason why the court could not properly exercise subject matter jurisdiction of the case; § 65.2-201 merely transferred jurisdiction of workers’ compensation claims from the state courts to the Virginia Workers’ Compensation Commission, but did not provide any indication of why the United States should have been deprived of its right to seek reimbursement because of the injured worker’s voluntary release of his worker’s compensation claims. United States v. Chartis Ins. Agency, Inc., 834 F. Supp. 2d 459, 2011 U.S. Dist. LEXIS 117628 (E.D. Va. 2011).

    Workers’ Compensation Commission lacked jurisdiction over an employee’s claim filed on October 27, 2010, because the claim did not correctly identify the date of the injury, and, as such, the filing did not satisfy a Commission rule; the Commission also lacked jurisdiction over the employee’s attempt to amend the date in an April 11, 2011, filing because the filing constituted a new claim made after the two-year time limitation had run and did not relate back to an initial valid claim. Hogan v. NPC Int'l, Inc., 2013 Va. App. LEXIS 361 (Va. Ct. App. Dec. 10, 2013).

    The commission has the power to devise a test for determining whether to reconvene an evidentiary hearing. Estate of Kiser v. Pulaski Furniture Co., 41 Va. App. 293, 584 S.E.2d 464, 2003 Va. App. LEXIS 423 (2003).

    Apportion weight given to testimony. —

    Virginia Workers’ Compensation Commission did not err in finding that an employee’s knee pain was causally related to his work accident because there was testimony from a doctor and from the employee regarding the relation between the knee injury and the work accident, and the Commission was free to apportion the weight of the testimony. Apollo Mining Corp. v. Looney, 2004 Va. App. LEXIS 615 (Va. Ct. App. Dec. 14, 2004).

    In reversing the deputy commissioner’s termination of benefits, the Virginia Workers’ Compensation Commission was entitled to accord a claimant’s treating physician’s opinion greater weight than that of a chiropractor who saw the claimant only once, while performing an independent medical examination. Argenbright Sec., Inc. v. Jackson, 2005 Va. App. LEXIS 92 (Va. Ct. App. Mar. 8, 2005).

    Authority to issue certificate for authentication purposes. —

    Virginia Workers’ Compensation Commission did not err in finding that a certificate was not issued pursuant to § 65.2-710 because the certificate of authentication was issued pursuant to the general authority of the commission under §§ 8.01-390 and 8.01-391 , and the commission, which was acting pursuant to its legal authority when it entered the award for benefits to a workers’ compensation claimant as the agency responsible for workers’ compensation awards, had authority to issue a certificate without relying on § 65.2-710 ; the interpretation of a Virginia Workers’ Compensation Commission document is not left to the desires of a claimant, and the commission determines the nature of its orders and rulings. Hodnett v. Stanco Masonry, Inc., 58 Va. App. 244, 708 S.E.2d 429, 2011 Va. App. LEXIS 161 (2011).

    Blue letter or guide sent for one injury does not trigger the statutory per se lack of prejudice for second injury. —

    Blue letter or workers’ compensation guide sent for one injury does not trigger the statutory per se lack of prejudice for a second injury, even if it is received after the incident that caused the second injury. Absence of prejudice as a matter of law is triggered only when a claimant receives a workers’ compensation guide or blue letter relating to the specific injury at issue after that injury occurs. To trigger a per se absence of prejudice, each injury requires its own timely blue letter. Falls Church Cabinetry v. Jewell, 60 Va. App. 134, 724 S.E.2d 236, 2012 Va. App. LEXIS 134 (2012).

    Although a workers’ compensation claim was filed more than two years after the date of injury, the statute of limitations was tolled under § 65.2-602 because the employer failed to file an accident report under § 65.2-900 , and the claimant was unaware of the statute of limitations because no blue letter was sent under subsection D of § 65.2-201 . Falls Church Cabinetry v. Jewell, 60 Va. App. 134, 724 S.E.2d 236, 2012 Va. App. LEXIS 134 (2012).

    Sua sponte dismissal without prejudice was proper. —

    Virginia Workers’ Comp. Comm’n R. 1.12 expressly permitted the Virginia Workers’ Compensation Commission to act sua sponte to dismiss a claim, with or without prejudice; the commission’s sua sponte dismissal of a claim without prejudice was not an abuse of discretion where the claimant worker and his counsel had missed a scheduled hearing. Jenkins v. Webb, 47 Va. App. 404, 624 S.E.2d 115, 2006 Va. App. LEXIS 8 (2006).

    Workers’ Compensation Commission did not abuse its discretion in dismissing an employee’s claim against employer without prejudice because the decision fell within the range of permitted, reasonable choices where the employee’s failure to comply with the Commission’s discovery orders and failure to appear at the hearing fell short of the deliberate abuse of process necessary to justify a dismissal with prejudice. Republic Servs. of Va., L.L.C. v. Candio, 2015 Va. App. LEXIS 300 (Va. Ct. App. Oct. 27, 2015).

    Amended version of Rule 13 of the Industrial (now Workers’ Compensation) Commission may not be applied retrospectively. Sargent Elec. Co. v. Woodall, 228 Va. 419 , 323 S.E.2d 102, 1984 Va. LEXIS 319 (1984).

    Evidence supported Commission’s findings. —

    Appellate court found there was certainly credible evidence in the record to support the Virginia Workers’ Compensation Commission’s finding that the claimant continued to suffer temporary total disability related to the factures of her vertebrae that she sustained from the fall, thus, the court could not say that the Commission erred in its unanimous ruling awarding the claimant continuing temporary total disability benefits. Truteam Ace Am. Ins. Co. v. Dequintanilla, 2022 Va. App. LEXIS 26 (Va. Ct. App. Feb. 1, 2022).

    The Commission did not err by refusing to order employer to pay $767.52 to the employee for outstanding medical travel expenses as a means of protecting its award from imposition caused by fraud and misrepresentation; the Commission’s refusal to award the employee $767.52 for medical travel expenses did not result in a credit against future compensation benefits. Four L. Ranch v. Towles, 1994 Va. App. LEXIS 237 (Va. Ct. App. Apr. 26, 1994).

    OPINIONS OF THE ATTORNEY GENERAL

    Authority of court inherent to appoint guardian ad litem. —

    The Circuit Court may appoint a guardian ad litem in proceedings pending before the Virginia Workers’ Compensation Commission. See opinion of Attorney General to the Honorable Charles N. Dorsey, Judge, Twenty-third Judicial Circuit, 13-006, (4/19/13).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Administrative Procedures Act:

    The Commission is not subject to the Administrative Procedures Act. Correia v. Stafford County School Board, VWC File No. 215-12-05 (June 5, 2007).

    Administrative Procedures Act:

    The Commission is not subject to the Administrative Procedures Act. Correia v. Stafford County School Board, VWC File No. 215-12-05 (June 5, 2007).

    Procedure:

    Also see notes to § 65.2-704 and Rules of the Commission.

    Where the employer on review argued that statements it obtained from witnesses were work product, the Commission has jurisdiction to define the scope of that privilege. Baugh v. Rust Industrial Cleaning Service, 75 O.W.C. 309 (1996).

    While an Employer’s First Report of Accident is not used to determine how the accident occurred, it is probative as to whether and when an alleged accident was reported. A deputy commissioner may use the Employer’s First Report of Accident sua sponte to corroborate the testimony of the claimant and his wife that notice of accident was timely communicated to the employer, and to impeach the contrary testimony of the employer. Blankenship v. K E T, Inc., 76 O.W.C. 68 (1997).

    Section 65.2-900 grants the Commission discretion to promulgate regulations governing the means by which employers report accidental injuries. Pursuant to 16 VAC 30-90-20, an employer must file an Employer’s Accident Report if the injury meets any of seven criteria. If the injury does not meet any of the criteria set out in the regulation, the injury is deemed minor and the employer may file the abbreviated Form 45-A (Report of Minor Injuries). If the employer files either form, whether or not the employer filed the correct form, the statute of limitations is not tolled. Filing either form triggers the Commission to send the claimant an information brochure, informing the claimant about the statute of limitations and the need to file a claim within two years of the accident. Komrowski v. Stafford (County of) School Board, VWC File No. 204-36-96 (April 5, 2002).

    § 65.2-202. Subpoena powers of the Commission; production of records and papers.

    1. The Commission or any member or deputy commissioner shall have authority to enforce the attendance of all parties in interest and of witnesses and the production and examination of books, papers and records and to punish for contempt or disobedience of its orders as is vested in courts and judges by § 18.2-456 , or Chapter 21 (§ 19.2-339 et seq.) of Title 19.2. Such attendance, production, and examination shall be required by subpoena of the Commission upon timely request therefor by any party to a proceeding before it, unless the Commission finds that the issuance of such subpoena is for dilatory purposes, would cause substantial inconvenience to such witnesses, or is not likely to produce significant relevant evidence.
    2. The county or city sheriff or town sergeant, and their respective deputies, shall serve subpoenas of the Commission or its deputies and shall receive the same fees as are now provided by law for like civil actions.  Each witness who appears in obedience to such subpoena of the Commission shall receive for attendance the fees and mileage for witnesses in civil cases in courts.
    3. The clerk of any court of record shall, upon the application of any party in interest to a proceeding pending under this title, issue a subpoena for the attendance at such proceeding of any witness whose testimony is sought. The return of any subpoena so issued shall be made to the Commission, which shall enforce the attendance of any such witness at such proceeding.

    History. Code 1950, §§ 65-17 through 65-18.1; 1952, c. 470; 1968, c. 660, §§ 65.1-19 through 65.1-21; 1970, c. 470; 1971, Ex. Sess., c. 7; 1981, c. 531; 1991, c. 355.

    Cross references.

    As to enforcement of awards for birth-related neurological injuries, see § 38.2-5012 .

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 9 Discovery. § 9.08 Production of documents and things. Bryson.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 1 Courts. § 1.08 Workers’ Compensation Commission. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 63.

    CASE NOTES

    Scope of authority of Workers’ Compensation Commission. —

    Workers’ Compensation Commission has the same authority as a court to punish for noncompliance with its discovery orders and it has the inherent authority to strike a party’s defenses for failure to comply with a discovery order. Jeff Coal, Inc. v. Phillips, 16 Va. App. 271, 430 S.E.2d 712, 9 Va. Law Rep. 1261, 1993 Va. App. LEXIS 95 (1993).

    Commission has full authority to enforce its orders and protect itself from deception. While the language of former § 65.1-100.1 (now § 65.2-710 ) is permissive and provides that a party may enforce an award in court, it must be read and considered in pari materia with the Commission’s power pursuant to former § 65.1-20 to punish for disobedience of its orders. Hudock v. Industrial Comm'n, 1 Va. App. 474, 340 S.E.2d 168, 1986 Va. App. LEXIS 226 (1986) (decided under prior law).

    Commission’s discretion not unbridled. —

    The decision to punish a party for disobedience of an order is a matter committed to the commission’s discretion. An appellate court cannot, however, resign its jurisdiction over an administrative agency or lower court simply because a matter is committed to that agency’s or court’s discretion. The discretion granted to such bodies is not unbridled. Rather, it is a judicial discretion, the exercise of which implies conscientious judgment. Mason v. Danis Enters. Corp., 1995 Va. App. LEXIS 358 (Va. Ct. App. Apr. 11, 1995).

    Power of contempt. —

    The Commission, as a quasi-judicial body within the area of its jurisdiction, has the power of contempt over those in disobedience of its lawful orders. This is a concomitant of judicial power, necessary to the proper and effective discharge of its duties. Hudock v. Industrial Comm'n, 1 Va. App. 474, 340 S.E.2d 168, 1986 Va. App. LEXIS 226 (1986) (decided under prior law).

    The workers’ compensation commission has the same authority as a court to punish for noncompliance with its orders. Martin v. C & J Clark Am., Inc., 1995 Va. App. LEXIS 926 (Va. Ct. App. Dec. 29, 1995).

    Virginia Workers’ Compensation Commission abused its discretion in assessing 34 separate contempt fines for a professional employer organization’s failure to appear at a show cause hearing, one for each of its 34 client companies, as there was no statute or rule that vested the Commission with the authority to summarily divide one case into 34. Cura Group, Inc. v. Va. Workers' Comp. Comm'n, 45 Va. App. 559, 612 S.E.2d 735, 2005 Va. App. LEXIS 181 (2005).

    When a judicial body punishes for contempt, it is obliged to use the least possible power adequate to the end proposed. Thus, when a contemnor is subjected to Draconian punitive measures, such as the outright dismissal of a case with prejudice or the striking of evidence central to a claim or defense, the record must support the assertion that no lesser sanction could have adequately compelled compliance and preserved the dignity of the tribunal. Mason v. Danis Enters. Corp., 1995 Va. App. LEXIS 358 (Va. Ct. App. Apr. 11, 1995).

    Laches held inapplicable. —

    In a contempt proceeding arising out of the charging of an improper attorney’s fee, the doctrine of laches did not apply to delay from settlement of the claim to the finding of contempt, where, upon being advised by the claimant of the additional attorney’s fee that had been charged, the Commission moved expeditiously. Hudock v. Industrial Comm'n, 1 Va. App. 474, 340 S.E.2d 168, 1986 Va. App. LEXIS 226 (1986) (decided under prior law).

    Imposition of lesser sanctions warranted. —

    Where no fault could be charged to claimant other than on account of his selection of counsel, and in light of the deputy commissioner’s letter directing that counsel was “alone” responsible for rescheduling the deposition, the commission had within its power less extreme sanctions, which it should have imposed upon counsel as the responsible party, before imposing the most severe sanction of striking the medical records. Mason v. Danis Enters. Corp., 1995 Va. App. LEXIS 358 (Va. Ct. App. Apr. 11, 1995).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Discovery:

    Where the claimant is on an outstanding award there is a proceeding under the title such as to allow for discovery, and the Commission has the authority to require the production of documents and other things. Habina v. Jasper Construction, VWC File No. 173-22-55 (Aug. 26, 2005).

    The 21 day time frame contained in Rule 1.8 for providing answers to interrogatories also applies to request for production of documents. After a party has been provided the initial 21 days, it is within the discretion of the deputy commissioner to determine the time frame for responses to an Order to Compel. Habina v. Jasper Construction, VWC File No. 173-22-55 (Aug. 26, 2005).

    Deputy Commissioner properly excluded video surveillance evidence because evidence was in existence prior to employer’s responses to discovery seeking such evidence and employer did not produce evidence, as requested; employer’s assertion that employee would not be prejudiced by late admission of evidence not relevant to question of whether employer failed to comply with pre- hearing discovery. Davis v. Lasco Bathware, VWC File No. 211-12-03 (Nov. 24, 2003).

    Deputy Commissioner properly refused to allow employer to call witness not identified in discovery; employer’s discovery response was that it had not decided whom to call as witness; Commission agreed with Deputy Commissioner’s finding that this response was not complete when made and thus employer required to supplement response. Crowe v. Lowe’s of South Boston Va., VWC File No. 208-09-67 (Oct. 16, 2003).

    The Commission is vested with the authority of courts and judges to enforce the production of records. Since the Commission can enforce the production of records, the Commission may also determine what records are to be produced. Morgan v. Eastern State Hospital, 78 O.W.C. 192 (1999).

    An employee should not be compelled to seek out and obtain a document pursuant to a motion for production filed by an adverse party, absent evidence that the document to be produced is otherwise unavailable to the requesting party. Zeballos v. Mendez, 75 O.W.C. 229 (1996).

    An employee cannot ignore or neglect proper discovery requests, but must answer them substantively within the time period allowed by discovery rules, or within that period challenge requests she considers objectionable. Commission discovery orders may not be ignored with impunity. Dismissal of the claim is an appropriate sanction for such conduct. Zeballos v. Mendez, 75 O.W.C. 229 (1996).

    While the Act does not contain specific authority to impose sanctions as provided in Virginia Supreme Court Rule 4:12, Va. Ann. Code § 65.2-202 does grant the Commission the same authority to enforce its orders as is vested in the circuit courts of Virginia. This Section has been interpreted to include the sanctions set out in Rule 4:12. The Commission’s authority to impose sanctions for failure to discover are stated in Rule 1.12 of the Rules of the Commission. Foster v. Hooker Furniture Corp., 75 O.W.C. 355 (1996).

    Dismissal of a claim is not an appropriate sanction for dilatory conduct during discovery that obstructs the efficient administration of the claim, where the claimant has finally complied. A more appropriate sanction for repeated dilatory conduct that obstructs the administration of the proceedings may be found in the Commission’s power to punish for contempt, which may be enforced at an interlocutory show cause hearing and may be more easily tailored to the degree of offense. Foster v. Hooker Furniture Corp., 75 O.W.C. 355 (1996).

    Counsel in workers’ compensation cases under § 65.2-402 (involving the presumption as to death or disability from respiratory disease, hypertension, or heart disease in regard to certain workers) are entitled to discover underlying facts and assumptions upon which an expert opinion is based in such cases, but the physician-patient confidentiality must also be protected. The Commission held that an expert witness identified in the case was required to produce, pursuant to a subpoena duces tecum, all opinion reports issued in cases before the Virginia Workers’ Compensation Commission during the period from January 1, 1998 to the present, with the claimants’ names redacted, in which the report was requested by a claimant or an employer and in which the expert witness was not the treating physician. Brandon v. City of Richmond Fire Department, 78 O.W.C. 216 (1999).

    A third party claim accident report is discoverable, inasmuch as it directly relates to the workers’ compensation claim and could reasonably lead to other discoverable information. Zeballos v. Mendez, 75 O.W.C. 229 (1996).

    Subpoenas:

    Electronic Communications Privacy Act (18 U.S.C. section 2702) protects information on the Facebook website, and the Commission lacks authority to compel Facebook to provide such information in response to a subpoena duces tecum. .Hensley v. Colgan Air, Inc., VWC File No. 232-16-19 (Apr. 9, 2010).

    When exercising the powers of a court of record with respect to matters within its jurisdiction, the Commission has the authority to require Child Support Enforcement to comply with a subpoena duces tecum for its records provided such records are relevant to the proceeding pending before the Commission. Dignazio, Jr., v. Continental Commercial Corporation/Hillsborough Vineyards, VWC File No. 222-30-88 (Nov. 1, 2005).

    Deputy Commissioner properly denied DMV’s motion to quash subpoena for medical information concerning employee’s application for disabled parking permit; medical information in question found to be material and relevant and neither employee nor physician supplying information had expectation of privacy; protective order issued to allow Deputy Commissioner to examine records in camera before ruling on admissibility. Seeman v. Belfort Furniture, Inc., VWC File No. 213-79-35 (Nov. 18, 2003).

    Deputy Commissioner correctly refused to quash subpoena for non-party’s medical records, which was resisted under the Health Insurance Portability and Accountability Act of 1996; HIPAA does not preclude issuance of a subpoena of non-party’s medical records and also does not apply to workers’ compensation provisions allowing production of such records. Goodwin v. Sentara Norfolk Gen’l Hosp., VWC File No. 208-72-40 (Aug. 6, 2003).

    It is proper for the Commission to refuse to issue a subpoena duces tecum where the contracts sought were immaterial to the employment status of the deceased employee. Deacon v. Atlantic Lumber Co., 52 O.I.C. 78 (1970).

    Witness Fees:

    Witness fees assessed against claimant upon filing of affidavit under § 14.1-190. Thompson v. Farstop Corp., 55 O.I.C. 349 (1973).

    The person requesting a witness subpoena for a medical expert must pay the witness fee set by the Commission. Dotti v. Sonco Wholesale Fence Company, Inc., 70 O.I.C. 307 (1991).

    Power of Contempt:

    When an order of the Commission is ignored, the contempt is against the Commission and not against the claimant or any other party to the underlying claim. There is no provision allowing any party to the underlying claim to use the Commission’s enforcement powers to obtain attorney fees or costs. Harrington v. Food Lion DC2, VWC File No. 196-40-35 (Aug. 10, 2004).

    The Workers’ Compensation Commission has the same authority as a court to punish for noncompliance with its orders. Bremby v. Newport News Shipbuilding, 76 O.W.C. 470 (1997).

    A deputy commissioner has the power to punish an attorney for criminal contempt for failure to represent his client at a scheduled hearing for which notice was duly provided. Bremby v. Newport News Shipbuilding, 76 O.W.C. 470 (1997).

    Claimant’s attorney failed to appear for a scheduled hearing, and the deputy commissioner subsequently determined the attorney had a schedule conflict with another judicial hearing. The attorney had not requested a continuance or previously advised the deputy commissioner about the conflict. The Commission strongly supports the authority of the deputy commissioner to attempt to preserve the power and to vindicate the dignity of the Commission, but held that procedures he followed fell short of those applicable to indirect criminal contempt. Bremby v. Newport News Shipbuilding, 76 O.W.C. 470 (1997).

    Proceedings for contempt of court are of two classes. Proceedings prosecuted to preserve the power and to vindicate the dignity of the Court are criminal and punitive in their nature. Proceedings prosecuted to preserve and enforce the rights of private parties are civil, remedial, and coercive in their natures. Bremby v. Newport News Shipbuilding, 76 O.W.C. 470 (1997).

    In order to determine the correct procedure for handling contempt, it must be determined whether the contempt was direct or indirect. A direct contempt is one which occurs in the hearing and in the presence of the trial judge, and one in which all elements of the contempt are within the personal knowledge of the trial judge. Indirect or constructive contempt is contempt occurring at least partially outside the hearing and presence of the trial judge and in which at least one element of the contempt is not within the personal knowledge of the trial judge. Bremby v. Newport News Shipbuilding, 76 O.W.C. 470 (1997).

    The correct procedure for prosecuting an indirect criminal contempt procedure is to begin by notifying the defendant by personal service of motion or rule regarding the facts alleged to constitute the contempt and the time and place of the hearing for the prosecution of the contempt. A summary proceeding is appropriate for indirect criminal contempt. Bremby v. Newport News Shipbuilding, 76 O.W.C. 470 (1997).

    The possibility of imprisonment for more than six months or a fine of more than $ 500.00 may entitle the defendant to a jury trial. Where the punishment is not for imprisonment and is for a fine of $ 200.00, a jury trial is not necessary. Bremby v. Newport News Shipbuilding, 76 O.W.C. 470 (1997).

    § 65.2-203. Powers and duties of deputy commissioners and bailiffs.

    1. Deputy commissioners shall have the power to subpoena witnesses, administer oaths, take testimony and hear the parties at issue and their representatives and witnesses, decide the issues in a summary manner, and make an award carrying out the decision. Deputies may exercise other powers and perform any duties of the Commission delegated to them by the Commission.
    2. The bailiffs of the Commission shall, in all matters within the jurisdiction of the Commission, have the powers, discharge the functions, and perform the duties of a sheriff under the law.  They shall preserve order during the public sessions of the Commission; may make arrests and serve and make return on any writ or process awarded by the Commission; and shall execute any writ, order, or process of execution awarded upon the findings or judgments of the Commission in any matter within its jurisdiction.  They shall exercise other powers and perform any duties as may be delegated to them.

    History. Code 1950, §§ 65-10.1, 65-14; 1960, c. 287; 1962, c. 339; 1968, c. 660, §§ 65.1-12, 65.1-13; 1971, Ex. Sess., c. 155; 1991, c. 355.

    Cross references.

    As to this chapter being exempt from the hearing officer requirements of the Administrative Process Act, see § 2.2-4024 .

    CASE NOTES

    Deputy appointed to sit with commissioners. —

    The Commission acted under the authority granted to it by this section when it appointed a deputy to sit with two members of the Commission to review the termination of an award. Clinch Valley Med. Ctr. v. Hayes, 34 Va. App. 183, 538 S.E.2d 369, 2000 Va. App. LEXIS 835 (2000).

    Deputy commissioner authorized to take additional evidence. —

    The Commission has authority to take additional evidence. The Commission also has the power to delegate duties to the deputy commissioners. Therefore, the deputy commissioner has authority to take additional evidence in a case when ordered to do so by the Commission. Smith v. Weber, No. 0873-85 (Ct. of Appeals Nov. 5, 1986) (decided under former § 65.1-12).

    Deputy commissioner’s authority. —

    Award of benefits to the claimant in a workers’ compensation action was appropriate, in part under subsection A of § 65.2-203 because the deputy commissioner and the Workers’ Compensation Commission were not plainly wrong in accepting the claimant’s testimony as credible. Oftentimes the full commission would not review the evidence in the same way that the deputy commissioner did and to the extent the full Commission had not actually viewed the witnesses and their appearance or demeanor, it naturally followed that it would simply adopt the deputy commissioner’s credibility determinations about those witnesses, which it was free to do without explanation. Va. Int'l Terminals v. McCarthy, 2011 Va. App. LEXIS 216 (Va. Ct. App. June 28, 2011).

    Virginia Birth-Related Neurological Injury Compensation Act Claims. —

    Deputy commissioner of the Virginia Workers’ Compensation Commission who heard the claim filed under the Virginia Birth-Related Neurological Injury Compensation Act, § 38.2-5000 et seq., had the power to extend nonjurisdictional filing deadlines and grant continuances. Kidder v. Va. Birth-Related Neurological Injury Comp. Program, 37 Va. App. 764, 560 S.E.2d 907, 2002 Va. App. LEXIS 174 (2002).

    Commission properly reversed deputy Commissioner’s termination of benefits. —

    As the Virginia Workers’ Compensation Commission’s finding that a surveillance tape did not show a claimant exceeding restrictions imposed by his doctor or that he failed to accurately report his condition to the doctor, and the deputy commissioner made no determination as to claimant’s credibility based on his demeanor, the Commission properly reversed the deputy’s order terminating benefits. Argenbright Sec., Inc. v. Jackson, 2005 Va. App. LEXIS 92 (Va. Ct. App. Mar. 8, 2005).

    Failure to have full commission hear review. —

    Decision reviewing the award of benefits to a claimant was reversed on appeal as the Virginia Workers’ Compensation Commission lacked authority to review the employer’s appeal of that decision as a result of having only two out of three statutorily required Commissioners hear the review due to a vacancy existing on the Commission. The employer had not waived the issued since it had raised the same in a motion to reconsider or vacate the decision. Hitt Constr. v. Pratt, 53 Va. App. 422, 672 S.E.2d 904, 2009 Va. App. LEXIS 76 (2009).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Administrative agencies, like trial courts, speak through their orders. The Commission’s orders determine whether a claim is dismissed, regardless of what the parties intended. Where no order was entered by the Commission dismissing Stellute, he is still a party to the proceedings. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    § 65.2-204. Administrative provisions: offices, meetings, travel, salary, and expenses.

    1. The Commission shall be provided with adequate offices in the Capitol or in some other suitable building in the Commonwealth, in which the records shall be kept and its official business transacted during regular business hours. The Commission shall also be provided with necessary office furniture, stationery, and other supplies.
    2. The Commission or any member thereof may hold sessions at any place within the Commonwealth as may be deemed necessary by the Commission.
    3. All salaries and expenses of the Commission shall be audited and paid out of the state treasury in the manner prescribed for similar expenses in other departments or branches of state government.

    History. Code 1950, §§ 65-12, 65-13, 65-15; 1968, c. 660, §§ 65.1-15 through 65.1-17; 1991, c. 355; 2013, c. 14.

    The 2013 amendments.

    The 2013 amendment by c. 14 substituted “Commonwealth” for “City of Richmond” in the first sentence of subsection A.

    OPINIONS OF THE ATTORNEY GENERAL

    Use of funds. —

    The Commission is not authorized under current law to use funds in the Criminal Injuries Compensation Fund to purchase a new office building in which to house the headquarters of the Commission and the Director of CICF and her staff. There is no constitutional or other legal impediment to the introduction of future legislation that would enable the Commission to utilize the Fund for such purposes. Effective July 1, 2013, the Commission is permitted to locate its headquarters outside the City of Richmond, provided the facility remains within the Commonwealth. See opinion of Attorney General to Ms. Evelyn McGill, Executive Director, Virginia Workers’ Compensation Commission, 11-101, 2013 Va. AG LEXIS 21 (4/12/13).

    § 65.2-205. Ombudsman program; confidentiality.

    1. The Commission may create an Ombudsman program and appoint an ombudsman to administer such program. The purpose of the Ombudsman program shall be to provide neutral educational information and assistance to persons who are not represented by an attorney, including those persons who have claims pending or docketed before the Commission. The ombudsman shall be an attorney licensed by the Virginia State Bar, in active status, and in good standing. The ombudsman and any Ombudsman program personnel shall carry out their duties with impartiality and shall not serve as an advocate for any person or provide legal advice.
    2. All memoranda, work products, and other materials contained in the case files of the ombudsman or Ombudsman program personnel shall be confidential. Any communication between the ombudsman or Ombudsman program personnel and a person receiving assistance as provided by this section that is made during or in connection with the provision of Ombudsman program services, including screening, intake, and scheduling, shall be confidential.Confidential materials and communications are not subject to disclosure and shall not be admissible in any judicial or administrative proceeding except where (i) a threat to inflict bodily injury is made; (ii) communications are intentionally used to plan, attempt to commit, or commit a crime or conceal an ongoing crime; (iii) a complaint is made against Ombudsman program personnel by a person receiving assistance to the extent necessary for the complainant to prove misconduct or the Ombudsman program personnel to defend against such complaint; or (iv) communications are sought or offered to prove or disprove a claim or complaint of misconduct or malpractice filed against the legal representative of a person who received assistance from the Ombudsman program.Confidential materials and communications as described in this section are not subject to mandatory disclosure under the Virginia Freedom of Information Act (§ 2.2-3700 et seq.).
    3. The ombudsman and Ombudsman program personnel are immune from civil liability in their performance of the duties specified in this section.

    History. 2020, c. 616.

    Chapter 3. Application and Effect of Title.

    § 65.2-300. Presumption of acceptance of provisions of title; exemptions; notice and rejection.

    1. Every employer and employee, except as herein stated, shall be conclusively presumed to have accepted the provisions of this title respectively to pay and accept compensation for personal injury or death by accident arising out of and in the course of the employment and shall be bound thereby. Except as otherwise provided herein, no contract or agreement, written or implied, and no rule, regulation or other device shall in any manner operate to relieve any employer in whole or in part of any obligation created by this title.
    2. An executive officer may reject coverage under this title for injury or death by accident, but not with respect to occupational disease, if prior to such accident, notice is given to the employer and filed with the Commission in the manner described herein.The notice shall be in substantially the form prescribed by the Commission and shall be given by the executive officer by sending the same in a registered letter, addressed to the employer at his last known address or place of business, or by giving it personally to the employer or any of his agents upon whom a summons in a civil action may be served under the laws of the Commonwealth. A copy of the notice in prescribed form shall also be filed with the Commission. Such notice shall be effective as of the last to occur of (i) the date of the inception of the policy or (ii) the delivery of such notice to the employer as provided in this subsection.
    3. An executive officer who rejects coverage under this title shall, in any action to recover damages for personal injury or death brought against an employer accepting the compensation provisions of this title, proceed at common law, and the employer may avail himself of the defenses of contributory negligence, negligence of a fellow servant and assumption of risk, as such defenses exist at common law.
    4. An executive officer who has rejected coverage under this title may nevertheless by notice revoke such rejection and thereby accept coverage under the provisions of this title. A notice revoking such rejection shall be given to the employer and a copy filed with the Commission in the manner provided for rejecting such coverage. Coverage under this title shall not be extended to injuries that occur within five days of the giving of such notice.

    History. Code 1950, §§ 65-20, 65-22, 65-23, 65-34, 65-40; 1968, c. 660, §§ 65.1-23, 65.1-25, 65.1-26, 65.1-37, 65.1-44; 1972, c. 619; 1973, c. 542; 1991, c. 355; 2000, c. 530.

    The 2000 amendments.

    The 2000 amendment by c. 530, in subsection B, in the second paragraph, deleted “writing or print in” preceding “substantially the,” substituted “address” for “residence,” and added the last sentence; deleted former subsection C, which read: “If an accident resulting in injury or death occurs within thirty days after such notice is given, the notice shall be deemed ineffective unless given concurrently with the commencement of employment”; redesignated former subsections D and E as present subsections C and D; and substituted “five” for “thirty” near the end of present subsection D.

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1972-1973, see 59 Va. L. Rev. 1632 (1973).

    For article, “Effect of Virginia Workmens’ Compensation Act Upon the Right of a Third-Party Tortfeasor to Obtain Contribution From an Employer Whose Concurrent Negligence Causes Employee’s Death or Injury,” see 13 U. Rich. L. Rev. 117 (1978).

    For article covering significant developments in workers’ compensation law in Virginia since 1985, see 26 U. Rich. L. Rev. 903 (1992).

    For article, “Virginia’s Rule of Non-waiver of Liability for Negligent Acts: Hiett v. Lake Barcroft Community Association, Inc.,” see 2 Geo. Mason L. Rev. 27 (1994).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 6 Pleading. § 6.03 Defendant’s pleadings. Bryson.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 14, 18, 40, 41.

    CASE NOTES

    This section should be interpreted in the light of the purpose of the act as a whole and its other provisions. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942) (decided under prior law).

    Participation in the Virginia system is mandatory for all employees and employers covered by the act. Dillard v. Industrial Comm'n, 416 U.S. 783, 94 S. Ct. 2028, 40 L. Ed. 2d 540, 1974 U.S. LEXIS 143 (1974) (decided under prior law).

    Exempted employers must give employees notice of intention to come under act. —

    It is the manifest purpose of the rules of the Commission promulgated pursuant to the authority granted by former § 65.1-18 (see now § 65.2-201 ) to require an employer of the class excluded by this section, including farmers, desiring to come within the purview of the Workmen’s (now Workers’) Compensation Act, to so notify his employees, either by posting notices of his intention in a place or places where they are likely to be seen by the employees, or, where such posting is not practicable, to give such employees actual notice of his intention. Any employee then has the right to reject the Act by so notifying the Commission, and in the absence of such notification the employees are presumed to have elected to be bound by the act. Dey v. Logan, 175 Va. 68 , 7 S.E.2d 102, 1940 Va. LEXIS 147 (1940) (decided under prior law).

    Decedent did not suffer identifiable compensable injury. —

    Where Workers’ Compensation Commission denied benefits after claimant’s husband suffered from sudden cardiac arrest while he was exposed to radar waves at work and died, claimant failed to establish that the husband suffered an identifiable compensable injury because claimant’s alleged identifiable incident, three weeks of exposure for six to eight hours per workday, was an example of repeated exposures over weeks, not a single, definite occasion of exposure. Johnson v. Gen. Dynamics Corp., 2022 Va. App. LEXIS 61 (Va. Ct. App. Mar. 8, 2022).

    Contractual releases. —

    Employee’s waiver of travel expenses and potential liability claims during transit did not run afoul of subsection A, which precluded contractual releases of statutory benefits except where permitted by statute, because such a stipulation, in form and substance, served as a partial compromise of an existing or potential claim, and was a binding and enforceable obligation that protected the employer against any exposure to travel reimbursement costs or to liability claims arising out of the transit to and from his treatment with the Virginia physician. Apple Constr. Corp. v. Sexton, 44 Va. App. 458, 605 S.E.2d 351, 2004 Va. App. LEXIS 587 (2004).

    A truck driver’s remedies against a statutory employer were limited to those exclusively provided under the Virginia Workers’ Compensation Act, § 65.2-100 et seq., regardless of the contractual employment relationship between the driver and the statutory employer. Meredith v. Honeywell Int'l, Inc., 245 Fed. Appx. 325, 2007 U.S. App. LEXIS 20099 (4th Cir. 2007).

    Insurance contracts should not be interpreted by referencing the Worker’s Compensation Statute. —

    In the insurer’s declaratory action suit, the insured asserted that because Virginia Courts have concluded that sexual assault did not occur out of and in the course of employment under the Workers’ Compensation Statute, the court should have found that the identical language in the insurance policies did not extend to the employee’s claims for sexual assault and harassment; however, Virginia Courts interpreted insurance contracts according to their plain meaning, not by referencing the Worker’s Compensation Act. State Farm Fire & Cas. Co. v. One Stop Cellular, Inc., No. 4:05-CV-00067, 2006 U.S. Dist. LEXIS 63435 (W.D. Va. Sept. 6, 2006).

    No duty to take exclusive possession of parking lot. —

    Employer did not violate this section by failing to undertake maintenance of a parking lot, or by failing to take exclusive possession of the parking lot by its contract with its landlord because the statute clearly requires only that an employer not attempt to “contract out” of his or her duties and obligations under the Virginia Workers’ Compensation Act. It does not require that an employer make agreements that would effectively extend its liability beyond the bounds of its own premises. Campbell v. Food Lion LLC, #835, 2004 Va. App. LEXIS 364 (Va. Ct. App. July 27, 2004).

    Route carrier’s injuries sustained when she was shot while waiting at night to pick up newspapers to be delivered arose out of and in the course of her employment and her only remedy was under the act. Plummer v. Landmark Communications, Inc., 235 Va. 78 , 365 S.E.2d 739 (1988) (decided under prior law).

    Squatting in front of machine not covered. —

    Plaintiff was injured while engaged in an activity that is required and carried out in everyday life in many circumstances. In her own words, she described the squat in front of a machine as normal, and of the type “you would make if you had to bend to pick up something at home, pick up around the house or whatever.” Plaintiff was not holding anything at the time of the squat and conducted the motion in an unobstructed area. Where, as here, there was not significant exertion, the action of squatting involved no awkward position, and no condition peculiar to the workplace caused the injury, the injury cannot be said to have “arisen out of” the employment. Plaintiff’s injury did not arise out of her employment, and therefore, it is noncompensable under this section. Bassett-Walker, Inc. v. Wyatt, No. 1002-96-3 (Ct. of Appeals March 4, 1997).

    Injury of left knee caused by prior injury to right knee. —

    The uncontradicted medical records and testimony of three doctors provide ample credible evidence to support the commission’s finding that claimant’s compensable right knee injury caused a material aggravation of his preexisting left knee surgery. The doctrine of compensable consequences provides that, “when the primary injury is shown to have arisen out of and in the course of employment, every natural consequence that flows from the injury likewise arises out of the employment, unless it is the result of an independent intervening cause attributable to claimant’s own intentional conduct.” C. W. Wright Constr. Co., No. 2301-96-3 (Ct. of Appeals March 4, 1997).

    Wrongful death claim barred. —

    As a widow’s husband was an employee of a contractor and his death was caused by an accident that occurred in the course of and arose out of that employment, Virginia’s Workers’ Compensation Act applied and the contractor’s defense, that the widow was not a dependent, merely rendered her claim non-compensable; as the Act applied, its exclusivity provision barred her wrongful death claim against the contractor and its subcontractors. Giordano v. McBar Indus., 284 Va. 259 , 729 S.E.2d 130, 2012 Va. LEXIS 138 (2012).

    Accident. —

    Worker collapsed at work after the last blow to head, he died several days later, and it was undisputed that he died during work training, which was a condition of employment that exposed the worker to the hazard of blows to the head, and thus his death was properly construed as accidental; the circuit court did not err in holding that the exclusivity provision barred this action. Kohn v. Marquis, 288 Va. 142 , 762 S.E.2d 755, 2014 Va. LEXIS 117 (2014).

    CIRCUIT COURT OPINIONS

    Intentional tort claims barred as the circumstances met the requirements for exclusivity. —

    Employee’s intentional tort claims were barred because the circumstances satisfied the exclusivity requirements of the Workers’ Compensation Act in that the injury was an “accident,” even though it was intentional (the employee’s manager bit her on the arm for not immediately helping her with a project), which arose out of the employment (the employee concretely framed the dispute as one created by, and arising out of, refusal to assist her supervisor), and it arose in the course of the employment (the injuries occurred at the store where she was employed, during working hours, at a time when she was fulfilling her duties as a cashier). Wood v. Lowe's Home Ctrs., Inc., 63 Va. Cir. 461, 2003 Va. Cir. LEXIS 247 (Roanoke Dec. 16, 2003).

    Workplace shooting. —

    Where a workplace shooting was caused by the culmination of a gunman’s infatuation with a female victim and his belief that the female victim and a male victim were engaged in an extra-marital affair, the shooting was personal in nature, and the subsequent deaths did not arise out of employment for purposes of the Workers’ Compensation Act. Crump v. Morris, 73 Va. Cir. 85, 2007 Va. Cir. LEXIS 233 (Rockingham County Mar. 12, 2007).

    Exclusivity of remedies for longshoreman. —

    Because the longshoreman was a “statutory employee” of a shipping company, his sole remedy for injuries received while engaged in his employment as it related to the subcontractors was governed by the Workers’ Compensation Act. Butts v. York Int'l Corp., 59 Va. Cir. 422, 2002 Va. Cir. LEXIS 232 (Portsmouth Sept. 5, 2002).

    Exclusivity of remedy. —

    Where a pre-existing relationship between a subcontractor and his son created an expectation that the son was to be compensated for the work he did, the son was his father’s statutory employee under an implied contract of hire on the day of injury; thus, he was barred from bringing a personal injury claim against the contractor, as his exclusive remedy was provided by the Virginia Workers’ Compensation Act. Goff v. Robert Hauser Homes, Inc., 63 Va. Cir. 297, 2003 Va. Cir. LEXIS 355 (Charlottesville Oct. 15, 2003).

    Where an employee filed a workers’ compensation claim and allegedly exacerbated an injury during a second functional capacity evaluation, a settlement agreement barred the employee’s negligence claim against the workers’ compensation insurer because: (1) the injuries were properly treated as an extension of the employee’s original workers’ compensation claim; and (2) the insurer and its agents enjoyed the same immunity from liability that the employer did under the Workers’ Compensation Act, since Virginia did not recognize the “dual capacity doctrine.” Mathes v. Davis, 74 Va. Cir. 411, 2007 Va. Cir. LEXIS 298 (Norfolk Dec. 3, 2007).

    Injured employee for a subcontractor on a construction project was barred by §§ 65.2-300 and 65.2-307 from bringing suit against the general contractor and two other subcontractors for the construction project because, under subsection B of § 65.2-302 , the general contractor was the statutory employer of the employee and the subcontractors were statutory co-employees of the employee. Aguilar v. Diaz, 88 Va. Cir. 44, 2014 Va. Cir. LEXIS 6 (Loudoun County Feb. 10, 2014).

    Claims not barred by exclusivity. —

    Since an employee’s mental and physical injuries from a co-worker’s alleged sexual harassment arose over four or five months, § 65.2-300 did not bar her claims against her employer; the egregiousness and physical nature of the alleged conduct, along with the employee’s claims of distress, were sufficient to overrule demurrers to her claim of intentional infliction of emotional distress. Hazzis v. Modjadidi, 69 Va. Cir. 385, 2005 Va. Cir. LEXIS 331 (Norfolk Dec. 19, 2005).

    Because contractors did not have an employer in common with the decedent, they were not statutory co-employees, and none of the self-described statutory co-employees were employed by the decedent’s actual employer; thus, the contractors were “other parties,” and the exclusivity provision of the Virginia Workers’ Compensation Act did not apply to the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Holding company was not the decedent’s statutory employer because it manufactured and sold tissue paper, and converting a copy paper plant into a tissue paper plant was an essential preliminary step to allow the holding company to manufacture and sell tissue paper, but the business of the decedent’s employer was manufacturing, not converting plants; thus, the holding company was an “other party,” and the exclusivity provision did not apply in the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Since employer was corporation with five officers and directors and none provided written notice that they rejected workers’ compensation coverage, corporation was employer under the Act. In re: Deli, Inc., VWC File No. E-0208-79080 (Sept. 8, 2004).

    Any person hired by the employer to work in the usual course of the employer’s business is an “employee” under the Act, regardless of how often or for how long he may be employed. With the exception of farm and horticultural businesses, both full-time and part-time employees who are regularly employed to carry out the trade or business of the employer must be counted in determining the number of employees “regularly in service.” Pineda v. Brothers, 78 O.W.C. 1 (1999).

    Section 65.2-101(2)(h) requires only that the employer have three or more employees “regularly in service” to be within the jurisdiction of the Act. Temporary fluctuations in the number of employees do not enable an employer to avoid jurisdiction. The controlling member must be determined in light of the employer’s established mode of business. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    The number of employees regularly in service of the employer is the number used to carry out the established mode of performing the work of the business, even though the work may be recurrent instead of constant. In determining whether the employer has three or more employees regularly in service, the Commission focuses on “the character of the business” rather than “the character of the employment relationship.” Pineda v. Brothers, 78 O.W.C. 1 (1999).

    The fact that a business is seasonal is not determinative. The Commission has held that a seasonal landscaping business, which regularly employs three or more persons, full or part-time, to work in the employer’s usual course of business, comes under the Act. Pineda v. Brothers, 78 O.W.C. 1 (1999).

    When an executive employee exempts himself from the Act by giving notice under § 65.1-23 (now § 65.2-300 ), the Commission is without jurisdiction as to any accident occurring more than 30 days after giving of notice, except as to accidents within 30 days after employment. After an employee waives the exemption, the Commission remains without jurisdiction for 30 days after notice of waiver is given. Bauer v. Eastern Neon, Inc., 37 O.I.C. 30 (1955).

    The provisions of § 65.2-300 governing an executive’s option to reject workers’ compensation coverage must be strictly construed and applied. Where there may be some question, for purposes of workers’ compensation jurisdiction, whether the employer maintains three or more employees in regular service, it is both mandatory and imperative that any executive officers seeking to reject coverage strictly comply with § 65.2-300 . Failure by an executive officer to file a rejection of coverage is not excused by the questionable belief that the employer was not subject to the Commission’s jurisdiction because it purportedly employed fewer than three workers on a regular basis. Walker v. RLF and JMG, LLC/Affordable Muffler and Brakes, VWC File No. 204-06-78 (May 20, 2002).

    In determining whether an employee or independent contractor relationship exist, the facts of the cases rather than a written agreement are controlling. A contract rejecting the right to claim compensation under the Act is of no legal effect. Harland v. Lake Edward Corp., 55 O.I.C. 156 (1973).

    Section 65.2-300 provides that “no contract or agreement, written or implied . . . shall in any manner operate to relieve any employer in whole or in part of any obligation created by [the Workers’ Compensation Act].” There is no “labor broker exception” to the principles imposing liability on special masters or employers. McClellan v. H.L. Yoh Company, 77 O.W.C. 141 (1998).

    An owner who parcels a part of his trade or business, to be performed by another person who in turn engages other employees and supervises their activities, cannot escape liability by a contract providing that in no event shall such owner be deemed the employer. Dunnavant v. Continent Oil Co., 19 O.I.C. 102 (1937).

    The purpose of § 65.2-302 is to prevent employers from escaping coverage of the Act by doing through independent contractors and subcontractors what they normally would do through employees, by holding such employer liable for any compensation payable to the injured worker for which it would have been liable to pay if the worker had been immediately employed by it. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Whether partner who paid an employee’s entire salary is entitled to proportionate reimbursement from other partner is not for Commission to decide. Echols v. Drs. Riley & Natcig, 56 O.I.C. 102 (1974).

    Where an employee having a claim under the Act accepts a sum of money from his employer and gives him a release, such release cannot defeat a claim for compensation, although employer may have credit if the amount was paid in good faith. Jones v. American Railway Express Co., 3 O.I.C. 637 (1921).

    Once parties stipulate to the facts of a claim, they are bound by those stipulations. Pinto v. Williams, 75 O.W.C. 255 (1996).

    An agreement that is not approved by the Commission is void. Pinto v. Williams, 75 O.W.C. 255 (1996).

    Sick and Vacation Leave/Disability Policy:

    The Commission’s jurisdiction is limited to compensation matters and does not include authority over the employer’s policies regarding sick leave such as to order reinstatement. However, the employer/carrier is not entitled to a credit for paid time off leave which consists of accrued sick, vacation and holiday time in the absence of evidence of reinstatement of any such deductions. Epps v. Inova Fair Oaks Hospital, VWC File No. 213-55-21 (March 23, 2007), aff’d on other issues, No. 0908-07-4 (Ct. App. Va., July 31, 2007).

    Paying employee for absence from work following accident does not relieve or limit liability of employer, where such payments are charged against sick leave or vacation. Lucas v. Research Analysis Corp., 51 O.I.C. 161 (1969); Berg v. City of Richmond, 47 O.I.C. 33 (1965). Sick or leave time cannot be deducted when full salary paid in lieu of compensation. Trimiew v. City of Richmond, 52 O.I.C. 259 (1970).

    Lost time by one entitled to compensation benefits may not be charged against sick or vacation time. Thompson v. AMI, 57 O.I.C. 348 (1976).

    An employer may not credit compensation disability against accumulated sick leave. Cain v. Perdue Farms, Inc., 71 O.W.C. 312 (1992).

    An employer is entitled to a credit for payments made pursuant to a disability policy because the employee is not entitled to a double recovery. Cain v. Perdue Farms, Inc., 71 O.W.C. 312 (1992).

    § 65.2-301. Victims of sexual assault.

    1. Any employee who, in the course of employment, is sexually assaulted, as defined in §§ 18.2-61 , 18.2-67.1 , 18.2-67.3 , or § 18.2-67.4 , and promptly reports the assault to the appropriate law-enforcement authority, where the nature of such employment substantially increases the risk of such assault, upon a proper showing of damages compensable under this title, shall be deemed to have suffered an injury arising out of the employment and shall have a valid claim for workers’ compensation benefits.
    2. Notwithstanding the provisions of this title, an employee who is sexually assaulted and can identify the attacker may elect to pursue an action-at-law against the attacker, even if the attacker is the assaulted employee’s employer or co-employee, for full damages resulting from such assault in lieu of pursuing benefits under this title, and upon repayment of any benefits received under this title.
    3. Nothing in this title shall create a remedy for sexual harassment nor shall this title bar any action at law, that might otherwise exist, by an employee who is sexually harassed.

    History. 1982, c. 303, § 65.1-23.1; 1986, c. 395; 1988, c. 635; 1991, c. 355; 1992, c. 469.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 25, 26.

    CASE NOTES

    In general. —

    This section provided that an employee who is sexually assaulted in the course of employment and promptly reports the assault to law enforcement, shall be deemed to have suffered an injury by accident arising out of the employment, where the nature of the employment substantially increases the risk of such assault. Williams v. City of Norfolk, 1995 Va. App. LEXIS 73 (Va. Ct. App. Jan. 31, 1995).

    Enactment of section did not alter definition of “injury by accident.” —

    The General Assembly, in enacting this section, did not alter the definition of “injury by accident” found in Virginia case law as it relates to intentional act of sexual assault as coming within, rather than excluded from, the purview of the Act. Haddon v. Metropolitan Life Ins. Co., 239 Va. 397 , 389 S.E.2d 712, 6 Va. Law Rep. 1613, 1990 Va. LEXIS 30 (1990).

    Sexual harassment related tort claims allowed. —

    Amendments to the Worker’s Compensation Act, which became effective on July 1, 1992, allow sexual harassment related tort claims apart from the Worker’s Compensation Act, and this includes a claim for intentional infliction of emotional distress. Beardsley v. Isom, 828 F. Supp. 397, 1993 U.S. Dist. LEXIS 16186 (E.D. Va. 1993), aff'd sub nom. Beardsley v. Webb, 30 F.3d 524, 1994 U.S. App. LEXIS 19151 (4th Cir. 1994).

    For case holding that sexual assault did not arise out of the employment of claimant, see City of Richmond v. Braxton, 230 Va. 161 , 335 S.E.2d 259, 1985 Va. LEXIS 263 (1985) (decided under prior law).

    Injuries resulting from a sexual assault by a co-employee of police department. —

    Commission correctly determined that employee did not suffer an injury “arising out of” her employment; credible evidence supported the commission’s determination that the sexual assault on employee by co-employee was personal and not directed against her as an employee or because of her employment. In addition, credible evidence supported the Commission’s conclusion that employee’s employment at the police department did not substantially increase the risk of sexual assault. Carr v. City of Norfolk, 15 Va. App. 266, 422 S.E.2d 417, 9 Va. Law Rep. 435, 1992 Va. App. LEXIS 266 (1992).

    The record failed to show an injury by accident arising out of the employment where employee was raped at work and the assailant, a customer, was personally acquainted with the employee, and on the day of the assault, his first inquiry was whether he and his intended victim were alone and he did not mention money; his first act was to shove her at knifepoint into the bathroom and there, behind a closed door, he forced her to submit to sexual relations and after taking money from his victim’s purse, he repeated the sexual assault, threatened to kill her and her children if she reported the offenses to the authorities, and required her to remain in the bathroom when he left. Not until then did the rapist take time to steal the employer’s money from the petty cash box. Reamer v. National Serv. Indus., Inc., 237 Va. 466 , 377 S.E.2d 627, 5 Va. Law Rep. 2035, 1989 Va. LEXIS 47 (1989) (decided under prior law).

    Proving requisite causal connection. —

    In order to prove the requisite causal connection between an employee’s sexual assault and the conditions under which the employer required the work to be performed, the evidence must show that the attack was directed against the claimant as an employee or because of the employment. Moreover, the statutory presumption of this section applies only when it appears that the nature of the employment substantially increased the risk of sexual assault. Williams v. City of Norfolk, 1995 Va. App. LEXIS 73 (Va. Ct. App. Jan. 31, 1995).

    A sexual assault on a police woman by her co-worker was personal and not directed against her as an employee or because of her employment. In addition, her employment at the central police desk did not substantially increase the risk of sexual assault. Carr v. City of Norfolk, 15 Va. App. 266, 422 S.E.2d 417, 9 Va. Law Rep. 435, 1992 Va. App. LEXIS 266 (1992).

    The plaintiff was precluded by the Act’s exclusive remedies provision under this section, from seeking redress in court for her personal injuries which were sustained when her employer fired her and forcibly removed her from the place of employment. Sutter v. First Union Nat'l Bank, 932 F. Supp. 753, 1996 U.S. Dist. LEXIS 10985 (E.D. Va. 1996).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Claimant, a female correctional officer, was found to have sustained a compensable injury after she was grabbed by a nude inmate in a bear hug around her arms, and the inmate later pled guilty to the charge of aggravated sexual battery. Claimant would also have been entitled to compensation for a purely psychological injury, even in the context of a prison environment, because the confrontation by a naked convicted rapist was a sudden shocking or frightening event. Shortridge v. Keen Mountain Correctional Center, JCN VA00000239081 (Feb. 7, 2013).

    Benefits denied upon claimant’s failure to establish injury or necessity for medical treatment after being touched in an offensive manner. Clayton v. City of Newport News, 61 O.I.C. 112 (1982).

    § 65.2-301.1. Public safety officers.

    In situations where weather constitutes a particular risk of a public safety officer’s employment and where the public safety officer’s injury arose out of and in the course of his employment, absent a misconduct defense asserted pursuant to § 65.2-306 , such injury shall be compensable under this title. As used in this section, “public safety officer” shall have the meaning ascribed to it in § 9.1-801 .

    History. 2013, cc. 174, 458.

    § 65.2-301.2. Employee classification; disaster; personal protective equipment not considered.

    1. For the purposes of this section, the terms “communicable disease of public health threat,” “disaster,” and “state of emergency” have the same meaning as provided in § 44-146.16.
    2. In any proceeding under the provisions of this title, a hiring party providing an individual with personal protective equipment in response to a disaster caused by a communicable disease of public health threat for which a state of emergency has been declared pursuant to § 44-146.17 shall not be considered in any determination regarding whether such individual is an employee or independent contractor.

    History. 2021, Sp. Sess. I, c. 448.

    Effective date.

    This section is effective July 1, 2021, pursuant to Va. Const. Art. IV, § 13.

    § 65.2-302. Statutory employer.

    1. When any person (referred to in this section as “owner”) undertakes to perform or execute any work which is a part of his trade, business or occupation and contracts with any other person (referred to in this section as “subcontractor”) for the execution or performance by or under such subcontractor of the whole or any part of the work undertaken by such owner, the owner shall be liable to pay to any worker employed in the work any compensation under this title which he would have been liable to pay if the worker had been immediately employed by him.
    2. When any person (referred to in this section as “contractor”) contracts to perform or execute any work for another person which work or undertaking is not a part of the trade, business or occupation of such other person and contracts with any other person (referred to in this section as “subcontractor”) for the execution or performance by or under the subcontractor of the whole or any part of the work undertaken by such contractor, then the contractor shall be liable to pay to any worker employed in the work any compensation under this title which he would have been liable to pay if that worker had been immediately employed by him.
    3. When the subcontractor in turn contracts with still another person (also referred to as “subcontractor”) for the performance or execution by or under such last subcontractor of the whole or any part of the work undertaken by the first subcontractor, then the liability of the owner or contractor shall be the same as the liability imposed by subsections A and B of this section.
      1. Liability for compensation pursuant to this section may not be imposed against any person who, at the time of an injury sustained by a worker engaged in the maintenance or repair of real property managed by such person, and for which injury compensation is sought: D. 1. Liability for compensation pursuant to this section may not be imposed against any person who, at the time of an injury sustained by a worker engaged in the maintenance or repair of real property managed by such person, and for which injury compensation is sought:
        1. Was engaged in the business of property management on behalf of the owners of such property and was acting merely as an agent of the owner;
        2. Did not engage in and had no employees engaged in the same trade, business or occupation as the worker seeking compensation; and
        3. Did not seek or obtain from such property’s owners, or from any other property owners for whom such person rendered property management services, profit from the services performed by individuals engaged in the same trade, business or occupation as the worker seeking compensation.
      2. For purposes of this subsection, “the business of property management” means the oversight, supervision, and care of real property or improvements to real property, on behalf of such property’s owners.
      3. For purposes of this subsection, “property owners” or “property’s owners” means (i) owners in fee of such property or (ii) persons having legal entitlement to the use or occupation of such property at the time of the injury for which liability is sought to be imposed pursuant to this section.

    History. Code 1950, §§ 65-26 through 65-28; 1968, c. 660, §§ 65.1-29 through 65.1-31; 1991, c. 355; 1999, c. 877.

    Cross references.

    As to effect of this section on employee’s right to bring common-law action for injuries, see notes to §§ 65.2-307 and 65.2-309 .

    The 1999 amendment added subsection D.

    Law Review.

    For comment on workers’ compensation and negligent third parties, see 17 Wash. & Lee L. Rev. 315 (1960).

    For survey of Virginia law on torts for the year 1969-1970, see 56 Va. L. Rev. 1419 (1970).

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1972-1973, see 59 Va. L. Rev. 1632 (1973).

    For article, “Recovery for Accidental Injuries Under the Virginia Workmen’s Compensation Act,” see 14 U. Rich. L. Rev. 659 (1980).

    Michie’s Jurisprudence.

    For related discussion, see 9B M.J. Independent Contractors, § 19; 21 M.J. Workers’ Compensation, §§ 6, 10, 54.

    CASE NOTES

  • Analysis
  • I.General Consideration.

    Editor’s note.

    Some of the cases annotated below were decided under former §§ 65.1-29, 65.1-30, and 65.1-31 or prior law.

    Purpose. —

    The purpose of former §§ 65.1-29 through 65.1-34 is to bring within the operation of the Workmen’s (now Workers’) Compensation Act all persons engaged in any work that is a part of the trade, business or occupation of the original party who undertakes as owner, or contracts as contractor, to perform that work, and to make liable to every employee engaged in that work every such owner, or contractor, and subcontractor, above such employee. Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959); Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980); Smith v. Horn, 232 Va. 302 , 351 S.E.2d 14, 3 Va. Law Rep. 1265, 1986 Va. LEXIS 257 (1986).

    The legislative intention in enacting this section was to impose the obligations of the Act upon an owner in every case in which the work being done is a kind of work which employees of the owner usually or appropriately do, though, in the particular instance, some or all of the work is being accomplished through independent contractors. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    The purpose of this section is to bring within the operation of the Workers’ Compensation Act all persons engaged in any work that is a part of the trade, business, or occupation of the “owner” which is customarily done by the owner’s employees. Southeastern Tidewater Area Manpower Auth. v. Coley, 221 Va. 859 , 275 S.E.2d 589, 1981 Va. LEXIS 220 (1981); Pearman v. United States, 528 F. Supp. 598, 1981 U.S. Dist. LEXIS 16545 (W.D. Va. 1981).

    This section is to prevent employers from escaping coverage of the Workers’ Compensation Act by doing, through independent contractors and subcontractors, what they normally would do through employees. Vess v. Davis Elec. Constructors, Inc., 613 F. Supp. 1047, 1985 U.S. Dist. LEXIS 17775 (W.D. Va. 1985), aff'd, 818 F.2d 30, 1987 U.S. App. LEXIS 5600 (4th Cir. 1987).

    The central purpose of this section is to bring within the operation of the compensation act all persons engaged in any work that is a part of the trade, business or occupation of the original party who undertakes as owner, or contracts as contractor, to perform that work, and to make liable to every employee engaged in that work every such owner, contractor and subcontractor above the employee. Vess v. Davis Elec. Constructors, Inc., 613 F. Supp. 1047, 1985 U.S. Dist. LEXIS 17775 (W.D. Va. 1985), aff'd, 818 F.2d 30, 1987 U.S. App. LEXIS 5600 (4th Cir. 1987).

    Former § 65.1-30, as well as the parallel provisions contained in former §§ 65.1-29 and 65.1-31, were designed to assure employees of protection under the Act. Together these provisions imposed liability on an owner, contractor or subcontractor who subcontracted work which was a part of his trade to another person or a subcontractor who in turn subcontracted with another person. All were liable to pay compensation to any worker employed in the work that each undertook. Smith v. Weber, 3 Va. App. 379, 350 S.E.2d 213, 3 Va. Law Rep. 1114, 1986 Va. App. LEXIS 372 (1986).

    This provision is meant to prevent an owner from escaping liability under the Workers’ Compensation Act by the simple expedient of subcontracting away work which is part of its trade, business, or occupation. Such an owner will remain liable under the Act to the extent the work subcontracted is part of that owner’s trade, business, or occupation. Henderson v. Central Tel. Co., 233 Va. 377 , 355 S.E.2d 596, 3 Va. Law Rep. 2494, 1987 Va. LEXIS 203 (1987).

    The primary purpose of this section is to protect the employees of subcontractors who are not financially responsible and to prevent employers from relieving themselves of liability (for compensation) by doing through independent contractors what they would otherwise do through direct employees. Oakwood Hebrew Cem. Ass’n v. Spurlock, No. 1978-91-2 (Ct. of Appeals Aug. 18, 1992).

    The purpose of the statute is to expand the popular definition of “employer” in order to bring within the Virginia Workers’ Compensation Act independent contractors and subcontractors who are engaged in work that is part of the trade, business, or occupation of the owner. McCotter v. Smithfield Packing Co., 849 F. Supp. 443, 1994 U.S. Dist. LEXIS 5164 (E.D. Va. 1994).

    Purpose of this section is to insure compensation coverage for employees of independent contractors and subcontractors, not the subcontractor himself. Clinchfield Coal Co. v. Coleman, 1999 Va. App. LEXIS 662 (Va. Ct. App. Dec. 7, 1999).

    The plain meaning of this section is to hold the statutory employer liable to pay compensation as if the worker were his own immediate employee, and the posture of the statutory employer, once he is established as such, is thus one of direct liability. Clinchfield Coal Co. v. Coleman, 1999 Va. App. LEXIS 662 (Va. Ct. App. Dec. 7, 1999).

    Former § 65.1-104.2 (see now § 65.2-802 ) does not remove right to proceed under this section. —

    The fact that all members of the Virginia Coal Producers Group (VCPG) are jointly and severally obligated to each other under former § 65.1-104.2 does not remove from an injured employee the right to proceed against a statutory employer under this section, but rather, the joint and several liability of the members of the VCPG under former § 65.1-104.2 simply operates to give the statutory employer a broader base of possible indemnification, and it does not, and moreover cannot, alter the statutory employer’s obligations which are plainly set forth in this section. Clinchfield Coal Co. v. Coleman, 1999 Va. App. LEXIS 662 (Va. Ct. App. Dec. 7, 1999).

    The issue whether a person is a statutory employee presents a mixed question of law and fact which must be resolved in light of the facts and circumstances of each case. Stone v. Door-Man Mfg. Co., 260 Va. 406 , 537 S.E.2d 305, 2000 Va. LEXIS 134 (2000).

    It is well established that the borrowed servant doctrine applies to state and federal workers’ compensation acts. McCotter v. Smithfield Packing Co., 849 F. Supp. 443, 1994 U.S. Dist. LEXIS 5164 (E.D. Va. 1994).

    A general contractor cannot avoid liability simply because another insured statutory employer preceded it in the ascending employment hierarchy. Thus, employees of an uninsured sub-subcontractor may look to the subcontractor, and to the general contractor, for coverage, although recovery is not permitted from both. Sites Constr. Co. v. Harbeson, 16 Va. App. 835, 434 S.E.2d 1, 10 Va. Law Rep. 107, 1993 Va. App. LEXIS 328 (1993).

    General contractor and subcontractor subject to liability for awards. —

    Where neither subcontractor nor general contractor used the service of any of the claimants for pay, neither falls within the definition of “employer” set forth in § 65.2-101 . However, both are subject to liability for awards to the claimants under the Virginia Workers’ Compensation Act because of their status as statutory employers pursuant to this section. Sites Constr. Co. v. Harbeson, 16 Va. App. 835, 434 S.E.2d 1, 10 Va. Law Rep. 107, 1993 Va. App. LEXIS 328 (1993).

    Award against first statutory employer permitted. —

    The commission’s policy of entering an award against only the first statutory employer in the ascending scale with adequate coverage is neither contrary to nor inconsistent with any statute, has a rational basis in furthering the overall objectives of the act by expediting the receipt of benefits, and has been implicitly approved by the legislature. Sites Constr. Co. v. Harbeson, 16 Va. App. 835, 434 S.E.2d 1, 10 Va. Law Rep. 107, 1993 Va. App. LEXIS 328 (1993).

    Owner can subcontract all its work yet remain liable under Workers’ Compensation Act. —

    This section contemplates that an owner can subcontract all its work yet remain liable under the Workers’ Compensation Act. Henderson v. Central Tel. Co., 233 Va. 377 , 355 S.E.2d 596, 3 Va. Law Rep. 2494, 1987 Va. LEXIS 203 (1987).

    Recovery limited to that specified in Act. —

    If a person is engaged in work which is part of the undertaking of the owner or general contractor, regardless of his relationship to the injured workman and his immediate employer, the Workmen’s (now Workers’) Compensation Act operates to place the economic loss upon the project and to limit the workman’s recovery to that specified in the Act. Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964); Bergen v. Fourth Skyline Corp., 501 F.2d 1174, 1974 U.S. App. LEXIS 7193 (4th Cir. 1974).

    Liability imposed on certain parties. —

    The Workmen’s (now Workers’) Compensation Act imposes liability not only on the workmen’s employer, but also on the third party who has contracted with the workmen’s employer for the work which is a part of the third party’s trade, business or occupation. Snowden v. VEPCO, 432 F. Supp. 266, 1976 U.S. Dist. LEXIS 11989 (E.D. Va. 1976).

    Phrase “workman employed in the work,” to whom compensation benefits are owed, refers to employees, not the subcontractor himself. A subcontractor does not, anywhere, come within the terms of the Act as entitled to compensation. Intermodal Servs., Inc. v. Smith, 234 Va. 596 , 364 S.E.2d 221, 4 Va. Law Rep. 1560, 1988 Va. LEXIS 4 (1988).

    Statutory fellow employees. —

    Contractors, subcontractors, and all workers who are engaged in the trade, business, or occupation of the owner of a project are deemed to be statutory fellow employees. The remedy for any injury suffered by one of them as a result of the alleged negligence of another, while engaged in the trade, business, or occupation of the owner, is limited to that available under the Workers’ Compensation Act. Nichols v. VVKR, Inc., 241 Va. 516 , 403 S.E.2d 698, 7 Va. Law Rep. 2377, 1991 Va. LEXIS 55 (1991).

    Owner became “statutory employer” of contractor’s employees. —

    Former §§ 65.1-29 through 65.1-32 (now §§ 65.2-302 and 65.2-303 ) required the owners of a project to accept responsibility for the compensation of injured employees of contractors hired by the owner. The owner thus became the “statutory employer” of the contractor’s employees who, in turn, were the “statutory employees” of the owner. Farish v. Courion Indus., Inc., 722 F.2d 74, 1983 U.S. App. LEXIS 14855 (4th Cir. 1983).

    Liability as a statutory employer was properly imposed upon party with whom injured truck driver’s immediate employer had subcontracted, even though the truck driver was injured enroute to the job site and the contractual obligation was conditional upon arrival at the job site. A.G. Van Metre, Jr., Inc. v. Gandy, 7 Va. App. 207, 372 S.E.2d 198, 5 Va. Law Rep. 391, 1988 Va. App. LEXIS 110 (1988).

    Statutory employer has right of indemnity. —

    The statute provides that, though liable to the employee, the statutory employer has the right of indemnity against the immediate employer. Race Fork Coal Co. v. Turner, 5 Va. App. 350, 363 S.E.2d 423, 4 Va. Law Rep. 1430, 1987 Va. App. LEXIS 247 (1987), rev'd, 237 Va. 639 , 379 S.E.2d 341, 5 Va. Law Rep. 2382, 1989 Va. LEXIS 70 (1989).

    Exclusive remedy is under Workmen’s (now Workers’) Compensation Act. —

    Where a subcontractor is able to perform the work itself and requires no unreasonable specialized knowledge not possessed by the general contractor, the subcontractor is performing work which was part of the trade, business, or occupation of the general contractor; and because of former §§ 65.1-30 and 65.1-40 (now subsection B and § 65.2-307 ), the exclusive remedy of an employee of the subcontractor is under the Workmen’s Compensation Act. Snead v. Nello L. Teer Co., 353 F. Supp. 434, 1973 U.S. Dist. LEXIS 15205 (W.D. Va. 1973).

    Common-law right to sue abrogated. —

    A general partner’s statutory election to be covered as an employee by the Virginia Workers’ Compensation Act abrogated his common-law right to sue the owner of a project for injuries sustained while working on the project. Counts v. Stone Container Corp., 239 Va. 152 , 387 S.E.2d 481, 6 Va. Law Rep. 1109, 1990 Va. LEXIS 8 (1990).

    Section applies only where there are at least four persons in interest. —

    This section is applicable only to cases in which there are at least four persons in interest, namely: (1) an owner or other person who is having work executed for himself; (2) an independent contractor who has undertaken to execute the work for the person first mentioned; (3) a subcontractor, between whom and the independent contractor (the person secondly mentioned), there is a contract for the execution by or under the subcontractor of the whole or some part of the work; and (4) a workman “employed in the work.” Where there are four such persons in interest, the section does depart from the classification made by the general provisions of the Workmen’s (now Workers’) Compensation Act, based on the existence of the relationship of master and servant between the person liable and the workman. Bamber v. City of Norfolk, 138 Va. 26 , 121 S.E. 564 , 1924 Va. LEXIS 8 (1924); Holt v. Bowie, 343 F. Supp. 962, 1972 U.S. Dist. LEXIS 13479 (W.D. Va. 1972) (see discussion of).Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947).

    This section was not intended to relieve employers from liability for their own negligence which causes injury to the employees of independent contractors engaged in the performance of work for employers outside the scope of the employers’ occupation. Sears, Roebuck & Co. v. Wallace, 172 F.2d 802, 1949 U.S. App. LEXIS 2779 (4th Cir. 1949); Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980); Farish v. Courion Indus., Inc., 722 F.2d 74, 1983 U.S. App. LEXIS 14855 (4th Cir. 1983).

    Former § 65.1-5 (now § 65.2-101 ) must be read and reconciled with former §§ 65.1-29 through 65.1-31. Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959); Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980).

    Former § 65.1-5 (now § 65.2-101 ) must be reconciled with former § 65.1-29 (now subsection A). Holt v. Bowie, 343 F. Supp. 962, 1972 U.S. Dist. LEXIS 13479 (W.D. Va. 1972).

    Former § 65.1-5 (now § 65.2-101 ) must be read and reconciled with provisions of former § 65.1-30 (now subsection B). Smith v. Weber, 3 Va. App. 379, 350 S.E.2d 213, 3 Va. Law Rep. 1114, 1986 Va. App. LEXIS 372 (1986).

    Effect of former § 65.1-5 (now § 65.2-101 ). —

    When the employee reaches an employer in the ascending scale, of whose trade, business or occupation the work being performed by the employee is not a part, then that employer is not liable to that employee for compensation under this section. At that point former § 65.1-5 (now § 65.2-101 ) intervenes and the employee’s right of action at common law is preserved. Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959); Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980).

    If there is any doubt that this section does not include the owner of property who employs an independent contractor to do work for him, it is set at rest by former § 65.1-5 (now § 65.2-101 ), which provides that nothing in the Workmen’s (now Workers’) Compensation Act shall be construed to make the employees of an independent contractor the employees of the person contracting with him. Bamber v. City of Norfolk, 138 Va. 26 , 121 S.E. 564 , 1924 Va. LEXIS 8 (1924) (see discussion of this case in).Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947).

    Former §§ 65.1-29 and 65.1-30 have same purpose and effect. —

    While former §§ 65.1-29 and 65.1-30 place the liability under the Workmen’s (now Workers’) Compensation Act on different people, they do have the same purpose and effect and are in reality almost identical in operation. Snead v. Nello L. Teer Co., 353 F. Supp. 434, 1973 U.S. Dist. LEXIS 15205 (W.D. Va. 1973).

    The effect of this section and former § 65.1-32 (now § 65.2-303 ) is to render the owner or contractor the statutory employer of all employees engaged in the work. Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964).

    Section does not affect status of subcontractor. —

    This section and former §§ 65.1-30 through 65.1-34 never were intended to affect the status of a subcontractor. They only took in a class of employees (employees of a subcontractor) and made them eligible to compensation just as the employees of the owner or contractor are eligible under the definition of employee in former § 65.1-4 (now § 65.2-101 ). Baker v. Nussman, 152 Va. 293 , 147 S.E. 246 , 1929 Va. LEXIS 170 (1929).

    Thus he is not entitled to compensation. —

    A subcontractor does not, anywhere, come within the terms of the Workmen’s (now Workers’) Compensation Act as entitled to compensation. His status is now, just as it was before the enactment of this section and former §§ 65.1-30 through 65.1-34, determined by the common law. Baker v. Nussman, 152 Va. 293 , 147 S.E. 246 , 1929 Va. LEXIS 170 (1929).

    Liability of principal contractor to subcontractor is secondary. —

    While under former §§ 65.1-30 through 65.1-32 the liability of the principal contractor is directly to the workman, as between the principal contractor and subcontractor, the liability of the principal contractor is secondary, and the principle of exoneration does not operate in favor of one primarily liable against one secondarily liable. Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947). But see McGann v. Moss, 50 F. Supp. 573, 1943 U.S. Dist. LEXIS 2436 (D. Va. 1943).

    Section does not apply where owner and subcontractor occupy relation of buyer and seller. —

    One who contracts with the owner of a mill to buy, cut and remove logs from another’s land and deliver them to the mill, carrying on an independent business, performing his own work according to his own methods, using his own equipment, and employing his own servants and exercising exclusive supervision over them, is an independent contractor. The relation between the parties is that of buyer and seller, and the mill owner is not liable under this section for an injury to a workman of the contractor. Perkinson v. Thomas, 158 Va. 699 , 164 S.E. 561 , 1932 Va. LEXIS 289 (1932).

    Present contractor, who impliedly assumed previous contractor’s liabilities, was statutory employer. —

    Where general contractors conduct similarly manifested an implied agreement to assume previous general contractor’s contractual liabilities with subcontractors, the present general contractor was the statutory employer of employee of subcontractor at the time of his injury. States Roofing Corp. v. Bush Constr. Corp., 15 Va. App. 613, 426 S.E.2d 124, 9 Va. Law Rep. 808, 1993 Va. App. LEXIS 12 (1993).

    Builder was general contractor and statutory employer. —

    The record contained credible evidence from which the commission could have concluded that builder contracted to deliver a completed home, not merely to supervise its construction, making builder both the general contractor and claimant’s statutory employer. C. Richard Bogese Bldr., Inc. v. Robertson, 17 Va. App. 700, 440 S.E.2d 622, 10 Va. Law Rep. 895, 1994 Va. App. LEXIS 68 (1994).

    In a workers’ compensation matter involving an injury at a construction site, because sufficient evidence existed to support the workers’ compensation commission’s finding that the claimant was acting as a borrowed employee at the time of an accident, the commission did not err in finding the general contractor liable as the statutory employer. Liberty Mut. Ins. Corp. v. Herndon, 59 Va. App. 544, 721 S.E.2d 32, 2012 Va. App. LEXIS 36 (2012).

    Liability as a statutory employer was properly imposed upon party with whom injured truck driver’s immediate employer had subcontracted, even though the truck driver was injured enroute to the job site and the contractual obligation was conditional upon arrival at the job site. A.G. Van Metre, Jr., Inc. v. Gandy, 7 Va. App. 207, 372 S.E.2d 198, 5 Va. Law Rep. 391, 1988 Va. App. LEXIS 110 (1988).

    Employees of subcontractor considered employees for determining applicability of Act. —

    The subcontractor’s employees are employees of the contractor for purposes of liability. Since they are the contractor’s employees for purposes of determining liability, reason dictates that they should also be considered employees for determining applicability of the Act. Smith v. Weber, 3 Va. App. 379, 350 S.E.2d 213, 3 Va. Law Rep. 1114, 1986 Va. App. LEXIS 372 (1986).

    Immunity as between employee of one subcontractor and other subcontractor. —

    If a particular subcontractor and an injured employee’s common law or statutory employer are both working on the same project and are both engaged in the owner’s or general contractor’s work, that particular subcontractor, as a statutory co-employee of the injured worker, is also entitled to the common law immunity provided by the exclusivity provision. Pfeifer v. Krauss Constr. Co. of Va., Inc., 262 Va. 262 , 546 S.E.2d 717, 2001 Va. LEXIS 60 (2001).

    The nonresident employee of a nonresident subcontractor was a statutory employee of a Virginia owner under this section. McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    Status of State prisoner on work release. —

    See Owens v. Swift Agric. & Chem. Corp., 477 F. Supp. 91, 1979 U.S. Dist. LEXIS 9887 (E.D. Va.), aff'd, 612 F.2d 1309 (4th Cir. 1979).

    Salesman as employee. —

    While a producer’s ultimate objective is to place its products in the hands of the consumer public, it does not follow that the salesman handling a manufactured product which reaches the consumer public through a retail store is the statutory employee of the manufacturer. Barnhart v. AMOCO, 237 F. Supp. 492, 1965 U.S. Dist. LEXIS 9737 (E.D. Va. 1965), aff'd, 354 F.2d 659, 1966 U.S. App. LEXIS 7570 (4th Cir. 1966).

    If an employee can show that he was unaware of the relationship between his employer and some third party, who was his statutory employer at the time of his injury, and could not reasonably have known of it within 30-day period, he has the right under former § 65.1-85 (now § 65.2-600 ) to introduce evidence in an attempt to satisfy the Industrial Commission that there was a reasonable excuse for not giving the notice. Race Fork Coal Co. v. Turner, 237 Va. 639 , 379 S.E.2d 341, 5 Va. Law Rep. 2382, 1989 Va. LEXIS 70 (1989).

    Cancellation of subcontractor’s insurance without notice to contractor did not impose liability on it as a statutory employer without due process of law; contractor’s liability arose from its employment of subcontractor and, vicariously, subcontractor’s employee; its liability as a statutory employer existed without reference to insurance; furthermore, if it were obliged to pay benefits to employee, it was entitled to seek indemnity from subcontractor, and therefore, this was a circumstance which did not fix liability on contractor. Girdley Constr. Co. v. Widger, 1990 Va. App. LEXIS 241 (Va. Ct. App. May 29, 1990).

    Insurance carrier required to defend employee. —

    Although deemed a statutory employee for purposes of workers’ compensation, individual was not an employee of insured within the plain meaning of the policy. Accordingly, the trial court erred in determining that the employee exclusion clause of the policy permitted insurance company to refuse to fulfill its obligation to defend insured. VEPCO v. Northbrook Property & Cas. Ins. Co., 252 Va. 265 , 475 S.E.2d 264, 1996 Va. LEXIS 81 (1996).

    Employer estopped from asserting claimant not statutory employee. —

    By virtue of the final order of the circuit court barring claimant’s action at law on the ground that he was the statutory employee of employer, an order which was granted upon employer’s motion, employer was estopped from asserting otherwise when claimant pursued a claim before the Virginia Workers’ Compensation Commission. Richfood, Inc. v. Ragsdale, 26 Va. App. 21, 492 S.E.2d 836, 1997 Va. App. LEXIS 682 (1997).

    II.Political Subdivisions.

    “Any person” does not include State or political subdivision. —

    This section makes no mention of the State or its political subdivisions or municipal corporations. The general term “any person” does not apply to municipal corporations and political subdivisions of the State, and therefore this section is not applicable to them. City of Portsmouth v. Daniels, 157 Va. 614 , 162 S.E. 324 , 1932 Va. LEXIS 316 (1932); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    Test used for governmental entity. —

    Statutory employer status is attributed to an owner when the injured employee performs work that is part of the owner’s trade, business or occupation. As applied to a governmental entity such as the United States Navy in the instant case, the appropriate test is what activities the putative statutory employer is mandated to do by statute or regulation. In other words, any activity which a government entity is authorized or required to do is considered its trade, business or occupation. Perry v. United States, 882 F. Supp. 537, 1995 U.S. Dist. LEXIS 4891 (E.D. Va. 1995).

    When a subcontractor’s employee was injured while removing electrical conduit from a public university’s building, the university was his statutory employer because the maintenance and preservation of the university’s buildings was something the university was required by § 23-76 to do, so it was part of the university’s trade, business or occupation, and the worker’s remedies against the university were limited to his workers’ compensation remedies, under the exclusivity provision of the Virginia Workers’ Compensation Act, § 65.2-307 A. Jones v. Commonwealth, 267 Va. 218 , 591 S.E.2d 72, 2004 Va. LEXIS 22 (2004).

    Any activity of the University of Virginia authorized or required by statute is the trade, business, or occupation of the University for purposes of the Virginia Workers’ Compensation Act, § 65.2-100 et seq. Jones v. Commonwealth, 267 Va. 218 , 591 S.E.2d 72, 2004 Va. LEXIS 22 (2004).

    Thus, section does not render city liable to contractor’s employee. —

    Where the defendant city in its proprietary capacity was engaged in maintaining a water system and in selling water, and entered into a contract with deceased’s employer for the erection of a standpipe by the employer for the city, and deceased was killed in the course of his employment while working on the standpipe, the city was not liable under this section. Bamber v. City of Norfolk, 138 Va. 26 , 121 S.E. 564 (1924). But see discussion of this case in Sykes v. Stone & Webster Eng’r Corp., 186 Va. 116 , 41 S.E.2d 469 (1947).

    But a turnpike authority is an “owner” within the meaning of this section, though the act creating it provides that it is “created and constituted a political subdivision of the Commonwealth.” Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    The Federal Employees’ Compensation Act does not exempt federal employees from the Virginia Workers’ Compensation Act (VWCA). The statute merely shields the United States from liability arising out of the death of a federal employee in any type of proceeding, including a proceeding brought under a state workers’ compensation act such as the VWCA. McCotter v. Smithfield Packing Co., 849 F. Supp. 443, 1994 U.S. Dist. LEXIS 5164 (E.D. Va. 1994).

    The statutory-employer test applied to governmental entities differs from that usually applied to private business entities. Consequently, local governments’ trade, business, or occupation must be judged according to the public duties they are authorized and empowered by legislative mandate to perform. Roberts v. City of Alexandria, 246 Va. 17 , 431 S.E.2d 275, 9 Va. Law Rep. 1418, 1993 Va. LEXIS 102 (1993).

    Recovery under Federal Tort Claims Act precluded. —

    The United States Air Force was a statutory employer of a worker killed in an explosion while working for a corporation which was under contract with the Air Force to develop rocket fuel, and thus the exclusive remedy provision of this section prevented any recovery from the government under the Federal Tort Claims Act. Pendley v. United States, 856 F.2d 699, 1988 U.S. App. LEXIS 12649 (4th Cir. 1988), cert. denied, 490 U.S. 1005, 109 S. Ct. 1640, 104 L. Ed. 2d 155, 1989 U.S. LEXIS 1700 (1989).

    Employer plant not statutory employer of employee hired by federal government. —

    Where plaintiff was hired, trained, and placed at the employer’s plant by the federal government pursuant to federal law requiring food inspectors at meat packing facilities, plaintiff had been paid by the federal government, supervised exclusively by federal employees, and could be fired only by the federal government and employer had no control over the manner in which plaintiff performed her duties, employer was not plaintiff’s statutory employer. McCotter v. Smithfield Packing Co., 849 F. Supp. 443, 1994 U.S. Dist. LEXIS 5164 (E.D. Va. 1994).

    Construction of roof was part of municipality’s business or occupation. —

    Municipality which engaged a contractor to replace a roof on one of its waterworks facilities was the statutory employer of the contractor’s employee who lost his life in the performance of the contract, since construction of the roof was part of the “trade, business or occupation” of the city. Ford v. City of Richmond, 239 Va. 664 , 391 S.E.2d 270, 6 Va. Law Rep. 2241, 1990 Va. LEXIS 64 (1990).

    Medical services delivered to jails are within city’s trade, business, or occupation. —

    Because the city is authorized and empowered to operate the jail, and to provide medical services there, the delivery of those medical services are within the city’s trade, business, or occupation. Roberts v. City of Alexandria, 246 Va. 17 , 431 S.E.2d 275, 9 Va. Law Rep. 1418, 1993 Va. LEXIS 102 (1993).

    United States as statutory employer. —

    Where the work of the plaintiff involved repair and maintenance to a United States Naval vessel and said repair and maintenance was a part of the ordinary operational and readiness concern of the United States Navy, the plaintiff was engaged in the “trade, business or occupation” of the United States Navy, rendering the United States his statutory employer. Hyman v. United States, 796 F. Supp. 905, 1992 U.S. Dist. LEXIS 12502 (E.D. Va. 1992).

    State workers’ compensation benefits were the exclusive remedy of an employee of a subcontractor who was injured while working to provide meals at a Marine base since the Marine Corps was her statutory employer under state workers’ compensation law because the Marine Corps was required by statute and regulation to provide meals for its enlisted members, and therefore the work subcontracted out to a food service provider and performed by the employee was part of the Marine Corps’ trade, business, or occupation. Coulter v. United States, 256 F. Supp. 2d 484, 2003 U.S. Dist. LEXIS 6036 (E.D. Va. 2003), aff'd, 90 Fed. Appx. 60, 2004 U.S. App. LEXIS 5345 (4th Cir. 2004).

    III.Statutory Employers.
    A.Trade, Business, or Occupation.
    1.General Consideration.

    “Owner” does not necessarily mean a general contractor. —

    This section would be meaningless if construed to reach an owner only if the owner is also a general contractor, already subject to the obligations of the Act. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    Section refers to owner who procures another to perform work undertaken by owner. —

    This section refers to an owner who undertakes to perform any work which is a part of his trade or business and procures another to perform the whole or any part of that work which the owner had undertaken. Shell Oil Co. v. Leftwich, 212 Va. 715 , 187 S.E.2d 162, 1972 Va. LEXIS 246 (1972).

    Action for damages not barred where owner is “other party.” —

    The Workmen’s (now Workers’) Compensation Act does not bar an action by the injured employees of an independent contractor against an owner as third party if the owner is one referred to in the Act as an “other party.” Snowden v. VEPCO, 432 F. Supp. 266, 1976 U.S. Dist. LEXIS 11989 (E.D. Va. 1976).

    When owner not “other party.” —

    The owner under the Workmen’s (now Workers’) Compensation Act is not an “other party” if the subcontractor for whom injured plaintiff worked was performing work which was a part of the “trade, business or occupation” of the owner at the time of the injury. Snowden v. VEPCO, 432 F. Supp. 266, 1976 U.S. Dist. LEXIS 11989 (E.D. Va. 1976).

    The interests of the statutory employer and the actual employer are not sufficiently identical to regard the employer as representing all of the legal rights and defenses the statutory employer may have against the claimant. Race Fork Coal Co. v. Turner, 237 Va. 639 , 379 S.E.2d 341, 5 Va. Law Rep. 2382, 1989 Va. LEXIS 70 (1989).

    When general contractor is statutory employer. —

    If a general contractor contracts with another contractor to perform work which is part of the general contractor’s trade, business or occupation, that other contractor is a subcontractor within the meaning of the Workmen’s (now Workers’) Compensation Act, and, under this section, the general contractor is a statutory employer of the other contractor’s workmen. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    The effect of this section is to render the general contractor a statutory employer of all employees engaged in the work. If the general contractor is deemed a statutory employer, he is treated as an employer within the meaning of former §§ 65.1-40 and 65.1-103 (see now §§ 65.2-307 and 65.2-800 ), and is therefore immune from a common-law action brought by an injured workman. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    If the subcontractor was performing work which the general contractor was required to perform then the general contractor would be liable to the workmen of the subcontractor, and the injured workmen would be precluded from suing the general contractor. Snead v. Nello L. Teer Co., 353 F. Supp. 434, 1973 U.S. Dist. LEXIS 15205 (W.D. Va. 1973).

    Under an arrangement with a subcontractor, the contractor became a statutory employer within the meaning of the Workmen’s (now Workers’) Compensation Act and was therefore immune from any common-law action by him. Spangler v. Kranco, Inc., 481 F.2d 373, 1973 U.S. App. LEXIS 9092 (4th Cir. 1973).

    The principle is well established that a general contractor is the statutory employer of a subcontractor’s employee under this section of the Workers’ Compensation Act if the employee is engaged in the trade, business, or occupation of the general contractor at the time of his injury. Yancey v. JTE Constructors, Inc., 252 Va. 42 , 471 S.E.2d 473, 1996 Va. LEXIS 64 (1996).

    General contractor which had a contract to complete and sell a home to a buyer was the statutory employer for workers’ compensation benefits of an employee of a tree service company the contractor hired to trim the trees behind a house pursuant to the contract with the buyer, after the employee was injured in a fall from a tree. Princess Anne Builders, Inc. v. Faucette, 37 Va. App. 102, 554 S.E.2d 113, 2001 Va. App. LEXIS 606 (2001).

    Virginia Workers’ Compensation Commission’s finding that a general contractor was a statutory employer was affirmed as the Commission’s finding that the installation of driveway culverts, during which a workers’ compensation claimant was injured, was part of a subcontract was supported by testimony by a subcontractor and an employee of the subcontractor that installing the culverts was a part of the subcontract and an invoice submitted by the subcontractor, which the general contractor paid, that listed installation of the culverts as a portion of the job; the general contractor could not abandon its admission that it hired the subcontractor as a subcontractor, and its self-serving declaration that the culverts were not a part of the job was properly rejected. King George Custom Homes, Inc. v. Hernandez, 2006 Va. App. LEXIS 299 (Va. Ct. App. July 5, 2006).

    The decisive factor in making the statutory employer determination under this section is whether the work being performed by the injured workman was part of the trade, business or occupation of the general contractor. If the work being performed was not a part of the general contractor’s trade, business or occupation, then the general contractor is not a statutory employer under former § 65.1-40 (now § 65.2-307 ) and is not liable for workmen’s (now workers’) compensation. Furthermore, if the general contractor is not a statutory employer, the injured workman’s right to maintain an action at common law is preserved by former § 65.1-5 (now § 65.2-101 ). Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    A manufacturer doing construction work for itself, but not for others, can be a substituted employer of the employees of subcontractors within the meaning of the Workmen’s (now Workers’) Compensation Act. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    This section bars suit by employee of contractor or subcontractor against owner of project if employee is injured in work which is a part of owner’s trade, business or occupation. Evans v. Newport News Shipbuilding & Dry Dock Co., 361 F.2d 364, 1966 U.S. App. LEXIS 6204 (4th Cir.), cert. denied, 385 U.S. 959, 87 S. Ct. 397, 17 L. Ed. 2d 304, 1966 U.S. LEXIS 202 (1966).

    This section concerns only suits by employees of subcontractors against the owners of the project. Snead v. Nello L. Teer Co., 353 F. Supp. 434, 1973 U.S. Dist. LEXIS 15205 (W.D. Va. 1973).

    Owner is liable for compensation only if work is part of his trade or business. —

    The section makes the owner liable if the workman, no matter how far down the line, is doing work which the owner has undertaken to perform as a part of his own trade, business or occupation. But if the work which the workman is doing is not a part of the trade, business or occupation of the owner, and the owner contracts with a contractor to do it, the contractor is liable to the workman, but the owner is not. Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980).

    Former §§ 65.1-29 through 65.1-34 do not refer to any person, who, as owner, undertakes to have any work executed for him by another, not as an employee, but as an independent contractor, which work is not yet “a part of,” but which, when completed, is intended to be used in the owner’s trade, business, or occupation. Bamber v. City of Norfolk, 138 Va. 26 , 121 S.E. 564 , 1924 Va. LEXIS 8 (1924).

    An owner would be liable to workmen of the contractor or subcontractor if these people did work which the owner ordinarily performed in his trade, business or occupation. Holt v. Bowie, 343 F. Supp. 962, 1972 U.S. Dist. LEXIS 13479 (W.D. Va. 1972).

    There is a distinction between an owner or employer who contracts out work which he himself generally does perform or which in the ordinary course of his particular trade or business companies similarly situated actually do or could be expected to perform, and an owner or employer who contracts out work which he does not or never could be expected to perform. In the first situation liability of the owner under the Workmen’s (now Workers’) Compensation Act would attach; in the second case it would not. Holt v. Bowie, 343 F. Supp. 962, 1972 U.S. Dist. LEXIS 13479 (W.D. Va. 1972).

    Owners of projects are liable under the Workmen’s (now Workers’) Compensation Act to employees of subcontractors, if these subcontractors are performing work which is part of the trade, business, or occupation of the owner. Snead v. Nello L. Teer Co., 353 F. Supp. 434, 1973 U.S. Dist. LEXIS 15205 (W.D. Va. 1973).

    In order for this section to control, the “owner” would have had to have been supervising the construction as part of its daily business, and the defendant would then have had to have sued the “owner.” Snead v. Nello L. Teer Co., 353 F. Supp. 434, 1973 U.S. Dist. LEXIS 15205 (W.D. Va. 1973).

    Virginia Workers’ Compensation Commission denied a worker’s claim for compensation benefits because an historical society was not his statutory employers; the complete reconstruction of a school was not a part of the historical society’s trade, business, or occupation but was beyond the restoration project envisioned by the historical society, and its members were not involved in the reconstruction project or other construction activities. Jeffreys v. Uninsured Employer's Fund, 2017 Va. App. LEXIS 249 (Va. Ct. App. Oct. 3, 2017), aff'd, 297 Va. 82 , 823 S.E.2d 476, 2019 Va. LEXIS 8 (2019).

    Workers’ compensation claimant failed to prove that a church or its historical society were his statutory employers under subsection A of § 65.2-302 where the complete restructure of a school was beyond the society’s capabilities, the society’s trade, business, or occupation did not include the complete restructure of the building, and none of the society’s members could have undertaken the construction project. Jeffreys v. Uninsured Employer's Fund, 297 Va. 82 , 823 S.E.2d 476, 2019 Va. LEXIS 8 (2019).

    Type of work may determine relationship. —

    Where credible evidence proved that lumber mill owner did not have any employees who normally carried out the type of work which caused claimant’s injury, i.e., the cutting and harvesting of standing timber, this work, although necessary to lumber mill’s business, was done by independent contractors, such as claimant’s employer. Therefore, the Commission did not err in finding that mill was not claimant’s statutory employer pursuant to subsection A. Uninsured Employer's Fund v. Hilltop Lumber Co., 2000 Va. App. LEXIS 455 (Va. Ct. App. June 20, 2000).

    Mowing and maintenance activity that subcontractor had agreed to perform for cemetery association was part of the association’s “trade, business or occupation” within the meaning of former § 65.1-29, and thus, the association was the statutory employer of subcontractor’s employee when he was injured. Oakwood Hebrew Cem. Ass’n v. Spurlock, No. 1978-91-2 (Ct. of Appeals Aug. 18, 1992).

    Construction or rehabilitation of a transportation/retail facility was not the trade, business, or occupation of providing mass transportation services, in an action to determine if engineering firm and construction company employees were statutory fellow employees. Nichols v. VVKR, Inc., 241 Va. 516 , 403 S.E.2d 698, 7 Va. Law Rep. 2377, 1991 Va. LEXIS 55 (1991).

    Retail sales business. —

    Where defendant corporation’s “trade, business or occupation” is a retail sales business whose revenues derive entirely from retail sales, the fact that defendant has a “Property Development Division” concerned with construction oversight, does not place it into the construction trade for purposes of the Workers’ Compensation Act. Ramsburg v. Target Stores, Inc., 982 F. Supp. 1194, 1997 U.S. Dist. LEXIS 16715 (W.D. Va. 1997).

    Area manpower authority not liable for employee of nonprofit organization. —

    Where an employee was accidentally injured while working for a nonprofit organization which was not insured under any workers’ compensation policy and did not qualify as a self-insured, and where an area manpower authority obtained, disbursed and monitored federal funds for the nonprofit organization, the injured employee was not a statutory employee of the area manpower authority since the administration of the nonprofit organization’s programs, the selection of the individuals to participate therein, the selection of instructors and employees to service the programs, and the salaries, grants, and allowances to be paid were all activities which the area manpower authority did not normally carry on through its employees and which it was not designated to carry on. Southeastern Tidewater Area Manpower Auth. v. Coley, 221 Va. 859 , 275 S.E.2d 589, 1981 Va. LEXIS 220 (1981).

    Where portrait photographer operated portrait photography department in retail department store pursuant to license agreement, the retail sales aspect of the photographer’s work was a part of the department store’s trade, business or occupation and the photographer was statutory employee at the time he sustained his injury. Carmody v. F.W. Woolworth Co., 234 Va. 198 , 361 S.E.2d 128, 4 Va. Law Rep. 793, 1987 Va. LEXIS 229 (1987).

    Painting not done as part of owners trade or business. —

    Manufacturer who engaged a general contractor to construct a building for use in the conduct of its business was not the statutory employer of a worker hired by a subcontractor engaged by the general contractor to paint the building since engaging an independent contractor to perform this work did not constitute a part of manufacturer’s trade, business, or occupation. Cinnamon v. IBM Corp., 238 Va. 471 , 384 S.E.2d 618, 6 Va. Law Rep. 628, 1989 Va. LEXIS 134 (1989).

    Company “employer” under Workers’ Compensation Act. —

    Virginia Workers’ Compensation Commission did not err in finding that a company was an “employer” under the Virginia Workers’ Compensation Act, subsection A of § 65.2-302 , because the company conducted its business primarily through the employees of its other family-owned business and contracted with that business to perform the upkeep and day-to-day operations of its business, and the Commission had sufficient evidence to conclude that those employees were engaged in the regular business of the company; as such, those employees were statutory employees of the company at the time of claimant’s accident, and the company fell under the jurisdiction of the Act. Sherman & Sherman Props. v. Long, 2011 Va. App. LEXIS 128 (Va. Ct. App. Apr. 12, 2011).

    Contracting company was a claimant’s statutory employer because the company contracted with an individual to perform a roofing project during which claimant was injured; thus, the company was liable for the claimant’s work-related injury. Associated Aluminum Prods. v. Elvira-Menez, 2014 Va. App. LEXIS 317 (Va. Ct. App. Sept. 16, 2014).

    Exclusivity. —

    Where a North Carolina employee was injured while working in Virginia and received workers’ compensation benefits under North Carolina law, the exclusivity provision of the Virginia Workers’ Compensation Act barred the employee’s personal injury suit against a Virginia subcontractor because the injury occurred in Virginia and the subcontractor was a statutory co-employee under Virginia law; the Full Faith and Credit Clause did not require Virginia to defer to the law of North Carolina, the state that paid the employee benefits, in determining whether the suit was barred. Demetres v. East West Constr., Inc., 776 F.3d 271, 2015 U.S. App. LEXIS 629 (4th Cir. 2015).

    2.Delivery and Loading/Unloading.

    Statutory employer determination. —

    Defendant corporation was a “statutory employer” of plaintiff, thus barring plaintiff’s personal injury suit, where the corporation undertook to perform work that was part of its trade, business, or occupation (the manufacture of caprolactam and nylon fiber) and contracted with plaintiff’s employer on a long-term basis to perform a part of that work—the transport of caprolactam, a chemical intermediate used in the manufacture of nylon, between the corporation’s plants; plaintiff, was injured on the corporation’s premises while the corporation was loading his truck with caprolactam, a necessary step in the transport process. Meredith v. Honeywell Int'l, 445 F. Supp. 2d 661, 2006 U.S. Dist. LEXIS 60326 (E.D. Va. 2006), aff'd, 245 Fed. Appx. 325, 2007 U.S. App. LEXIS 20099 (4th Cir. 2007).

    Act of sitting in a chair was not a “discrete activity” removed from the loading process (an essential part of the work that defendant corporation performed in the manufacture and processing of caprolactam was transporting the caprolactam between the corporation’s plants), where plaintiff presented documentation to the control operator, a required step in the loading process, and then attempted to sit down in the chair; the act of sitting did not remove plaintiff’s activity from the trade, business, or occupation of the corporation. Meredith v. Honeywell Int'l, 445 F. Supp. 2d 661, 2006 U.S. Dist. LEXIS 60326 (E.D. Va. 2006), aff'd, 245 Fed. Appx. 325, 2007 U.S. App. LEXIS 20099 (4th Cir. 2007).

    A truck driver’s remedies against a statutory employer were limited to those provided under the Virginia Workers’ Compensation Act, § 65.2-100 et seq., regardless of the contractual employment relationship between the driver and the statutory employer. Meredith v. Honeywell Int'l, Inc., 245 Fed. Appx. 325, 2007 U.S. App. LEXIS 20099 (4th Cir. 2007).

    In a wrongful death action the trial court erred in finding the parties were statutory employees of the Virginia Port Authority and therefore subject to the exclusivity provisions of the Virginia Workers’ Compensation Act; a schedule of rates between the decedent’s employer and the Virginia Port Authority was not a contract that created a statutory employer relationship under subsection A of § 65.2-302 . Moore v. Va. Int'l Terminals, Inc., 283 Va. 232 , 720 S.E.2d 117, 2012 Va. LEXIS 4 (2012).

    Trucker as employee. —

    Plaintiff was transporting goods to a distribution center, an activity which defendant grocery chain normally performed as part of its grocery business, thus, the transportation, loading and unloading of canned goods was an essential function of its business and independent trucker became its statutory employee when he performed those duties at the time of his injury. Hayden v. Kroger Co., 17 F.3d 74, 1994 U.S. App. LEXIS 3089 (4th Cir. 1994).

    Barge terminal not statutory employer of stevedore workers. —

    Trial court erred in dismissing an injured worker’s personal injury action against another worker; a barge terminal at which the truck accident occured was not the statutory employer of the two workers, as the terminal was not a party to any contract that required the injured worker or his employer to load or unload a barge. Hudson v. Jarrett, 269 Va. 24 , 606 S.E.2d 827, 2005 Va. LEXIS 2 (2005).

    United States Postal Service as statutory employer. —

    The U.S. Postal Service was the statutory employer of a truck driver employed by a contract mail hauler as the truck driver transported mail between distribution points and thus engaged in one of the most fundamental aspects of the mail delivery process. Nelson v. United States Postal Serv., 189 F. Supp. 2d 450, 2002 U.S. Dist. LEXIS 3496 (W.D. Va. 2002).

    Materialman delivering mixed concrete is not considered to be engaged in the construction of a building; therefore, as a stranger to the business, he may be sued at common law by a workman whom he has injured on the project. Bergen v. Fourth Skyline Corp., 501 F.2d 1174, 1974 U.S. App. LEXIS 7193 (4th Cir. 1974).

    When materialman immune from suit at common law. —

    If in addition to supplying materials, a materialman delivering mixed concrete also engages in the business of the owner-contractor by working on the job, he is immune from suit. Bergen v. Fourth Skyline Corp., 501 F.2d 1174, 1974 U.S. App. LEXIS 7193 (4th Cir. 1974).

    “Trade, business or occupation” of shipowner. —

    Where a shipowner had space-chartered a portion of the cargo space on one of its vessels to the United States, pursuant to a contract with Military Sea Transport Service (M.S.T.S.), and the personnel to load and stow the cargo was to be supplied by M.S.T.S. in accordance with the contract, and M.S.T.S. contracted with a stevedoring firm to furnish such personnel, and plaintiff, an employee of the stevedoring firm, was injured on the pier while loading the cargo, the loading of the vessel did not constitute a part of the “trade, business or occupation” of the shipowner within the meaning of this section, and plaintiff as the employee of another independent contractor could maintain a suit at common law against the shipowner. American Export Lines v. Revel, 266 F.2d 82, 1959 U.S. App. LEXIS 5107 (4th Cir. 1959).

    Supplier of parts to automobile repair shop not statutory employee. —

    A plaintiff who was the sole manager and operator of an automobile supply warehousing business was not a statutory employee of a repair shop where, after personally taking a delivery to the rear service area and assisting the defendant’s employee in unpacking, sorting, and stocking the products contained within the delivery and taking an inventory of the store’s parts to determine which products needed reordering, the plaintiff left the shop to go out to her vehicle and retrieve a product parts catalog or update sheets to check for a new item the employee wished to order and returned to check the catalog for the item with the employee. The plaintiff ceased performing the work of the repair shop when she went to retrieve the catalog and, upon her return to the store, she was acting on behalf of her own employer, not the repair shop, in taking a product order. Rice v. VVP Am., Inc., 137 F. Supp. 2d 658, 2001 U.S. Dist. LEXIS 4888 (E.D. Va. 2001).

    Work not part of trade, business or occupation of claimant’s employer. —

    If a subcontractor was engaged in work that was not a part of the trade, business or occupation of the injured party’s common law or statutory employer, that subcontractor would be “another party” or a “stranger to the employment,” and not a statutory co-employee entitled to immunity from suit under the provisions of this section. Pfeifer v. Krauss Constr. Co. of Va., Inc., 262 Va. 262 , 546 S.E.2d 717, 2001 Va. LEXIS 60 (2001).

    Test. —

    The test is not whether the owner, by engaging an independent contractor to perform some part of his business, thereby engages in the business of the independent contractor; it is whether the independent contractor is performing work that is part of the trade, business or occupation of the owner. Barnhart v. AMOCO, 237 F. Supp. 492, 1965 U.S. Dist. LEXIS 9737 (E.D. Va. 1965), aff'd, 354 F.2d 659, 1966 U.S. App. LEXIS 7570 (4th Cir. 1966).

    Where a project is undertaken either by an owner as part of his trade, business or occupation or by a general contractor, the responsibility in damages of any party to a workman injured in the project must be tested with reference to his relationship to the overall project. Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964); Bergen v. Fourth Skyline Corp., 501 F.2d 1174, 1974 U.S. App. LEXIS 7193 (4th Cir. 1974).

    The test is not one of whether the subcontractor’s activity is useful, necessary or even absolutely indispensable to the statutory employer’s business, since, after all, this could be said of practically any repair, construction or transportation service. The test (except in cases where the work is obviously a subcontracted fraction of a main contract) is whether this indispensable activity is, in that business, normally carried on through employees rather than independent contractors. Shell Oil Co. v. Leftwich, 212 Va. 715 , 187 S.E.2d 687 (1972); SUNOCO v. Lawrence, 213 Va. 596 , 194 S.E.2d 687, 1973 Va. LEXIS 190 (1973) (see Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323 (1976); Vandergrift v. United States, 500 F. Supp. 237 (E.D. Va. 1979), aff’d, 634 F.2d 628 (4th Cir. 1980); Farish v. Courion Indus., Inc., 722 F.2d 74 (4th Cir. 1983), aff’d on reh’g en banc, 754 F.2d 1111 (4th Cir. 1985)).

    The inquiry is not whether owner was engaged in the business of the subcontractor or had ever been, but whether subcontractor’s business activity or work was a part of the business of owner. Snowden v. VEPCO, 432 F. Supp. 266, 1976 U.S. Dist. LEXIS 11989 (E.D. Va. 1976).

    Developing the appropriate test and determining whether activities fall within or without an entity’s trade, business, or occupation is not a simple, straightforward exercise. Deciding what is the trade, business, or occupation of an entity is a mixed question of law and fact and is a question that does not readily yield to categorical or absolute standards. Henderson v. Central Tel. Co., 233 Va. 377 , 355 S.E.2d 596, 3 Va. Law Rep. 2494, 1987 Va. LEXIS 203 (1987).

    The normal work test, which relates to the determination of whether an owner is the statutory employer of the employees of the owner’s general contractors or subcontractors in the circumstances set forth in subsection A, is defined as follows: If the work out of which the industrial accident arose is work normally carried on through the owner’s employees rather than independent contractors, it is, in the language of the statute, a part of the owner’s trade, business or occupation. In such case, the owner is the statutory employer of the injured worker, whether directly employed by the independent contractor or by a subcontractor. Evans v. B.F. Perkins Co., a Div. of Standex Intern Corp., 166 F.3d 642, 1999 U.S. App. LEXIS 1139 (4th Cir. 1999).

    In determining whether owner and subcontractor qualified as plaintiff’s statutory employers, the question was whether plaintiff was performing part of owner’s main business concern. Evans v. B.F. Perkins Co., a Div. of Standex Intern Corp., 166 F.3d 642, 1999 U.S. App. LEXIS 1139 (4th Cir. 1999).

    Contractors, subcontractors and all workers who are engaged in the trade, business or occupation of the owner of a project are deemed to be that owner’s statutory employees under the workers’ compensation law. An activity is part of the trade, business or occupation of the owner if the activity is, in that business, normally carried on through employees rather than independent contractors. Rice v. VVP Am., Inc., 137 F. Supp. 2d 658, 2001 U.S. Dist. LEXIS 4888 (E.D. Va. 2001).

    Determined from all the facts. —

    Whether the work being performed is a part of the trade, business or occupation of the owner must be determined from all of the facts. Snowden v. VEPCO, 432 F. Supp. 266, 1976 U.S. Dist. LEXIS 11989 (E.D. Va. 1976).

    Whether employees of independent contractor could maintain negligence action against defendant bank depended upon whether the work performed by independent contractor was part of the defendant’s “trade, business or occupation.” Johnson v. Jefferson Nat'l Bank, 244 Va. 482 , 422 S.E.2d 778, 9 Va. Law Rep. 501, 1992 Va. LEXIS 120 (1992) (decided under former § 65.1-29).

    Liability not based on future use of project. —

    The determination of liability is not based on the future use to which any particular project will be put. Holt v. Bowie, 343 F. Supp. 962, 1972 U.S. Dist. LEXIS 13479 (W.D. Va. 1972).

    Frequency and regularity of performance are factors to be considered in determining whether work is “normally carried on through employees.” Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980).

    The fact that services are useful, necessary, or even absolutely indispensable to the work does not conclusively make them part of defendant’s “trade, business or occupation.” Salih v. Lane, 244 Va. 436 , 423 S.E.2d 192, 9 Va. Law Rep. 475, 1992 Va. LEXIS 116 (1992) (decided under former § 65.1-30).

    Mere capacity to perform, standing alone, is not determinative. Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980).

    Nor is performance which is a de minimis part of the total business operation. Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980).

    Work appropriately performed by employer’s own employees is part of his business. —

    If the work is of such a character that it ordinarily or appropriately would be performed by the principal employer’s own employees in the prosecution of its business, or as an essential part in the maintenance thereof, it is a part or process of his work. Sears, Roebuck & Co. v. Wallace, 172 F.2d 802, 1949 U.S. App. LEXIS 2779 (4th Cir. 1949).

    Thus plant maintenance or construction work regularly and customarily done by a manufacturer for himself is part of his trade, business or occupation within the meaning of this section. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    And a manufacturer doing construction work for itself, and not for others, can be a substituted employer of the employees of subcontractors within the meaning of the Workmen’s (now Workers’) Compensation Act. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    Construction work not part of manufacturing business. —

    As a general rule, the several trades involved in construction work are not part of the business of manufacturing products for sale; every manufacturer must have a plant, but this fact alone does not make the work of constructing a plant a part of the trade or business of every manufacturer who engages a contractor to construct a plant. Stone v. Door-Man Mfg. Co., 260 Va. 406 , 537 S.E.2d 305, 2000 Va. LEXIS 134 (2000).

    Shared responsibility for loading and securing owner’s transformers made driver shared employee. —

    Driver who was employed by a subcontractor and fell off an owner’s ladder while tarping a load of power transformers was the owner’s statutory employee under subsection A of § 65.2-302 because the owner’s employees and the subcontractor’s employees shared responsibility for tarping and securing the transformers to a trailer; thus, § 65.2-307 barred the driver from suing the owner for negligence. Armendarez v. ABB, Inc., No. 7:07CV00557, 2008 U.S. Dist. LEXIS 82241 (W.D. Va. Oct. 16, 2008).

    Work not done as part of owner’s trade or business. —

    One who contracts with the owner of a mill to buy, cut and remove logs from another’s land and deliver to the mill, carrying on an independent business, performing his own work according to his own methods, using his own equipment and employing his own servants and exercising exclusive supervision over them, does not perform any work for the mill owner which constitutes part of the mill owner’s trade or business. Perkinson v. Thomas, 158 Va. 699 , 164 S.E. 561 , 1932 Va. LEXIS 289 (1932).

    3.Stranger to the Business.

    “Stranger to the work” test. —

    The work in which a Ford employee’s employer was engaged was the particular business of manufacturing and selling motor vehicles and the defendants, who were contractors and subcontractors hired by Ford to construct a new body shop, were strangers to that business and, therefore, could not show that the employee was their statutory fellow employee and the employee’s common-law action for personal injuries against the defendants was not barred. Stone v. Door-Man Mfg. Co., 260 Va. 406 , 537 S.E.2d 305, 2000 Va. LEXIS 134 (2000).

    Where, in an area covered by a distributor under his contract with an oil company, only the distributor could solicit business—the oil company was forbidden to do so, except as to certain national accounts over which the distributor had no control—it was not a part of the trade, business or occupation of the oil company to carry on business in the area allocated to the distributor. Barnhart v. AMOCO, 237 F. Supp. 492, 1965 U.S. Dist. LEXIS 9737 (E.D. Va. 1965), aff'd, 354 F.2d 659, 1966 U.S. App. LEXIS 7570 (4th Cir. 1966).

    When the owner of a merchandising business employed a contractor to make alterations in its storage warehouse to facilitate its merchandising activity, the owner was free from the obligation to furnish compensation to the contractor’s employees and remained liable for its torts. Sears, Roebuck & Co. v. Wallace, 172 F.2d 802, 1949 U.S. App. LEXIS 2779 (4th Cir. 1949).

    The work of building a church was not a part of the trade, business or occupation of the church so as to make the church liable for compensation under this section. Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37, 1957 Va. LEXIS 205 (1957); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    An oil company which is engaged in exploring, drilling and processing petroleum products and then wholesaling such products to retail dealers but which does not operate retail service stations or provide automotive services through its own employees is not a statutory employer of employees of the independent contractors which retail its products. Shell Oil Co. v. Leftwich, 212 Va. 715 , 187 S.E.2d 162, 1972 Va. LEXIS 246 (1972).

    Where the four oil companies operated service stations which constituted less than two percent of all service stations of a certain brand name in Virginia, the oil company was not normally in the business of retailing petroleum products and performing automotive services; therefore, the employee of an independent dealer was not the statutory employee of the oil company. SUNOCO v. Lawrence, 213 Va. 596 , 194 S.E.2d 687, 1973 Va. LEXIS 190 (1973).

    Tobacco companies do not as a part of the conduct of their usual business operations send out their own trucks to pick up tobacco from their suppliers; therefore, employees of a trucking company do not become the employees of the tobacco companies by operation of this section and they are not precluded from suing the tobacco companies because of former § 65.1-40 (now § 65.2-307 ). Barber v. Loews Theatres, Inc., 355 F. Supp. 136, 1972 U.S. Dist. LEXIS 10741 (W.D. Va. 1972).

    Where no evidence showed that construction and leasing company normally installed and maintained leasing signs through its own employees, thus, although claimant’s work may have been useful or necessary to the company’s business, because the company did not perform such work through its own employees, the commission did not err in finding that claimant’s activity was not part of the company’s trade, business, or occupation. Accordingly, the commission did not err in finding that the company was not claimant’s statutory employer. Spitzer v. Fried Co., 1997 Va. App. LEXIS 331 (Va. Ct. App. May 27, 1997).

    In the manufacturing industry, construction work is typically outside the custom of the trade, and manufacturers who use their employees for such work generally do so only infrequently and irregularly. The courts have largely agreed that such manufacturers are not statutory employers of employees of independent contractors hired for such work. Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976).

    Where appellant claimant was injured while building sheds for a contractor who had agreed to build the sheds for a mill, the mill was not the claimant’s statutory employer under the first prong of the Shell Oil test and subsection A of § 65.2-302 because, although the mill provided the materials for the sheds and sold the sheds when they were completed, the mill was not in the business, trade, or occupation of building sheds and never built sheds except on one occasion when the claimant was injured. Berger v. Dalton Lumber Corp., 2002 Va. App. LEXIS 202 (Va. Ct. App. Apr. 2, 2002).

    But where a manufacturer regularly does its own construction work with its own employees, designation of that manufacturer as a statutory employer may occur according to the other circumstances of the case. Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976).

    Janitorial subcontractor. —

    Virginia Worker’s Compensation Act statutory bar prevented the employee from recovering from the employer’s janitorial subcontractor; the facts established the subcontractor not a stranger to the employer’s business. The essential nature of the subcontractor’s function was demonstrated by the fact the subcontractor’s work was required to be performed every regular business day; further, the fact the employer was responsible for paying the subcontractors associated with cleaning/trash pickup emphasized such parties’ overarching responsibility for properly maintaining the premises. McGowan v. ABM Janitorial Servs., Northeast, Inc., No. 2:10cv388, 2011 U.S. Dist. LEXIS 70621 (E.D. Va. June 29, 2011), aff'd, 464 Fed. Appx. 153, 2012 U.S. App. LEXIS 2266 (4th Cir. 2012).

    Construction work not part of owner’s trade or business. —

    Decedent, an employee of a contractor hired by an owner to construct warehouses, was not engaged in the owner’s trade or business when he suffered fatal injuries in the course of employment, as his construction work was not part of the owner’s business, which was real estate development; thus, the owner was not his statutory employer, and workers compensation exclusivity under § 65.2-307 did not bar plaintiff’s wrongful death suit against the owner. Rodriguez v. Leesburg Bus. Park, LLC, 287 Va. 187 , 754 S.E.2d 275, 2014 Va. LEXIS 25 (2014).

    Installation and erection of an air compressor was part of a shipyard’s “trade, business or occupation,” so that an employee of the seller of the compressor, engaged in such installation, was not a “stranger” to the business of the shipyard, and the Workers’ Compensation Act was applicable. McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    Where a foundation constructed by an independent contractor was an integral part of the installation of an air compressor on the premises of a shipyard, the work performed by the independent contractor constituted a part of the “trade, business or occupation” of the shipyard and the independent contractor would not be considered a “stranger to the business” of the shipyard. McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    Injury caused by “stranger to the business.” —

    Where the injury is caused by the negligence of one not engaged in the overall undertaking, a “stranger to the business,” it is not an accident inherent in the project, the cost of which should ultimately be borne by the project, and the injured workman’s rights and remedies outside of the Act are preserved. Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964); Bergen v. Fourth Skyline Corp., 501 F.2d 1174, 1974 U.S. App. LEXIS 7193 (4th Cir. 1974).

    Public utility liable where installation of the equipment was required by law. —

    Though the public utility did not normally install the type of central office equipment that subcontractor’s employee was installing, the installation of that equipment was nevertheless part of the public utility’s trade, business, or occupation because it was an addition to the physical plant that the public utility was required by law to provide. Henderson v. Central Tel. Co., 233 Va. 377 , 355 S.E.2d 596, 3 Va. Law Rep. 2494, 1987 Va. LEXIS 203 (1987).

    B.Subcontracted Fraction.

    Subcontracted fraction test. —

    Under the “subcontracted fraction of the work” test, a general contractor was the statutory employer of an employee of a subcontractor and was obligated to provide benefits to the claimant where the general contractor had been hired to repair and reshingle a flat roof, reshingle the rest of the roof and build a new front porch, and had subcontracted the fraction of the contract requiring the replacement of the roof to the claimant’s employer; the general contractor’s trade, business or occupation was general home repair, which includes roof repair, it had entered into a single contract to repair the porch and roof of a residence and, when the claimant was injured while working on the subcontracted fraction of the work involving the replacement of the roof, he was engaged in the general contractor’s trade or business. Mount Vernon Bldrs., Inc. v. Rotty, 28 Va. App. 511, 507 S.E.2d 95, 1998 Va. App. LEXIS 616 (1998).

    Workers’ Compensation Commission properly denied a worker benefits for an injury he received while installing laminate flooring in a commercial building because the employer had less than three employee, the worker failed to prove that any of the alleged employers were statutorily liable for his injuries where the building manager was merely acting as an agent for the owner in contracting with a tenant for work on a portion of the building, and the owner hired independent contractors — not subcontractors — including the employer to perform the work on its building. Divino v. Uninsured Emplr's Fund, 2020 Va. App. LEXIS 202 (Va. Ct. App. July 14, 2020).

    Subcontracted fraction exception. —

    The subcontracted fraction exception is defined as follows: If the work out of which the accident arose was obviously a subcontracted fraction of that contract and, in the language of the statute, not part of the trade, business or occupation of the owner, the general contractor who engaged the subcontractor to perform that fraction is the statutory employer of the injured worker, whether directly employed by the primary subcontractor or by a secondary subcontractor. Evans v. B.F. Perkins Co., a Div. of Standex Intern Corp., 166 F.3d 642, 1999 U.S. App. LEXIS 1139 (4th Cir. 1999).

    Where work employee performed was a subcontracted fraction of owner’s “main business concern,” under the statute, owner and general contractor qualified as employee’s statutory employers and, as such, were immune from employee’s Virginia common law action. Evans v. B.F. Perkins Co., a Div. of Standex Intern Corp., 166 F.3d 642, 1999 U.S. App. LEXIS 1139 (4th Cir. 1999).

    Although the Commission did not specifically analyze the subcontractor’s status using the subcontracted-fraction test, the Commission did not err in requiring the subcontractor to pay benefits to claimant. The divit installation was clearly a subcontracted fraction of the main remodeling contract and not part of the trade, business, or occupation of the owner, whose business was operating a restaurant. Thus, the subcontractor was claimant’s statutory employer and liable for benefits under this section. F. Richard Wilton, Jr., Inc. v. Gibson, 22 Va. App. 606, 471 S.E.2d 832, 1996 Va. App. LEXIS 430 (1996).

    C.Independent Contractors.

    Section not applicable to independent contractors. —

    Where independent contractor drove truck for employer and was in accident, commission did not erroneously make distinction between his status and that of other drivers of his trucks, since this section is not applicable to independent contractors even though they may otherwise be engaged in work of owner. Smith v. Charles G. Crews Sons, No. 0246-88-3 (Ct. of Appeals March 7, 1989).

    Roofer was acting as an independent contractor at time of his injury, and therefore was not entitled to recover from roofing company as a statutory employer under this section. Juarez v. C. Woolfrey Constr., 1999 Va. App. LEXIS 370 (Va. Ct. App. June 22, 1999).

    One who is engaged in the trade, business or occupation of another, when engaged as a subcontractor, falls under the protective canopy of the Workmen’s (now Workers’) Compensation Act. In certain instances this is true even if the party is an independent contractor. Barnhart v. AMOCO, 237 F. Supp. 492, 1965 U.S. Dist. LEXIS 9737 (E.D. Va. 1965), aff'd, 354 F.2d 659, 1966 U.S. App. LEXIS 7570 (4th Cir. 1966).

    The workers’ compensation exclusive remedy provision barred a personal injury suit by an employee of one subcontractor on a condominium construction project against another subcontractor for personal injuries sustained during the course of the employee’s job. Both the plaintiff’s employer, which had contracted to complete the exterior finish system of the project, and the defendant subcontractor, which had contracted to dig, install and test natural gas lines and to connect them to the condominium buildings, were engaged in the work of the general contractor and, therefore, the defendant subcontractor was the plaintiff’s co-statutory employee and was immune from suit. Pfeifer v. Krauss Constr. Co. of Va., Inc., 262 Va. 262 , 546 S.E.2d 717, 2001 Va. LEXIS 60 (2001).

    Relationship of independent contractor not transformed into that of master-servant. —

    The relationship of statutory employer does not transform the relationship of independent contractor into that of master-servant or invoke the doctrine of respondeat superior. Race Fork Coal Co. v. Turner, 5 Va. App. 350, 363 S.E.2d 423, 4 Va. Law Rep. 1430, 1987 Va. App. LEXIS 247 (1987), rev'd, 237 Va. 639 , 379 S.E.2d 341, 5 Va. Law Rep. 2382, 1989 Va. LEXIS 70 (1989).

    Protection afforded to independent contractor. —

    Although the basic purpose of this section is to assure that workers are protected by responsible employers paying workers’ compensation benefits, the section has the ancillary effect of placing independent contractors subject to its terms under the protective umbrella of the owner’s workers’ compensation coverage. An independent contractor performing services for a “statutory employer” cannot be an “other party” liable in a common-law action. The contractor’s employees are therefore barred from suing their employer to the same extent that they are barred from suing the owner who is their “statutory employer.” Farish v. Courion Indus., Inc., 722 F.2d 74, 1983 U.S. App. LEXIS 14855 (4th Cir. 1983); Vess v. Davis Elec. Constructors, Inc., 613 F. Supp. 1047, 1985 U.S. Dist. LEXIS 17775 (W.D. Va. 1985), aff'd, 818 F.2d 30, 1987 U.S. App. LEXIS 5600 (4th Cir. 1987).

    When workmen employed by independent contractor may maintain common-law action against general contractor. —

    If a general contractor contracts with another contractor to perform work which is not a part of the general contractor’s trade, business or occupation, that other contractor is an independent contractor within the meaning of the Workmen’s (now Workers’) Compensation Act, and under former § 65.1-5 (now § 65.2-101 ), workmen employed by the other contractor are not precluded from maintaining a common-law action against the general contractor. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    Owner is not required to furnish compensation for the employee of a contractor or subcontractor and remains liable as a third party to the employee for negligence which causes injury, unless the work undertaken by the contractor is part of the owner’s trade, business or occupation. When the work is not within the scope of the owner’s business, and he undertakes to have it executed by an independent contractor, the latter’s employees, to use the language of former § 65.1-5 (now § 65.2-101 ), are not considered “the employees of the person or corporation employing or contracting with such independent contractor.” Sears, Roebuck & Co. v. Wallace, 172 F.2d 802, 1949 U.S. App. LEXIS 2779 (4th Cir. 1949).

    Contractor had no duty to inquire into work eligibility of subcontractor’s employees. —

    Claimant was employed by subcontractor, and contractor, though a statutory employer of claimant, had no duty to inquire into the work eligibility of his subcontractor’s employees. Manis Construction Co. v. Arellano, 13 Va. App. 292, 411 S.E.2d 233, 8 Va. Law Rep. 1466, 1991 Va. App. LEXIS 301 (1991).

    Firm was not statutory employer. —

    Firm hired to “oversee and coordinate the work remaining with the existing subcontractors” on a home building project was not claimant’s statutory employer, where there was no contract between the firm and the carpentry contractor who employed claimant and who was paid directly by the homeowners. R & Q Constr. Co. v. Muddiman, No. 1720-89-4 (Ct. of Appeals Oct. 30, 1990).

    Owner is liable for compensation only if work is part of his trade or business. —

    Liability will only be imposed on an owner if an independent contractor is doing work which the owner generally does perform. Holt v. Bowie, 343 F. Supp. 962, 1972 U.S. Dist. LEXIS 13479 (W.D. Va. 1972).

    An owner, simply by acting as his own general contractor, contracting with independent contractors, does not thereby become a statutory employer unless the work performed by the independent contractor “is a part of [the owner’s] trade, business or occupation.” Bassett Furn. Indus., Inc. v. McReynolds, 216 Va. 897 , 224 S.E.2d 323, 1976 Va. LEXIS 223 (1976).

    The trial court did not err in rejecting in claimant’s argument that even if the commission did not err in finding that he was an independent contractor, it erred in not holding defendant responsible to him for workers’ compensation benefits pursuant to this section; this section does not provide workers’ compensation benefits to independent contractors who are not employees under the Act. Rather, it renders an owner liable for workers’ compensation benefits to workers employed by a subcontractor, where the owner has contracted with the subcontractor for the subcontractor to perform work which is a part of the owner’s trade, business, or occupation. Bowling v. P & G Oil Corp., 1996 Va. App. LEXIS 780 (Va. Ct. App. Dec. 10, 1996).

    But owner may perform part of trade or business through subcontractor. —

    There was no merit in the contention that though the owner, a turnpike authority, was vested with the power and responsibility of building a road it did not exercise such power in that it employed no workmen for that purpose. The answer to this argument is that by its express terms this section contemplates that the owner may perform or execute work which is a part of his trade, business or occupation through a “subcontractor.” Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    Then employees of subcontractor are statutory employees of owner. —

    Once it is established that the work being done by the subcontractor is a part of the owner’s general business, the employees of the subcontractor became statutory employees of the owner even though their immediate employer is an independent contractor. Snowden v. VEPCO, 432 F. Supp. 266, 1976 U.S. Dist. LEXIS 11989 (E.D. Va. 1976).

    Where an independent contractor is performing work which is a part of the trade, business or occupation of the owner, the employees of the independent contractor are statutory employees of the owner, and as such limited to the benefits and compensation under the Workmen’s (now Workers’) Compensation Act, and precluded from instituting or maintaining a suit at common law against the owner. This is so even where employee’s employer carried workmen’s (now workers’) compensation for his employees, and thus made it unnecessary for the employee to look to the owner for said benefits. Snowden v. VEPCO, 432 F. Supp. 266, 1976 U.S. Dist. LEXIS 11989 (E.D. Va. 1976).

    Lawn care provider was not a statutory employer under subsection A of § 65.2-302 because a business owner, who had subcontracted all of his lawn care business to the provider and used the provider’s employees, retained control of daily operations and oversaw the work to be done at the time of the claimant’s accident. The business owner was the claimant’s statutory employer and had to comply with its obligation to provide coverage under the Workers’ Compensation Act. Turf Care, Inc. v. Henson, 51 Va. App. 318, 657 S.E.2d 787, 2008 Va. App. LEXIS 104 (2008).

    Construction contractor and electrical contractor held statutory employees of utility company. —

    Even though a construction contractor and an electrical contractor were independent contractors, in a construction project for a utility company their employees were statutory employees of the utility company since both contractors were engaged in the trade, occupation and business of the utility company. Thus, plaintiff, the administrator of the estate of an employee of the construction contractor who was electrocuted, could not be allowed to pursue a common-law negligence action against the electrical contractor. Vess v. Davis Elec. Constructors, Inc., 613 F. Supp. 1047, 1985 U.S. Dist. LEXIS 17775 (W.D. Va. 1985), aff'd, 818 F.2d 30, 1987 U.S. App. LEXIS 5600 (4th Cir. 1987).

    CIRCUIT COURT OPINIONS

    Claim barred. —

    Subcontractor to federal government agency, whose employees allegedly injured an employee of another subcontractor to the federal government agency, could not be sued by the injured employee, since under the authorized governmental activity test the employees were engaged in the federal government agency’s trade, business, or occupation, and were statutory fellow employees; therefore, the injured employee’s claim was barred by the operation of the exclusivity provisions of the Workers’ Compensation Act. Burke v. H & H Consol., Inc., 55 Va. Cir. 84, 2001 Va. Cir. LEXIS 242 (Norfolk Mar. 15, 2001).

    Where a subcontractor was, at the time of the injury, a statutory employee, he was barred from pursuing a common law claim by application of the Virginia Code. Ferreira v. Boeing Serv. Co., 60 Va. Cir. 237, 2002 Va. Cir. LEXIS 279 (Fairfax County Oct. 17, 2002).

    Accident victim’s claim against a contracting elevator company that maintained city elevators was barred by the exclusive remedy provision, § 65.2-307 , of the Virginia Workers’ Compensation Act, § 65.2-100 et seq., as (1) the victim was a statutory employee of the city; (2) the mandate of the city included the improvement, repair, and maintenance of public buildings; (3) the work delegated by the city to the elevator contracting company, and performed by its employees, was part of the trade, business, or occupation of the city; and (4) the elevator contracting company was not an “other party” against whom the victim could maintain a suit in tort, under § 65.2-309 . Brooks v. Blueridge Gen., Inc., 67 Va. Cir. 274, 2005 Va. Cir. LEXIS 46 (Portsmouth May 9, 2005).

    Injured employee for a subcontractor on a construction project was barred by §§ 65.2-300 and 65.2-307 from bringing suit against the general contractor and two other subcontractors for the construction project because, under subsection B of § 65.2-302 , the general contractor was the statutory employer of the employee and the subcontractors were statutory co-employees of the employee. Aguilar v. Diaz, 88 Va. Cir. 44, 2014 Va. Cir. LEXIS 6 (Loudoun County Feb. 10, 2014).

    Claim not barred. —

    Truck driver’s action to recover damages for injuries he sustained while unfolding a tarp was not barred because pursuant to the Normal Work Test, a company could not be designated as a statutory employer for purposes of the exclusivity provision of the Virginia Workers’ Compensation Act since tarping was not an activity in its normal course of business carried on by its employees; there was no evidence the company’s employees held a responsibility to assist contracted drivers in tarping loads. Pack v. Georgia-Pacific LLC, 95 Va. Cir. 351, 2017 Va. Cir. LEXIS 74 (Roanoke Apr. 6, 2017).

    Longshoreman as statutory employee. —

    Because the longshoreman was a “statutory employee” of a shipping company, his sole remedy for injuries received while engaged in his employment as it related to the subcontractors was governed by the Workers’ Compensation Act. Butts v. York Int'l Corp., 59 Va. Cir. 422, 2002 Va. Cir. LEXIS 232 (Portsmouth Sept. 5, 2002).

    Subcontractor as statutory employee. —

    Suit filed by an injured worker, who was employed by a trucking company, against a dairy was dismissed as he was a statutory employee of the dairy under § 65.2-302 and his exclusive remedy was to file a claim under the Virginia Workers’ Compensation Act, § 65.2-100 et seq., as: (1) the worker was injured while reloading returned goods and empty milk crates onto trailers at the time of his injury, (2) loading returned goods and empty milk crates onto trailers for return to the dairy was a part of the dairy’s business of distributing dairy products, and was done by dairy employees at nearly every distribution center, and (3) that loading returned goods and empty crates onto the trailers was the trucking company’s contractual obligation was demonstrated by the plain language of the contract. Bishop v. Valley Rich Dairy, 62 Va. Cir. 354, 2003 Va. Cir. LEXIS 121 (Roanoke July 28, 2003).

    Employee of subcontractor as statutory employee. —

    Truck driver who worked for a company that was hired by a business to transport merchandise from a distribution center the business owned to its stores was a statutory employee of the business, and he was precluded by the Virginia Workers’ Compensation Act from suing the business to recover damages for injuries he sustained when he was struck by a tractor driven by one of the business’s employees while he was at the distribution center to pick up merchandise for transport. Leake v. Family Dollar Stores, Inc., 62 Va. Cir. 46, 2003 Va. Cir. LEXIS 317 (Warren County May 7, 2003).

    Subcontracted fraction exception. —

    Injured party was employed by a security firm to assist in controlling the crowd at an auto race when the injured party was hit by a piece of debris that fell from a hydraulic lift operated by a broadcasting company. The injured party was a statutory employee of racetrack by means of the subcontracted fraction exception, and therefore workers’ compensation was the exclusive remedy as to the racetrack. There was no evidence that the racing league that sponsored the event was in the business of broadcasting, and because the broadcasting company was a stranger to the work of the racing league and not engaged in the racing league’s trade, business, or occupation, the broadcasting company was not a statutory employee of the racing league under the Virginia Workers’ Compensation Act, nor a fellow statutory employee with the injured party, and therefore those defendants were “other parties” as defined by § 65.2-309 and were subject to suit. Lincoln v. Int'l Speedway Corp., 59 Va. Cir. 133, 2002 Va. Cir. LEXIS 333 (Richmond May 29, 2002).

    Subcontractor fraction test was inapplicable because there was no general contractor; the owner of the machinery hired multiple independent, prime contractors to perform the work of converting the machinery. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Work not part of trade, business or occupation of claimant’s employer. —

    Business’s plea in bar asserting that an injured contractor was its statutory employee at the time of his injury, and thus, he was limited to a claim for workers’ compensation benefits in his personal injury action, was overruled because the work being performed by his direct employer, installing and repairing fire detection and sprinkler systems, was not part of the normal trade, business, or occupation of the business, which primarily involved meat processing; moreover, any plumbing work on the waterlines performed by the business’s 50 to 60 person maintenance team was a de minimis part of the business’s 500-contractor work force. Fose v. Gwaltney of Smithfield, Ltd., 67 Va. Cir. 347, 2005 Va. Cir. LEXIS 47 (Portsmouth May 12, 2005).

    Plea in bar by an elevator company, which contracted with an employer to maintain and repair the elevators at a building which the employer managed, on the basis of the exclusive remedy provision of subsection A of § 65.2-307 was denied because the employer, which paid workers’ compensation benefits to its employee who was injured when an elevator at the building malfunctioned, was not the elevator company’s statutory employer. While the maintenance of the elevators in the building was clearly an indispensable activity of the businesses of both the employer and the owners of the building, the evidence was insufficient to persuade the court that elevator maintenance and repair was an activity that was normally carried on by employees of either the employer or the building owner. Guardian Realty Mgmt., Inc. v. Otis Elevator Co., 2006 Va. Cir. LEXIS 40 (Fairfax County Jan. 5, 2006).

    Because contractors did not have an employer in common with the decedent, they were not statutory co-employees, and none of the self-described statutory co-employees were employed by the decedent’s actual employer; thus, the contractors were “other parties,” and the exclusivity provision of the Virginia Workers’ Compensation Act did not apply to the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Holding company was not the decedent’s statutory employer because it manufactured and sold tissue paper, and converting a copy paper plant into a tissue paper plant was an essential preliminary step to allow the holding company to manufacture and sell tissue paper, but the business of the decedent’s employer was manufacturing, not converting plants; thus, the holding company was an “other party,” and the exclusivity provision did not apply in the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    “Stranger to the work” test. —

    Exclusive remedy provisions of the Virginia Workers’ Compensation Act did not prevent, plaintiff, subcontractor 1’s employee, from suing defendant subcontractor 2 for injuries he received on the job site while painting a coal loader, because plaintiff was a stranger to the owner’s work and not a statutory employee of the owner for purposes of subsection A of § 65.2-302 . Applying the normal work test, the court held that the highly specialized and infrequently performed painting project was not a part of the owner’s trade, business, or occupation. Masterson v. Am. Heavy Indus., 84 Va. Cir. 432, 2012 Va. Cir. LEXIS 126 (Norfolk Apr. 12, 2012).

    Employees of stevedoring companies were statutory employees of Virginia Port Authority. —

    Where plaintiff employee and defendant employee worked for stevedoring companies operating at a general cargo terminal owned by the Virginia Port Authority (VPA), and plaintiff alleged that he was injured as a result of defendant’s negligence, plaintiff’s exclusive remedy was under the Virginia Workers’ Compensation Act because plaintiff and defendant were statutory fellow employees. The work of the parties’ employers constituted the “trade, business, or occupation” of the VPA. Stephen v. Dickens, 63 Va. Cir. 403, 2003 Va. Cir. LEXIS 348 (Norfolk Nov. 13, 2003).

    Roanoke Regional Airport Commission not statutory employer. —

    Roanoke Regional Airport Commission was not the statutory employer of a driver of a transportation service since the founding act establishing the Commission granted it the authority to establish and operate an airport and air navigation facilities, and the power to grant the authority to operate a ground transportation service, but not the power to operate a ground transportation facility; since the Commission did not and could not subcontract with the driver’s employer to provide transportation services, the Commission was not the statutory employer of the driver, and the driver’s suit was not barred by the exclusivity rule of subsection A of § 65.2-307 . Cunningham v. Roanoke Reg'l Airport Comm'n, 2006 Va. Cir. LEXIS 273 (Roanoke County Dec. 28, 2006).

    Grocery store was truck driver’s statutory employer. —

    Because a truck driver was still in the process of completing a delivery at the time of his alleged injury, and hence, still engaged in the trade, business, or occupation of the grocery store at the time of the accident, his exclusive remedy for said injury was under the laws covering workers’ compensation; thus, the grocery store’s plea of the workers’ compensation bar was sustained. Walls v. Food Lion, L.L.C., 66 Va. Cir. 26, 2004 Va. Cir. LEXIS 341 (Richmond July 13, 2004).

    CASE NOTES

    Statutory employer. —

    Repair company’s plea of workers’ compensation bar to the tort claims brought by a worker injured while operating equipment was denied where although the repair company and the worker’s employer were subsidiaries of the same parent company, there was no evidence of a contractual relationship between the repair company and the parent company to rebuild the subject roof bolter, and as a result, the repair company was not a statutory employee under § 65.2-302 (A). Gobble v. Maxxim Rebuild Co., LLC, 2015 Va. Cir. LEXIS 252 (Wise County Oct. 7, 2015).

    Laborer’s sole and exclusive remedy was limited to that available under the Virginia Workers’ Compensation Act because the laborer was engaged in the exact same work as an entertainment company’s own employees, which, pursuant to the “normal work” and “stranger to the work” tests, made the company the laborer’s statutory employer under subsection A of § 65.2-302 . Hazlegrove v. Vee Corp., 84 Va. Cir. 331, 2012 Va. Cir. LEXIS 116 (Salem Feb. 22, 2012).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Where two employers constitute insured statutory employers of the claimant, the Commission enters an award against only the first statutory employer with coverage in an ascending scale. Miranda v. Arevalo, VWC File No. 212-09-03 (Feb. 25, 2005).

    Sections 65.1-29 to 65.1-31 (now § 65.2-302 ), when applicable enlarge the definition of employees provided for in § 65.1-4 (now § 65.2-101 ), and make eligible to receive compensation a class of employees between whom and the person responsible for the payment thereof there does not exist the immediate common law relationship of master and servant. Sykes v. Stone & Webster Eng. Corp., 186 Va. 116 , 41 S.E.2d 469 (1947); Baker v. Nussman, 152 Va. 293 , 147 S.E. 246 (1929); Sheets v. Blevins, 55 O.I.C. 313, 316 (1973); Nickles v. Robin Coal Co., Inc., 43 O.I.C. 80 (1961).

    The purpose of § 65.2-302 is to “protect the employees of subcontractors who are not financially responsible and to prevent employers from relieving themselves of liability for compensation by doing through independent contractors what they would otherwise do through direct employees.” Faucette v. Princess Anne Builders, Inc., 78 O.W.C. 174 (1999).

    The purpose of § 65.2-302 is to prevent employers from escaping coverage of the Act by doing through independent contractors and subcontractors what they normally would do through employees, by holding such employer liable for any compensation payable to the injured worker for which it would have been liable to pay if the worker had been immediately employed by it. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Laws and or regulations that fall within the state’s “police power,” which include all general welfare laws, are presumed valid and will be upheld, unless no reasonable state of facts can be conceived to support them, or unless there is no rational relationship to the end sought. The burden of proof is on the person challenging the law. Due process under such laws is satisfied if the law has a reasonable relation to a proper purpose, does not impact a fundamental right, and is neither arbitrary nor discriminatory. The purpose of § 65.2-302 is to protect all employees engaged in the trade, business, or occupation of the owner or general contractor. There is a rational relationship between this purpose and the statutory scheme that imposes liability and insurance obligations on statutory employers, and § 65.2-302 is therefore constitutional. Taylor v. Stone Builders, 75 O.W.C. 11 (1996).

    The employees of an uninsured sub-subcontractor may look to the subcontractor, and to the general contractor, for workers’ compensation coverage, although recovery is not permitted from both. Faucette v. Princess Anne Builders, Inc., 78 O.W.C. 174 (1999).

    Employee of subcontractor doing work part of general contractor business is a statutory employee of general contractor. Justice v. Channel Coal Co., 48 O.I.C. 142 (1966); Hutchison v. H & H Contractors, 46 O.I.C. 118 (1964); Meredith v. Cecil E. Shell, 59 O.I.C. 209 (1980).

    In determining whether the minimum number of employees exists to invoke the jurisdiction of the Act over a contractor, the Commission counts the total number of persons on the job employed by the contractor and all its subcontractors. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Where the general contractor, together with its subcontractors, have a collective total of three or more employees working to complete the same project, the general contractor is considered to have three or more employees and is under the jurisdiction of the Act. Taylor v. Stone Builders, 75 O.W.C. 11 (1996).

    The subcontractors’ employees are counted as employees of the general contractor for purposes of evaluating liability under the Act. Incorporated subcontractors, who are considered employees under the Act, count as statutory employees of the owner contractor. Velonza v. Pandell Builders, Inc., 75 O.W.C. 172 (1996).

    Employees of a prime contractor’s real estate business are not counted as employees of his construction business, where there a clear and complete separation of the two businesses. Velonza v. Pandell Builders, Inc., 75 O.W.C. 172 (1996).

    A statutory employer otherwise exempt from the Act because it has fewer than three employees may be fined for failure to insure its workers’ compensation liability where the collective total of employees, counting those of its subcontractors, is three or more. Taylor v. Stone Builders, 75 O.W.C. 11 (1996).

    A joint subcontractor cannot be the statutory employee of a general contractor. McDonough v. Wisco Aluminum Corp., 75 O.W.C. 263 (1996).

    The claimant, as an independent contractor, could not be a statutory employee of another contractor. Only his employees, had there been any, would qualify as statutory employees. Whitlock v. Whitlock Mechanical, 75 O.W.C. 350 (1996).

    A builder constructing his own personal residence is still subject to the Workers’ Compensation Act as an owner, so long a such work is part of his trade, business, occupation, or profession. A mere owner of an anticipated residence, not engaged in his trade or business, is not an employer subject to the Virginia Workers’ Compensation Act. Hartley v. Garland E. Pugh Mech. Contr., 76 O.W.C. 129 (1997).

    A statutory employee is one who is an employee of a subcontract engaged in the trade, business or occupation of the general contractor. A claimant not employed by one of the general contractor’s subcontractors cannot be the general contractor’s statutory employee. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    The general contractor is liable as a statutory employer if the employee is doing work, no matter how remote, that the general contractor has undertaken to perform as a part of his own trade, business, or occupation. Velonza v. Pandell Builders, Inc., 75 O.W.C. 172 (1996).

    In determining whether a party is a statutory employer under the Workers’ Compensation Act, Virginia employs a two-pronged test. The normal-work test applies where the work performed by the employee is part of the trade, business or occupation of the statutory employer, or is the kind of work normally performed by employees of the statutory employer and not by independent contractors. On the other hand, a subcontractor obliged under a contract with another to perform work, which subcontractor subcontracts a portion of that obligated work to another, becomes the statutory employer of the sub-subcontractor’s employees, even if that work is not part of the subcontractor’s normal work, if the work to be performed is obviously a subcontracted fraction of a main contract. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    The “subcontracted-fraction test” of § 65.2-302 (B) has been defined by the Virginia Supreme Court as an obligation of general contractor in a contract with an owner to complete the whole project, including a “subcontracted fraction” of the work not normally part of the trade, business, or occupation of the owner. In such cases, the contractor who engages a subcontractor to perform that fraction is the statutory employer of employees of the subcontractor. Williamson v. Sabourin, 76 O.W.C. 202 (1997).

    Prince William contracted with the owner for the purchase and installation of vinyl siding and windows. The contractor subcontracted the installation portion of the work, which was clearly a subcontracted portion of the main contract. The Commission held that the contractor was the statutory employer the claimant. Williamson v. Sabourin, 76 O.W.C. 202 (1997).

    The alleged statutory employer personally subcontracted with homeowners for the sale of its vinyl siding, including the installation, and it agreed to personally handle communications with the sub-subcontractor if there were any problems with such installation. Moreover, its subcontractor agreement instructed that the sub-subcontractors it retained were to hold themselves out to be its employees. Thus, because the evidence showed that the alleged statutory employer retained responsibility for delivering the completed work to the homeowner, i.e., vinyl siding complete with installation, the Commission held that it was the statutory employer of the claimant. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    Critical test is whether Sun Oil normally retailed petroleum products and offered automotive services through its own employees. Sun Oil Co. v. Lawrence, 213 Va. 596 , 194 S.E.2d 687 (1973); Shell Oil Co. v. Leftwich, 212 Va. 715 , 187 S.E.2d 162 (1972). Control exercised by prime contractor over employees of subcontractor is immaterial. Hunley v. Hawkins, 57 O.I.C. 184 (1976).

    A cemetery, charged by statute with certain duties, may not escape liability under the Workers’ Compensation Act by subcontracting these responsibilities. Spurlock v. Chester Lineberry & Hebrew Oakwood Cemetery Assoc., 70 O.I.C. 22 (1991).

    An award will be entered against the first statutory employer who has workers’ compensation insurance. Harbeson v. D & B Builders, 71 O.W.C. 47 (1992).

    Liability for compensation or indemnification as a statutory employer under § 65.2-302 exists without reference to its insured status. When both the immediate and the statutory employer are uninsured, a determination should be made as to the liability of each, and they may both be held jointly and severally liable to pay for compensation. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Any entitlement to contribution between a first and second statutory employer must be pursued through a court of general jurisdiction rather than the Commission. Harbeson v. D & B Builders, 71 O.W.C. 47 (1992).

    An independent contractor is not an employee or statutory employee merely because he performs work in the trade, business, occupation, or profession of the employer which is usually performed by employees, if the employer retains no right to control the manner in which the work is performed. Reynolds v. Yellow Cab Co., 75 O.W.C. 76 (1996).

    An employee of an independent contractor is entitled to compensation benefits from a statutory employer if an injury occurs while engaged in an activity that’s part of the same trade, business or occupation of the statutory employer. The statutory employer is not responsible for the payment of benefits to an employee who is injured while doing the personal work of subcontractor. Proctor v. Woodyard Auto Sales, Inc., 70 O.I.C. 27 (1991).

    Mere inclusion of the claimant’s name as the “named insured” on a policy of workers’ compensation insurance is an insufficient basis to claim that he is an “employee” under the Act. A sole proprietor is not considered an “employee” without a voluntary election by the proprietor to come within the coverage of the Act. Where the policy of insurance was apparently purchased by the proprietor to satisfy his own liability to the employees of uninsured subcontractors, and there was no evidence that the insurer was put on notice of the alleged election, the policy language was insufficient to establish that he was an “employee.” Parrish v. Media One, VWC File No. 199-09-41 (May 8, 2001).

    State/Political Subdivisions:

    This section makes no mention of the State, its political subdivisions or municipal corporations and is not applicable to them. An employee of an independent contractor performing work for a city cannot seek compensation from the city. Portsmouth v. Daniels, 157 Va. 614 , 162 S.E (1932); Broughman v. City of Alexandria, 36 O.I.C. 221 (1954).

    The Richmond Turnpike Authority was an “owner” within the meaning of the Act though it was created as a political subdivision of the Commonwealth, it being created for a special and limited public purpose only. Williams v. Gresham Co., Inc., 201 Va. 457 , 111 S.E.2d 498, 1959 Va. LEXIS 249 (1959); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    Notice:

    An employee must give notice of an accident to statutory employers within thirty days of its occurrence or show that he was unaware of the employment relationship, could not reasonably have known of it within the prescribed time period and the delay in reporting did not result in prejudice. Race Fork Coal Co. v. Turner, 237 Va. 639 , 379 S.E.2d 341, 5 Va. Law Rep. 2382, 1989 Va. LEXIS 70 (1989).

    Where the employee is unaware of a relationship between his employer and some third party, who is a potential statutory employer at the time of his injury, and the employee does not discover that relationship within 30 days after his work accident, these facts constitute a reasonable basis for failure to give notice, and benefits may still be awarded, unless the statutory employer shows it was prejudiced by the untimely notice. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    Section 65.2-600 A, provides that notice of accident to a statutory employer is timely, if given to the statutory employer so that it has at least sixty days notice before an evidentiary hearing. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    Section 65.2-600 A, subsections (i), which refers to 60-days notice to the statutory employer, and (ii), which speaks of prejudice to such employer, are presented in the conjunctive, and both conditions must be established before the statutory employer can obtain relief for lack of notice. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    The burden of establishing prejudice for untimely notice rests with the statutory employer. The prejudice contemplated by § 65.2-600 D consistently falls within either of two categories: (1) harm flowing from the employer’s inability to provide immediate medical treatment to reduce the seriousness of the injury; and (2) harm attributable to the employer’s inability to sufficiently investigate a claim or prepare a defense because of the delay. Here, where the statutory employer presented no evidence to show that it could have or would have done anything differently to reduce the seriousness of the claimant’s injury, or that it was unable to prepare a defense to the claim, the notice defense was rejected. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    An award against the statutory employer was denied because the employee failed to give timely notice of the accident to the statutory employer despite being aware of its existence. Ignorance of the law regarding statutory employers is not a basis for excusing an employee from providing timely notice. Sampson v. C & C Trucking/Timberline Logging, Inc., 71 O.W.C. 41 (1992).

    Where the statutory employer received timely notice of the accident but the immediate employer was not provided notice within the required time frame and no reasonable excuse was provided, it is appropriate to enter the award against the statutory employer and dismiss the claim against the direct employer. Wagner Enterprises, Inc. v. Brooks, 12 Va. App. 890, 407 S.E.2d 32, 8 Va. Law Rep. 213, 1991 Va. App. LEXIS 159 (1991).

    Examples:

    Where the number of employees of the general contractor and the subcontractor total three or more, the general contractor is subject to jurisdiction of the Act as the statutory employer. Cook v. Jimmy Ball Constr. Co., VWC File No. 211-37-32 (July 30, 2004).

    A contractor is the “statutory employer” of its subcontractor employees whenever it engages such subcontractor to perform work which is part of the trade, business, or occupation of the contractor. Installation of “drivit,” a relatively new synthetic plaster, is not an activity so distinct as to be outside the nature of the contractor’s drywall installation business. Gibson v. Conley and F. Richard Wilton, Jr., Inc., 74 O.W.C. 132 (1995).

    Sears Roebuck was found to be a statutory employer on the basis that it previously performed insulation work which was now subcontracted, it advertised and made the arrangements for the installation, and it controlled the installation process by carefully selecting contractors and following up on their work when required. Campbell v. Salyer Electric, 64 O.I.C. 7 (1985).

    The Commission held that the motor lodge that leased facilities to an adjacent restaurant operator and required the operator to provide certain services that benefited the motor lodge thereby made the restaurant an extension of its own business services. The motor lodge was therefore the statutory employer of the claimant injured in an accident arising out of her work as an employee of the restaurant. Price v. M & M Restaurant Group t/a Howard Johnson, 74 O.W.C. 51 (1995).

    Where the engineers and the construction company were both independent contractors engaged in construction of the Turnpike, neither was a stranger to the occupation and the work, rather they were both (as was the Turnpike Authority) under the canopy of the Act, and claimant was a statutory fellow servant to the employees of the construction company. Williams v. Gresham Co., Inc., 201 Va. 457 , 111 S.E.2d 498, 1959 Va. LEXIS 249 (1959); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    Where subcontractor contracted to haul coal from mine to railroad siding, this work was part of business of the mining corporation. Compton v. Laurel Fork Coal Corp., 32 O.I.C. 210 (1950).

    Timberline Logging, Inc., a business involved in cutting, skidding, loading and delivering logs and pulpwood, was found to be in the same trade, business or occupation as the immediate employer, a trucking business engaged in delivering logs. Sampson v. C & C Trucking, Inc./Timberline Logging, Inc., 71 O.W.C. 41 (1992).

    Where contractor cut timber on land of owner and delivered same to plant of owner at fixed price, this work was part of business of owner where contractor never exercised alleged right to sell cut timber to others. Hamlett v. Jones, 36 O.I.C. 177 (1954).

    The employee worked for a tree service that had contracted with Princess Anne Builders [owner] to remove tree limbs from a residential lot prior to a sales closing on that lot, where the real property contract of sale provided that trees would be trimmed or removed. Although the work of the employee was deemed not part of the trade, business, or occupation of Princess Anne Builders, the Commission found that the owner was a statutory employer of the employee because the work that caused the injury constituted a subcontracted fraction of the main contract, which anticipated the ultimate sale to the buyers of the real property. Faucette v. Princess Anne Builders, Inc., 78 O.W.C. 174 (1999).

    Where an owner undertakes to perform work with his own employees, such owner in fact makes such work part of his trade, business occupation. The partnership constructed a new warehouse, all work being done by their employees except tar papering the roof and installing skylights, which was contracted to Sage who did not carry workmen’s compensation insurance. When one of his employees was injured, he was held to be a statutory employee of owner. Compensation awarded against owner and contractor. Allen v. Sage, 47 O.I.C. 1 (1965) (appeal denied).

    Immediate employer and statutory employer both liable for compensation, with whatever right latter may have to indemnity from former. Sheets v. Blevins, 55 O.I.C. 313, 316 (1973).

    A poultry processing company in constant state of physical expansion, made construction a part of their business and claimant was not a casual employee. Baker v. Marval Poultry Co., Inc., 55 O.I.C. 22 (1973).

    The contract between the owner and the immediate employer cannot preclude the injured employee from invoking this section where the work which he was doing was a part of the owner’s business. Dunnavant v. Continental Oil Co., 19 O.I.C. 102 (1937) (appeal denied); James v. National Cash Register Co., 8 O.I.C. 335 (1926).

    Unless the owner of land, who is acting as his own general contractor in the construction of a personal residence, is also engaged in the same type of employment as part of his trade, business or occupation, he is not a statutory employer under this section. Boozer v. Otis Johnson, a/k/a Mike Johnson, 65 O.I.C. 297 (1986).

    Employee who worked for “owner” not subject to the Act, could not claim against prime contractor who was contracting private residence for owner for injuries received on the project. Sprouce v. Currier, 57 O.I.C. 341 (1976).

    The claimant was found to be an employee of an independent contractor, who did not have the requisite number of employees to bring him under the Act. It was also found that he was not a statutory employee of the co-defendant at whose place of business the work was being performed because the work was not part of the co-defendant’s trade, business or occupation. Sylvia v. Graveley Construction Company, 63 O.I.C. 346 (1984).

    Employees of the manufacturer of a commodity, who employs his own servants and exercises exclusive supervision over them, do not become employees of a purchaser of such commodity by virtue of this section. Perkinson v. Thomas, 158 Va. 699 , 164 S.E. 561 , 1932 Va. LEXIS 289 (1932).

    Contractor constructing television tower not part of business of owner who would subsequently use tower. Newcome v. Havens & Martin, Inc., 36 O.I.C. 468 (1954). Shell Oil Co. was not statutory employer of employee of independent contractor; Shell does not sell to consumer. Shell Oil Co. v. Leftwich, 212 Va. 715 , 187 S.E.2d 687 (1972) (see also Sun Oil v. Lawrence, 213 Va 194, 596 S.E.2d 687 (1973) (previously cited)).

    The phrase “undertakes to perform or execute any work”, used this section, refers to work already a part of the owner’s trad business or occupation, not something which the owner will use his business after completion. Bamber v. City of Norfolk, 138 Va. 26 , 121 S.E.2d 564 (1924); Newcome v. Havens & Martin, Inc., 36 O.I.C. 468 (1954).

    Marriott, a restaurant and food supply corporation, was not in the business of designing and installing walk-in food freezers and was therefore not a statutory employer. Levi v. Elliott Williams Co., 55 O.I.C. 226, 229 (1973) (appeal denied).

    Burden is on employee to show that immediate employer had contract with prime contractor. Evidence that two contractors were working on same project held insufficient to establish that one was the subcontractor of the other. Stallard v. Mills Co. and/or Moore Gulf, 56 O.I.C. 299 (1975).

    § 65.2-303. Recovery from subcontractor; proceedings against owner or contractor.

    1. Nothing in §§ 65.2-302 and 65.2-304 shall be construed as preventing a worker from recovering compensation under this title from a subcontractor (as described in § 65.2-302 ) instead of from the principal contractor (as described in § 65.2-302) but he shall not collect from both.
    2. When compensation is claimed from or proceedings are taken against the owner or contractor (as described in § 65.2-302 ), then, in the application of this title, reference to the owner or contractor shall be substituted for reference to the subcontractor (as described in § 65.2-302 ), except that the amount of compensation shall be calculated with reference to the earnings of the worker under the subcontractor by whom he is immediately employed.

    History. Code 1950, §§ 65-29, 65-31; 1968, c. 660, §§ 65.1-32, 65.1-34; 1991, c. 355.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 10.

    CASE NOTES

    Owner becomes “statutory employer” of contractor’s employees. —

    Former §§ 65.1-29 through 65.1-32 (now § 65.2-302 and this section) required the owners of a project to accept responsibility for the compensation of injured employees of contractors hired by the owner. The owner thus became the “statutory employer” of the contractor’s employees who, in turn, were the “statutory employees” of the owner. Farish v. Courion Indus., Inc., 722 F.2d 74, 1983 U.S. App. LEXIS 14855 (4th Cir. 1983) (decided under former § 65.1-32).

    CIRCUIT COURT OPINIONS

    Nothing in this section provides an exception to the Workers’ Compensation exclusivity provision. —

    Employee’s claim brought under § 65.2-303 alleging his employer’s failure to provide him with medical attention following an eye injury at work, leading to an infection and permanent loss of vision, failed to state a claim upon which relief could be granted because the Workers’ Compensation Act applied exclusively. Ayers v. White, 77 Va. Cir. 302, 2008 Va. Cir. LEXIS 237 (Prince William County Dec. 1, 2008).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The employees of an uninsured sub-subcontractor may look to the subcontractor, and to the general contractor, for workers’ compensation coverage, although recovery is not permitted from both. Faucette v. Princess Anne Builders, Inc., 78 O.W.C. 174 (1999).

    § 65.2-304. Indemnity of principal from subcontractor.

    When the principal contractor is liable to pay compensation under § 65.2-302 or § 65.2-303 , he shall be entitled to indemnity from any person who would have been liable to pay compensation to the worker independently of such sections or from an intermediate contractor and shall have a cause of action therefor.

    A principal contractor when sued by a worker of a subcontractor shall have the right to join that subcontractor or any intermediate contractor as a party.

    History. Code 1950, § 65-30; 1968, c. 660, § 65.1-33; 1991, c. 355.

    CASE NOTES

    Cancellation of subcontractor’s insurance without notice to contractor did not impose liability on it as a statutory employer without due process of law; contractor’s liability arose from its employment of subcontractor and, vicariously, subcontractor’s employee; its liability as a statutory employer existed without reference to insurance; furthermore, if it were obliged to pay benefits to employee, it was entitled to seek indemnity from subcontractor, and therefore, this was a circumstance which did not fix liability on contractor. Girdley Constr. Co. v. Widger, 1990 Va. App. LEXIS 241 (Va. Ct. App. May 29, 1990) (decided under former § 65.1-33).

    Indemnity action against subcontractor. —

    Trial court did not err in granting the subcontractor’s demurrer in the general contractor’s indemnity action against the subcontractor after the injured employee of the subcontractor obtained workers’ compensation benefits from the general contractor; the general contractor in its indemnity action had to show that the subcontractor was liable to pay the workers’ compensation benefits, but the general contractor failed to plead facts showing that the subcontractor, which had a principal place of business in Maryland, was subject to the Virginia Workers’ Compensation Act, § 65.2-100 et seq., as the general contractor did not show that the subcontractor had at least three employees regularly in the service of the Commonwealth, as was required pursuant to § 65.2-101 to subject an employer to the Act. Mark Five Constr., Inc. v. Castle Contr., 274 Va. 283 , 645 S.E.2d 475, 2007 Va. LEXIS 80 (2007).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Where an owner undertakes to perform work with his own employees and contracts part of work to another, such owner makes such work part of his trade, business or occupation and is liable to injured employee of contractor, but is entitled to indemnity from contractor for payment to contractor’s employee. Allen v. Sage, 47 O.I.C. 1 (1965) (appeal denied).

    Immediate employer and statutory employer both liable for compensation but the latter may have right of indemnification against the former. Sheets v. Blevins, 55 O.I.C. 313, 316 (1973); Scott v. Wilkins, 50 O.I.C. 292 (1968).

    If the immediate employer of injured workman has the required number of employees and can comply with an award for compensation he, rather than the owner or other intervening contractor, will be directed to make the payments, the liability under § 65.1-29 to § 65.1-31 (now § 65.2-302 ) of persons other than the immediate employer being secondary only. Possin v. Eubank, 12 O.I.C. 444 (1930).

    An employee is not required to file a claim against his immediate employer but may elect to file a claim against any statutory employer in the ascending employment hierarchy who receives timely notice of the accident as required by statute. Wagner Enterprises, Inc. v. Brooks, 12 Va. App. 890, 407 S.E.2d 32, 8 Va. Law Rep. 213, 1991 Va. App. LEXIS 159 (1991).

    Insurer of statutory employer paid compensation to employee, entitled to award against immediate employer. Harland v. Lake Edward Corp., 55 O.I.C. 156 (1973).

    Insurer of statutory employer paid compensation to employee; immediate employer did not have five [now three] employees, had not elected to be bound by Act; insurer not entitled to indemnity. Spear v. Gardner, 55 O.I.C. 325 (1973).

    § 65.2-305. Voluntary subjection to provisions of title; effect of taking out insurance or qualifying as self-insurer.

    1. Those employers not subject to this title may, by complying with the provisions of this title and the applicable rules of the Commission, voluntarily elect to be bound by it as to accidents or occupational diseases or both.
    2. Every employer taking out a workers’ compensation insurance policy, or qualifying as a self-insurer, shall be subject to all the provisions of this title, regardless of the number of employees or whether he is an employer of farm and horticultural laborers and domestic servants.  Such employers not otherwise covered by this title shall be subject to this title only during the period covered by such insurance.  Every employee of an employer who has complied with the foregoing requirements shall be subject to all the provisions of this title except that executive officers may reject coverage as provided in § 65.2-300 .

    History. Code 1950, § 65-32; 1964, c. 602; 1968, c. 660, § 65.1-35; 1991, c. 355.

    Cross references.

    For presumption that certain health conditions causing death or disability of officers of the police force maintained by the Metropolitan Washington Airports Authority are occupational diseases, for such period as the Authority subjects itself to the provisions of Chapter 4 of Title 65.2, see § 65.2-402 B.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 14.

    CASE NOTES

    Independent contractor who failed to elect coverage not entitled to sole proprietor benefits. —

    Claimant was an independent contractor who failed to properly elect coverage under the statutes, and therefore, was not entitled to benefits as a sole proprietor. Whitlock v. Whitlock Mechanical/Check Servs., Inc., 25 Va. App. 470, 489 S.E.2d 687, 1997 Va. App. LEXIS 563 (1997).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Student volunteer firefighter held employee covered by Act under this section. Bruce v. Hampden-Sydney College, 61 O.I.C. 78 (1982).

    § 65.2-306. When compensation not allowed for injury or death; burden of proof.

    1. No compensation shall be awarded to the employee or his dependents for an injury or death caused by:
      1. The employee’s willful misconduct or intentional self-inflicted injury;
      2. The employee’s attempt to injure another;
      3. The employee’s intoxication;
      4. The employee’s willful failure or refusal to use a safety appliance or perform a duty required by statute;
      5. The employee’s willful breach of any reasonable rule or regulation adopted by the employer and brought, prior to the accident, to the knowledge of the employee; or
      6. The employee’s use of a nonprescribed controlled substance identified as such in Chapter 34 (§ 54.1-3400 et seq.) of Title 54.1.
    2. The person or entity asserting any of the defenses in this section shall have the burden of proof with respect thereto. However, if the employer raises as a defense the employee’s intoxication or use of a nonprescribed controlled substance identified as such in Chapter 34 of Title 54.1, and there was at the time of the injury an amount of alcohol or nonprescribed controlled substance in the bodily fluids of the employee which (i) is equal to or greater than the standard set forth in § 18.2-266 , or (ii) in the case of use of a nonprescribed controlled substance, yields a positive test result from a Substance Abuse and Mental Health Services Administration (SAMHSA) certified laboratory, there shall be a rebuttable presumption, which presumption shall not be available if the employee dies as a result of his injuries, that the employee was intoxicated due to the consumption of alcohol or using a nonprescribed controlled substance at the time of his injury. The employee may overcome such a presumption by clear and convincing evidence.

    History. Code 1950, § 65-35; 1968, c. 660, § 65.1-38; 1991, cc. 166, 355; 1994, cc. 600, 804; 2002, c. 636.

    The 2002 amendments.

    The 2002 amendment by c. 636, in subsection B, deleted “or death” following “injury” in two places, in the second sentence, inserted “which presumption shall not be available if the employee dies as a result of his injuries” following “presumption” and inserted “due to the consumption of alcohol” following “was intoxicated,” and added the last sentence.

    Law Review.

    For article, “Recovery for Accidental Injuries Under the Virginia Workmen’s Compensation Act,” see 14 U. Rich. L. Rev. 659 (1980).

    For Essay, “Analyzing the Virginia Workers’ Compensation Act’s Governance of Employer Non-Compliance,” see 51 U. Rich. L. Rev. 193 (2016).

    Research References.

    Larson’s Workers’ Compensation Law (Matthew Bender). § 34.01 Summary of “Misconduct” Statutes; § 35.01 Summary and General Construction of Safety Rule Statutes; § 38.03 Chain of Causation Test. Larson and Larson.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 16, 35, 36, 56, 65.

    CASE NOTES

  • Analysis
  • I.Intentional Acts.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-38 or prior law.

    A.“Willfulness” generally.

    “Willful” imports something more than a mere exercise of the will in doing the act. It imports a wrongful intention, an intention to do an act that the employee knows, or ought to know, is wrongful, or forbidden by law. It involves the idea of premeditation and determination to do the act, though known to be forbidden. There cannot be a willful failure to perform an unknown duty. The language used in this section covers something more than negligence, however gross. King v. Empire Collieries Co., 148 Va. 585 , 139 S.E. 478 , 1927 Va. LEXIS 257 (1927).

    “Willful misconduct” is a question of fact. —

    The question of whether an employee was guilty of willful misconduct is a question of fact to be resolved by the commission. Watford v. Colonial Williamsburg Foundation, 13 Va. App. 501, 413 S.E.2d 69, 8 Va. Law Rep. 1662, 1992 Va. App. LEXIS 2 (1992) (decided under former § 65.1-38).

    This claim was denied on the ground that the employee who died in an industrial accident had engaged in willful misconduct. Adams ex rel. Boysaw v. Hercules, Inc., 21 Va. App. 458, 465 S.E.2d 135, 1995 Va. App. LEXIS 931 (1995).

    The questions of whether an employee is guilty of willful misconduct and whether such misconduct is a proximate cause of the employee’s accident are issues of fact. Brockway v. Easter, 20 Va. App. 268, 456 S.E.2d 159, 1995 Va. App. LEXIS 452 (1995).

    “Willful misconduct” in abstract mixed question of fact and law. —

    Whether employee’s conduct in the abstract constitutes willful misconduct is a mixed question of fact and law and is reviewable by Court of Appeals. Buzzo v. Woolridge Trucking, Inc., 17 Va. App. 327, 437 S.E.2d 205, 10 Va. Law Rep. 578, 1993 Va. App. LEXIS 560 (1993).

    It signifies “with deliberate intent.” —

    The meaning of the word “willful” in this connection is “with deliberate intent.” If the employee knows the rule, and yet intentionally does the forbidden thing, he has “willfully failed to obey” the rule. Riverside & Dan River Cotton Mills, Inc. v. Thaxton, 161 Va. 863 , 172 S.E. 261 , 1934 Va. LEXIS 311 (1934).

    Willful misconduct requires something more than negligence. “ ‘Willful’ . . . imports something more than a mere exercise of the will in doing the act. It imports a wrongful intention.” One of the salutary purposes of worker’s compensation acts is to provide specified benefits for injuries arising out of and in the course of employment regardless of fault of the employer or employee, except instances of willful misconduct or intentional injury. The common law defense of contributory negligence is abolished by the act. Uninsured Employer's Fund v. Keppel, 1 Va. App. 162, 335 S.E.2d 851, 1985 Va. App. LEXIS 78 (1985).

    Negligence, regardless how gross, does not bar recovery for worker’s compensation benefits. Uninsured Employer's Fund v. Keppel, 1 Va. App. 162, 335 S.E.2d 851, 1985 Va. App. LEXIS 78 (1985).

    Where it was unclear whether an employee’s failure to stop at a stop sign was willful disobedience or negligence, the employee was improperly denied workers’ compensation benefits for his injures in an accident arising from his failure to stop; willful misconduct requires something more than negligence. Finney v. Mason, 2004 Va. App. LEXIS 344 (Va. Ct. App. July 13, 2004).

    Proof of negligence, even gross negligence, alone will not support the defense, for willful misconduct imports something more than a mere exercise of the will in doing the act; it imports a wrongful intention. Buzzo v. Woolridge Trucking, Inc., 17 Va. App. 327, 437 S.E.2d 205, 10 Va. Law Rep. 578, 1993 Va. App. LEXIS 560 (1993).

    Proof of negligence will not support the defense of willful misconduct; willful misconduct requires something more than negligence. Phipps v. Rann Indus., Inc., 16 Va. App. 394, 429 S.E.2d 886, 9 Va. Law Rep. 1342, 1993 Va. App. LEXIS 119 (1993).

    Notice and burden of proof. —

    This section and Rule 4 of the Rules of the Industrial (now Workers’ Compensation) Commission merely require the giving of notice if the employer intends to interpose an affirmative defense to bar an otherwise meritorious claim. Neither provision relieves the claimant of the burden of proving his case. Anderson v. East Coast Fish & Scallop, 10 Va. App. 215, 391 S.E.2d 347, 6 Va. Law Rep. 2306, 1990 Va. App. LEXIS 69 (1990).

    Virginia Workers’ Compensation Commission properly found that a workers’ compensation benefits claimant’s evidence established an injury by accident because there were no inconsistencies in the claimant’s testimony; because a credible claim was established, evidence of self-inflicted injury under § 65.2-306 could only be admitted to contradict the claim upon notice that the defense would be raised, and an employer failed to give such notice. Jenkins v. Webb, 52 Va. App. 206, 662 S.E.2d 633, 2008 Va. App. LEXIS 300 (2008).

    Virginia Workers’ Compensation Commission properly awarded a workers’ compensation claimant benefits because an employer offered no excuse or explanation for its failure to comply with the notice requirements of Va. Workers’ Comp. Comm’n R. 1.10; the employer never asserted a self-inflicted injury defense under § 65.2-306 , and the failure to give proper notice deprived the claimant of the opportunity to subpoena witnesses and gather evidence in response to the defense. Jenkins v. Webb, 52 Va. App. 206, 662 S.E.2d 633, 2008 Va. App. LEXIS 300 (2008).

    Suicide may be compensable. —

    Where injury and its consequences directly result in worker’s loss of normal judgment and domination by a disturbance of the mind causing the suicide, his suicide is compensable. A suicide committed by worker suffering from this degree of disturbance is not considered “willful” or an “intentional” injury even though the action is volitional since the suicide relates back to the original injury rather than existing independently of the injury. Food Distribs. v. Estate of Ball, 24 Va. App. 692, 485 S.E.2d 155, 1997 Va. App. LEXIS 311 (1997).

    Failure to report OSHA violation. —

    Evidence was not sufficient to show that complainant was guilty of willful misconduct by failing to report an Occupational Safety & Health Act (OSHA) violation. Wyle v. Professional Services Industries, 12 Va. App. 684, 406 S.E.2d 410, 7 Va. Law Rep. 2961, 1991 Va. App. LEXIS 142 (1991).

    Facts not showing willful misconduct. —

    Where a member of the national guard, while returning to camp with an intoxicated companion, suffered injury when struck by an electric car while attempting to recover his companion from the track, it was held that the fact that claimant might have dozed while sitting on the track was not such misconduct as precluded recovery under this section. Globe Indem. Co. v. Forrest, 165 Va. 267 , 182 S.E. 215 , 1935 Va. LEXIS 295 (1935).

    Although employee may have been guilty of driving too fast under the circumstances of the heavy load on his truck and the curve in the highway, and thus causing his truck to overturn which caused his death, and in so doing, his conduct was negligent, possibly even grossly negligent, however, proof of gross negligence did not equate with proof of willful misconduct, thus, proof of trucker’s violation of the statute through negligence, without more, did not support a finding of willful misconduct to justify barring award of death benefits to trucker’s widow and daughter. Buzzo v. Woolridge Trucking, Inc., 17 Va. App. 327, 437 S.E.2d 205, 10 Va. Law Rep. 578, 1993 Va. App. LEXIS 560 (1993).

    Credible evidence supported Commissions’s finding that claimant was engaged in a “troubleshooting mission” and that, under these circumstances, it was permissible to work on the belt with the drive pulley operating. Upon this finding, employer’s defense of willful misconduct or violation of a safety rule could not prevail. Brockway v. Easter, 20 Va. App. 268, 456 S.E.2d 159, 1995 Va. App. LEXIS 452 (1995).

    Willful misconduct barring award to tow truck driver was not present where there was no evidence that his failure to wear a seat belt was willful or intentional and the evidence was insufficient to prove that he had been wearing his seat belt at the time of the accident, this would have prevented the injury. Old v. Huckaby, 1995 Va. App. LEXIS 563 (Va. Ct. App. July 5, 1995).

    Credible evidence proved that the October 1995 injury was minor and did not cause disability. Claimant testified that she was not aware that she had sustained any fracture as a result of the October 1995 incident. Based upon this evidence, the commission could conclude that claimant did not intend to mislead her employer or her doctors when she failed to mention the October 1995 incident. Accordingly, the Commission did not err in holding that claimant was not barred from receiving an award of compensation benefits on the ground of willful misconduct. Georgia-Pacific Corp. v. Hicks, 1997 Va. App. LEXIS 558 (Va. Ct. App. Aug. 26, 1997).

    Evidence was insufficient to show that the claimant willfully failed to use a safety appliance at the time that he was injured while demolishing a chimney where (1) the claimant testified that he had never demolished a chimney before and sought instruction from employer, but received no safety directions, and (2) no evidence showed that the employer ever held safety meetings; that the employer ever promulgated safety rules, or that the employer ever told its employees, including the claimant, to shore the chimney by using a brace. Jungers v. Powers, 1998 Va. App. LEXIS 545 (Va. Ct. App. Oct. 27, 1998).

    The Workers’ Compensation Commission did not err in failing to find that the claimant was barred from recovery by subdivisions (A)(1) or (5) based on his conduct in reaching into a machine that split concrete blocks in order to remove a chunk of concrete where the claimant and other employees testified that the employer did not train or instruct its employees with regard to the method of removing chunks from the machine and that employees routinely reached into the machine with their hands to remove chunks. Tarmac America, Inc. v. Salmon, Jr., 1998 Va. App. LEXIS 636 (Va. Ct. App. Dec. 8, 1998).

    Where a truck driver had been injured in an accident which occurred when he was unable to stop before striking another vehicle and the employer argued that the speed at which the driver was traveling was excessive given the weather conditions, even if the court was to conclude that the weather conditions dictated a lesser speed, the driver’s conduct, at most, might be characterized as negligent and negligence alone, even gross negligence, will not support a finding of willful misconduct. Dan River, Inc. v. Giggetts, 34 Va. App. 297, 541 S.E.2d 294, 2001 Va. App. LEXIS 61 (2001).

    No intentional or willful violation of a company safety rule that an employee behave in a certain way if he was behind, crossing, or in a driver’s blind spot existed where an employee was killed by a vacuum truck that unexpectedly backed over the employee, as credible evidence supported the finding that the employee was unaware that the employee was behind the vacuum truck or in the driver’s blind spot. Mega Contrs. v. Burrell, 2003 Va. App. LEXIS 35 (Va. Ct. App. Feb. 4, 2003).

    Where the workers’ compensation claimant, a professional hockey player, was injured in a fight that the claimant was ordered by the claimant’s coach to instigate, the employer, in a workers’ compensation case, did not show that the claimant’s injury was the result of willful misconduct under § 65.2-306 , as the employer failed to rebut the evidence that the claimant was engaged in an activity required by the claimant’s employment; furthermore, the employer failed to rely on the willful misconduct defense in accordance with Virginia Workers’ Comp. Comm’n R. 1.10. Norfolk Admirals v. Jones, 2005 Va. App. LEXIS 443 (Va. Ct. App. Nov. 1, 2005).

    Workers’ Compensation Commission did not err in rejecting the employer’s willful misconduct defense based on the fact that the claimant tested positive for methadone after the accident, because the testimony of the director of the medical clinic where the claimant received methadone explained that the medication was administered in a structured program under a doctor’s supervision, and would not have interfered with a patient’s normal activities, including the ability to work. Dominion Coal Corp. v. Bowman, 53 Va. App. 367, 672 S.E.2d 122, 2009 Va. App. LEXIS 55 (2009).

    Claimant was entitled to temporary total disability and medical benefits, following an altercation at work with a coworker, because credible evidence supported a finding that the claimant’s lower back injury arose out of the claimant’s employment, in that the claimant was not the aggressor in the work-related altercation and in that the claimant did not intend to act unprofessionally, did not willfully breach the employer’s professional conduct rules, or otherwise willfully commit misconduct. Fairfax Cnty. Gov't v. Monroe, 2015 Va. App. LEXIS 125 (Va. Ct. App. Apr. 14, 2015).

    Employee guilty of willful misconduct. —

    Where an electrician was killed by replacing light bulbs without taking out the switch controlling adjoining power lines, which, by a rule of his employer, he was required to do, it was held that the electrician was guilty of “willful misconduct” and could not recover. Riverside & Dan River Cotton Mills, Inc. v. Thaxton, 161 Va. 863 , 172 S.E. 261 , 1934 Va. LEXIS 311 (1934).

    Commission held justified in concluding that claimant, a lineman, was guilty of willful misconduct in disregarding a company rule that he wear rubber gloves when working on an energized line, and that this conduct was the proximate cause of his injury since it was his hand which first came in contact with the line. Mills v. VEPCO, 197 Va. 547 , 90 S.E.2d 124, 1955 Va. LEXIS 254 (1955).

    In a claim arising out of the amputation of the claimant’s hand when she attempted to dislodge a piece of meat debris from the tray of a machine she was assigned to clean, the Commission correctly concluded that the claimant had successfully rebutted the employer’s defense of willful breach of a safety rule where the evidence revealed that at least one supervisor occasionally used his hand to remove stuck meat debris without fear of any disciplinary consequences from the employer, the claimant’s testimony indicated that she witnessed her supervisor on several occasions remove meat debris from the tray by using his hands, the claimant further testified that she was instructed by the supervisor to use her hands to remove meat debris while the machine was running and a co-worker testified that she regularly used her hands to remove stuck meat debris while the machine was engaged. Gwaltney of Smithfield, Ltd. v. Hagins, 32 Va. App. 386, 528 S.E.2d 162, 2000 Va. App. LEXIS 328 (2000).

    The Commission did not err in ruling that an employee was barred from receiving workers’ compensation benefits on the grounds that he had willfully violated a safety rule by being lifted into the air by a forklift while standing on a pallet. The evidence established that a rule prohibited lifting a worker on a forklift without a safety cage, that this rule was designed to provide for the safety of employees, and that the employee knew of the rule. Wallace v. Prod. Support Servs., 2001 Va. App. LEXIS 315 (Va. Ct. App. June 5, 2001).

    Denial of a worker’s claim for compensation for injury caused by his use of an “up-cut” saw was proper pursuant to subsection A of § 65.2-306 because the worker’s supervisor testified that the worker was never trained to use the saw, had enough wood already at his workstation to complete his project, and could have used another available saw on day of the accident; the workers’ compensation commission found the supervisor’s testimony credible and rejected the worker’s testimony. The worker testified that he understood “pretty much” everything and knew he was not to use equipment for which he received no training. Pinoth v. Glaize Co., 2006 Va. App. LEXIS 303 (Va. Ct. App. July 11, 2006).

    B.Safety Rules, Regulations, etc.

    To prevail upon a defense of willful misconduct under this section, employer had to establish: (1) that the safety rule was reasonable, (2) that the rule was known to employee, (3) that the rule was for employee’s benefit, and (4) that employee intentionally undertook the forbidden act. Spruill v. C. W. Wright Construction Company, Inc., 8 Va. App. 330, 381 S.E.2d 359, 5 Va. Law Rep. 2951, 1989 Va. App. LEXIS 72 (1989).

    If the safety rule is reasonable and is known to the employee and for his benefit, and yet he intentionally does the forbidden act, then he is guilty of willful misconduct within the meaning of this section. Watford v. Colonial Williamsburg Foundation, 13 Va. App. 501, 413 S.E.2d 69, 8 Va. Law Rep. 1662, 1992 Va. App. LEXIS 2 (1992) (decided under former § 65.1-38).

    To successfully raise a defense of willful misconduct, the employer must establish (1) that the safety rule or other duty was reasonable, (2) that the rule was known to the employee, (3) that the rule was for the employee’s benefit, and (4) that the employee intentionally undertook the forbidden act. Buzzo v. Woolridge Trucking, Inc., 17 Va. App. 327, 437 S.E.2d 205, 10 Va. Law Rep. 578, 1993 Va. App. LEXIS 560 (1993).

    To establish a defense based on an employee’s willful breach of a rule or regulation adopted by the employer, the employer must prove: (1) The rule was reasonable; (2) the employee knew of the rule; (3) the rule was for the employee’s benefit and (4) the employee intentionally performed the forbidden act. Dan River, Inc. v. Giggetts, 34 Va. App. 297, 541 S.E.2d 294, 2001 Va. App. LEXIS 61 (2001).

    Employer must prove “willful” disregard. —

    The employer bears the burden of proving that the claimant’s conduct was in “willful” disregard of a reasonable safety rule established by the employer and made known to the claimant. Gwaltney of Smithfield, Ltd. v. Hagins, 32 Va. App. 386, 528 S.E.2d 162, 2000 Va. App. LEXIS 328 (2000).

    Breach of express safety rule or order. —

    Ordinarily, the breach of an express rule or order will be held to be serious or willful misconduct as a matter of fact, especially if the rule or order was made especially for the safety of the employee. Riverside & Dan River Cotton Mills, Inc. v. Thaxton, 161 Va. 863 , 172 S.E. 261 , 1934 Va. LEXIS 311 (1934).

    Where an employee, with actual knowledge of a safety rule, with practical knowledge of its importance and purpose, and despite the warning of his superior and that of his fellow workman, deliberately and willfully failed to comply with the regulation, and failed to use the safety appliance designed for his protection and security, the situation came squarely within this section. Griffey v. Clinchfield Coal Corp., 183 Va. 715 , 33 S.E.2d 178, 1945 Va. LEXIS 219 (1945).

    If a safety rule is reasonable and is known to the employee and for his benefit, and yet he intentionally does the forbidden act, then he is guilty of willful misconduct within the meaning of this section. The employer is not required to prove that the employee, with the rule in mind, purposely determined to break it. Mills v. VEPCO, 197 Va. 547 , 90 S.E.2d 124, 1955 Va. LEXIS 254 (1955); Peanut City Iron & Metal Co., Inc. v. Jenkins, 207 Va. 399 , 150 S.E.2d 120, 1966 Va. LEXIS 235 (1966).

    Disregard of an express order, especially one made for the safety of the employees, usually constitutes willful misconduct. Uninsured Employer's Fund v. Keppel, 1 Va. App. 162, 335 S.E.2d 851, 1985 Va. App. LEXIS 78 (1985).

    Where an experienced steel worker knew about a safety rule and its purpose, but was not in compliance when injured, credible evidence supported the workers’ compensation commission’s finding that the worker willfully violated a safety rule and was not entitled to workers’ compensation benefits. Byam v. North Star Constr. Corp., 2003 Va. App. LEXIS 209 (Va. Ct. App. Apr. 8, 2003).

    Where an employer had created reasonable safety rules regarding hair, the employee was aware of the rules, and the employee willfully violated the rules by failing to restrain the employee’s hair while working on a machine, the employee was not entitled to workers’ compensation benefits under subdivision A 5 of § 65.2-306 . Daniel v. Atlas Roofing, 2003 Va. App. LEXIS 682 (Va. Ct. App. Dec. 23, 2003).

    Evidence supported a workers’ compensation commission’s finding that a worker’s conduct was a willful disregard of a safety rule, and the commission’s denial of benefits to the worker where, although the worker was told to install toe boards on a roofing job, the worker failed to follow the directed procedure, leading to his fall from roof. Zeledon v. GCR, Inc., 2005 Va. App. LEXIS 426 (Va. Ct. App. Oct. 25, 2005).

    Workers’ Compensation Commission did not err in denying claimant benefits because credible evidence supported the findings that he intentionally violated a known safety rule by placing his left hand over a moving saw blade; the facts clearly proved that the requirement that a carpenter keep his hands away from the saw blade was a known safety rule, and claimant acknowledged that he intentionally placed his hand over the spinning blade to hold down a piece of wood. Gutierrez-Lazo v. Coburn & Clay Bldg. Dev. Corp., 2014 Va. App. LEXIS 230 (Va. Ct. App. June 3, 2014).

    Virginia Workers’ Compensation Commission did not err in concluding that an employer proved its affirmative defense of willful misconduct because credible evidence supported a finding that the claimant’s willful violation of his employer’s rule and the statutory requirement proximately caused his injuries; the Commission could reasonably infer that the claimant’s injuries resulted from being thrown out of the driver’s seat, which was a consequence of his failure to wear a seatbelt. Mailloux v. Am. Transp., 2018 Va. App. LEXIS 260 (Va. Ct. App. Oct. 9, 2018).

    Intentional violation not found. —

    Workers’ Compensation Commission properly found that the employer did not meet its burden of proving that claimant was injured because she intentionally violated a known safety rule; Commission was free to interpret claimant’s testimony as meaning that she had to do her job even if obstacles were in the way, as long as working around them did not violate employer’s clear path rule. Thus, claimant’s actions amounted to negligence at most, which did not preclude an award of benefits. Klockner Pentaplast of Am. v. Miller, 2021 Va. App. LEXIS 135 (Va. Ct. App. July 27, 2021).

    While this section generally bars an employee's claim before the Commission for injury sustained by willful breach of an employer's safety rule, an employee may overcome this bar by showing that the safety rule was not actually kept alive by any bona fide enforcement; the evidence is sufficient to conclude employer failed to adequately enforce its own safety rule. Truteam & Ace Am. Ins. Co. v. Dequintanilla, 2022 Va. App. LEXIS 26 (Va. Ct. App. Feb. 1, 2022).

    Reasonableness of rule mixed question of law and fact. —

    Whether the rule is reasonable and applies to the situation from which the injury results, and whether the claimant knowingly violated it, is a mixed question of law and fact to be decided by the Commission and reviewable by Appellate Court. Brockway v. Easter, 20 Va. App. 268, 456 S.E.2d 159, 1995 Va. App. LEXIS 452 (1995).

    Proof of a pattern or practice of failing to discipline employees guilty of willful violations of a safety rule defeats the defense afforded an employer by this section, but only when such violations occur under circumstances charging the employer with knowledge and acquiescence. VEPCO v. Kremposky, 227 Va. 265 , 315 S.E.2d 231, 1984 Va. LEXIS 242 (1984).

    Rule enforced by employer. —

    Workers’ compensation benefits were properly denied to a claimant under subsection A of § 65.2-306 on the basis that he breached a workplace safety rule requiring him to wear back brace. Though the claimant was never disciplined for not wearing a back brace, he was corrected each time he was observed not wearing one, and he complied with the correction; thus, the rule was enforced. Mouhssine v. Crystal City Laundry, 62 Va. App. 65, 741 S.E.2d 804, 2013 Va. App. LEXIS 153 (2013).

    Employer’s failure to enforce other rules was not a defense. —

    Employer’s subdivision A 5 of § 65.2-306 defense was successful as the employer’s failure to enforce a safety rule requiring employees to read a meat slicer manual and undergo training prior to operating the slicer did not negate the employer’s more specific safety rule requiring employees to unplug the slicer prior to cleaning. Pitt v. Shackleford's Rest. & Va. Commerce Group Self-Insurance Ass'n, 2012 Va. App. LEXIS 94 (Va. Ct. App. Mar. 27, 2012).

    Employee may rebut the defense of willful misconduct by showing that the violated rule was not kept alive by bona fide enforcement or that there was a valid reason for his inability to obey the rule. Buzzo v. Woolridge Trucking, Inc., 17 Va. App. 327, 437 S.E.2d 205, 10 Va. Law Rep. 578, 1993 Va. App. LEXIS 560 (1993).

    Knowledge of rule must be shown. —

    A claimant was not barred from receiving compensation because of his willful misconduct in disobeying an alleged rule where knowledge of the rule had not been brought home to him, and, moreover, it did not appear that the alleged regulation was approved by the Commission, as this section requires. Tyree v. Commonwealth, 164 Va. 218 , 179 S.E. 297 , 1935 Va. LEXIS 196 (1935).

    Where worker, who had limited command of the English language, did not understand the safety documents he signed, was unaware of the employer’s written safety policy that prohibited his from putting his hands into the machines, did not recall being given safety instructions about his hands, and was not shown a safety video, the commmission’s determination that the employer did not prove it had made the rule known to the worker or had taken “reasonable steps” to do so was supported by credible evidence, and the commission’s award of benefits to the worker would be affirmed. Valleydale Foods, Inc. v. Lee, 2002 Va. App. LEXIS 21 (Va. Ct. App. Jan. 15, 2002).

    Virginia Workers’ Compensation Commission did not err in finding that a decedent’s death was not due to willful misconduct that barred his heirs’ recovery, because the evidence supported the Commission’s finding that the decedent’s method of riding on a lift was, at most, negligent and did not violate a known safety rule. Va. Linen Serv. v. Wise, 2005 Va. App. LEXIS 224 (Va. Ct. App. June 7, 2005).

    Workers’ Compensation Commission did not err in relying on claimant’s use of a table saw, rather than a jigsaw, to cut a small piece of wood to bar his compensation benefits because the employer’s notice included the particular allegation of violation; the employer’s notice stated that in addition to safety guard and push stick violations, claimant did not keep his hands away from the saw blade while cutting the board. Gutierrez-Lazo v. Coburn & Clay Bldg. Dev. Corp., 2014 Va. App. LEXIS 230 (Va. Ct. App. June 3, 2014).

    Intentional violation of safety rule properly found. —

    Sufficient evidence supported a finding that a workers’ compensation claimant intentionally violated a known safety rule for subdivision A 5 of § 65.2-306 purposes where: (1) although the employer did not train the claimant in the operation and cleaning of a meat slicer, the claimant had used one in his previous job; (2) safety rules governing the operation of the slicer were posted directly above it; (3) the claimant admitted he knew he was supposed to unplug the machine before cleaning it; (4) the claimant, who had already removed the slicer’s visible safety equipment and handle for cleaning, was away from the machine for no more than 5 to 10 seconds, and there was not sufficient time for anyone else to plug the machine back in; and (5) based on the fact that the slicer came on when the clamant began to clean it, the workers’ compensation commission was entitled to disbelieve his testimony that he unplugged the machine before cleaning it. Pitt v. Shackleford's Rest. & Va. Commerce Group Self-Insurance Ass'n, 2012 Va. App. LEXIS 94 (Va. Ct. App. Mar. 27, 2012).

    Claimant was not entitled to workers’ compensation benefits because the claimant intentionally committed conduct that was forbidden under a workplace safety rule which the employer had put in place that was communicated to the claimant on a number of occasions. Therefore, the claimant’s conduct was willful. Layne v. Crist Elec. Contr., Inc., 64 Va. App. 342, 768 S.E.2d 261, 2015 Va. App. LEXIS 37 (2015).

    Denial of workers’ compensation claim by an employee, a truck driver, was appropriate because the employee willfully violated known safety rules regarding securing company trucks that were promulgated in part for the benefit of the employee and the employee’s own failure to engage a truck’s emergency brake and to install tire chocks caused resulted in the employee’s injuries. In addition, the employee failed to rebut the defense as the evidence did not establish that the safety rule was not enforced. Callahan v. Rappahannock Goodwill, 2018 Va. App. LEXIS 288 (Va. Ct. App. Oct. 23, 2018).

    Workers’ Compensation Commission did not err in denying the claim for benefits because the claimant’s injury was caused by his violation of a known safety rule that was enforced by the employer as the claimant could have entered the fenced area through the gate, thus causing the machinery within the area to automatically deactivate, but, instead, he circumvented the gate and entered the area through a small opening not designed for ingress while the machines continued to operate, and one of those machines pinned the claimant’s leg and injured it; and the claimant himself acknowledged that the safety rule requiring employees to enter the fenced area through the gate, thereby deactivating the equipment in the area, was enforced. Jones v. Crothall Laundry, 69 Va. App. 767, 823 S.E.2d 37, 2019 Va. App. LEXIS 35 (2019).

    Workers’ Compensation Commission properly barred an employee from an award of benefits because, by acknowledging that he intended to put his seat belt on at some point, and yet did not put it on when he knew he was required to do so, the employee demonstrated that he was violating the seatbelt statute purposefully, not accidentally, and with deliberate intent, and the uncontested and uncontroverted evidence supported the court’s finding that the employee’s injuries were proximately caused by his failure to wear his seat belt and his resulting ejection from his truck. Mizelle v. Holiday Ice, Inc., 2020 Va. App. LEXIS 68 (Va. Ct. App. Mar. 10, 2020).

    Intentional violation not found. —

    Workers’ Compensation Commission properly awarded total disability benefits and medical benefits to the employee because credible evidence supported the Commission’s finding that the employee established that he was injured while working for employer, and that his actions in attempting to guide a hand truck did not constitute “lifting” in violation of employer’s safety rule and the Virginia Code inasmuch as the employee never contended that he injured his back while lifting boxes. Snelling Staffing/Chesapeake & Ace Am. Ins. Co. v. Edwards, 2019 Va. App. LEXIS 79 (Va. Ct. App. Apr. 9, 2019).

    Because credible evidence supported the Workers’ Compensation Commission’s finding that the employer failed to meet its burden to prove that claimant willfully breached a known safety rule when claimant entered a trommel to clean it, the grant of benefits was upheld. Claimant presented the only evidence of what actually happened on the date of the accident, testifying the key to the trommel was in the off position when he entered the trommel, the trommel was not turning when he entered it, and after he had been working inside the machine for two minutes, the trommel began to spin. Loudoun Composting, LLC v. Hernandez, 2020 Va. App. LEXIS 185 (Va. Ct. App. June 30, 2020).

    Recovery not barred where application of safety rule not clear. —

    Sufficient evidence supported the holding of the Virginia Workers’ Compensation Commission that § 65.2-306 did not bar a workers’ compensation claim arising from the claimant’s injury suffered while lifting a slab of granite because, although a known safety rule existed that required the use of a forklift for certain lifting, it was not obvious when the use of forklifts was required, and the employer’s owner admitted that he had not given specific rules or guidelines as to when to use a forklift. Am. Zurich Ins. Co. v. Amundsen, 2009 Va. App. LEXIS 150 (Va. Ct. App. Mar. 31, 2009).

    Finding by Commission that rule is reasonable satisfies statutory requirement. —

    The statutory requirement of Commission approval is satisfied by the finding of the Commission, in the course of claim litigation, that the rule is reasonable and proper for enforcement. Watford v. Colonial Williamsburg Foundation, 13 Va. App. 501, 413 S.E.2d 69, 8 Va. Law Rep. 1662, 1992 Va. App. LEXIS 2 (1992) (decided under former § 65.1-38).

    Acts prohibited by statute. —

    If an employee is injured by an accident which arises out of and in the course of his employment, and which proximately causes the injury complained of, he is not barred from recovery under the section by the fact that at the time of the accident he was engaged in doing an act which was forbidden by a general statute of the State, for the violation of which a penalty is prescribed, unless the employer can show that he had knowledge of the statute, or that reasonable steps had been taken to bring home to him notice of its existence. The burden is on the employer to show that the employee willfully neglected or refused to observe the statute. King v. Empire Collieries Co., 148 Va. 585 , 139 S.E. 478 , 1927 Va. LEXIS 257 (1927).

    Any violation of any traffic law did not constitute a willful failure to perform a duty required by statute. Finney v. Mason, 2004 Va. App. LEXIS 344 (Va. Ct. App. July 13, 2004).

    Workers’ compensation claim was properly denied on the ground that the claim was barred under subsection A of § 65.2-306 by the claimant’s willful failure to perform a duty required by statute since the evidence showed that, despite highway signs warning against stopping on the side of the road unless it was an emergency, the claimant stopped his truck on the shoulder to urinate and, therefore, failed to comply with § 46.2-830 by not obeying lawfully erected signs. The Workers’ Compensation Commission’s finding that the claimant’s excuse, unsupported by any evidence that he had a medical condition that caused the sudden need to urinate, did not constitute an “emergency” was a matter for the Commission to determine based upon an assessment of the evidence and the claimant’s credibility. Patterson v. Valley Proteins, Inc., 2006 Va. App. LEXIS 68 (Va. Ct. App. Feb. 21, 2006).

    Workers’ Compensation Commission’s finding that a workers’ compensation claimant’s violation of state law by stopping his truck on the shoulder of a highway to urinate was the proximate cause of his subsequent accident in which he was struck by another truck while he was pulling his truck back onto the highway was supported by the evidence. The claimant’s act of merging into traffic necessarily followed his act of deliberately stopping on the side of the road, and thus, stopping on the side of the road began a natural and continuous sequence that proximately caused the accident. Patterson v. Valley Proteins, Inc., 2006 Va. App. LEXIS 68 (Va. Ct. App. Feb. 21, 2006).

    Failure to wear safety belt was not willful violation of rule. —

    Commission’s finding, that claimant’s failure to wear a safety belt at the time he fell into an elevator shaft was not a willful violation of the employer’s safety rule, was supported by credible evidence; claimant was not working inside the shaft but he was merely looking down into it and did not believe that a safety belt was necessary. Miller & Long Co. v. Harrison, No. 0514-89-4 (Ct. of Appeals April 24, 1990).

    Although claimant willfully violated employer’s safety seat belt rule, he was allowed recovery because his injuries arose from a deliberate attack on his person which occurred after he was out of the truck’s cab, circumstances totally unrelated to those safety considerations which underpinned employer’s seat belt rule. Smithfield Packing Co. v. Carlton, 29 Va. App. 176, 510 S.E.2d 740, 1999 Va. App. LEXIS 133 (1999).

    II.Intoxication, Nonprescribed Controlled Substance.

    Intoxication causing accident. —

    Finding that claimant’s consumption of alcoholic beverages impaired his ability to operate and control his vehicle, and thus was the proximate cause of his accident, was sufficient to establish willful misconduct which disqualified the claimant for compensation benefits under subdivision (3) (now subdivision A 3) of this section. Morgan v. Morgan, No. 1471-87-2 (Ct. of Appeals Nov. 1, 1988).

    Injury must be proximately caused by intoxication. —

    To establish the affirmative defense in subdivision (3) (now subdivision A 3), an employer must prove by a preponderance of the evidence that intoxication proximately caused the claimant’s injuries. American Safety Razor Company v. Hunter, 2 Va. App. 258, 343 S.E.2d 461, 1986 Va. App. LEXIS 266 (1986).

    Commission was required to consider whether complainant’s intoxication played any part in contributing to his injury, i.e. by affecting his balance or causing him to disregard the danger of an unsecured ladder. Wyle v. Professional Services Industries, 12 Va. App. 684, 406 S.E.2d 410, 7 Va. Law Rep. 2961, 1991 Va. App. LEXIS 142 (1991) (decided under former § 65.1-38).

    Virginia Workers’ Compensation Commission did not err in finding a compensable injury and awarding the claimant benefits because, although the Commission found that employer had proven that the claimant was intoxicated at work, that it had a safety rule, known by the employee, prohibiting employees from being at work while under the influence of alcohol, and that the claimant willfully violated that safety rule, the employer did not establish that the claimant’s intoxication was a proximate cause of his fall from the ladder as the claimant had performed his job on the ladder successfully for some period of time before his fall; and the Commission found that the claimant’s fall was caused by the inherent dangers posed by working on ladders. Andersen Interior Contr. v. Nimmo, 2017 Va. App. LEXIS 49 (Va. Ct. App. Feb. 21, 2017).

    Severe intoxication. —

    An employee may abandon his employment by reaching an advanced state of intoxication which renders the employee incapable of engaging in his duties. This result is not based upon a special statutory defense of intoxication. Rather, a severely intoxicated employee has removed himself from the scope of his employment. Any injuries thereafter suffered are not “in the course of” the employment. The rule does not apply, however, where an intoxicated employee continues actively to perform his duties. American Safety Razor Company v. Hunter, 2 Va. App. 258, 343 S.E.2d 461, 1986 Va. App. LEXIS 266 (1986).

    Evidence of intoxication. —

    There was credible evidence that claimant’s ability to control his vehicle was impaired by consumption of alcoholic beverages and that such impairment and loss of control proximately caused the accident, where claimant, when admitted to the emergency room about three hours after the accident, had the odor of alcohol on his breath and an analysis of claimant’s blood showed a concentration of alcohol equivalent to .215%, according to the testimony of a toxicologist. Ivey v. Jerry P. Puckett Constr. Co., 230 Va. 486 , 338 S.E.2d 640, 1986 Va. LEXIS 150 (1986).

    Toxicologist’s intoxication opinion not binding. —

    Although the toxicologist’s opinion was that the claimant had a blood alcohol content of .20 and was intoxicated at the time of the accident, that evidence could be found to be contrary to the evidence of those who observed the claimant, his condition, his activities, and his work during the course of the morning. The toxicologist’s extrapolation of the claimant’s blood alcohol level at an earlier time was based on variables which are not clear from the record, and the opinion is not binding and conclusive upon the fact finder. Ball Lumber Co. v. Jones, No. 1716-94-2 (Ct. of Appeals April 18, 1995).

    No evidence injury due to alcohol consumption. —

    There was no credible evidence to support the Commission’s finding that claimant’s injury was due to alcohol consumption, where there was no evidence presented that his manner, disposition, speech, muscular movement, general appearance or behavior were affected and the accident was as likely attributable to youthful, poor judgment as to the consumption of two or three beers. Gardiner v. Superior Supply Assocs., No. 0263-89-2 (Ct. of Appeals April 24, 1990).

    CIRCUIT COURT OPINIONS

    Employee’s conduct. —

    This section requires that no compensation shall be awarded to the employee or his or her dependents for an injury or death caused by six categories of conduct, including, inter alia, intoxication, the failure to use a safety appliance, and the willful breach of any reasonable rule or regulation adopted by the employer and known to the employee. Such defenses are clearly at odds with strict liability. Bailey v. Hensley, 93 Va. Cir. 344, 2016 Va. Cir. LEXIS 74 (Roanoke May 6, 2016).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Note: Notice of a § 65.2-306 defense must be given no less than 15 days prior to the hearing. See Commission Rule 1.10.

    Section 65.1-38 (now § 65.2-306 ) and Rule 4 (now Rule 1.10) merely require that an employer give notice if he intends to interpose an affirmative defense to bar an otherwise meritorious claim. It does not relieve an employee from the burden of proving his case. Therefore, the Commission acted properly in denying benefits on the basis that the employee’s gunshot wound was self-inflicted despite the employer’s failure to allege willful misconduct. Anderson v. East Coast Fish & Scallop, 10 Va. App. 215, 391 S.E.2d 347, 6 Va. Law Rep. 2306, 1990 Va. App. LEXIS 69 (1990).

    Claim alleging suicide linked to chronic pain and depression resulting from the work accident is not barred by § 65.2-306 (A)(1), since the work accident was not self-inflicted. Ball v. Food Distributors, 75 O.W.C. 187 (1996).

    An employee will be estopped from asserting Rule 4 (now Rule 1.10) when his testimony at the hearing indicates a willful violation of a safety rule but prior to the hearing he denied a material fact that was critical to a safety violation defense. A party will not be denied the benefit of a statutory right by enforcement of an administrative rule when the rule could not have reasonably been pursued due to a false statement of the opposing party. Wyle v. Professional Services Industries, Inc., 69 O.I.C. 77 (1990). (Remanded on other grounds, 12 Va. App. 684, 406 S.E.2d 410 (1991)).

    The burden of proof is on the party who claims exemption or forfeiture. Whitfield v. Va. Dyeing Corp., 52 O.I.C. 282 (1970) (appeal denied).

    Defendant has burden of proving willful misconduct. Where the Commission can as readily assume that injury resulted from inadvertence or carelessness as from an intentional violation of a known rule, defendant has not sustained the burden. Morgan v. Va. Tractor Co., Inc., 51 O.I.C. 193 (1969) (appeal denied); Shifflet v. Dept. of Highways, 40 O.I.C. 137 (1958); Brockman v. Va. Elec. & Power Co., 31 O.I.C. 9, 106, 552 (1949).

    Proof of a pattern or practice of failing to discipline employees guilty of willful violations of a safety rule defeats the willful misconduct defense. Taylor v. Stone Builders, 75 O.W.C. 11 (1996).

    Where a claimant breaks his arm as the result of an industrial accident but prior to the entry of an award rebreaks his arm during an altercation, the employer is entitled to rely upon the defense of willful misconduct with respect to any disability from the second incident. Mallow v. Herbert Brothers, Inc., 66 O.I.C. 45 (1987).

    The Commission has interpreted § 65.2-306 and Commission Rule 1.10 as requiring that the employer provide a specific written statement of its intent to rely upon one of the defenses set out in § 65.2-306 , detailing the particular act(s) upon which it bases its defense. Rule 1.10 is not satisfied by mere discovery responses, and proof of “actual notice” of the defense is insufficient for compliance with the rule. Rule 1.10 requires that “a notice” of the defense be timely provided to the claimant, and that a copy of the notice be “filed” with the Commission. Failure to comply with the rule may result in rejection of the defense, as was the case here. Campbell v. Lowes of Short Pump Virginia, VWC File No. 201-91-57 (August 10, 2001), aff’d sub nom. Lowes of Short Pump Virginia v. Campbell, 38 Va. App. 55, 561 S.E.2d 757, 2002 Va. App. LEXIS 213 (2002).

    Willful Misconduct:

    To prevail on a willful misconduct defense, the employer must establish: (1) that the safety rule was reasonable; (2) that the rule was known to the employee; (3) that the rule was for the employee’s benefit; and (4) that the employee intentionally engaged in the forbidden act. McCrary v. Universal Carpet & Rug Co., 75 O.W.C. 333 (1996) (see also Taylor v. Stone Builders, 75 O.W.C. 11 (1996); Pineda v. Brothers, 78 O.W.C. 1 (1999)).

    There must be the deliberate exercise of the will by employee in doing an act known by him to be forbidden. However, employer need not prove that employee, with rule in mind, purposely determined to break it. Mills v. VEPCO, 197 Va. 547 , 90 S.E.2d 124, 1955 Va. LEXIS 254 (1955).

    Disregard of an express order, especially one made for the safety of the employees, usually constitutes willful misconduct. McCrary v. Universal Carpet & Rug Co., 75 O.W.C. 333 (1996).

    Gross negligence alone on the part of employee is not willful misconduct. Haskins v. National Freight, Inc., 57 O.I.C. 167 (1977); Baughman v. Fairfax County Public Schools, 59 O.I.C. 13 (1980).

    Mere bad judgment does not amount to willful misconduct. Hill v. Game Commission, 34 O.I.C. 370, 447 (1952).

    While a claimant may be guilty of negligence in choosing a ladder too short or standing on the top rung, such action was not a bar to his claim if it could be considered poor judgment. Brown v. Powell’s Paint Co., 68 O.I.C. 113 (1989).

    An early return to work where employer knew of physician’s recommendation to stop work but allowed employee to return is not misconduct. Moore v. Doyle & Russell, Inc., 52 O.I.C. 185 (1970).

    Employee testing roller coaster fell from car and was fatally injured. No showing that accident was caused by willful misconduct. Lamm v. Ocean View Improvement Corp., 57 O.I.C. 220 (1976).

    Where the claimant is injured in a tractor trailer accident, the employer fails to prove that the claimant fell asleep while driving, in violation of the employer’s policy, with evidence that the claimant “nodded off,” where the testimony of the claimant established that he remembered all the elements of maneuvering the truck prior to the accident. Thompson v. Petroleum Marketers, Inc., 78 O.W.C. 109 (1999).

    The employee operated a glue press that malfunctioned. The employee attempted to clean the glue from the rollers before it hardened following normal procedures, but he was unsuccessful. The employer had emphasized the cost to replace rollers if the glue hardened, and the claimant was injured when he tried to clean them with a wet brush. Held, the employee was injured following operating procedures to protect the machinery for the benefit of his employer, and his conduct was not willful. Chaplin v. D-Scan, Inc., 75 O.W.C. 247 (1996).

    Where the employee has voluntarily placed himself in a manifestly dangerous place which was not required by any task connected with the employment, the resulting accident arose out of his own willful misconduct. Jenkins v. Dee Shoring Company, 60 O.I.C. 228 (1981).

    Where claimant was injured while moving boxes after being specifically told by supervisor not to try to move them without help, her actions were tantamount to willful misconduct and injury was not compensable under § 65.2-38 (now § 65.2-306 ). Tinsley v. Alexandria Hospital, 60 O.I.C. 454 (1981).

    Intoxication:

    Even though the claimant had been smoking marijuana at some time prior to the accident, there was no evidence to prove it was the proximate cause of the accident. The statement that he used it “close in time” to the accident is insufficient to determine when he used it or that it was the proximate cause of the accident. Novak v. Michael B. Hill Construction Company, VWC File No. 231-99-55 (March 27, 2009).

    Employer failed to prove that employee’s alleged cocaine use caused accident; evidence showed that accident occurred while performing tree-clearing work caused by employee’s working on steep, slippery bank that gave way beneath his feet. Shrader v. Asplundh Tree Expert Co., VWC File No. 210-94-69 (Oct. 24, 2003).

    Employer proved benefits barred by employee’s intoxication at time of accident; employee injured while pushing machine and wheels locked, causing employee to strike shin and shoulder on machine; blood alcohol tests showed level of .10; evidence showed employee’s judgment impaired by alcohol, which contributed to accident. Price v. Goodyear Tire & Rubber Co., VWC File No. 203-02-61 (Apr. 28, 2003).

    Compensation cannot be awarded to an employee for an injury caused by intoxication. The burden of proof is on the employer to prove the claim is barred. Page v. Commercial Plastering & Drywall, 79 O.W.C. 145 (2000).

    Subsection A of this section provides that compensation may not be awarded for an employee’s injury that was caused by his intoxication or by his use of a nonprescribed controlled substance. The party asserting this defense bears the burden of proof, but a rebuttable presumption arises that the employee was intoxicated or was using a nonprescribed controlled substance at the time of his injury, if a positive test result is presented from a laboratory certified pursuant to § 65.2-306 B. However, the employer must prove by a preponderance of the evidence that the use of the forbidden substance[s] proximately caused the employee’s injury. The mere fact that a laboratory result showed the presence of alcohol or controlled substances in the claimant’s body does not prove causation. Foster v. Smithfield Packing Co., Inc., 79 O.W.C. 184 (2000).

    Burden of proof is on the defendant to establish that the death was proximately caused by intoxication. Written medical reports on blood alcohol test customarily admitted by Commission. Morgan v. Va. Tractor Co., Inc., 51 O.I.C. 193 (1969) (appeal denied); King v. Morris, 49 O.I.C. 173 (1967).

    The Commission may take judicial notice of matters of common knowledge or matters that may be easily ascertained by reference to reliable sources. The Federal Register is a reliable source of which judicial notice may be taken. Foster v. Smithfield Packing Co., Inc., 79 O.W.C. 184 (2000).

    The employer disclosed in its discovery responses to the claimant the results of tests taken after the work accident that showed recent use of marijuana and alcohol by the employee. However, the employer did not disclose that the laboratory that had performed the tests was a certified laboratory, pursuant to § 65.2-306 B. The Commission agreed with the Deputy Commissioner that, because the cover letter from the laboratory for the tests had not been disclosed to the claimant in discovery as a potential hearing exhibit, the employer could not offer the letter at the hearing to establish proof of such certification. The Commission also agreed that the Deputy Commissioner properly excluded testimony from the employer’s clinic manager that the laboratory was a certified laboratory, and that the Deputy properly refused to take judicial notice of the certification, because the documentation had not been provided in discovery. Foster v. Smithfield Packing Co., Inc., 79 O.W.C. 184 (2000).

    The evidence must establish that an employee’s intoxication was the actual cause of the injury. The mere fact that the employee was intoxicated is not sufficient to preclude an award of compensation benefits. American Safety Razor Company v. Hunter, 2 Va. App. 258, 343 S.E.2d 461, 1986 Va. App. LEXIS 266 (1986).

    The employer has the burden to prove that the intoxication caused the accident. To do this, the employer must prove the intoxication played a part in contributing to the claimant’s accident. The employer does not have to prove that the intoxication was the only proximate cause, but only that the intoxication played any part in contributing to the accident, that is, that it was a cause of the accident. Page v. Commercial Plastering & Drywall, 79 O.W.C. 145 (2000).

    Compensation was denied because the claimant’s ethanol level of .26 was found to have impaired his judgment and made him more likely to fall. Brown v. Powell’s Paint Co., 68 O.I.C. 113 (1989).

    In order for intoxication to preclude receipt of workers’ compensation benefits, it is necessary to establish that the injury would not have occurred but for the intoxication. Wyle v. Professional Services Industries, 12 Va. App. 684, 406 S.E.2d 410, 7 Va. Law Rep. 2961, 1991 Va. App. LEXIS 142 (1991).

    The employee’s supervisor recalled talking to the claimant on the day of the accident, and he testified that the claimant did not appear to be under the influence of drugs or alcohol, and that he did not behave in an unusual manner. Laboratory tests after the accident showed recent alcohol use, but below the level set forth in § 18.2-266 , and the claimant testified that he had not smoked marijuana for almost a month prior to the accident. The Commission held that the employer presented no evidence that the claimant’s alleged intoxication or use of a controlled substance contributed to the accident, even if the presumption of § 65.2-306 B was assumed. Foster v. Smithfield Packing Co., Inc., 79 O.W.C. 184 (2000).

    Safety Appliance:

    While the deliberate refusal to use a safety appliance provided by the employer might in a particular case amount to such wanton and reckless conduct as to defeat a claim for compensation, in the ordinary case the use of such appliances is required by specific instructions of the employer or by a rule or regulation adopted by him. An intentional refusal to use such appliances under such circumstances bars a claim for compensation if the cause of the accident. Brown v. Vanguard Constr. Corp., 50 O.I.C. 58 (1968).

    Negligent failure to use safety appliance not sufficient; employer must show intentional failure. Emma S. Martin v. General Foam Plastics Corp., 56 O.I.C. 205 (1974) (appeal denied).

    Safety Rule:

    Benefits denied where claimant’s failure to wear a seatbelt was willful, not excused by the circumstances and the proximate cause of his injuries. Mailloux v. American Transportation, JCN VA02000022106 (April 9, 2018), aff’d. No. 0636-18-4 (Ct. App. of Va., Oct. 9, 2018) (unpublished opinion).

    Elements required for establishing a safety rule violation not satisfied where claimant police officer thought a statutory exception in Va. Code § 46.2-1094 prevented the employer’s rule requiring use of a safety belt from applying to her at the time of her motor vehicle accident. Taylor v. Loudoun Cnty., JCN VA00000926589 (Dec. 7, 2016).

    Where she offered no evidence of lack of enforcement of a safety rule and of not being disciplined for failure to comply with it, and the employer testified that there had been no previous violations, that it did have a disciplinary procedure in effect, and that the safety rule would be enforced, the claimant failed to meet her burden of proving that employer did not enforce a safety rule. Portillo v. Marriott Hotel, VWC File No. 233-21-15 (Sept. 25, 2008).

    Employer failed to prove willful violation of safety rule based on employee’s injury that occurred while disconnected from safety line; employee was working on roof when safety line became tangled; employee disconnected safety line to untangle it, and fell; although employee did not abide by 100%-tie-off policy, Commission found that he did not act with wrongful intention by briefly disconnecting line to untangle it in order to complete assigned job duties. Dasch v. Emclos Corp., VWC File No. 203-69-26 (Jan. 12, 2004).

    Employee injured while moving inoperable soda machine in parking lot so he could park in space; supervisor had recently warned employee not to move or “touch” machine; employee’s claim for benefits denied by intentionally violating rule, in place for his benefit, which directly caused injury. Lopez v. PGM Enterprises, Inc., VWC File No. 208-33-82 (May 1, 2003).

    Where the employee had notice of a safety rule adopted by his employer, yet deliberately and knowingly violated it and such violation caused the accident, compensation must be denied. Peanut City Iron & Metal Co., Inc. v. Jenkins, 207 Va. 399 , 150 S.E.2d 120 (1966); Griffey v. Clinchfield Coal Corp., 83 Va. 715 , 33 S.E.2d 178 (1945); Riverside Mills v. Thaxton, 161 Va. 863 , 172 S.E.2d 261 (1934); Hypes v. Hercules Powder Co., Inc., 34 O.I.C. 376 (1952); Hamilton v. Commonwealth, 26 O.I.C. 563 (1944) (appeal denied); Wells v. Splash Dam Smokeless Coal Corp., 25 O.I.C. 797 (1943); 26 O.I.C. 115 (1944) (appeal denied); McBee v. Sears, Roebuck & Co., 24 O.I.C. 549 (1942); Dickenson v. Va. Coal & Coke Co., 9 O.I.C. 864, 975 (1927); White v. Portsmouth Lumber Co., 58 O.I.C. 356 (1979).

    An employee was precluded from receiving compensation benefits because of willful misconduct in wearing sunglasses rather than protective eye wear as required by the employer’s safety rule. Watford v. Colonial Williamsburg Foundation, 13 Va. App. 501, 43 S.E.2d 69 (1992).

    Willful failure to wear safety shoes was basis for denying claim. Carter v. Smith Iron & Metal Co., Inc., 51 O.I.C. 43 (1969).

    Use of front-end loader constituted more than negligence. Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962) (rehearing denied).

    Willful misconduct must be shown to be causally related to injury in order to bar compensation. Delp v. Mountain Empire Flying Service, 56 O.I.C. 94 (1975) (affd. on review); Williams v. Benedict Coal Corp., 181 Va. 478 , 25 S.E.2d 251, 1943 Va. LEXIS 197 (1943); Tyree v. Commonwealth, 164 Va. 218 , 179 S.E. 297 , 1935 Va. LEXIS 196 (1935).

    Compensation benefits are denied where employee willfully violated an established safety rule and engaged in willful misconduct which contributed to her death. Ackerman v. Commonwealth of Virginia/Department of Highways and Transportation, 60 O.I.C. 1 (1981).

    The claimant who suffered severe electrical burns while working on a power line without rubber gloves in violation of a safety rule was not barred from receiving compensation benefits. Since the claimant believed that the power on the line was off, he did not intentionally violate a safety rule. Spruill v. C. W. Wright Construction Company, Inc., 8 Va. App. 330, 381 S.E.2d 359, 5 Va. Law Rep. 2951, 1989 Va. App. LEXIS 72 (1989).

    The employer’s safety rules directed employees to “[g]et help to lift heavy loads when lifting, bend your knees,” “[f]ollow all safety rules written or unwritten,” and “[p]erform his or her job according to safe operating procedures established by the company.” Such rules are essentially unenforceable, leaving to the employee’s discretion whether assistance is needed before lifting any particular object. To find that an employee made a poor choice, within his discretion, is far different from a determination that he willfully and intentionally violated an established safety rule. Louderback v. Rocco Quality Foods, Inc., 76 O.W.C. 234 (1997).

    The employee was injured when an electric carpet cutter became stuck and he attempted to dislodge the blade by hitting blade guard. Held, the employer’s instructions not to force the blade, to wait, and to open the carpet cutter did not constitute an express prohibition or specific safety instruction. McCrary v. Universal Carpet & Rug Co., 75 O.W.C. 333 (1996).

    The claimant was operating a meat processing machine, on which was posted a warning sign stating, “Danger - Keep Fingers Out of Door Opening.” While pressing on meat above the door area, the claimant’s right hand slipped and his ring finger came in contact with the auger. The Commission held that there was clearly no willful intent on the claimant’s part to place his fingers in the door opening and in close proximity of the auger. Carter v. Conagra Frozen Foods, 76 O.W.C. 160 (1997).

    Where there is no evidence that the employer adopted a safety rule requiring ladders to be tied, the employee in failing to secure such ladder did not engage in willful misconduct. Wyle v. Professional Services Industries, 12 Va. App. 684, 406 S.E.2d 410, 7 Va. Law Rep. 2961, 1991 Va. App. LEXIS 142 (1991).

    Approval and Enforcement of Rule:

    (Note: October 1, 1991 recodification no longer requires the Commission to approve safety rules.).

    It is not required that such work rule be submitted to the Commission for its approval prior to hearing. Morgan v. Va. Tractor Co., Inc., 51 O.I.C. 193 (1969) (appeal denied). See also Watford v. Colonial Williamsburg Foundation, 13 Va. App. 501, 413 S.E.2d 69, 8 Va. Law Rep. 1662, 1992 Va. App. LEXIS 2 (1992).

    In order for § 65.1-38 (now § 65.2-306 ) to be applicable, the employer’s evidence must establish the enforcement of a safety rule. Ooghe v. Office Overland Personnel, 64 O.I.C. 248 (1985).

    In order for there to be a violation of a safety rule the evidence must establish that an employee was informed of the promulgated safety rule and that the regulation was adopted and enforced by the employer prior to the industrial accident. Forehand v. Kempsville Building Materials, Inc., 65 O.I.C. 140 (1986).

    Definition of “strict enforcement” of known work rule to use safety appliance. Rush v. C & M Tire Exchange, Inc., 50 O.I.C. 281 (1968).

    “Strict enforcement” of a safety rule requires positive action which demonstrates insistence on safe work procedures but does not require an employer to suspend an employee or reduce his wages when a violation of a work rule occurs. A written warning for failure to use a safety belt is sufficient evidence of enforcement. Carrigan v. Cablevision Industries, Inc., 70 O.I.C. 194 (1991).

    Where rule requiring use of safety appliance is frequently violated without disciplinary action by employer, compensation is not barred. Breeden v. Ames & Webb, Inc., 34 O.I.C. 410 (1952); Boone v. Suffolk Chemical Co., 57 O.I.C. 45 (1977).

    It is not essential that employer suspend employee from job or reduce his wages for violating work rule in order for there to be strict enforcement of rule to bar compensation. Peanut City Iron & Metal Co., Inc. v. Jenkins, 207 Va. 399 , 150 S.E.2d 120, 1966 Va. LEXIS 235 (1966).

    Where a claimant who is repeatedly admonished by the employer not to do heavy lifting continues to perform this duty but is not disciplined, willful misconduct has not been established. Pellerin v. Hematology and Oncology Associates, Ltd., 67 O.I.C. 212 (1988).

    The right to compensation benefits was forfeited due to willful misconduct by an employee whose failure to properly secure her hair as required by a company safety rule resulted in it being caught in a machine. Watkins v. HBA Cast Products Co., Inc., 70 O.I.C. 188 (1991).

    Safety rule not enforced by employer, and, in addition, it is doubtful that the work in which claimant was engaged at the time of accident was covered by employer’s safety rule. Birt v. Allen Roofing, 57 O.I.C. 31 (1977).

    Employee was intent on completing work and not purposely disobeying foreman. Murphy v. City of Franklin, 48 O.I.C. 173 (1966).

    Statutory Duty:

    Claimant’s travelling, at most, seven miles greater than the advisory safe speed at the time of a motor vehicle accident did not constitute willful and wanton conduct, reckless conduct, or willful and intentional conduct. Ahmad v. Richmond Refrigeration Service, JCN VA00001128790 (Jan. 19, 2017).

    Claimant convicted of improper driving did not deliberately or intentionally chose to violate a known safety rule or traffic statute or act in a reckless or wanton manner in utter disregard of probable consequences when confronted with emergency situation found by the Deputy Commissioner, acting to avoid collision with another vehicle. Sundance v. Republic Services, Inc., JCN VA02000022644 (Dec. 5, 2016).

    Defendant had the burden of proving that claimant’s failure to wear a seatbelt caused his injury. Based on the presented evidence, it would be speculation to conclude that such failure resulted in the injury. Williams v. Mid Atlantic Pavement Markings LLC, JCN VA000000874041 (Sept. 4, 2015).

    A truck driver’s deliberate act of pulling onto the shoulder of the Interstate in the absence of an emergency violated a statute concerning failing to obey road signs and thus injuries sustained in an accident that occurred when the driver pulled back onto the Interstate were the result of his willful misconduct. Patterson v. Valley Proteins, Inc., VWC File No. 213-42-77 (June 14, 2005), aff’d, No. 1707-05-3 (Ct. App. Va., Feb. 21, 2006) (Unpublished Opinion).

    By use of the word “ willful ” the legislature has made an exception to the ordinary rule that everyone is presumed to know the law. The duty required by statute which imposes a penalty for such failure or refusal, does not constitute willful misconduct, unless employee is apprised of such statute and intentionally violates the same and sustains injury as the proximate cause thereof. The mere exercise of the will in doing the act is not sufficient; there must be determination to do the act, though known to be forbidden by law. There cannot be a “willful” failure to perform an unknown duty and employer cannot rely upon defense contained in this section unless it be shown the statute violated had been in some way brought to employee’s attention or he otherwise knew of it. King v. Empire Collieries Co., 148 Va. 585 , 139 S.E. 478 , 1927 Va. LEXIS 257 (1927).

    Compensation benefits will be denied where there is a willful failure to perform a duty required by statute only if the violation was the proximate cause of the injury. Carter v. American Cleaning Services, 67 O.I.C. 209 (1988).

    Failure to follow speed limit resulted in accident and constituted willful misconduct. Bennett v. F. Richard Wilton, Jr., Inc., 59 O.I.C. 19 (1980).

    The evidence failed to establish that the employee willfully violated § 46.2-322 C requiring a report of his seizure disorder condition when obtaining a driver’s license. The record failed to establish that the claimant’s seizure disorder caused the motor vehicular accident. Derting v. Scott County Dept. of Social Services, 69 O.I.C. 162 (1990).

    The claimant, a commercial tractor trailer driver, was tested by police and found to have a blood alcohol content of .02, because of which he was convicted for a traffic infraction of driving a commercial motor vehicle with any amount of alcohol in the blood, in violation of Va. Code Ann. § 46.2-341.31 . The Commission reversed the finding that this was such a violation of both state law and the employer’s policy that the claimant’s injuries did not arise out of the employment because the claimant was prohibited and unauthorized to drive in that condition. The Commission instead held that the evidence was insufficient to establish that the accident was caused by intoxication, that the alcohol ingestion per se was the proximate cause of the motor vehicle accident, or that the claimant’s violation of the employer’s policy caused the accident. Thompson v. Petroleum Marketers, Inc., 78 O.W.C. 109 (1999).

    The evidence failed to establish that the employee purposely violated a safety rule requiring the use of a seat belt. While the employee may have been negligent, his infrequent operation of the emergency vehicle and the necessity for a prompt response rather than an intentional violation of a safety rule caused him to fail to secure his seat belt. In addition, the evidence failed to establish that the failure to use the seat belt was the cause of the subsequent motor vehicle accident and the employee’s injuries. Custer v. City of Newport News, 70 O.I.C. 199 (1991).

    An employee is not barred from receiving workers’ compensation benefits despite his contributing negligence when the injury is a result of a violation of a statute such as the Occupational Safety and Health Act that is designed to benefit a class of employees of which he is a member. Wyle v. Professional Services Industries, 12 Va. App. 684, 406 S.E.2d 410, 7 Va. Law Rep. 2961, 1991 Va. App. LEXIS 142 (1991).

    Injury to Another:

    For additional cases on assault and horseplay see notes to § 65.2-101 .

    Compensation is denied a worker injured by assault where worker himself was the aggressor. This provision of this section will be applied where the injured employee provoked assault upon himself. Angolia v. Sweetman & Hall, Inc., 35 O.I.C. 373 (1953); Gates v. Mathieson Alkali Works, 11 O.I.C. 206 (1929).

    Compensation denied where the claimant was the aggressor and her injuries grew out of her attempt to injure co-worker. Claimant may still have a cause of action at law against one who injured her. Meekins v. Saga Food Service, Inc., 53 O.I.C. 200 (1971).

    Where claimant was grabbed by a larger and stronger co-employee and was spun in the air against his will, he was not a willing participant in horseplay and the defense of willful misconduct must fail. Seabright v. Fairfax County Fire & Rescue Service, 60 O.I.C. 382 (1981).

    Where the evidence shows that the claimant was the victim of an assault from a coworker, and was not a willing participant in a fight, but only tried to cover his face to protect himself from his assailant, he does not violate an employer’s rule against fighting. Butcher v. Abex Friction Products, 77 O.W.C. 279 (1998).

    A single derogatory remark uttered by the claimant as he turned to walk away, after a number of derogatory and profane remarks uttered by a coworker, is not a sufficient or reasonably expected provocation for an assault by that coworker, so as to constitute a violation of the employer’s rule against fighting. Butcher v. Abex Friction Products, 77 O.W.C. 279 (1998).

    Where claimant is injured while engaged in horseplay condoned by the employer, the injury arose out of the employment. Jackness v. National Automobile Dealers Association, 60 O.I.C. 224 (1981).

    § 65.2-307. Employee’s rights under Act exclude all others; exception.

    1. The 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, his personal representative, parents, dependents, or next of kin, at common law or otherwise, on account of such injury, loss of service, or death.
    2. If a court of the Commonwealth makes a finding in a final unappealed order based on an evidentiary hearing or a factual stipulation of the parties and participants thereto that the cause of action relating to an accident, injury, disease, or death is barred by this section, that finding shall be res judicata between those same parties and estop them and any employer, uninsured employer’s fund, guarantee fund, responsible entities, or statutory employer from arguing before the Commission that the accident, injury, disease, or death did not arise out of and in the course of such employee’s employment. If the Commission or a court on appeal from the Commission makes a finding in a final unappealed order based on an evidentiary hearing, hearing on the record, or a factual stipulation of the parties that the claims relating to an accident, injury, disease, or death did not arise out of or in the course of such employee’s employment, then that finding shall be res judicata and estop those same parties from arguing before a court of the Commonwealth that the accident is barred by the exclusivity provisions of the Act. However, except in the case of a self-insured employer or business entity closely related to a party to the court proceeding, in order for the court finding to be res judicata as to a non-party, notice shall be provided in the same manner as allowed in subsection F of § 38.2-2206 or § 8.01-288 to any employer, uninsured employer’s fund, guarantee fund, responsible entities, or statutory employer sought to be bound. In addition, any such entities so notified shall be given the same opportunity to be heard in that court proceeding as a party to the same, but limited to the issue of whether the accident, injury, disease, or death arose out of and in the course of the employee’s employment. Failure to provide notice to any party to the court proceeding shall not affect the rights, privileges, or obligations of said parties thereto but shall affect only the applicability of this subsection and only as stated herein. Furthermore, the findings by either the Commission or the court under this subsection shall not prevent the parties and participants to those proceedings from raising or relying upon any and all other available defenses.
    3. Notwithstanding this exclusion, nothing in the Act shall bar an employer from voluntarily agreeing to pay an employee compensation above and beyond those benefits provided for in the Act. Nothing herein, however, shall be deemed to affect or alter any existing right or remedy of the employer or employee under the Act.

    History. Code 1950, § 65-37; 1968, c. 660, § 65.1-40; 1991, c. 355; 1999, c. 842; 2015, cc. 606, 624.

    Cross references.

    As to application of Overhead High Voltage Line Safety Act, see § 59.1-414.

    The 1999 amendment added the subsection A designator and added subsection B.

    The 2015 amendments.

    The 2015 amendments by cc. 606 and 624 are identical, and added subsection B and redesignated former subsection B as subsection C.

    Law Review.

    For survey of Virginia law on insurance for the year 1969-1970, see 56 Va. L. Rev. 1356 (1970).

    For survey of Virginia law on torts for the year 1969-1970, see 56 Va. L. Rev. 1419 (1970).

    For survey of Virginia law on workers’ compensation for the year 1970-1971, see 57 Va. L. Rev. 1520 (1971).

    for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1972-1973, see 59 Va. L. Rev. 1632 (1973).

    For article, “Effect of Virginia Workmen’s Compensation Act Upon the Right of a Third-Party Tortfeasor to Obtain Contribution From an Employer Whose Concurrent Negligence Causes Employee’s Death or Injury,” see 13 U. Rich. L. Rev. 117 (1978).

    For article, “Recovery for Accidental Injuries Under the Virginia Workmen’s Compensation Act,” see 14 U. Rich. L. Rev. 659 (1980).

    For survey of Virginia law on practice and pleading for the year 1978-1979, see 66 Va. L. Rev. 343 (1980).

    For article, “Workers’ Compensation for Disease in Virginia: The Exception Swallows the Rule,” see 20 U. Rich. L. Rev. 161 (1985).

    For note, “Employer Intentional Torts in Virginia: Proposal for An Exception to The Exclusive Workers’ Compensation Remedy,” see 25 U. Rich. L. Rev. 339 (1991).

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    For annual survey essay, “Virginia Should Abolish the Archaic Tort Defense of Contributory Negligence and Adopt a Comparative Negligence Defense In Its Place,” see 46 U. Rich. L. Rev. 359 (2011).

    For essay, “An Analysis of Intentional Infliction of Emotional Distress Claims in the Virginia Workplace,” see 54 U. Rich. L. Rev. 283 (2019).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 6 Pleading. § 6.03 Defendant’s pleadings. Bryson.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 6, 10, 16, 19, 26, 53, 54.

    CASE NOTES

  • Analysis
  • I.Legislative Intent.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-40 or prior law.

    This section should be interpreted in the light of the purpose of the Act as a whole and its other provisions. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    The purpose of the Virginia statute as interpreted by its highest court is to limit the recovery of all persons engaged in the business under consideration to compensation under the Act, and to deny an injured person the right of recovery against any other person unless he be a stranger to the business. Doane v. E.I. DuPont de Nemours & Co., 209 F.2d 921, 1954 U.S. App. LEXIS 3683 (4th Cir. 1954); Rea v. Ford, 198 Va. 712 , 96 S.E.2d 92, 1957 Va. LEXIS 129 (1957); Bristow v. Safway Steel Prods., 327 F.2d 608, 1964 U.S. App. LEXIS 6723 (4th Cir. 1964); Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964); Jennings v. Franz Torwegge Mach. Works, 347 F. Supp. 1288, 1972 U.S. Dist. LEXIS 12098 (W.D. Va. 1972).

    Act defines relations between employer and employee. —

    The provisions of this section, construed with the entire Workmen’s (now Workers’) Compensation Act, define the relations existing between an employee and an employer. The relations of an employee to other parties are not mentioned. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    And not relations between employee and stranger. —

    It was the legislative intent to make the Act exclusive in the industrial field so that, in the event of an industrial accident, the rights of all those engaged in the business would be governed solely thereby. The remedies afforded the employee under the Act are exclusive of all his former remedies within the field of the particular business, but the Act does not extend to accidents caused by strangers to the business. If the employee is performing the duties of his employer and is injured by a stranger to the business, the compensation prescribed by the Act is available to him, but that does not relieve the stranger of his full liability for the loss, and if he is financially responsible, there is no reason to cast this loss as an expense upon the business. Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946); Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    Intent of the General Assembly in enacting uninsured motorist protection provisions. —

    Where the employee of an employer which self-insured its motor vehicles was allowed to recover under the uninsured motorist statute, such application of the Workers’ Compensation Act, the uninsured motorist protection provision, § 38.2-2206 , and the motor vehicle code, § 46.2-368 , as they relate to an employee, was consistent with the language of the statutes and the intent of the General Assembly in enacting uninsured motorist protection provisions. William v. City of Newport News, 240 Va. 425 , 397 S.E.2d 813, 7 Va. Law Rep. 854, 1990 Va. LEXIS 129 (1990).

    In binding partners to the provisions of this section by way of former § 65.1-4.2 (now § 65.2-101 ), the General Assembly considered that any insurance premiums paid by a partnership for individual coverage of its partners would ultimately be reflected in the cost of doing the various jobs on which the partners might be injured. Counts v. Stone Container Corp., 239 Va. 152 , 387 S.E.2d 481, 6 Va. Law Rep. 1109, 1990 Va. LEXIS 8 (1990).

    An employee going to or from his or her place of employment is not performing a service arising out of and incidental to the employment. Ramey v. Bobbitt, 250 Va. 474 , 463 S.E.2d 437, 1995 Va. LEXIS 128 (1995).

    II.Exclusivity.

    Exclusive remedy. —

    When an employee in Virginia is injured in the performance of her duties for her employer, the Virginia Workers’ Compensation Act provides her sole and exclusive remedy against the employer. McCotter v. Smithfield Packing Co., 849 F. Supp. 443, 1994 U.S. Dist. LEXIS 5164 (E.D. Va. 1994).

    This section declares an employee’s right to compensation to be his exclusive remedy. Evans v. Newport News Shipbuilding & Dry Dock Co., 361 F.2d 364, 1966 U.S. App. LEXIS 6204 (4th Cir.), cert. denied, 385 U.S. 959, 87 S. Ct. 397, 17 L. Ed. 2d 304, 1966 U.S. LEXIS 202 (1966).

    Once an owner is found to be a statutory employer, it is subject to all the mandates, duties, and rights as to its statutory employee mandated by the Virginia Workers’ Compensation Act, § 65.2-100 et seq., including the “exclusivity rule.” Jones v. Commonwealth, 267 Va. 218 , 591 S.E.2d 72, 2004 Va. LEXIS 22 (2004).

    Truck driver’s personal injury claims against a warehouse owner and warehouse worker for injuries he received during the course of making a delivery to the warehouse were dismissed for lack of subject matter jurisdiction where the transportation of goods to the warehouse, including the unloading and storage procedures, was an essential part of the owner’s warehousing business, when the truck driver suffered his injury, he was engaged in the warehouse owner’s usual trade, business, or occupation, and therefore was within the scope of the Virginia Workers’ Compensation Act, and as a result, pursuant to the exclusivity provision of § 65.2-307 , his sole relief was under Virginia’s Workers’ Compensation Act. Glenn v. Lafon, 427 F. Supp. 2d 675, 2006 U.S. Dist. LEXIS 7843 (W.D. Va. 2006).

    Plaintiff, who was struck by a car driven by a U.S. Navy service member in the scope of employment, had received benefits under the Longshore and Harbor Workers’ Compensation Act (LHWCA), 33 U.S.C.S. § 901 et seq., and had also received benefits under the Virginia Workers’ Compensation Act (VWCA) that were applied to the LHWCA award under 33 U.S.C.S. § 903(e). Plaintiff therefore was barred under § 65.2-307 of the VWCA from further recovery from the United States as statutory employer and was barred pursuant to 28 U.S.C.S. § 2674 from recovering from the United States under the Federal Tort Claims Act. Wells v. United States, No. 2:06cv177, 2006 U.S. Dist. LEXIS 75255 (E.D. Va. Oct. 16, 2006).

    A truck driver’s remedies against a statutory employer were limited to those exclusively provided under the Virginia Workers’ Compensation Act, § 65.2-100 et seq., regardless of the contractual employment relationship between the driver and the statutory employer. Meredith v. Honeywell Int'l, Inc., 245 Fed. Appx. 325, 2007 U.S. App. LEXIS 20099 (4th Cir. 2007).

    Applicable law, properly construed, did not provide for a balancing test in the traditional sense, under which the relative strength of either side’s interests could potentially tip the balance in favor of or against application of general maritime law; instead, a court had to first determine whether the litigant properly asserted a substantive right that was recognized by federal general maritime law, and if the court found that the litigant had, in fact, asserted such a right, the court could give effect to otherwise applicable state law if, and only if, the state law in question did not operate to deprive the litigant of that right. In the instant case, the exclusivity provision would operate to preclude the employee’s maritime tort claim entirely, and because such a result would have been the quintessence of deprivation, the court could not allow § 65.2-307 to preclude the employee’s federal maritime tort claim. Moore v. Capitol Finishes, Inc., 699 F. Supp. 2d 772, 2010 U.S. Dist. LEXIS 27564 (E.D. Va. 2010).

    Trial court erred in sustaining a shipyard’s plea in bar because a service member’s estate was unaffected by the exclusivity bar of § 65.2-307 where the member was serving on active duty with the United States Navy at the time of the member’s injury, and the Navy was not subject to the requirements of Virginia’s Workers’ Compensation Act, §§ 65.2-100 through 65.2-1310. Gibbs v. Newport News Shipbuilding & Drydock Co., 284 Va. 677 , 733 S.E.2d 648, 2012 Va. LEXIS 189 (2012).

    Worker collapsed at work after the last blow to head, he died several days later, and it was undisputed that he died during work training, which was a condition of employment that exposed the worker to the hazard of blows to the head, and thus his death was properly construed as accidental; the circuit court did not err in holding that the exclusivity provision barred this action. Kohn v. Marquis, 288 Va. 142 , 762 S.E.2d 755, 2014 Va. LEXIS 117 (2014).

    Where a North Carolina employee was injured while working in Virginia and received workers’ compensation benefits under North Carolina law, the exclusivity provision of the Virginia Workers’ Compensation Act barred the employee’s personal injury suit against a Virginia subcontractor because the injury occurred in Virginia and the subcontractor was a statutory co-employee under Virginia law; the Full Faith and Credit Clause did not require Virginia to defer to the law of North Carolina, the state that paid the employee benefits, in determining whether the suit was barred. Demetres v. East West Constr., Inc., 776 F.3d 271, 2015 U.S. App. LEXIS 629 (4th Cir. 2015).

    In a case in which a deceased employee’s estate administrator appealed district court’s dismissal of the complaint, because the employee was brutally murdered, in a location she believed was unsecure, by an unfamiliar man with whom she was brought into contact through her capacity as an employee of an apartment complex, her injury arose out of her employment, and the estate administrator’s sole remedy lay under the Virginia Workers’ Compensation Act. Scott v. CG Bellkor, LLC, 711 Fed. Appx. 158, 2018 U.S. App. LEXIS 3335 (4th Cir. 2018).

    Circuit court did not err in granting the employer’s plea in bar and in dismissing the personal representative’s complaint alleging that the employer, which operated a residential program for at-risk youth, had negligently failed to protect the employee who had been murdered by one of the residents because the Virginia Workers’ Compensation Act provided the exclusive remedy for the employee’s death. Lopez v. Intercept Youth Servs., Inc., 300 Va. 190 , 861 S.E.2d 392, 2021 Va. LEXIS 91 (2021).

    Employee assured of recovery without having to defend against contributory negligence. —

    Under the Workers’ Compensation Act the employee is assured of recovery without having to defend against allegations of contributory negligence, assumption of risk, or causation by fellow servants; the exclusive nature of the act, however, does not bar a suit for negligence in all circumstances. Rasnick v. Pittston Co., 237 Va. 658 , 379 S.E.2d 353, 5 Va. Law Rep. 2401, 1989 Va. LEXIS 67 (1989).

    An employee who has accepted the provisions of the Workmen’s (now Workers’) Compensation Act is limited to the exclusive rights and remedies under the Act as against his employer. Snowden v. VEPCO, 432 F. Supp. 266, 1976 U.S. Dist. LEXIS 11989 (E.D. Va. 1976).

    Employee may not sue employer for lost income from secondary employment. —

    The statute barred an action by an employee against his employer to recover for lost income from unrelated secondary employment since (1) losses related to secondary employment may be accounted for under the Workers’ Compensation Act, and (2) even if secondary employment does not qualify for coverage under the act, an employee is still not permitted to bring a separate action in tort against his employer. Nelson v. United States Postal Serv., 189 F. Supp. 2d 450, 2002 U.S. Dist. LEXIS 3496 (W.D. Va. 2002).

    But the Act is exclusive only so far as it covers the field of industrial accidents. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    The workers’ compensation act is exclusive in so far as it covers the field of industrial accidents, but no further; to the extent that the field is not touched by the statute, the legislature intended that the employee’s common-law remedies against his employer are to be preserved unimpaired. Adams v. Alliant Techsystems, Inc., 261 Va. 594 , 544 S.E.2d 354, 2001 Va. LEXIS 57 (2001).

    The exclusivity of recovery is only as to an employee and his employer, and only his right to sue his employer for damages is barred by the acceptance of compensation under the act. Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980).

    Exclusivity provisions did not void expressed indemnification agreement between an employer and a third party, as enforcement of the agreement merely enforced the loss distribution agreed to by them, and that loss distribution did not affect either the payment of workers’ compensation to an injured employee or the policy of limiting an employer’s liability. Safeway, Inc. v. DPI Midatlantic, Inc., 270 Va. 285 , 619 S.E.2d 76, 2005 Va. LEXIS 74 (2005).

    Under this section, the exclusive remedy is a proceeding in the Industrial (now Workers’ Compensation) Commission, if there is an employment relation, as defined in the statutes between the parties. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    And Act is exclusive remedy for injury by fellow employee. —

    An award under the Workmen’s (now Workers’) Compensation Act is the exclusive remedy where an employee subject to the Act is injured by a fellow employee. Phillips v. Brinkley, 194 Va. 62 , 72 S.E.2d 339, 1952 Va. LEXIS 207 (1952); Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962).

    Workers unloading barges were not statutory employees of barge terminal. —

    Trial court erred in dismissing an injured worker’s personal injury action against another worker; a barge terminal at which the truck accident occured was not the statutory employer of the two workers pursuant to § 65.2-302 , as the terminal was not a party to any contract that required the injured worker or his employer to load or unload a barge, and so the trial court erred in finding workers’ compensation exclusivity under § 65.2-307 applied. Hudson v. Jarrett, 269 Va. 24 , 606 S.E.2d 827, 2005 Va. LEXIS 2 (2005).

    Act as exclusive remedy for occupational disease even in case of intentional tort. —

    Because occupational disease coverage is not expressly modified by a requirement that the disease be accidentally produced, an employee’s remedy against his employer for even an intentional tort would appear to be exclusively within the act. Joyce v. A.C. & S., Inc., 785 F.2d 1200, 1986 U.S. App. LEXIS 22853 (4th Cir. 1986).

    Intentional tortious conduct of fellow employee. —

    The Virginia Worker’s Compensation Act is the exclusive remedy for an employee who suffers an injury as a result of the intentional tortious conduct of a fellow employee. Guiden v. Southeastern Public Serv. Auth., 760 F. Supp. 1171, 1991 U.S. Dist. LEXIS 5226 (E.D. Va. 1991).

    Employee’s tort claims for assault, battery, and false imprisonment were barred by the exclusivity provision under § 65.2-307 of Virginia’s Workers’ Compensation Act, since the Act covers injuries caused by an intentional assault upon an employee by a co-worker; the employee’s allegations, that her supervisor shoved her into a door, pushed her into a chair, and refused to allow her to leave after she asked to see the sexual harassment policies, met all three requirements for coverage under the Act. Miller v. Wash. Workplace, Inc., 298 F. Supp. 2d 364, 2004 U.S. Dist. LEXIS 5773 (E.D. Va. 2004).

    Although a co-worker’s physical assault upon an employee arose “in the course” of their employment, because the assault was personal to the employee, it did not arise “out of” their employment; consequently, the employee did not plead into the bar of § 65.2-307 by alleging respondeat superior liability. Butler v. S. States Coop., Inc., 270 Va. 459 , 620 S.E.2d 768, 2005 Va. LEXIS 87 (2005).

    Shared employee barred from suing owner for negligence. —

    Driver who was employed by a subcontractor and fell off an owner’s ladder while tarping a load of power transformers was the owner’s statutory employee under subsection A of § 65.2-302 because the owner’s employees and the subcontractor’s employees shared responsibility for tarping and securing the transformers to a trailer; thus, § 65.2-307 barred the driver from suing the owner for negligence. Armendarez v. ABB, Inc., No. 7:07CV00557, 2008 U.S. Dist. LEXIS 82241 (W.D. Va. Oct. 16, 2008).

    Exclusivity provisions did not bar contractual indemnity action. —

    Exclusivity provisions of the Virginia State Workers’ Compensation Act or of the Longshore and Harbor Workers’ Compensation Act (LHWCA) did not bar a contractual indemnity action by a contractor against a subcontractor, when neither the contractor nor the subcontractor was the immediate employer of the harbor worker suing the contractor. Ward v. Norfolk Shipbuilding & Drydock Corp., 770 F. Supp. 1118, 1991 U.S. Dist. LEXIS 11370 (E.D. Va. 1991).

    Employee’s Federal Tort Claims Act action was dismissed. —

    State workers’ compensation benefits were the exclusive remedy of an employee of a subcontractor who was injured while working to provide meals at a Marine base since the Marine Corps was her statutory employer under state workers’ compensation law; her claim under the Federal Tort Claims Act (FTCA), 28 U.S.C.S. § 2671 et seq., was dismissed for lack of subject matter jurisdiction. Coulter v. United States, 256 F. Supp. 2d 484, 2003 U.S. Dist. LEXIS 6036 (E.D. Va. 2003), aff'd, 90 Fed. Appx. 60, 2004 U.S. App. LEXIS 5345 (4th Cir. 2004).

    III.Availability of Common-Law Action.

    An employer is immune from suit at common law by employees engaged in work which is part of his trade, business or occupation, in accordance with this section and former § 65.1-103 (now § 65.2-800 ). Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964).

    Under this section, an employee is precluded from maintaining a common-law action against his employer for an injury sustained in the course of employment when he and his employer have accepted the provisions of the Workmen’s (now Workers’) Compensation Act. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    And injured employee is granted compensation in lieu of action for damages. —

    This section deprives the employee or his personal representative of a common-law right of action for damages against the employer in a particular class of cases, that is, where the injury or death is from an accident arising out of and in the course of the employment, because the Act gives to the employee or his dependents in lieu thereof the right to an award of compensation. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    Right to maintain common-law action continues unless expressly or impliedly curtailed. —

    If the employer-employee relationship does not exist in fact, and is not created by the compensation statutes, then the compensation law is not applicable and does not control the rights and liabilities of the litigants inter se. If the right to maintain a common-law action would otherwise exist, it continues unless expressly or by necessary implication it is denied or curtailed by the Workmen’s (now Workers’) Compensation Act. Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37, 1957 Va. LEXIS 205 (1957).

    And employee’s common-law remedies are unimpaired where Act does not apply. —

    To the extent that the field of industrial accidents is not touched by the statute, the legislature intended that the employee’s common-law remedies against his employer are to be preserved unimpaired. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    Where plaintiff could not have successfully maintained any claim for compensation under the Virginia Workmen’s (now Workers’) Compensation Act because he was not embraced therein and, not being within the Virginia Act and not having accepted an award thereunder, he is not prohibited by the Act nor by common law from maintaining his action for the injuries received against the negligent third person or persons responsible for them. Such plaintiff could not have obtained any of the benefits of the Virginia Act and he is not required to suffer and bear the prohibitions of it. The prohibition of this section of the Virginia Act does not apply to him. Soloman v. Call, 159 Va. 625 , 166 S.E. 467 , 1932 Va. LEXIS 222 (1932).

    The common-law right of an employee to maintain an action against a party whose negligence caused his injuries still remains unless the statute expressly or by necessary inference curtails or denies it. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    If for any reason the statute is inapplicable to the case, the employee may have recourse to his common-law remedy. Perrin v. Brunswick Corp., 333 F. Supp. 221, 1971 U.S. Dist. LEXIS 10927 (W.D. Va. 1971).

    As where injury, etc., does not arise in course of employment. —

    The Act leaves unimpaired the common-law right of action for damages for the personal injury or death of the employee when such does not arise out of and in the course of the employment. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    Dismissal of a decedent’s estate administrator’s action, seeking recovery of damages for personal injury and resulting death after a co-worker assaulted the decedent by using a defibrillator on the decedent, resulting in death due to cardiac arrest and electrocution, was error, as the injury did not arise out of the employment, such that under §§ 65.2-101 and 65.2-307 , it was not within the exclusive remedy coverage of the Virginia Worker’s Compensation Act; the co-worker’s assault was purely personal on the decedent, and the employer’s workplace requirements had no causal connection with the risk of injury by assault. Hilton v. Martin, 275 Va. 176 , 654 S.E.2d 572, 2008 Va. LEXIS 18 (2008).

    Or employer has failed to comply with Act. —

    Where an employer failed to comply with the provisions of the Act, notwithstanding it was subject thereto, and the employee-claimant has been unsuccessful in collecting the award decreed him by the Commission, the employee-claimant is not barred from resorting to a civil action to recover damages from the employer. Delp v. Berry, 213 Va. 786 , 195 S.E.2d 877, 1973 Va. LEXIS 232 (1973).

    Or where claim under Act is dismissed. —

    The filing of a claim for compensation under the Workmen’s (now Workers’) Compensation Act, which is dismissed because not within the purview of the Act, does not estop the employee from thereafter pursuing his common-law remedy, if any, against the employer. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    Statutory employers are not “other parties.” —

    Because statutory employers are not strangers to the employment and work of the owner, they are not “other parties” under the provisions of former § 65.1-41 (now § 65.2-309 ); therefore, even though they are independent contractors and are not the injured employees’ common-law employers, they are under the canopy of the act and entitled to the immediate employers’ statutory immunity from common-law actions provided by this section. Evans v. Hook, 239 Va. 127 , 387 S.E.2d 777, 6 Va. Law Rep. 1081, 1990 Va. LEXIS 22 (1990).

    IV.Third Party Liability.

    Employee may bring action at law against negligent third person. —

    The Workmen’s (now Workers’) Compensation Act does not deny an injured employee the right to pursue his action at law against a negligent third party. The rights and remedies granted under this section are exclusive only as to an employee and his employer, and only his right to sue his employer for damages is barred by the acceptance of compensation under the Act. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951); Vandergrift v. United States, 500 F. Supp. 237, 1979 U.S. Dist. LEXIS 8325 (E.D. Va. 1979), aff'd, 634 F.2d 628 (4th Cir. 1980).

    When the employee’s injuries arise from the conduct of a third party, an “other party” in the Workers’ Compensation Act’s terms, he or she may recover in a tort action against that party aside from receiving statutory compensation from the employer. Kast v. PPG Indus., Inc., 664 F. Supp. 237, 1987 U.S. Dist. LEXIS 6438 (W.D. Va. 1987).

    If liability of a third party tort-feasor exists it is not taken away from the employee by the compensation laws which control his right against his employer. Veale v. Norfolk & W. Ry., 205 Va. 822 , 139 S.E.2d 797, 1965 Va. LEXIS 139 (1965).

    An employee has no cause of action against another party for injuries received while working for his employer unless that other party is a stranger to the business and the work being done. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    “Another party.” —

    “Another party” or “a stranger to the employment” is a person or entity not entitled to the benefit of the exclusivity provision of the act and against whom the injured employee or his employer who has a subrogation claim for benefits paid under the act has a common law claim arising out of the industrial accident. Pfeifer v. Krauss Constr. Co. of Va., Inc., 262 Va. 262 , 546 S.E.2d 717, 2001 Va. LEXIS 60 (2001).

    Liability of independent contractor to employee of owner. —

    In determining whether an injured employee may maintain an action against an independent contractor, the test is not whether the owner, by engaging the independent contractor to perform some part of his business, thereby engages in the business of the independent contractor but whether the independent contractor is performing work that is part of the trade, business or occupation of the owner. If he is, and in doing the work injures an employee of the owner, then the independent contractor, in the same fashion as any other employee of the owner, is not a third party against whom the injured employee’s right of action is preserved; but the employee so injured is limited to the compensation provided by the workers’ compensation law. Fowler v. International Cleaning Serv., Inc., 260 Va. 421 , 537 S.E.2d 312, 2000 Va. LEXIS 136 (2000).

    And action against third person does not bar claim under Act. —

    The mere institution of an action by an injured employee against a negligent third person is not a bar to a claim for compensation for the same injuries from the employer under the Workmen’s (now Workers’) Compensation Act. Drinkard v. Drinkard-Payne Corp., 181 Va. 253 , 24 S.E.2d 421, 1943 Va. LEXIS 173 (1943) (see Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209 (1942)).

    If liability of a third party tort-feasor exists, it is not taken away from the employee by the compensation laws which control his right against his employer. Veale v. Norfolk & W. Ry., 205 Va. 822 , 139 S.E.2d 797, 1965 Va. LEXIS 139 (1965).

    Defendant must be stranger to work in order for employee to maintain action. —

    In order for an injured employee to maintain a common-law action against the person causing his injuries, the defendant must be a stranger to the trade, occupation, or business in which the employee was involved. Whalen v. Dean Steel Erection Co., 229 Va. 164 , 327 S.E.2d 102, 1985 Va. LEXIS 189 (1985).

    The work in which a Ford employee’s employer was engaged was the particular business of manufacturing and selling motor vehicles and the defendants, who were contractors and subcontractors hired by Ford to construct a new body shop, were strangers to that business and, therefore, the employee’s common-law action for personal injuries against the defendants was not barred. Stone v. Door-Man Mfg. Co., 260 Va. 406 , 537 S.E.2d 305, 2000 Va. LEXIS 134 (2000).

    Whether defendant was a stranger to work is factual question. —

    The facts of each case must be analyzed to determine whether the defendant in a common-law action brought by an injured employee was, at the time of the employee’s injury, a stranger to the work in which the employee was engaged. If the defendant was “no stranger,” then he was not an “other party” within former § 65.1-41 (now § 65.2-309 ), and the common-law action against him would be barred by this section. Whalen v. Dean Steel Erection Co., 229 Va. 164 , 327 S.E.2d 102, 1985 Va. LEXIS 189 (1985).

    Cleaning service not stranger to work. —

    As appellees’ provision of cleaning and janitorial services was not part of an employer’s business of operating a call center, appellees were strangers to that business and were thus subject to an employee’s action for damages as “other parties” under subsection A of § 65.2-309 ; as they were not the employee’s co-employees, workers compensation exclusivity did not apply. Napper v. ABM Janitorial Servs. - Mid Atl., 284 Va. 55 , 726 S.E.2d 313, 2012 Va. LEXIS 130 (2012).

    Liability of contractor’s supplier. —

    Widow’s wrongful death action against a supplier of building materials was not barred by the workers’ compensation exclusivity provision, as the supplier’s mere delivery and stacking of drywall was not within the trade, business, or occupation of the contractor for whom the widow’s husband was working at the time of his accidental death. Giordano v. McBar Indus., 284 Va. 259 , 729 S.E.2d 130, 2012 Va. LEXIS 138 (2012).

    Act does not limit right of third person to insure himself against liability. —

    While the Workmen’s (now Workers’) Compensation Act excludes the employer’s liability to the employee or others entitled to recover “on account of” the employee’s injury or death, it does not exclude or limit the right of a third person to insure himself against liability for injury to the employee of a contractor either by a bond of indemnity, or by the contractor’s own agreement to save him harmless. Pearson v. National Trust for Historic Preservation, 145 F. Supp. 378, 1956 U.S. Dist. LEXIS 2609 (D.D.C. 1956).

    V.Practice and Procedure.

    Jurisdiction. —

    If this section abrogates the common-law action, jurisdiction of the subject matter would be vested solely in the Industrial Commission of Virginia. Perrin v. Brunswick Corp., 333 F. Supp. 221, 1971 U.S. Dist. LEXIS 10927 (W.D. Va. 1971).

    A proceeding under the Workmen’s (now Workers’) Compensation Act is not one to recover damage for a wrong, for the employer’s liability is not based upon tort. Perrin v. Brunswick Corp., 333 F. Supp. 221, 1971 U.S. Dist. LEXIS 10927 (W.D. Va. 1971).

    Question of appropriate forum is preliminary and collateral. —

    Whether the Compensation Commission or the common-law court is the exclusive and appropriate forum for the adjudication of the rights of the injured claimant is a preliminary question, related only collaterally to the substantive cause of action. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    And appropriate for summary judgment. —

    Question of appropriate forum for adjudication of claimant’s rights is peculiarly appropriate for summary judgment when there is no genuinely disputed issue of fact. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    Plea involving employment status treated as an affirmative defense. —

    See Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    Defendant in action may not implead employer. —

    Where an injured employee brought an action against the supplier and installer of the machine whereby he was injured, the defendant was not entitled to implead the employer as a third-party defendant on the theory of negligence on the part of the employer. Jennings v. Franz Torwegge Mach. Works, 347 F. Supp. 1288, 1972 U.S. Dist. LEXIS 12098 (W.D. Va. 1972).

    Express indemnity clause not prohibited. —

    The rationale behind workers’ compensation indicates that workers’ compensation precludes an action for contribution against an employer, but does not prevent that employer from agreeing to indemnify another party. The Virginia Workers’ Compensation Act does not invalidate an express indemnity clause. Bieger v. Consolidation Coal Co., 650 F. Supp. 1294, 1987 U.S. Dist. LEXIS 434 (W.D. Va. 1987).

    Factual issues as to employment status submitted to jury in federal court. —

    Though the courts of a state may have construed its Workmen’s (now Workers’) Compensation Act as a limitation upon the jurisdiction of its common-law courts so as to require the court, rather than a jury, to resolve questions of fact as well as of law in determining the jurisdictional fact of employment status, the Supreme Court of the United States has held that in the federal diversity jurisdiction factual issues involved in that determination must be submitted to a jury. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960).

    Unless facts are not genuinely in dispute. —

    If no issue of fact genuinely is in dispute, the question of employment status need not be submitted to a jury. Walker v. United States Gypsum Co., 270 F.2d 857, 1959 U.S. App. LEXIS 5062 (4th Cir. 1959), cert. denied, 363 U.S. 805, 80 S. Ct. 1240, 4 L. Ed. 2d 1148, 1960 U.S. LEXIS 1084 (1960); McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    Decisions construing section as it was in 1920 are authoritative. —

    This section and former §§ 65.1-41, 65.1-42 and 65.1-112 (now §§ 65.2-309 , 65.2-310 and 65.2-812 ) are now substantially the same as they were when enacted by the Acts of 1920, and, therefore, the decisions of the court construing these sections as they were in 1920 should be looked to for the proper construction of the sections as they are at present. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942); McGann v. Moss, 50 F. Supp. 573, 1943 U.S. Dist. LEXIS 2436 (D. Va. 1943).

    Judgment at law against employer reversed on appeal does not bar right to compensation. —

    The action of counsel for the employee in bringing an action against the employer at law and obtaining a judgment in favor of the employee, which was reversed on appeal, did not cut off the employee’s right to compensation, where, there being no negligent third party, no question of prejudice to the employer’s right of subrogation was involved. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947).

    The employee-claimant is entitled to only one full recovery and can collect only one time. But where he has effected no recovery, he has not received the satisfaction that can come only with payment. Delp v. Berry, 213 Va. 786 , 195 S.E.2d 877, 1973 Va. LEXIS 232 (1973).

    Supplemental compensation award from another state. —

    A state has no legitimate interest within the context of the federal system in preventing another state from granting a supplemental compensation award when that second state would have had the power to apply its workers’ compensation law in the first instance. The Full Faith and Credit Clause should not be construed to preclude successive workers’ compensation awards. Thomas v. Washington Gas Light Co., 448 U.S. 261, 100 S. Ct. 2647, 65 L. Ed. 2d 757, 1980 U.S. LEXIS 54 (1980).

    Nonresidents working in Virginia have same remedies and restrictions as residents. —

    Although the compensation statutes make no reference to the status of nonresidents working in Virginia at the time of an accident, Virginia intended to grant such remedies to, and impose such restrictions and limitations upon, such nonresidents to the same extent as though they were residents and employed by a Virginia employer. McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    Res judicata not invoked. —

    Where the denial of a compensation claim as to bronchitis is based upon a holding that the Workmen’s (now Workers’) Compensation Act does not touch the ailment, and where the issue of fault has not been determined, res judicata does not bar a subsequent negligence action. Perrin v. Brunswick Corp., 333 F. Supp. 221, 1971 U.S. Dist. LEXIS 10927 (W.D. Va. 1971).

    Comity barred tort action where employer compensated out of state. —

    Virginia would as a matter of comity treat an employer’s North Carolina compensation award as his exclusive remedy and hold his common-law tort action against his statutory employer as barred in Virginia. Kelly v. Guyon Gen. Piping, Inc., 882 F.2d 108, 1989 U.S. App. LEXIS 11971 (4th Cir. 1989).

    VI.Contractors.

    Denial of right to sue subcontractor not unconstitutional. —

    The fact that the Workers’ Compensation Act deprived an employee of a general contractor injured on the job of the right to sue a subcontractor did not deny him due process, equal protection of the laws, or the right of trial by jury. Whalen v. Dean Steel Erection Co., 229 Va. 164 , 327 S.E.2d 102, 1985 Va. LEXIS 189 (1985).

    Contractors, subcontractors, and all workers who are engaged in the trade, business, or occupation of the owner of a project are deemed to be statutory fellow employees. The remedy for any injury suffered by one of them as a result of the alleged negligence of another, while engaged in the trade, business, or occupation of the owner, is limited to that available under the Workers’ Compensation Act. Nichols v. VVKR, Inc., 241 Va. 516 , 403 S.E.2d 698, 7 Va. Law Rep. 2377, 1991 Va. LEXIS 55 (1991).

    An independent contractor’s provision of cleaning and janitorial services to a retail furniture store was a part of the owner’s trade, business or occupation in that the combined efforts of the defendant and owner were designed to accomplish the owner’s goal of making its store clean, attractive, and safe and, by its participation in those efforts, the defendant was performing an essential part of the owner’s business and was not a stranger to the owner’s business who could be sued by one of the owner’s employees. Fowler v. International Cleaning Serv., Inc., 260 Va. 421 , 537 S.E.2d 312, 2000 Va. LEXIS 136 (2000).

    The workers’ compensation exclusive remedy provision barred a personal injury suit by an employee of one subcontractor on a condominium construction project against another subcontractor for personal injuries sustained during the course of the employee’s job. Both the plaintiff’s employer, which had contracted to complete the exterior finish system of the project, and the defendant subcontractor, which had contracted to dig, install and test natural gas lines and to connect them to the condominium buildings, were engaged in the work of the owner and general contractor and, therefore, the defendant subcontractor was the plaintiff’s co-statutory employee and was immune from suit. Pfeifer v. Krauss Constr. Co. of Va., Inc., 262 Va. 262 , 546 S.E.2d 717, 2001 Va. LEXIS 60 (2001).

    The effect of former § 65.1-30 (now § 65.2-302 ) is to render the general contractor a statutory employer of all employees engaged in the work. If the general contractor is deemed a statutory employer, he is treated as an employer within the meaning of this section and former § 65.1-103 (now § 65.2-800 ), and is therefore immune from a common-law action brought by an injured workman. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    Contractor immunity. —

    On payment or provision for payment of compensation, a contractor, subcontractor or owner is immune to suit by the injured employee for damages. Bristow v. Safway Steel Prods., 327 F.2d 608, 1964 U.S. App. LEXIS 6723 (4th Cir. 1964).

    Contractor that manufactures product to meet requirements of specific project of the owner may be engaged in the business of the owner so as to fall within the protection of the statute and be immune from common law liability. Evans v. B.F. Perkins Co., a Div. of Standex Intern Corp., 166 F.3d 642, 1999 U.S. App. LEXIS 1139 (4th Cir. 1999).

    Where work employee performed was subcontracted fraction of owner’s main business concern, owner and general contractor qualified as employee’s statutory employers and, as such, were immune from employee’s Virginia common law action. Evans v. B.F. Perkins Co., a Div. of Standex Intern Corp., 166 F.3d 642, 1999 U.S. App. LEXIS 1139 (4th Cir. 1999).

    Employee of one independent contractor can sue another independent contractor at common law for the negligence of such other independent contractor or his employee, both contractors being engaged in work which is to become a component part of the same structure. Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37, 1957 Va. LEXIS 205 (1957); American Export Lines v. Revel, 266 F.2d 82, 1959 U.S. App. LEXIS 5107 (4th Cir. 1959).

    Unless both contractors are engaged in trade, business or occupation of owner. —

    An independent contractor was not subject to an action at law for damages for personal injuries to a second independent contractor’s employee, where both contractors were engaged in work which was part of the trade, business or occupation of the owner, for neither contractor was a stranger to the employment and the work, and they, as well as the owner, were under the canopy of the Workmen’s (now Workers’) Compensation Act. Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    Or if defendant was engaged in business of plaintiff’s employer. —

    Whether defendant was an independent contractor or a fellow servant, plaintiff is limited to compensation under this Act if defendant was engaged in the business of plaintiff’s employer when plaintiff’s injuries were sustained. Lucas v. Biller, 204 Va. 309 , 130 S.E.2d 582, 1963 Va. LEXIS 149 (1963).

    Action by employee of subcontractor against independent contractor. —

    An action to recover for death by wrongful act because of injuries received by an employee of a subcontractor against an alleged third party wrongdoer, and independent contractor performing services on the same building project, is limited to a claim under the Virginia Workmen’s (now Workers’) Compensation Act. Beall v. Standard Elec. Co., 404 F.2d 881, 1968 U.S. App. LEXIS 4356 (4th Cir. 1968).

    Injured employee has no right of action against subcontractor of his employer or subcontractor’s offending servants. Western Contracting Corp. v. Power Eng'g Co., 369 F.2d 933, 1966 U.S. App. LEXIS 4139 (4th Cir. 1966).

    When employee of independent contractor precluded from suing owner. —

    Liability would be imposed on the owner under the Workmen’s (now Workers’) Compensation Act only if the independent contractor was doing work which the owner generally performed. Therefore, an injured employee of an independent contractor would be precluded from suing the owner of a project because of this section if the independent contractor was performing work generally done by the owner. Barber v. Loews Theatres, Inc., 355 F. Supp. 136, 1972 U.S. Dist. LEXIS 10741 (W.D. Va. 1972).

    Suit by contractor’s employee against subcontractor barred. —

    Where the defendant in a suit brought by an injured employee of a general contractor was a subcontractor engaged in an essential part of the work which the general contractor had to do, so that defendant was no stranger to the work in which plaintiff’s employer was engaged, but was, on the contrary, performing an essential part of it, defendant was under the canopy of the Workers’ Compensation Act, and the trial court correctly ruled that the action was barred. Whalen v. Dean Steel Erection Co., 229 Va. 164 , 327 S.E.2d 102, 1985 Va. LEXIS 189 (1985).

    Right of employee of one contractor to sue another contractor. —

    This section and former § 65.1-41 (now § 65.2-309 ) bar common-law actions between fellow statutory employees, while allowing an injured employee of one contractor to proceed in an action at law against another contractor, where the two contractors are not engaged in a part of the trade, business, or occupation of the owner. Smith v. Horn, 232 Va. 302 , 351 S.E.2d 14, 3 Va. Law Rep. 1265, 1986 Va. LEXIS 257 (1986).

    Suit against an uninsured subcontractor, a statutory co-employee, was barred. —

    Contractor’s injured employee’s common-law action against an uninsured subcontractor and its employee was barred by the exclusivity provision of the Virginia Workers’ Compensation Act, § 65.2-307 , because the parties were statutory co-employees, and the employee had already fully recovered under the Act from his employer. David White Crane Serv. v. Howell, 282 Va. 323 , 714 S.E.2d 572, 2011 Va. LEXIS 184 (2011).

    Employee of one contractor held barred from suing employee of another contractor. —

    An injured employee of one independent contractor was barred from bringing a common-law tort action against an employee of another independent contractor engaged by the same owner, where the owner’s business was the mining, processing, and selling of coal and the contracted work performed by the independent contractors, mining and hauling coal to the owner’s plant for processing, was unquestionably a fraction of this main business concern. Smith v. Horn, 232 Va. 302 , 351 S.E.2d 14, 3 Va. Law Rep. 1265, 1986 Va. LEXIS 257 (1986).

    A subcontractor engaged in an essential phase of the work being done under a general contract is considered not to be a stranger to the work of the general contractor and is not an “other party” under the Workers’ Compensation Act; thus, when an employee of a general contractor is injured by the alleged negligence of a subcontractor, the employee is limited to compensation under the Workers’ Compensation Act and may not bring an action for damages against the subcontractor. Kast v. PPG Indus., Inc., 664 F. Supp. 237, 1987 U.S. Dist. LEXIS 6438 (W.D. Va. 1987).

    Subcontractor not a stranger to employer’s business. —

    Virginia Worker’s Compensation Act statutory bar prevented the employee from recovering from the employer’s janitorial subcontractor; the facts established the subcontractor was not a stranger to the employer’s business. The essential nature of the subcontractor’s function was demonstrated by the fact the subcontractor’s work was required to be performed every regular business day; further, the fact the employer was responsible for paying the subcontractors associated with cleaning/trash pickup emphasized such parties’ overarching responsibility for properly maintaining the premises. McGowan v. ABM Janitorial Servs., Northeast, Inc., No. 2:10cv388, 2011 U.S. Dist. LEXIS 70621 (E.D. Va. June 29, 2011), aff'd, 464 Fed. Appx. 153, 2012 U.S. App. LEXIS 2266 (4th Cir. 2012).

    Action by nonresident employee of nonresident contractor or subcontractor against owner or general contractor. —

    Where an employee of a District of Columbia subcontractor was injured in Virginia, and recovered compensation from the subcontractor under the compensation law applicable in the District of Columbia, the subcontractor’s insurance carrier could not maintain, as assignee, a common-law action against the Virginia general contractor, since the Virginia Compensation Act, governing as the law of the place of injury, makes a general contractor the statutory employer of a subcontractor’s employee, and precludes an action by an employee against an employer subject to the Act. Home Indem. Co. v. Poladian, 270 F.2d 156, 1959 U.S. App. LEXIS 5070 (4th Cir. 1959).

    The Virginia Workmen’s (now Workers’) Compensation Act applied to the nonresident employee of a nonresident contractor engaged in work which was part of the “trade, business or occupation” of an owner in Virginia, and the contractor’s employee became a statutory employee of the owner under former § 65.1-29 (now § 65.2-302 ) and thus could not maintain a common-law action against the owner, even though the employee had filed no claim under the Virginia Workmen’s (now Workers’) Compensation Act, and had filed a claim against the contractor under the New Jersey Act. McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    As general contractor and owner of a construction project were not the statutory employers of a worker who was injured using a crane to deliver sheetrock to an upper floor of a building in the project, they were not covered by the exclusivity provisions of § 65.2-307 . Bosley v. Shepherd, 262 Va. 641 , 554 S.E.2d 77, 2001 Va. LEXIS 138 (2001).

    Employee of bulk mail hauler for postal service. —

    Injured employee of a contractual bulk mail hauler for the postal service was barred from pursuing any action against the postal service, as the postal service was a statutory employer and the bulk mail hauler was contracted to perform work that ordinarily would be part of the trade, business, or occupation of the postal service; hence, the employee’s exclusive remedy was under the state’s workers’ compensation act. Nelson v. United States Postal Serv., No. 3:00CV00059, 2001 U.S. Dist. LEXIS 23491 (W.D. Va. July 6, 2001), dismissed, 189 F. Supp. 2d 450, 2002 U.S. Dist. LEXIS 3496 (W.D. Va. 2002).

    VII.Illustrative Cases.

    A prison inmate, assumed to have been a state prisoner on work release at the time of his injuries in the employ of the defendant, did not establish state action and stated no claim of constitutional dimensions such as would make applicable 42 U.S.C. § 1983 and such as would invoke the jurisdiction of the federal district court, where the plaintiff alleged that payment of compensation benefits ceased without notice or explanation, and where the plaintiff contended that the defendant must respond in damages for failure of its foreman to report the alleged injury. Plaintiff’s remedy, if any, was before the Industrial Commission. Owens v. Swift Agric. & Chem. Corp., 477 F. Supp. 91, 1979 U.S. Dist. LEXIS 9887 (E.D. Va.), aff'd, 612 F.2d 1309 (4th Cir. 1979).

    Conduct considered part of employer’s trade, business or occupation. —

    Where plaintiff, a tire company employee and defendant, a truck company were engaged in joint effort in unloading, tires, and defendant was required to follow the instructions of plaintiff’s employees when unloading a tire shipment, conduct was considered part of plaintiff’s employer’s trade, business or occupation. As a result, plaintiff’s claims against trucking company were barred based on this section. Kilmer v. Ryder Integrated Logistics, Inc., 82 F. Supp. 2d 568, 1999 U.S. Dist. LEXIS 20752 (W.D. Va. 1999).

    Where a worker who was employed by a wholesaler was arranging displays of flowers and assisting a flower retailer’s customers at the time she was injured, activities normally performed by the retailer’s employees, she was a statutory employee of the retailer at the time of the accident and her claim for negligence was barred by subsection A of § 65.2-307 . Burch v. Hechinger Co., 264 Va. 165 , 563 S.E.2d 745, 2002 Va. LEXIS 70 (2002).

    Acceptance of benefits under Act does not preclude seaman from suing under Jones Act or Longshoremen’s and Harbor Workers’ Compensation Act. Biggs v. Norfolk Dredging Co., 360 F.2d 360, 1966 U.S. App. LEXIS 6654 (4th Cir. 1966).

    Recovery under Federal Tort Claims Act precluded. —

    The United States Air Force was a statutory employer of a worker killed in an explosion while working for a corporation which was under contact with the Air Force to develop rocket fuel, and thus, the exclusive remedy provision of former § 65.1-29 (now § 65.2-302 ) prevented any recovery from the government under the Federal Tort Claims Act. Pendley v. United States, 856 F.2d 699, 1988 U.S. App. LEXIS 12649 (4th Cir. 1988), cert. denied, 490 U.S. 1005, 109 S. Ct. 1640, 104 L. Ed. 2d 155, 1989 U.S. LEXIS 1700 (1989).

    Where federal cause of action, Virginia act could not make employer immune from action. —

    Injured worker who was receiving benefits under the Longshore and Harbor Workers’ Compensation Act (LHWCA), 33 U.S.C. §§ 901-950, could not be barred by a state-law immunity available to “statutory employers” from asserting a federal maritime negligence action against a contractor for whom his immediate employer was performing work at the time of the injury. Ward v. Norfolk Shipbuilding & Drydock Corp., 770 F. Supp. 1118, 1991 U.S. Dist. LEXIS 11370 (E.D. Va. 1991).

    Emotional distress action not barred. —

    Employee’s motion for judgment against her former employer and fellow employees claiming intentional infliction of emotional distress was not barred by the exclusivity provisions of the Workers’ Compensation Act. The employee’s injury was not a compensable “injury by accident” as required by the act; the injury was gradually incurred and was not the result of an identifiable incident causing a mechanical or structural change in the body. Lichtman v. Knouf, 248 Va. 138 , 445 S.E.2d 114, 10 Va. Law Rep. 1554, 1994 Va. LEXIS 99 (1994).

    The exclusivity provision of the statute did not bar a cause of action for emotional distress arising out of an eight month period during which the plaintiff’s employer failed to accommodate her disability, as the alleged injury did not occur “by accident.” Hager v. First Va. Banks, Inc., No. 7:01CV00053, 2002 U.S. Dist. LEXIS 412 (W.D. Va. Jan. 10, 2002).

    Exacerbation of aneurysm due to negligent emergency medical treatment. —

    An employee who suffered a ruptured aneurysm over her lunch break while participating in an aerobics class sponsored by the employer and who alleged that her injury was the aggravation, exacerbation and/or acceleration of the aneurysm due to her employer’s negligence in providing emergency medical care, suffered an injury by accident arising out of and in the course of her employment and, therefore, was barred from pursuing a personal injury claim against her employer. Combs v. VEPCO, 259 Va. 503 , 525 S.E.2d 278, 2000 Va. LEXIS 38 (2000).

    Goosing action not barred. —

    An employee’s claim against his employer, asserted in a common law action for injury resulting from goosing by a fellow employee, is not barred by the exclusivity provision contained in the Virginia Workers’ Compensation Act. Richmond Newspapers, Inc. v. Hazelwood, 249 Va. 369 , 457 S.E.2d 56, 1995 Va. LEXIS 47 (1995).

    Employer’s actions committed with intent to injure employee as not accidental. —

    Where defendant employer’s actions were committed with intent to injure employee, those actions did not constitute “accidents” under former § 65.1-7 (now § 65.2-101 ) and employee’s suit for intentional infliction of emotional distress was not barred by the exclusivity provision of the Virginia Workers’ Compensation Act. McGreevy v. Racal-Dana Instruments, Inc., 690 F. Supp. 468, 1988 U.S. Dist. LEXIS 6655 (E.D. Va. 1988).

    Employee’s recovery not limited to worker’s compensation benefits where employer self-insures its motor vehicles. —

    The employee of an employer which self-insures its motor vehicles is entitled to recovery under the uninsured motorist protection statute, and the employee’s recovery was not limited to worker’s compensation benefits by the exclusivity provision in this section. William v. City of Newport News, 240 Va. 425 , 397 S.E.2d 813, 7 Va. Law Rep. 854, 1990 Va. LEXIS 129 (1990).

    Where plaintiff and defendant, both employed as carpenters on the same job, arrived at the job early in connection with the performance of certain preliminary tasks which had been assigned to them, they were properly found to be fellow employees, at the time, and the injury sustained by plaintiff because of the act of defendant arose out of and in the course of the employment. Therefore, plaintiff’s remedy was exclusively workmen’s (now workers’) compensation. Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962).

    Negligence of fellow employee. —

    Where the accident sustained by plaintiff arose out of and in the course of his employment, and it allegedly was caused by the negligence of a fellow employee who at the time was acting within the course of his employment, plaintiff’s rights and remedies were exclusively those provided under the Virginia Workmen’s (now Workers’) Compensation Act. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    Fact that employer may ultimately pay damages to third person is not a consideration. —

    Where the employee of a contractor sued a scaffolding supplier for injuries received when a scaffold toppled, the fact that the lease between the contractor and the supplier contained a “save harmless” clause which might result ultimately in the contractor’s payment of damages to the supplier, was not a consideration in the right of the employee to sue the supplier despite previous payment of compensation to the employment by the contractor. Bristow v. Safway Steel Prods., 327 F.2d 608, 1964 U.S. App. LEXIS 6723 (4th Cir. 1964).

    Where the employer paid a regular sum to defendant to transport plaintiff-employee to and from work, defendant was not a stranger to the business with respect to such transportation, and therefore plaintiff could not maintain a common-law action against defendant for an injury sustained incident thereto. Lucas v. Biller, 204 Va. 309 , 130 S.E.2d 582, 1963 Va. LEXIS 149 (1963).

    Because parent company was not a “stranger to the business” of coal company where employee was killed in mine explosion, employee’s representative’s exclusive remedy was under the Workers’ Compensation Act and no common law action for negligence existed. Rasnick v. Pittston Co., 237 Va. 658 , 379 S.E.2d 353, 5 Va. Law Rep. 2401, 1989 Va. LEXIS 67 (1989).

    Merely being in a parking lot utilized by employees is not enough to impose coverage of the Virginia Workers’ Compensation Act. Painter v. Simmons, 238 Va. 196 , 380 S.E.2d 663, 5 Va. Law Rep. 2915, 1989 Va. LEXIS 96 (1989).

    In a negligence case, where plaintiff asserted she was injured when struck by a motor vehicle operated by a fellow employee in a parking lot adjacent to their place of employment while both were departing from work, the trial court correctly ruled that the plaintiff’s exclusive remedy was under the Workers’ Compensation Act and the trial court properly sustained the plea to the jurisdiction. Barnes v. Stokes, 233 Va. 249 , 355 S.E.2d 330, 3 Va. Law Rep. 2332, 1987 Va. LEXIS 192 (1987).

    Common-law right to sue abrogated. —

    A general partner’s statutory election to be covered as an employee by the Virginia Workers’ Compensation Act abrogated his common-law right to sue the owner of a project for injuries sustained while working on the project. Counts v. Stone Container Corp., 239 Va. 152 , 387 S.E.2d 481, 6 Va. Law Rep. 1109, 1990 Va. LEXIS 8 (1990).

    Where the accident occurred at a place and time where employer expected both employees to be for employment purposes, a route of egress and ingress to and between the employer’s facilities and the employee who injured the other employee in an auto accident, clearly was using the lane for no purpose other than to commence his work for the day as anticipated by his employer, therefore the acts which gave rise to employee’s injury arose out of and in the course of his employment. Painter v. Simmons, 238 Va. 196 , 380 S.E.2d 663, 5 Va. Law Rep. 2915, 1989 Va. LEXIS 96 (1989).

    Wrongful death claim barred. —

    As a widow’s husband was an employee of a contractor and his death was caused by an accident that occurred in the course of and arose out of that employment, Virginia’s Workers’ Compensation Act applied and the contractor’s defense, that the widow was not a dependent, merely rendered her claim non-compensable; as the Act applied, its exclusivity provision barred her wrongful death claim against the contractor and its subcontractors. Giordano v. McBar Indus., 284 Va. 259 , 729 S.E.2d 130, 2012 Va. LEXIS 138 (2012).

    Where a widow’s husband was killed in the course of his employment and she filed a wrongful death action against his employer and its subcontractors, the “employee,” as defined in § 65.2-101 , was the husband; as subsection A of § 65.2-307 precludes “all other rights and remedies” available to the personal representative of an employee who is covered by Virginia’s Workers’ Compensation Act, the widow’s claim was barred. Giordano v. McBar Indus., 284 Va. 259 , 729 S.E.2d 130, 2012 Va. LEXIS 138 (2012).

    Had a widow’s husband survived his work-related accident, he could not have sued his employer or its subcontractors due to workers’ compensation exclusivity under subsection A of § 65.2-307 ; therefore, pursuant to subsection A of § 8.01-50 , the widow could not maintain a wrongful death action against them. Giordano v. McBar Indus., 284 Va. 259 , 729 S.E.2d 130, 2012 Va. LEXIS 138 (2012).

    Wrongful death claim not barred. —

    Decedent, an employee of a contractor hired by an owner to construct warehouses, was not engaged in the owner’s trade or business when he suffered fatal injuries in the course of employment, as his construction work was not part of the owner’s business, which was real estate development; thus, the owner was not his statutory employer under § 65.2-302 , and workers compensation exclusivity did not bar plaintiff’s wrongful death suit against the owner. Rodriguez v. Leesburg Bus. Park, LLC, 287 Va. 187 , 754 S.E.2d 275, 2014 Va. LEXIS 25 (2014).

    CIRCUIT COURT OPINIONS

    Exclusivity of remedy. —

    Injured party was employed by a security firm to assist in controlling the crowd at an auto race when the injured party was hit by a piece of debris that fell from a hydraulic lift operated by a broadcasting company. Workers’ compensation was the exclusive remedy as to the racetrack under the subcontracted exception. There was no evidence that the racing league that sponsored the event was in the business of broadcasting, and because the broadcasting company was a stranger to the work of the racing league and not engaged in the racing league’s trade, business, or occupation, the broadcasting company was not a statutory employee of the racing league under the Virginia Workers’ Compensation Act, nor a fellow statutory employee with the injured party, and therefore those defendants were “other parties” as defined by § 65.2-309 and were subject to suit. Lincoln v. Int'l Speedway Corp., 59 Va. Cir. 133, 2002 Va. Cir. LEXIS 333 (Richmond May 29, 2002).

    Because an employee’s injuries were compensable under the Virginia Workers’ Compensation Act, it provided the employee’s sole remedy against the employer and the dual capacity doctrine did not apply; therefore, §§ 65.2-307 and 65.2-605 barred a subsequent medical malpractice action against the employer for negligent treatment of the compensable injury. Budd v. Punyanitya, 69 Va. Cir. 148, 2005 Va. Cir. LEXIS 146 (Albemarle County Oct. 14, 2005).

    Workers’ Compensation Act barred the common-law negligence action against a crane owner and operator brought by the employee of a framing contractor who was injured when he fell during the placement of roof trusses because, in furnishing the crane and operator to position the trusses, the crane owner was engaged in an essential part of the work that the framing contractor had agreed to do. Alfaro-Molina v. McGee's Crane Rental, 72 Va. Cir. 559, 2007 Va. Cir. LEXIS 144 (Loudoun County Mar. 13, 2007).

    Defendants’ plea in bar under the exclusivity provisions of the Virginia Workers’ Compensation Act was sustained because, based on the relationship of the entities, the court was of the opinion that the dump truck driver that struck decedent was engaged in the same business or project of the owner, as was decedent; consequently, the truck driver was not “an other party” amenable to suit. Estate of Hill v. Smith, 74 Va. Cir. 341, 2007 Va. Cir. LEXIS 237 (Spotsylvania County Nov. 6, 2007).

    Injured employee for a subcontractor on a construction project was barred by §§ 65.2-300 and 65.2-307 from bringing suit against the general contractor and two other subcontractors for the construction project because, under subsection B of § 65.2-302 , the general contractor was the statutory employer of the employee and the subcontractors were statutory co-employees of the employee. Aguilar v. Diaz, 88 Va. Cir. 44, 2014 Va. Cir. LEXIS 6 (Loudoun County Feb. 10, 2014).

    Employer’s plea in bar to dismiss an employee’s negligent retention claims was sustained where the employee’s injuries occurred as a result of another employee shoving him into a cabinet, the incidents that led to the shove occurred while the employees were providing service to restaurant customers, and thus, the claims were barred by § 65.2-307 . Hayes v. Jones, 107 Va. Cir. 439, 2004 Va. Cir. LEXIS 419 (Essex County Aug. 20, 2004).

    No private civil right of action. —

    Employee’s personal injury claim against a co-worker and an underinsured motorist carrier was dismissed for lack of subject matter jurisdiction, because the employee’s exclusive remedy for an accident with a co-worker that occurred on the employee parking lot after the shift ended was under the Virginia Workers’ Compensation Act. The exclusivity provision was jurisidictional in nature and could be invoked at anytime during the proceeding, without regard to waiver or estoppel issues. Lilly v. Strawderman, 64 Va. Cir. 452, 2004 Va. Cir. LEXIS 162 (Rockingham County May 27, 2004).

    Intentional tortious conduct of fellow employee. —

    Employee’s claims against a general manager and an employer were not barred by the exclusivity provision because no conditions under which the employer required the employee’s work to be done contributed to the injury; the manager’s decision to take his frustration out on a fellow employee by assaulting her was entirely his own, and prior testimony that the manager chose to vent his frustration at the employee further demonstrated that the assault was directed at the employee personally. Morgan v. Brophy, 94 Va. Cir. 301, 2016 Va. Cir. LEXIS 147 (Chesapeake Sept. 27, 2016).

    Alleged assault by a manager on an employee was directed at the employee as an employee in that the manager was expressing dissatisfaction with quality and work performance of employees. The manager’s actions were in furtherance of the employer’s business to the extent that the actions involved the manager’s management style in addressing what the manager perceived as the shortcomings of employees and the inability of the employee to perform a task as the manager directed. Morgan v. Brophy, 107 Va. Cir. 164, 2021 Va. Cir. LEXIS 93 (Chesapeake Jan. 28, 2021).

    Injury from intentional bite by manager on employee’s arm met the requirements for exclusivity. —

    Employee’s intentional tort claims were barred because the circumstances satisfied the exclusivity requirements of the Workers’ Compensation Act in that the injury was an “accident,” even though it was intentional (the employee’s manager bit her on the arm for not immediately helping her with a project), which arose out of the employment (the employee concretely framed the dispute as one created by, and arising out of, refusal to assist her supervisor), and it arose in the course of the employment (the injuries occurred at the store where she was employed, during working hours, at a time when she was fulfilling her duties as a cashier). Wood v. Lowe's Home Ctrs., Inc., 63 Va. Cir. 461, 2003 Va. Cir. LEXIS 247 (Roanoke Dec. 16, 2003).

    Where work employee performed was subcontracted fraction of owner’s main business concern. —

    Business’s plea in bar asserting that an injured contractor was its statutory employee at the time of his injury, and thus, he was limited to a claim for workers’ compensation benefits in his personal injury action, was overruled because the work being performed by his direct employer, installing and repairing fire detection and sprinkler systems, was not part of the normal trade, business, or occupation of the business, which primarily involved meat processing; moreover, any plumbing work on the waterlines performed by the business’s 50 to 60 person maintenance team was a de minimis part of the business’s 500-contractor work force. Fose v. Gwaltney of Smithfield, Ltd., 67 Va. Cir. 347, 2005 Va. Cir. LEXIS 47 (Portsmouth May 12, 2005).

    Engaged in the trade, business, or occupation of the owner. —

    Stevedore company’s personal injury claim against a marine terminal contractor and its employee was barred under § 65.2-307 where, at the time of the accident, both employees were engaged in discharging a vessel and thus, they were fellow statutory employees engaged in the trade, business, or occupation of the vessel owner. Miles v. Va. Int'l Terminals, Inc., 74 Va. Cir. 518, 2008 Va. Cir. LEXIS 58 (Norfolk Mar. 13, 2008).

    Employee of one independent contractor can sue another independent contractor. —

    Exclusive remedy provisions of the Virginia Workers’ Compensation Act as set forth in § 65.2-307 did not prevent, plaintiff, subcontractor 1’s employee, from suing defendant subcontractor 2 for injuries he received on the job site while painting a coal loader, because plaintiff was a stranger to the owner’s work and not a statutory employee of the owner for purposes of subsection A of § 65.2-302 . Applying the normal work test, the court held that the highly specialized and infrequently performed painting project was not a part of the owner’s trade, business, or occupation. Masterson v. Am. Heavy Indus., 84 Va. Cir. 432, 2012 Va. Cir. LEXIS 126 (Norfolk Apr. 12, 2012).

    Maritime tort claims not barred. —

    Defendants remained subject to the sailors’ general maritime negligence claims as: (1) the sailors were injured by an explosion caused by the subcontractor’s employees’ use of a highly flammable liquid to perform deck work; (2) ship repair was a maritime activity, and the sailors’ work aboard ship was maritime in nature and had a direct relation to navigation and commerce; (3) the application of § 65.2-307 would materially prejudice general maritime law; (4) under the Supremacy Clause approach, where a plaintiff asserted a substantive right recognized by federal general maritime law, the court could give effect to otherwise-applicable state law only if the state law did not deprive the litigant of that right; and (5) application of § 65.2-307 would preclude the sailors’ maritime tort claims altogether. Jones v. Tecnico Corp., 83 Va. Cir. 336, 2011 Va. Cir. LEXIS 232 (Norfolk Sept. 9, 2011).

    Claim not barred. —

    Truck driver who made a delivery to the loading dock of a company was an other party within the meaning of the Workers’ Compensation Act, so a negligence action against the truck driver and the trucking company that employed him that was brought by an employee of the company who was injured while he was unloading the truck was not barred under the Act’s exclusivity provision. Smith v. Kirk, 54 Va. Cir. 71, 2000 Va. Cir. LEXIS 545 (Richmond 2000).

    Roanoke Regional Airport Commission was not the statutory employer of a driver of a transportation service since the founding act establishing the Commission granted it the authority to establish and operate an airport and air navigation facilities, and the power to grant the authority to operate a ground transporation service, but not the power to operate a ground transportation facility; since the Commission did not and could not subcontract with the driver’s employer to provide transportation services, the Commission was not the statutory employer of the driver, and the driver’s suit was not barred by the exclusivity rule of subsection A of § 65.2-307 . Cunningham v. Roanoke Reg'l Airport Comm'n, 2006 Va. Cir. LEXIS 273 (Roanoke County Dec. 28, 2006).

    In a personal injury action by a volunteer against a garden society, the volunteer’s claim was not barred under § 65.2-307 because, on the day of her injury, the volunteer was a non-compensated employee of a charitable organization. While it appeared that the volunteer was compensated for becoming a volunteer, she was not compensated for her labor actually rendered on the day of her injury. Her decision to work pulling weeds on the day of her injury was purely gratuitous. Harris v. Norfolk Botanical Garden Soc'y, Inc., 79 Va. Cir. 258, 2009 Va. Cir. LEXIS 238 (Norfolk Sept. 11, 2009).

    Because contractors did not have an employer in common with the decedent, they were not statutory co-employees, and none of the self-described statutory co-employees were employed by the decedent’s actual employer; thus, the contractors were “other parties,” and the exclusivity provision of the Virginia Workers’ Compensation Act did not apply to the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Holding company was not the decedent’s statutory employer because it manufactured and sold tissue paper, and converting a copy paper plant into a tissue paper plant was an essential preliminary step to allow the holding company to manufacture and sell tissue paper, but the business of the decedent’s employer was manufacturing, not converting plants; thus, the holding company was an “other party,” and the exclusivity provision did not apply in the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Truck driver’s action to recover damages for injuries he sustained while unfolding a tarp was not barred because pursuant to the normal work test, a company could not be designated as a statutory employer for purposes of the exclusivity provision of the Virginia Workers’ Compensation Act since tarping was not an activity in its normal course of business carried on by its employees; there was no evidence the company’s employees held a responsibility to assist contracted drivers in tarping loads. Pack v. Georgia-Pacific LLC, 95 Va. Cir. 351, 2017 Va. Cir. LEXIS 74 (Roanoke Apr. 6, 2017).

    Automobile accident victim’s civil negligence action against a co-employee who was driving the automobile was not barred by the exclusivity provision of the Virginia Workers’ Compensation Act, § 65.2-100 et seq., because the exclusivity provision was not applicable as the automobile accident took place in Virginia and the victim, who was a Maryland resident employed by a Maryland corporation, received workers’ compensation under Maryland law due to the injuries that the victim received from the accident. Gerben v. Edwards, 106 Va. Cir. 286, 2020 Va. Cir. LEXIS 464 (Fairfax County Nov. 13, 2020).

    Claim barred. —

    Injured party’s cause of action against defendants, a garbage company and individuals, was barred under the exclusivity provision of the Virginia Workers’ Compensation Act, § 65.2-307 ; the city which employed the injured party was authorized by state and local statutes to provide garbage collection and disposal, to provide and operate waste management facilities, and to contract with other entities to provide these services, and defendants were statutory employees of the city, as they performed an essential part of the city’s garbage collection business, and were therefore not “other parties” pursuant to § 65.2-309 . Hanner v. Clark, 60 Va. Cir. 485, 2001 Va. Cir. LEXIS 510 (Richmond Nov. 8, 2001).

    Where a subcontractor was, at the time of the injury, a statutory employee, he was barred from pursuing a common law claim by application of the Virginia Code. Ferreira v. Boeing Serv. Co., 60 Va. Cir. 237, 2002 Va. Cir. LEXIS 279 (Fairfax County Oct. 17, 2002).

    Employee’s action against defendants for assault, false imprisonment, malicious prosecution, intentional infliction of emotional distress, negligence, and vicarious liability was barred by the exclusivity provision of the Virginia Workers’ Compensation Act, codified at § 65.2-307 , where the employee’s injuries occurred by accident, and arose “out of” and “in the course of” her employment; the employee sustained injuries when her coworker attempted to remove the employee from the employer’s premises after the employee was terminated during a meeting with her supervisor. Abney v. Wimer, 60 Va. Cir. 87, 2002 Va. Cir. LEXIS 388 (Norfolk June 3, 2002).

    Employer’s plea in bar to employee’s complaint alleging claims for negligence, negligent misrepresentation, intentional tort, and fraudulent misrepresentation related to the employee’s sickness that occurred after the employer informed the employee the employer’s office building would be fumigated, was granted, as the employee’s claim for injury resulting from chemical exposure was an injury by accident that arose out of and in the course of her employment with the employer; accordingly, the employee’s sole and exclusive remedy was under the Virginia Workers’ Compensation Act, § 65.2-101 et seq., since that Act provided, in § 65.2-307 , that an employee’s sole and exclusive remedy under those circumstances was under the Act. Murhutta v. Planning Sys., 61 Va. Cir. 340, 2003 Va. Cir. LEXIS 53 (Fairfax County Mar. 19, 2003).

    When an employee sued a physician for fraud, alleging that the physician misrepresented the employee’s medical history in a report to the Virginia Workers’ Compensation Commission, to the extent the employee sought to raise issues about the credibility of the physician’s report, those issues were properly before the Commission and the court would not try them. Taylor v. Robinson, 62 Va. Cir. 515, 2003 Va. Cir. LEXIS 310 (Danville Sept. 29, 2003).

    Truck driver who worked for a company that was hired by a business to transport merchandise from a distribution center the business owned to its stores was a statutory employee of the business, and he was precluded by the Virginia Workers’ Compensation Act from suing the business to recover damages for injuries he sustained when he was struck by a tractor driven by one of the business’s employees while he was at the distribution center to pick up merchandise for transport. Leake v. Family Dollar Stores, Inc., 62 Va. Cir. 46, 2003 Va. Cir. LEXIS 317 (Warren County May 7, 2003).

    Accident victim’s claim against a contracting elevator company that maintained city elevators was barred by the exclusive remedy provision of the Virginia Workers’ Compensation Act, § 65.2-100 et seq., as (1) the victim was a statutory employee of the city; (2) the mandate of the city included the improvement, repair, and maintenance of public buildings; (3) the work delegated by the city to the elevator contracting company, and performed by its employees, was part of the trade, business, or occupation of the city; and (4) the elevator contracting company was not an “other party” against whom the victim could maintain a suit in tort, under § 65.2-309 . Brooks v. Blueridge Gen., Inc., 67 Va. Cir. 274, 2005 Va. Cir. LEXIS 46 (Portsmouth May 9, 2005).

    Employee’s claim brought under § 65.2-303 alleging his employer’s failure to provide him with medical attention following an eye injury at work, leading to an infection and permanent loss of vision, failed to state a claim upon which relief could be granted because the Workers’ Compensation Act applied exclusively. Ayers v. White, 77 Va. Cir. 302, 2008 Va. Cir. LEXIS 237 (Prince William County Dec. 1, 2008).

    Exclusivity provision of the Virginia Workers’ Compensation Act barred a retail store employee’s claim against an independent contractor and a subcontractor who contracted to remove snow and ice from the premises of the retail store because they were not strangers to the work and as such were not the other parties contemplated by § 65.2-309 . Young v. Pleasant View Lawn & Home Care, Inc., 88 Va. Cir. 28, 2013 Va. Cir. LEXIS 141 (Waynesboro Nov. 6, 2013).

    Employee who was injured in a workplace accident was barred from recovery in tort against a contractor to the employee’s employer, because the employee’s sole remedy was provided by the Virginia Workers Compensation Act, § 65.2-100 , as the contractor, a tow truck company, was not a stranger to the employer’s business of repairing vehicles, and, at the time of the accident, the contractor’s driver was performing the integral service of moving a vehicle from one location on the property of the employer to a bay for service. Pennell v. Hudson's Serv. Ctr., Inc., 95 Va. Cir. 202, 2017 Va. Cir. LEXIS 25 (Chesapeake Feb. 23, 2017).

    Conduct considered part of employer’s trade, business or occupation. —

    Where plaintiff, an employee of a store, slipped and fell on ice or snow while removing boxes from the store’s rear service entrance to a dumpster in a common area of the shopping center where the store was located, and she sued defendants, the shopping center’s owners and manager, for negligence arising from their failure to abide by a contractual duty under the store’s lease to remove snow and ice from common areas such as the rear service area, the exclusivity provision of the Virginia Workers’ Compensation Act barred the employee’s negligence suit because defendants’ work of removing snow and ice from the rear service area was essential to, and part of, the employer’s business. Lynskey v. Dan Assocs., 56 Va. Cir. 351, 2001 Va. Cir. LEXIS 470 (Danville Aug. 17, 2001).

    Elevator repair and maintenance. —

    Plea in bar by an elevator company, which contracted with an employer to maintain and repair the elevators at a building which the employer managed, on the basis of the exclusive remedy provision was denied because the employer, which paid workers’ compensation benefits to its employee who was injured when an elevator at the building malfunctioned, was not the elevator company’s statutory employer under § 65.2-302 . While the maintenance of the elevators in the building was clearly an indispensable activity of the businesses of both the employer and the owners of the building, the evidence was insufficient to persuade the court that elevator maintenance and repair was an activity that was normally carried on by employees of either the employer or the building owner. Guardian Realty Mgmt., Inc. v. Otis Elevator Co., 2006 Va. Cir. LEXIS 40 (Fairfax County Jan. 5, 2006).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    If the employer and employee come under the Act and the circumstances of accident are such that the employee may obtain an award for compensation, such remedy is the exclusive one against the employer. Bristow v. Cross, 210 Va. 718 , 173 S.E.2d 815, 1970 Va. LEXIS 191 (1970); Lucas v. Biller, 204 Va. 309 , 130 S.E.2d 582, 1963 Va. LEXIS 149 (1963); Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962); Floyd v. Mitchell, 203 Va. 269 , 123 S.E.2d 369, 1962 Va. LEXIS 138 (1962); Williams v. Gresham Co., Inc., 201 Va. 457 , 111 S.E.2d 498, 1959 Va. LEXIS 249 (1959); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959); Phillips v. Brinkley, 194 Va. 62 , 72 S.E.2d 339, 1952 Va. LEXIS 207 (1952); Chalkley v. Nolde Bros., 184 Va. 553 , 35 S.E.2d 827, 1945 Va. LEXIS 176 (1945); Garris v. Peoples Drug Stores, 162 Va. 428 , 174 S.E. 665 , 1934 Va. LEXIS 259 (1934); Humphries v. Boxley Bros. Co., 146 Va. 91 , 135 S.E. 890 , 1926 Va. LEXIS 314 (1926).

    Where all parties were under the canopy of the Workers’ Compensation Act the Commission has exclusive jurisdiction to determine an employee’s claim as the Act has deprived all trial courts of jurisdiction over such matters. Bristow v. Cross, 210 Va. 718 , 173 S.E.2d 815, 1970 Va. LEXIS 191 (1970); Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969); Floyd v. Mitchell, 203 Va. 269 , 123 S.E.2d 369, 1962 Va. LEXIS 138 (1962).

    Common law action by employee against employer and fellow servant are barred. Bristow v. Cross, 210 Va. 718 , 173 S.E.2d 815, 1970 Va. LEXIS 191 (1970); Lucas v. Biller, 204 Va. 309 , 130 S.E.2d 582, 1963 Va. LEXIS 149 (1963); Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962).

    For additional cases on jurisdiction see § 65.2-700 .

    Concurrent Jurisdiction:

    Note: These cases were decided before 2007 amendment to Code § 65.2-520 , which provides payment under Longshore and Harbor Workers’ Compensation Act may be deducted in full from amount to be paid as compensation for same injury under Virginia Act.

    Since compensation payments made to an employee under a Maryland award exceeded the benefits provided for in this jurisdiction, no payment is due under the Virginia Award as award has been fully satisfied. Bliss v. Kirlin, 57 O.I.C. 42 (1976), (appeal denied).

    An award in Virginia is not precluded merely because compensation has been awarded in another State. If a claim is compensable under Virginia law and the law of another State, concurrent jurisdiction exists. The employer will be granted a credit in Virginia for identical benefits paid under the law of another State. Whetzel v. Safeway Stores, Inc., 69 O.I.C. 22 (1990).

    Where claimant is injured on the navigable waters of Virginia, there is concurrent jurisdiction between the Virginia and the Federal Compensation Act. If the claimant is entitled to benefits under the Virginia Act which exceeds those available under the Federal Act, State benefits may be awards. Blizzard v. Newport News Shipbuilding & Dry Dock Co., 67 O.I.C. 154 (1988).

    An employer is entitled to file a claim in order to adjudicate its rights and obligations under the Virginia Workers’ Compensation Act. The employee’s receipt of benefits under the Longshore and Harbor Workers’ Act does not preclude the entry of an award under the Virginia Act. The employer will be granted credit for identical benefits paid under the Federal law. McKnight v. Virginia International Terminals, Inc., 69 O.I.C. 19 (1990).

    Credit is determined on a dollar for dollar basis as opposed to offsetting the number of weeks for which benefits are paid under the Act. Virginia International Terminals, Inc. v. Moore, 22 Va. App. 396, 470 S.E.2d 574, 1996 Va. App. LEXIS 368 (1996), aff'd, 254 Va. 46 , 486 S.E.2d 528, 1997 Va. LEXIS 55 (1997).

    A claimant who receives temporary total benefits pursuant to the Longshore and Harbor Workers’ Compensation Act may also be entitled to an award for permanent partial incapacity under Virginia Code § 65.1-56(19) (now § 65.2-503 ). Since the Federal Act does not provide for benefits for severely marked disfigurement, the claimant has not received a double recovery and the employer is not entitled to any credit for benefits paid under the Federal Act. Robinson v. Norfolk Shipbuilding & Dry Dock Corp., 66 O.I.C. 7 (1987).

    The United States Constitution did not prevent an award for permanent partial benefits to an employee injured while repairing a completed vessel on navigational waters. Norfolk Shipbuilding and Dry Dock Corporation v. Lathey, 8 Va. App. 306, 380 S.E.2d 665, 5 Va. Law Rep. 2661, 1989 Va. App. LEXIS 67 (1989), cert. denied, 493 U.S. 1079, 110 S. Ct. 1133, 107 L. Ed. 2d 1038, 1990 U.S. LEXIS 857 (1990).

    An award for permanent partial disability to the legs under the Longshore and Harbor Workers’ Act precludes an award for disfigurement under the Virginia Workers’ Compensation Act. Blizzard v. Newport News Shipbuilding & Dry Dock Co., 67 O.I.C. 154 (1988).

    Statutory Employers:

    A statutory employer, that is, an owner, contractor or subcontractor who could be held the employer of injured workman under § 65.1-29 to § 65.1-31 (now § 65.2-302 ) is entitled to the protection of this section, even where compensation may be had from the immediate employer. Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947).

    See Sykes v. Stone & Webster Eng. Co., supra , and Rea v. Ford , 198 Va. 712 , 96 S.E.2d 92 (1957), involving the right of employee of principal contractor to maintain an action at law against a subcontractor.

    Where the engineers and the construction company were both independent contractors engaged in construction of the Turnpike, neither was a stranger to the occupation and the work, rather they were both (as was the Turnpike Authority) under the canopy of the Act, and claimant was a statutory fellow servant to employees of construction company. Willlams v. Gresham Co., Inc., 201 Va. 457 , 111 S.E.2d 498 (1959); Anderson v. Thorington Constr. Co., Inc., 201 Va. 266 , 110 S.E.2d 396 (1959); a similar case involving an independent contractor not a stranger to employer’s work. Floyd v. Mitchell, 203 Va. 269 , 123 S.E.2d 369, 1962 Va. LEXIS 138 (1962) (see also Shook Co. v. Barksdale, 206 Va. 45 , 141 S.E.2d 738 (1965); Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37 (1957), where the work was not in the course of the trade, business or occupation of the owner).

    A fellow servant does not come within the intent of the phrase “any other party” as used in § 65.1-41 (now § 65.2-309 ). He is also a person “conducting” his master’s business within the intent of § 65.1-103 (now § 65.2-800 ). The other party who may be sued at law by employee or employer must be a stranger to the employment. Bosher v. Jamerson, 207 Va. 539 , 151 S.E.2d 375, 1966 Va. LEXIS 256 (1966); Shook Co. v. Barksdale, 206 Va. 45 , 141 S.E.2d 738, 1965 Va. LEXIS 167 (1965); Lucas v. Biller, 204 Va. 309 , 130 S.E.2d 582, 1963 Va. LEXIS 149 (1963); Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962); Floyd v. Mitchell, 203 Va. 269 , 123 S.E.2d 369, 1962 Va. LEXIS 138 (1962); Williams v. Gresham Co., Inc., 201 Va. 457 , 111 S.E.2d 498, 1959 Va. LEXIS 249 (1959); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959); Phillips v. Brinkley, 194 Va. 62 , 72 S.E.2d 339, 1952 Va. LEXIS 207 (1952); Coker v. Gunter, 191 Va. 747 , 63 S.E.2d 15, 1951 Va. LEXIS 133 (1951); Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946).

    A subcontractor is not an “other party” from whom recovery could be had even after receipt of compensation from principal contractor. Rea v. Ford, 198 Va. 712 , 96 S.E.2d 92, 1957 Va. LEXIS 129 (1957).

    When Section Does Not Apply:

    The Compensation Act is exclusive insofar as it covers the field of industrial accidents only. A servant injured by the negligence of his master under circumstances not entitling him to compensation may sue his master at common law. Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    Where the negligent injury cannot be regarded as an accident under the Act, the employer may be sued at law. Aistrop v. Blue Diamond Coal Co., 181 Va. 287 , 24 S.E.2d 546, 1943 Va. LEXIS 179 (1943).

    The employer of agricultural workers who have not elected to come under the Act cannot invoke this section. Dey v. Logan, 175 Va. 68 , 7 S.E.2d 102, 1940 Va. LEXIS 147 (1940).

    This section does not protect the employer from an action at law where his employee is engaged in a maritime employment. Colonna Shipyard v. Dunn, 151 Va. 740 , 145 S.E. 342 , 1928 Va. LEXIS 270 (1928), cert. denied, 279 U.S. 840, 49 S. Ct. 253, 73 L. Ed. 986, 1929 U.S. LEXIS 160 (1929).

    If the employer-employee relationship does not exist in fact, and is not created by the compensation statutes, then the compensation law is not applicable and does not control the rights and liabilities of the litigants inter se. Employee of independent contractor may sue another independent contractor at law. Kramer v. Kramer, 199 Va. 409 , 100 S.E.2d 37, 1957 Va. LEXIS 205 (1957). (See this opinion also for discussion of cases relative to independent contractors, subcontractors, etc.).

    A physician is not protected by this section from an action by an employee against him for alleged malpractice in treatment of a compensable injury, the physician being an independent contractor, not a fellow servant. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    Civil Actions:

    Where the employee cannot be certain whether his remedy against his employer is under the Act or at common law, he may sue at law and file a claim before the Commission and prosecute one proceeding to a conclusion before the other. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947).

    If the action at law be heard first and the facts upon which the exclusiveness of the Act are in dispute, the question may be left to a jury. Blue Diamond Coal Co. v. Aistrop, 183 Va. 23 , 31 S.E.2d 297, 1944 Va. LEXIS 126 (1944).

    Generally an unsuccessful result in the wrong forum will not bar additional action in the proper forum. See Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947); Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942); Va. Used Auto Parts, Inc. v. Robertson, 212 Va. 100 , 181 S.E.2d 613 (1971); Delp v. Berry, 213 Va. 786 , 195 S.E.2d 877, 1973 Va. LEXIS 232 (1973).

    Finding of fact made in a Commission hearing are conclusive of the same facts when the case is relitigated in a civil action. Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947); Griffith v. Raven Red Ash Coal Co., 179 Va. 790 , 20 S.E.2d 530, 1942 Va. LEXIS 275 (1942).

    Third Party Action:

    The fact that the injured employee obtains a judgment at law against a third party tort-feasor before seeking compensation under the Act does not constitute a bar where the judgment remains unsatisfied. In order to deprive himself of the right to compensation he must so conduct his claim at law against the third party as to prejudice the employer’s or his compensation insurer’s right of subrogation given under § 65.1-41 (now § 65.2-309 ) and § 65.1-112 (now § 65.2-812 ). Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    The fact that the employee has a third-party action pending is no bar to an application for compensation. Drinkard v. Drinkard-Payne Corp., 181 Va. 253 , 24 S.E.2d 421, 1943 Va. LEXIS 173 (1943).

    Employee did not prejudice his employer’s rights where carrier consented to the settlement. Burgess v. Baroody Candy Co., 46 O.I.C. 38 (1964).

    The employer cannot object to paying compensation upon the ground that employee unsuccessfully sued a fellow employee, since there never existed a negligent third party against whom employer could have asserted a subrogated interest. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947).

    An employer’s rights are not prejudiced by claimant’s compromise with his own insurer of claim against third party uninsured motorist since employer was subrogated to no rights against the uninsured motorist carrier. Under § 38.1-381 and § 65.1-41 (now § 65.2-309 ) the employer is subrogated to employee’s rights against negligent third party, but not under uninsured motorist coverage of a liability policy. Horne v. Superior Life Ins. Co., 203 Va. 282 , 123 S.E.2d 401, 1962 Va. LEXIS 140 (1962). [ Note: This case was prior to the July 1, 1995 amendment to § 38.2-2206 .] .

    Section 65.1-40 (now § 65.2-307 ) and § 65.1-41 (now § 65.2-308 ) give the injured employee opportunity to obtain one full recovery. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209 (1942); Burgess v. Cargill, Inc., 55 O.I.C. 53 (1973); Sheris v. Sheris Co., 212 Va. 325 , 188 S.E.2d 367 (1972), cert. denied by U.S. Supreme Court, November 2, 1972, 52 O.I.C. 232 (1970); Delp v. Berry, 213 Va. 786 , 195 S.E.2d 877 (1973); Dean v. Jefferson Mills, 58 O.I.C. 84 (1978).

    Where injured worker settles his common law right of action against third party tort-feasor, he cannot thereafter obtain compensation benefits from his employer, since by his own voluntary act he has destroyed his employer’s statutory right of subrogation. Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70, 1946 Va. LEXIS 168 (1946).

    Where employee refuses to accept compromise offered by third party and then loses common law action, he still retains rights against employer for compensation, there being nothing in the Act requiring employee to accept or reject a compromise offer at his peril. Davis v. Central Nat’l Bank, 35 O.I.C. (hearing opinion), 9, 237 (review opinion) (1953).

    In reversing the Court of Appeals, the Supreme Court set forth the method to be employed in calculating the amount of indemnity and the structure of the order suspending benefits when there has been a third party settlement. Henrico County School Board v. Bohle, 246 Va. 30 , 431 S.E.2d 924 (1993) (reversing 14 Va. App. 801, 421 S.E.2d 8 (1992)).

    § 65.2-308. Discharge of employee for exercising rights prohibited; civil action; relief.

    1. No employer or person shall discharge an employee solely because the employee intends to file or has filed a claim under this title or has testified or is about to testify in any proceeding under this title.  The discharge of a person who has filed a fraudulent claim is not a violation of this section.
    2. The employee may bring an action in a circuit court having jurisdiction over the employer or person who allegedly discharged the employee in violation of this section.  The court shall have jurisdiction, for cause shown, to restrain violations and order appropriate relief, including actual damages and attorney’s fees to successful claimants and the rehiring or reinstatement of the employee, with back pay plus interest at the judgment rate as provided in § 6.2-302 .

    History. 1982, c. 327, § 65.1-40.1; 1986, c. 259; 1991, c. 355.

    Editor’s note.

    Effective October 1, 2010, “§ 6.2-302 ” was substituted for “§ 6.1-330.54,” in subsection B to conform to the recodification of Title 6.1 by Acts 2010, c. 794.

    Law Review.

    For article, “The Status of the At-Will Employment Doctrine in Virginia after Bowman v. State Bank of Keysville,” see 20 U. Rich. L. Rev. 267 (1986).

    For note, “Erosion of the Employment-at-Will Doctrine: Recognition of an Employee’s Right to Job Security,” see 43 Wash. & Lee L. Rev. 593 (1986).

    For article, “The Law of Wrongful Discharge in Virginia,” see 10 G.M.U. L. Rev. 133 (1988).

    For a note, “Are You Breaking Some Sort of Law?: Protecting an Employee’s Informal Complaints Under the Fair Labor Standards Act’s Anti-retaliation Provision,” see 42 Wm. & Mary L. Rev. 319 (2000).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 14 Costs. § 14.01 Items included. Bryson.

    Michie’s Jurisprudence.

    For related discussion, see 12B M.J. Master and Servant, § 11; 21 M.J. Workers’ Compensation, § 64.

    CASE NOTES

    Right to jury trial. —

    Where a plaintiff has chosen only to seek actual damages and attorney fees for the defendant’s alleged violation of this section, a jury should determine whether he is entitled to such relief. Warner v. Buck Creek Nursery, Inc., 149 F. Supp. 2d 246, 2001 U.S. Dist. LEXIS 7025 (W.D. Va. 2001).

    Alternative pleading permissible. —

    Although it may be true that in order to prevail on a claim under this section, a discharged employee must prove that workers’ compensation retaliation was the sole reason for his discharge, such an employee has the right to set forth alternative, inconsistent causes of action in his complaint, and the fact that the complaint alleges other grounds for the employee’s discharge does not require dismissal of a claim under this section. Warner v. Buck Creek Nursery, Inc., 149 F. Supp. 2d 246, 2001 U.S. Dist. LEXIS 7025 (W.D. Va. 2001).

    Claim against employer and individual who discharged employee. —

    In light of the plain language of this section stating that no employer “or person” shall discharge an employee in retaliation for the filing of a workers’ compensation claim, a discharged employee may assert a claim for workers’ compensation retaliation against both his employer and the individual by whom he was discharged. Warner v. Buck Creek Nursery, Inc., 149 F. Supp. 2d 246, 2001 U.S. Dist. LEXIS 7025 (W.D. Va. 2001).

    Action brought by an employee under this section may not be removed to federal court. Green v. Hajoca Corp., 573 F. Supp. 1120, 1983 U.S. Dist. LEXIS 11821 (E.D. Va. 1983) (decided under prior law).

    No right to a jury trial. —

    A cause of action under this section does not give rise to a right to a trial by jury. Dunn v. Bergen Brunswig Drug Co., 848 F. Supp. 645, 1994 U.S. Dist. LEXIS 4986 (E.D. Va. 1994).

    A right to a jury trial does not attach since there is no common-law cause of action for retaliatory discharge. Dunn v. Bergen Brunswig Drug Co., 848 F. Supp. 645, 1994 U.S. Dist. LEXIS 4986 (E.D. Va. 1994).

    Evidence held sufficient to show that defendant was discharged for reason proscribed by section. —

    See Charlton v. Craddock-Terry Shoe Corp., 235 Va. 485 , 369 S.E.2d 175, 4 Va. Law Rep. 2986, 1988 Va. LEXIS 95 (1988) (decided under prior law).

    Jury question found on particular facts. —

    Since the plaintiff’s testimony, considered in its entirety, presented a question of fact concerning the employer’s motive for discharging her, she was entitled to have that evidence weighed by the jury together with all the other evidence in the case. Mullins v. Virginia Lutheran Homes, Inc., 253 Va. 116 , 479 S.E.2d 530, 1997 Va. LEXIS 6 (1997).

    No remedy of punitive damages. —

    The inconsistent treatment of punitive damages by the legislature indicates that a statutory provision prohibiting retaliatory discharge is not enough to establish a remedy of punitive damages. Dunn v. Bergen Brunswig Drug Co., 848 F. Supp. 645, 1994 U.S. Dist. LEXIS 4986 (E.D. Va. 1994).

    Evidence held insufficient to show that defendant was discharged for reason proscribed by section. See Cooley v. Tyson Foods, Inc., 257 Va. 518 , 514 S.E.2d 770, 1999 Va. LEXIS 67 (1999).

    Where the only evidence in plaintiff’s favor is that his termination was close in time to the date he notified his employer of his intention to file for workers’ compensation, such evidence was insufficient as a matter of law to go to the jury. O'Connell v. Isocor Corp., 56 F. Supp. 2d 649, 1999 U.S. Dist. LEXIS 10669 (E.D. Va. 1999).

    Former employee alleged that the former employer violated § 65.2-308 by discharging him solely in retaliation for filing his workers’ compensation claims, however the employee was not discharged following his claim for the 1999 injury; in addition, he did not have any evidence of retaliation for intending to file a claim for the 2002 injury. His claim of retaliation was based solely on the closeness in time between his 2002 injury, notice of his intention to file a claim, and his discharge and under Virginia law, closeness in time alone was insufficient to establish a prima facie violation of § 65.2-308 . Taylor v. Wal-Mart Stores, Inc., 376 F. Supp. 2d 653, 2005 U.S. Dist. LEXIS 14040 (E.D. Va.), aff'd, 158 Fed. Appx. 446, 2005 U.S. App. LEXIS 28200 (4th Cir. 2005).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Commission is not proper forum for action alleging employee’s discharge in violation of § 65.2-308 (A). Employee may bring an action in a circuit court having jurisdiction over employer or person who allegedly discharged employee in violation of this section. Jamison v. Sears Roebuck & Co., VWC File No. 167-09-30 (Dec. 9, 2003).

    Where an employee’s employment is terminated as a result of exercising rights under the Workers’ Compensation Act, an action at law may exist. Burnette v. Heilig Meyers Furn. Co., 62 O.I.C. 89 (1983).

    § 65.2-309. Lien against settlement proceeds or verdict in third party suit; subrogation of employer to employee’s rights against third parties; evidence; recovery; compromise.

    1. A claim against an employer under this title for injury, occupational disease, or death benefits shall create a lien on behalf of the employer against any verdict or settlement arising from any right to recover damages which the injured employee, his personal representative or other person may have against any other party for such injury, occupational disease, or death, and such employer also shall be subrogated to any such right and may enforce, in his own name or in the name of the injured employee or his personal representative, the legal liability of such other party. The amount of compensation paid by the employer or the amount of compensation to which the injured employee or his dependents are entitled shall not be admissible as evidence in any action brought to recover damages.
    2. Any amount collected by the employer under the provisions of this section in excess of the amount paid by the employer or for which he is liable shall be held by the employer for the benefit of the injured employee, his personal representative, or other person entitled thereto, less a proportionate share of such amounts as are paid by the employer for reasonable expenses and attorney’s fees as provided in § 65.2-311 .
    3. No compromise settlement shall be made by the employer in the exercise of such right of subrogation without the approval of the Commission and the injured employee or the personal representative or dependents of the deceased employee being first obtained.
    4. If an injured employee, his personal representative, or a person acting on behalf of the injured employee receives the proceeds of the settlement or verdict and the employer’s lien pursuant to subsection A has not been satisfied, the employer shall have the right to recover its lien either as a credit against future benefits or through a civil action against the person who received the proceeds.
    5. Any arbitration held by the employer in the exercise of such right of subrogation (i) shall be limited solely to arbitrating the amount and validity of the employer’s lien, (ii) shall not affect the employee’s rights in any way, and (iii) shall not be held unless:
      1. Prior to the commencement of such arbitration the employer has provided the injured employee and his attorney, if any, with an itemization of the expenses associated with the lien that is the subject of the arbitration;
      2. Upon receipt of the itemization of the lien, the employee shall have 21 days to provide a written objection to any expenses included in the lien to the employer, and if the employee does not do so any objections to the lien to be arbitrated shall be deemed waived;
      3. The employer shall have 14 days after receipt of the written objection to notify the employee of any contested expenses that the employer does not agree to remove from the lien, and if the employer does not do so any itemized expense objected to by the employee shall be deemed withdrawn and not included in the arbitration; and
      4. Any contested expenses remaining shall have been submitted to the Commission for a determination of their validity and the Commission has made such determination of validity prior to the commencement of the arbitration.

    History. Code 1950, § 65-38; 1960, c. 89; 1968, c. 660, § 65.1-41; 1991, c. 355; 2004, cc. 914, 941; 2017, cc. 81, 288.

    Cross references.

    As to settlement of third-party actions and decision approving the settlement is deemed consent by employer, see § 8.01-424.1 .

    The 2004 amendments.

    The 2004 amendments by cc. 914 and 941 are identical, and in subsection A, substituted “injury, occupational disease, or death benefits shall create a lien on behalf of the employer against any verdict or settlement arising from any right” for “injury, or death benefits shall operate as an assignment to the employer of any right,” and inserted “occupational disease” preceding “or death” and “also” preceding “shall be subrogated” and added subsection D.

    The 2017 amendments.

    The 2017 amendments by cc. 81 and 288 are identical, and added subsection E.

    Law Review.

    For note, “Tort Immunity and Workmen’s Compensation,” see 39 Va. L. Rev. 951 (1953).

    For discussion of who is an “other party” within meaning of this section, see 8 Wm. & Mary L. Rev. 700 (1967).

    For survey of Virginia law on workers’ compensation for the year 1970-1971, see 57 Va. L. Rev. 1520 (1971).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For article, “Effect of Virginia Workmen’s Compensation Act Upon the Right of a Third-Party Tortfeasor to Obtain Contribution From an Employer Whose Concurrent Negligence Causes Employee’s Death or Injury,” see 13 U. Rich. L. Rev. 117 (1978).

    For comment, “Toward a Uniform State Product Liability Law — Virginia and the Uniform Product Liability Act,” see 36 Wash. & Lee L. Rev. 1145 (1979).

    For comment, “Workers’ Compensation Third Party Actions and Subrogation: Should Virginia Recognize Workers’ Settlements Comprising Only Pain and Suffering Damages?,” see 6 G.M.U. L. Rev. 273 (1983).

    Research References.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 23 Damages. § 23.12 Collateral Source Rule. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 5A M.J. Costs, § 3; 6A M.J. Divorce and Alimony, §§ 35, 59, 72.2, 78; 14A M.J. Parent and Child, § 17.

    CASE NOTES

  • Analysis
  • I.General Consideration.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-41 or prior law.

    For history of this section and former §§ 65.1-40, 65.1-42 and 65.1-112 (see now §§ 65.2-307 , 65.2-310 and 65.2-812 ), see Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    Purpose. —

    This section and former § 65.1-42 (now § 65.2-310 ) have as their object the reimbursement of the employer when he is compelled to pay compensation as a direct result of the negligence of another. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)).

    The purpose of this section is to reimburse an employer who is compelled to pay compensation as a result of the negligence of a third party and to prevent an employee from obtaining a double recovery of funds already paid to him by his employer. Gartman v. Allied Towing Corp., 467 F. Supp. 439, 1979 U.S. Dist. LEXIS 13804 (E.D. Va. 1979).

    This section creates no new liability on or right against a third party. It merely assigns to the employer such rights, and only such rights, as the injured employee may have against the third party, and authorizes the employer to enforce such rights by an action, either in its own name or that of the employee. United States Fid. & Guar. Co. v. Blue Diamond Coal Co., 161 Va. 373 , 170 S.E. 728 , 1933 Va. LEXIS 327 (1933).

    This section and former §§ 65.1-42 and 65.1-112 (now §§ 65.2-310 and 65.2-812 ) did not give any new right to an injured employee. They did contain restrictions or limitations upon his right to compensation under the Act and upon his right to recover full damages for his injuries from a negligent third party. Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946).

    Under this section and former § 65.1-112 (now § 65.2-812 ), where an employee is injured by a third party, such third party is in no way liable to the employee under the Workmen’s (now Workers’) Compensation Act. His liability is merely that of a tort-feasor, and under § 8.01-243 unless the injured employee brings his action against the third party within one year (now two years) from the time the injury was inflicted, his right of action is barred. McKay v. Citizens Rapid Transit Co., 190 Va. 851 , 59 S.E.2d 121, 1950 Va. LEXIS 175 (1950).

    It prevents the employee from acquiring two separate remedies. —

    The express inclusion of the subrogation provision prevents the employee from acquiring for a single injury two separate remedies—the one, in tort, against the third party tort-feasor, the other, in contract, under the Workmen’s (now Workers’) Compensation Act; for it is quite generally held that, in the absence of such an express statutory grant to the employer, the employee retains the right to collect full damages from the third party tort-feasor, in addition to his right to collect compensation under the Act. Crab Orchard Imp. Co. v. C & O Ry., 115 F.2d 277, 1940 U.S. App. LEXIS 4763 (4th Cir. 1940), cert. denied, 312 U.S. 702, 61 S. Ct. 807, 85 L. Ed. 1135, 1941 U.S. LEXIS 836 (1941).

    This section was designed to prevent an employee from acquiring two remedies for a single injury — one in tort against the third-party tort feasor, the other in contract under the Workmen’s (now Workers’) Compensation Act. Gartman v. Allied Towing Corp., 467 F. Supp. 439, 1979 U.S. Dist. LEXIS 13804 (E.D. Va. 1979).

    He has no right to double recovery. —

    This section gave to the employer the right to recover from the wrongdoer whatever he had actually had to pay, and it took from the employee the right pro tanto to a double recovery, but beyond this it left the employee’s right to recover as it was before. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942) (see Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70 (1946); Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952))).

    The purpose of this section is to reimburse an employer who is compelled to pay compensation as the result of the negligence of a third party and to prevent an employee from obtaining a double recovery of funds. Tomlin v. Vance Int'l, Inc., 22 Va. App. 448, 470 S.E.2d 599, 1996 Va. App. LEXIS 377 (1996).

    The Act permits an injured employee the right to recover from a negligent third party full damages for injuries inflicted on him by such party, and the Act further gives to the employer and his insurance carrier the right to receive from such third party whatever amounts they actually had to pay for the benefit of the injured employee. It takes from the employee the right pro tanto to a double recovery, but beyond this it leaves the employee’s right to recover as it was before. Sheris v. Sheris Co., 212 Va. 825 , 188 S.E.2d 367, 1972 Va. LEXIS 278, cert. denied, 409 U.S. 878, 93 S. Ct. 132, 34 L. Ed. 2d 132, 1972 U.S. LEXIS 1673 (1972).

    Workers’ compensation insurer could seek a constructive trust against a worker that recovered a judgment against a third-party tort feasor because the insurer did not have an alternative remedy at law; the workers’ compensation statute provided only for a workers’ compensation carrier to seek reimbursement from a third-party tortfeasor, not from the worker himself. Mich. Mut. Ins. Co. v. Smoot, 183 F. Supp. 2d 806, 2001 U.S. Dist. LEXIS 24839 (E.D. Va. 2001).

    But he is no longer required to make election. —

    Under this section an injured employee is no longer required to elect whether he shall accept an award of compensation from the employer, or procure a judgment in an action at law against the negligent third party. Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70, 1946 Va. LEXIS 168 (1946).

    The employee is no longer required to elect whether he shall accept an award of compensation from the employer or proceed by an action at law. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947); Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)).

    An employee is no longer required to elect between pursuing a tort action or workers’ compensation claim, nor is the employee required to forego his or her tort claim; the employee may pursue both remedies, provided the employee does not impair the employer’s subrogation right, but is entitled to only one full recovery. Wood v. Caudle-Hyatt, Inc., 18 Va. App. 391, 444 S.E.2d 3, 10 Va. Law Rep. 1373, 1994 Va. App. LEXIS 293 (1994).

    And he may sue third party at common law. —

    Former § 65-37 (now § 65.2-307 ) was all there was on this subject in the original Compensation Act, and it was considered as meaning just that, and as barring any action at common law against all persons for the injury or death. The addition of this section and former §§ 65-39 and 65-108 (now §§ 65.2-310 and 65.2-812 ) had the effect of destroying that restriction and allowing such action against a person other than the employer. Sykes v. Stone & Webster Eng'r Corp., 186 Va. 116 , 41 S.E.2d 469, 1947 Va. LEXIS 135 (1947).

    The effect of this section is to preserve, subject to the subrogation rights of the employer, the injured employee’s common-law right of action against any “other party.” Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964).

    The Act does not deny an injured employee the right to pursue his action at law against a negligent third party. The rights and remedies granted under former § 65.1-40 (now § 65.2-307 ) are exclusive only as to an employee and his employer, and only his right to sue his employer for damages is barred by the acceptance of compensation under the Act. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)).

    The Workmen’s (now Workers’) Compensation Act does not bar a tort action if the person who causes the injury is an “other party” within the meaning of the Act. Burroughs v. Walmont, Inc., 210 Va. 98 , 168 S.E.2d 107, 1969 Va. LEXIS 203 (1969).

    An employee’s common-law right to maintain an action against a party whose negligence caused his injuries still remains unless the provisions of the Workmen’s (now Workers’) Compensation Act expressly or by necessary inference curtails or denies it. This right to maintain a common-law action is recognized in this section which gives an employer the right of subrogation to his employee’s right to recover damages from any other party for the injury or death. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    Even when employer may be required to pay damages. —

    Whatever the obligation of a contractor to a supplier of scaffolding under a lease providing contractor would save supplier harmless from any claim arising from the erection and maintenance, use or possession of the scaffold, it is not a consideration in the right of contractor’s employee to sue such supplier. The fact that such a suit may result in contractor’s payment of damages to its employee, despite previous payments of compensation cannot destroy such employee’s right at common law. Bristow v. Safway Steel Prods., 327 F.2d 608, 1964 U.S. App. LEXIS 6723 (4th Cir. 1964).

    How subrogation effected. —

    The assignment to the employer of any right to recover damages an injured employee may have against a third party for his injuries is effected by the employee making a “lawful claim against [his] employer for compensation.” Gartman v. Allied Towing Corp., 467 F. Supp. 439, 1979 U.S. Dist. LEXIS 13804 (E.D. Va. 1979).

    Workers’ compensation claimant was not entitled to a pro rata share of the money from the workers’ compensation insurer’s recovery of its workers’ compensation lien because the insurer did not receive the benefit of its lien as a result of a third-party settlement secured by the claimant. Williams v. Capital Hospice & Companion Prop. & Cas. Ins. Co., 66 Va. App. 161, 783 S.E.2d 67, 2016 Va. App. LEXIS 91 (2016).

    Court of Appeals of Virginia concludes that subsection C cannot apply to an action by an employer for the sole purpose of recovering its lien because interpreting the code section otherwise would be inconsistent with the overall statutory scheme. Sections 65.2-309 and 65.2-310 must be considered in a manner that harmonizes them and also gives effect to each section of the Virginia Workers’ Compensation Act. The requirements of subsection C cannot apply to an action between an employer and third party solely to recover its statutory lien because such action does not involve the employee or her rights under the Act, and thus, is not within the jurisdiction of the Virginia Workers’ Compensation Commission. Williams v. Capital Hospice & Companion Prop. & Cas. Ins. Co., 66 Va. App. 161, 783 S.E.2d 67, 2016 Va. App. LEXIS 91 (2016).

    Subsection C contemplates the exercise of the employer’s right of subrogation by prosecuting the tort case against the negligent third party, and therefore subsection C does not apply to an action by an employer against the third party solely to recover its lien. Williams v. Capital Hospice & Companion Prop. & Cas. Ins. Co., 66 Va. App. 161, 783 S.E.2d 67, 2016 Va. App. LEXIS 91 (2016).

    Employer’s right of subrogation is creature of statute. —

    The right of the employer, or his insurance carrier, does not rest on the principle of subrogation, but is wholly the creature of statute, and under this section and former § 65.1-112 (now § 65.2-812 ) the employer, or his insurance carrier, stands, in all respects, in the shoes of the employee. If the employee cannot recover, the employer, or his insurance carrier, cannot recover. United States Fid. & Guar. Co. v. Blue Diamond Coal Co., 161 Va. 373 , 170 S.E. 728 , 1933 Va. LEXIS 327 (1933).

    Subrogation provision is for employer’s benefit. —

    This section subrogates the employer who has paid compensation to his employee under the Act to the right to enforce any legal liability against such other party as may be liable in damages for the injury. The employer is not only subrogated to any right of the employee to enforce any such legal liability against another, but he may enforce it in his own name or in the name of the injured employee, or his personal representative. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    And not for benefit of third party. —

    This section, subrogating the employer to the rights of the employee, was not enacted for the benefit of the negligent third party. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    The provision as to subrogating the employer to the rights of the employee was not enacted for the benefit of the negligent third party; he has slight interest in it. He remains liable for the entire amount of such damages as may be lawfully recovered of him. The most that he could possibly claim is that after judgment he would be interested in having the proper apportionment made between the employer who has paid the compensation and the employee, if the recovery against him should exceed the amount paid to such employee under the Compensation Act. Smith v. Virginia Ry. & Power Co., 144 Va. 169 , 131 S.E. 440 , 1926 Va. LEXIS 239 (1926) (see also C & O Ry. v. Palmer, 149 Va. 560 , 140 S.E. 831 (1927)).

    An employer’s subrogation rights are triggered automatically when the injured employee files a claim against the employer and thereby assigns to the employer any claims against third parties. Tomlin v. Vance Int'l, Inc., 22 Va. App. 448, 470 S.E.2d 599, 1996 Va. App. LEXIS 377 (1996).

    Employer and insurer as real parties in interest in claim against third-party tortfeasor. —

    An employer and, in turn, his workers’ compensation insurance carrier, are subrogated to the rights of an injured employee who receives workers’ compensation benefits, and they are thus entitled to seek recovery of the amount of the benefits from a third-party tortfeasor. As such, they should be considered “real parties in interest” within the meaning of F.R.C.P. Rule 17(a). Ingram v. Link Belt Power Shovel Co., 94 F.R.D. 196, 1982 U.S. Dist. LEXIS 14023 (W.D. Va. 1982).

    Employer’s claim for reimbursement outside of Commission’s jurisdiction. —

    The Commission is empowered to decide matters between the employer and employee affecting compensation rights and directly related interests of the employee that spring from the act, but the act contains no provision entitling an employer or its insurer to reimbursement out of the employee’s tort settlement with a third party; neither a compensation right in claimant nor a reimbursement right in employer, which arises from the act, is at issue in such a case, and the employer’s reimbursement claim is outside the jurisdiction of the Commission. Henry's Wrecker Serv. Co. v. Smoot, 35 Va. App. 365, 545 S.E.2d 551, 2001 Va. App. LEXIS 225 (2001).

    Scope of employer’s right of recovery. —

    The language of §§ 65.2-309 and 65.2-310 does not restrict an employer’s right to obtain reimbursement of benefits paid to the amount that an individual beneficiary has recovered in a third-party action. In the absence of statutory language to that effect, there is no basis for placing such limits on an employer’s right of recovery under the statutory lien created by § 65.2-309 . Liberty Mut. Ins. Co. v. Fisher, 263 Va. 78 , 557 S.E.2d 209, 2002 Va. LEXIS 15 (2002) (overruling ACB Trucking, Inc. v. Griffin, 5 Va. App. 542, 365 S.E.2d 334 (1988), to the extent that its holding is inconsistent).

    Making a “claim” for workers’ compensation benefits works as an assignment of the employee’s “right to recover damages” from the tort-feasor. Wood v. Caudle-Hyatt, Inc., 18 Va. App. 391, 444 S.E.2d 3, 10 Va. Law Rep. 1373, 1994 Va. App. LEXIS 293 (1994).

    An express contract of indemnity would not be invalidated by the Virginia Workmen’s (now Workers’) Compensation Act. Burnette v. GE Co., 389 F. Supp. 1317, 1975 U.S. Dist. LEXIS 13862 (W.D. Va. 1975).

    The exclusivity provision of the Act will not bar an injured worker from asserting a federal cause of action in maritime tort. Mizenko v. Electric Motor & Contracting Co., 244 Va. 152 , 419 S.E.2d 637, 8 Va. Law Rep. 3331, 1992 Va. LEXIS 67 (1992) (decided under former § 65.1-41).

    The business is entitled to the opportunity to recoup the loss, if possible, from a negligent third party injuring an employee. Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946).

    If the employee is performing the duties of his employer and is injured by a stranger to the business, the compensation prescribed by the Act is available to him, but that does not relieve the stranger of his full liability for the loss, and, if he is financially responsible, there is no reason to cast this loss as an expense upon the business. Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946).

    If third party is found negligent. —

    In the absence of negligence on the part of the third party, the business cannot recoup the amount of compensation paid the injured employee, and the loss remains an expense of the business. Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946).

    Employer becomes assignee of employee’s rights to recover damages from other party. —

    Under this section it is clear that, upon the making of a lawful claim by the employee against his employer, the employer, by operation of law, becomes the assignee of any right to recover damages which the injured employee, or his personal representative, may have against any other party for the injury or death; and the employer is subrogated to the right of his employee and may enforce the same in his own name, or in the name of the employee. Southern Ry. v. United States Cas. Co., 136 Va. 475 , 118 S.E. 266 , 1923 Va. LEXIS 99 (1923) (see C & O Ry. v. Palmer, 149 Va. 560 , 140 S.E. 831 (1927)).

    As they existed at time of injury. —

    At the time of the injury to the employee, the employer has the right, upon the making of a lawful claim by the employee against the employer for compensation under the Act, to recover such damages as the injured employee might recover against any other party for such injury. Upon the making of such claim, the employer’s rights as assignee of the employee relate back and are the same as those of the employee at the time of the injury, and to these rights the insurance carrier is subrogated under former § 65.1-112 (now § 65.2-812 ). Southern Ry. v. United States Cas. Co., 136 Va. 475 , 118 S.E. 266 , 1923 Va. LEXIS 99 (1923).

    Where employee had filed his claim with the workers’ compensation commission before he proceeded with or settled his third-party tort claims, the assignment of any right to recover damages occurred and employer was subrogated to the employee’s right to recover damages at that time. Wood v. Caudle-Hyatt, Inc., 18 Va. App. 391, 444 S.E.2d 3, 10 Va. Law Rep. 1373, 1994 Va. App. LEXIS 293 (1994).

    No distinction between original injury and aggravation thereof. —

    This section makes no distinction between the liability of a third person who causes the original injury and that of a third person who causes an aggravation of such injury. In each instance the employee looks to the statutory liability of the employer for his loss-of-wage compensation. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)).

    Action by employee against physician who treated him for industrial injury. —

    See Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)).

    Where the accident occurred at a place and time where employer expected both employees to be for employment purposes, a route of egress and ingress to and between the employer’s facilities and the employee who injured the other employee in an auto accident, clearly was using the lane for no purpose other than to commence his work for the day as anticipated by his employer, therefore the acts which gave rise to employee’s injury arose out of and in the course of his employment. Painter v. Simmons, 238 Va. 196 , 380 S.E.2d 663, 5 Va. Law Rep. 2915, 1989 Va. LEXIS 96 (1989).

    Who merely delivers finished paper products is not a paper manufacturer, and therefore paper manufacturer is not the statutory employer of driver of delivery truck. McCall v. Bowater, Inc., 717 F. Supp. 1153, 1989 U.S. Dist. LEXIS 10114 (W.D. Va. 1989).

    Merely being in a parking lot utilized by employees is not enough to impose coverage of the Virginia Workers’ Compensation Act. Painter v. Simmons, 238 Va. 196 , 380 S.E.2d 663, 5 Va. Law Rep. 2915, 1989 Va. LEXIS 96 (1989).

    II.Amount of Compensation.

    Employer is entitled to recover amount paid in compensation. —

    This section assigns to the employer so much of the recovery against the third party as he is compelled to pay to the injured employee. It is not designed to relieve a negligent third party from any liability for damages he has inflicted. It divides the damages in just proportions between the employer who has paid and the employee who has been injured. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    This section has been construed to mean that in the event an employee has been injured by the negligence of a third party and has accepted compensation, then either the employer or the employee has a right to maintain an action against such party for the full amount of the damages sustained. The employer is limited in his recovery to the amount that he has paid or is liable to pay under the Act, and the employee is entitled to all in excess thereof. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    The right to subrogation under this section is limited, of course, to the amount of compensation for which the employer is obligated to pay his employee in the form of workmen’s (now workers’) compensation. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    If the employer sues, he may retain from the damages he recovers a sum sufficient to reimburse himself for the compensation paid, or payable, to the employee. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Virginia Workers’ Compensation Commission properly held that an employer was entitled to pay 30 percent towards a workers’ compensation claimant’s future entitlements until it recovered the claimant’s total settlement with a third party, even though the employer had not perfected its subrogation lien prior to the settlement with the third party, as the compensation and medical benefits for which the employer sought a credit had not yet accrued when the claimant received the distribution and they were not within the definition of “employer’s compensation lien,” but were “further entitlements.” Suggs v. Suggs Carpet Installation, 2006 Va. App. LEXIS 115 (Va. Ct. App. Mar. 28, 2006).

    Workers’ Compensation Commission properly construed and applied the statute in denying the employee’s request to exclude non-compensable damages from the amount of the third-party recovery subject to employer’s right of subrogation because, without a factual basis for finding that the employee’s third-party settlement included any non-compensable damages, there was no basis for finding error in the Commission’s calculation of the employer’s credit against its future compensation liabilities. Stowers v. Ga. Pac., LLC, 2022 Va. App. LEXIS 86 (Va. Ct. App. Mar. 29, 2022).

    While employee is entitled to any amount recovered in excess of compensation. —

    Under this section and former § 65.1-112 (now § 65.2-812 ), in an action by an injured employee against a negligent third party, instituted by or for the benefit of an employer or his insurance carrier, the injured employee or his personal representative is entitled to the full amount of any recovery less the amount of compensation paid or payable and reasonable expenses and attorney’s fees, if incurred by the employer or insurance carrier. VEPCO v. Mitchell, 159 Va. 855 , 164 S.E. 800 , 167 S.E. 424 , 1932 Va. LEXIS 225 (1932), aff'd, 159 Va. 855 , 167 S.E. 424 (1933).

    If an employer sues, he must account to the employee for money collected in excess of the award. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Amount of indemnity due employer. —

    Once the net third-party recovery of an employee was determined, she was entitled to payment of no further compensation or medical expenses after the date of the Commission’s suspension order until she could establish that further benefit entitlements exceeded the net amount received from the third-party recovery. Thus, the Commission did not foreclose the payment of attorney’s fees in increments as medical expenses and compensation benefits accrued during the suspension period, and the suspension order did not allow the employee a double recovery. After the employer was reimbursed the money paid as compensation benefits to the date of the suspension, the employer was excused from making payments during the suspension period to the extent the employee was otherwise entitled to continued medical or compensation benefits. 246 Va. 30 , 431 S.E.2d 36 (1993) (decided under former § 65.1-43).

    Medications. —

    Because a claimant conceded that the employer was entitled to a lien once the claimant independently reached a medical malpractice settlement with third parties, and because the claimant did not prove that certain medications should have been excluded from a lien on the claimant’s benefits, the amount of the lien was properly computed under subsection A of § 65.2-309 . Evans v. Xerox Corp., 2009 Va. App. LEXIS 3 (Va. Ct. App. Jan. 13, 2009).

    Employer and its insurer have no greater rights than injured employee against subcontractor. —

    An employer, or its insurance carrier as subrogee, after payment of the statutory compensation, may not hold a subcontractor or its servants in damages, as the employer and the carrier have no greater rights than the injured employee. Western Contracting Corp. v. Power Eng'g Co., 369 F.2d 933, 1966 U.S. App. LEXIS 4139 (4th Cir. 1966).

    Attorneys’ fees. —

    The modifications of this section and former § 65.1-42 (now § 65.2-310 ) by the 1960 amendment are procedural. They are designed to insure that the attorneys’ fees shall be apportioned in accordance with the substantive changes made in former § 65.1-43 (now § 65.2-311 ) when the proceeds of the judgment against the wrongdoer are disbursed. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    The debt owed an employer by virtue of the subrogation provisions of this section is nondischargeable in bankruptcy. County of Chesterfield v. Goyne, 26 Bankr. 47, 1982 Bankr. LEXIS 5318 (Bankr. E.D. Va. 1982).

    III.Settlements.

    Employee must not prejudice employer’s right of subrogation. —

    This section is so worded that it gives to the injured employee an opportunity to obtain one full recovery, but prohibits him from receiving a double recovery for his injuries. The right of the injured employee to pursue his action at law against the negligent third party is not prohibited. However, in the exercise of that common-law right, he must not prejudice the right of subrogation given to the employer. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942); Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70, 1946 Va. LEXIS 168 (1946).

    In the exercise of its right to pursue a third party claim, the employee must not prejudice the employer’s right to subrogation; the penalty for impairing this right may be loss of the employee’s right to compensation benefits. Overhead Door Co. v. Lewis, 22 Va. App. 240, 468 S.E.2d 700, 1996 Va. App. LEXIS 243 (1996).

    Or his right to compensation will be barred. —

    If the employer’s or the insurance carrier’s statutory right of subrogation is impaired by the act of the employee, the latter’s right to compensation is thereby barred. Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70, 1946 Va. LEXIS 168 (1946).

    An injured employee received a certain sum from the insurance carrier of a third party upon whose truck he was working at the time of the injury, and executed a full release under seal of all his claims against that party. Neither the employer nor its insurance carrier had any part in the settlement. It was held that the settlement barred the employee’s claim to compensation under the Workmen’s (now Workers’) Compensation Act, as against the contention that since no compensation had been paid to the employee, neither the employer nor its insurance carrier had acquired any right of subrogation which had been prejudiced by the settlement. The right of subrogation does not depend upon equitable principles which require actual payment before the right accrues, but is purely statutory and arises when the conditions specified in this section are met. Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70, 1946 Va. LEXIS 168 (1946).

    When an employer’s right to subrogation is defeated by an employee’s settlement with a third party without the knowledge or consent of the employer, the employee’s benefits under the Workers’ Compensation Act are terminated. White Elec. Co. v. Bak, 22 Va. App. 17, 467 S.E.2d 827, 1996 Va. App. LEXIS 175 (1996).

    Despite the fact that an employer’s petition seeking subrogation was filed prior to a verdict in the employee’s third party lawsuit against the tortfeasor, at the time the employer filed its petition to enforce its right of subrogation, the employee had already entered into a compromise settlement of his claims in exchange for a complete and absolute release of third party from any liability on those claims; thus, the employer no longer had a viable right to subrogation. Yellow Freight Sys., Inc. v. Courtaulds Performance Films, Inc., 266 Va. 57 , 580 S.E.2d 812, 2003 Va. LEXIS 62 (2003).

    Voluntary settlement with third party bars compensation. —

    The act of an injured employee in effecting a voluntary settlement with and executing a release of the third party bars a claim to compensation under the Workmen’s (now Workers’) Compensation Act. Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70, 1946 Va. LEXIS 168 (1946).

    Employee may not settle to the prejudice of employer’s rights. —

    Although employer, in the exercise of its subrogation rights, may enforce rights in its own name or in the name of the injured employee, the cause of action against a third-party belongs to the employee, who may also pursue that right; however, to protect the employer who may be required to provide the employee workers’ compensation benefits, the employee may not pursue his common law remedy in such a manner or settle his claim to the prejudice of the employer’s subrogation right and thereafter continue to receive worker’s compensation benefits. Wood v. Caudle-Hyatt, Inc., 18 Va. App. 391, 444 S.E.2d 3, 10 Va. Law Rep. 1373, 1994 Va. App. LEXIS 293 (1994).

    An employer can waive its subrogation rights as part of a settlement. Tomlin v. Vance Int'l, Inc., 22 Va. App. 448, 470 S.E.2d 599, 1996 Va. App. LEXIS 377 (1996).

    Benefits were properly terminated to workers’ compensation claimant when her injuries were aggravated by an automobile accident and she settled with and released the tortfeasor, thereby destroying employer’s right to subrogation. Barnes v. Wise Fashions, 16 Va. App. 108, 428 S.E.2d 301, 9 Va. Law Rep. 1085, 1993 Va. App. LEXIS 59 (1993).

    Voluntary settlement with third party held not to be a bar to compensation. —

    The claimant was entitled to compensation benefits for her 1984 industrial accident although she settled a claim against a third party tortfeasor who was responsible for a 1986 accident, which exacerbated her 1984 injury, without giving the employer the opportunity to protect its subrogation interest by participating in the settlement, because there was credible evidence to support the commission’s findings that the exacerbation caused by the 1986 accident was only temporary and that settlement of the claim did not prejudice the employer. City of Newport News v. Blankenship, 10 Va. App. 704, 396 S.E.2d 145, 7 Va. Law Rep. 231, 1990 Va. App. LEXIS 149 (1990).

    Settlement did not justify termination of award. —

    Finding that the employee was entitled to ongoing workers’ compensation benefits was appropriate because evidence of prejudice from the settlement as to injuries other than the compensable brain injury did not justify termination of the award for that injury. The evidence, viewed in the light most favorable to claimant, established that claimant suffered no exacerbation of his compensable 2004 brain injury in the 2006 auto accident and continued to be temporarily and totally disabled as a result of the 2004 brain injury after the 2006 auto accident. United Airlines, Inc. v. Hayes, 58 Va. App. 220, 708 S.E.2d 418, 2011 Va. App. LEXIS 163 (2011).

    Employee not prohibited from settling claim without consent of employer. —

    While subsection C of this section expressly precludes settlement of a third-party claim by an employer absent approval of both the Commission and the employee, an employee is not expressly prohibited from initiating and settling such a claim without the consent of employer and its insurer. Henry's Wrecker Serv. Co. v. Smoot, 35 Va. App. 365, 545 S.E.2d 551, 2001 Va. App. LEXIS 225 (2001).

    Settlement with third party without knowledge of employer terminates benefits under Act. —

    When an employer’s right to subrogation is defeated by an employee’s settlement with a third party without the knowledge or consent of the employer, the employee’s benefits under the Workers’ Compensation Act are terminated. This rule protects against an employee’s settlement with a third party for less than the employer’s liability for compensation. Such a settlement would extinguish, at least in part, the employer’s opportunity to obtain full reimbursement from the third party. Green v. Warwick Plumbing & Heating Corp., 5 Va. App. 409, 364 S.E.2d 4, 4 Va. Law Rep. 1713, 1988 Va. App. LEXIS 6 (1988).

    Employee necessarily prejudices his employer’s subrogation rights and, is barred from obtaining or continuing to receive benefits under a workers’ compensation award when an employee settles a third-party tort claim without notice, or without making a claim for workers’ compensation benefits, or without obtaining the consent of the employer. Wood v. Caudle-Hyatt, Inc., 18 Va. App. 391, 444 S.E.2d 3, 10 Va. Law Rep. 1373, 1994 Va. App. LEXIS 293 (1994).

    A third-party settlement by an employee, undertaken without the knowledge and consent of the employer and its insurer, wrongfully impairs the rights of subrogation provided the employer by the act, and therefore the employee forfeits any right to future compensation. Henry's Wrecker Serv. Co. v. Smoot, 35 Va. App. 365, 545 S.E.2d 551, 2001 Va. App. LEXIS 225 (2001).

    Awareness not proof of consent or notice. —

    Evidence that the employer may have been aware of employee’s third-party claim does not prove that the employer was given an opportunity to consent to the settlement or was given notice of the settlement. Miller v. Hall Auto Mall, 1995 Va. App. LEXIS 537 (Va. Ct. App. June 27, 1995).

    Where employee after automobile accident settled his accident claim that had exacerbated his work-related accident, the settlement extinguished any right the employer and its insurer might have had to seek full reimbursement from the third party for compensation benefits the employer would have to pay. The employee’s compensation benefits, therefore, should be terminated because of his failure to give the employer prior notice of the proposed settlement or to obtain its consent to it. Green v. Warwick Plumbing & Heating Corp., 5 Va. App. 409, 364 S.E.2d 4, 4 Va. Law Rep. 1713, 1988 Va. App. LEXIS 6 (1988).

    Employer is not subrogated to employee’s uninsured motorist coverage. —

    This section does not confer on the employer a right of subrogation to his employee’s claim against the employee’s automobile liability carrier under the Uninsured Motorist Law, subsection A of § 38.2-2206 . Horne v. Superior Life Ins. Co., 203 Va. 282 , 123 S.E.2d 401, 1962 Va. LEXIS 140 (1962).

    Hence, a settlement by the employee with the liability carrier does not impair employer’s right of subrogation. Horne v. Superior Life Ins. Co., 203 Va. 282 , 123 S.E.2d 401, 1962 Va. LEXIS 140 (1962).

    And settlement by employee is not double recovery. —

    An employee’s settlement with his own insurance carrier, who had contracted to pay him for injuries under the uninsured motorist provision of the liability policy, would not amount to a double recovery. Horne v. Superior Life Ins. Co., 203 Va. 282 , 123 S.E.2d 401, 1962 Va. LEXIS 140 (1962).

    But employer’s right of subrogation is superior to uninsured motorist’s insurer. —

    An employer’s right of subrogation against a negligent third party given by this section is superior to that of the insurance carrier under the Uninsured Motorist Law, subsection G of § 38.2-2206 . Horne v. Superior Life Ins. Co., 203 Va. 282 , 123 S.E.2d 401, 1962 Va. LEXIS 140 (1962).

    The procurement of a judgment which is unsatisfied is not a bar to the prosecution of a claim against the employer. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942); Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70, 1946 Va. LEXIS 168 (1946).

    Where claimant had no duty to consult with employer prior to settling malpractice claim, the commission had no authority under the Act to terminate claimant’s benefits or give the employer a credit for the amount of the malpractice proceeds. Overhead Door Co. v. Lewis, 29 Va. App. 52, 509 S.E.2d 535, 1999 Va. App. LEXIS 40 (1999).

    Trial court erred in barring an employer from recovering, under a workers’ compensation lien, as part of settlement of third-party wrongful death action, benefits paid to persons who did not participate in the settlement of the wrongful death action. Liberty Mut. Ins. Co. v. Fisher, 263 Va. 78 , 557 S.E.2d 209, 2002 Va. LEXIS 15 (2002).

    IV.Other Party.

    “Other party” refers exclusively to strangers to employment. It would seem that “other party,” as used in this section, refers exclusively to those persons who are strangers to the employment and the work, and does not include those who have accepted the Act and are within the express terms of former § 65.1-103 (now § 65.2-800 ). Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946); Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)); Rea v. Ford, 198 Va. 712 , 96 S.E.2d 92, 1957 Va. LEXIS 129 (1957); Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964).

    An employee covered by the Virginia Workmen’s (now Workers’) Compensation Act has no right of action against another party for injuries received while engaged in the business of his employer unless that other party is a stranger to the business. Doane v. E.I. DuPont de Nemours & Co., 209 F.2d 921, 1954 U.S. App. LEXIS 3683 (4th Cir. 1954); Rea v. Ford, 198 Va. 712 , 96 S.E.2d 92, 1957 Va. LEXIS 129 (1957); Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959); Bristow v. Safway Steel Prods., 327 F.2d 608, 1964 U.S. App. LEXIS 6723 (4th Cir. 1964).

    Where plaintiff was engaged in the sawmill business of his employer, who sold lumber from his sawmill to defendants which was delivered to their premises on a truck driven by plaintiff, and it was not a part of the trade, business or occupation of plaintiff’s employer to unload the truck, plaintiff, in undertaking to help unload it, was not engaging in the trade, business or occupation of his employer and defendants did not thereby become engaged in the business of plaintiff’s employer, but were clearly “other parties,” strangers to the business, against whom plaintiff’s right of action was preserved by this section. Shook Co. v. Barksdale, 206 Va. 45 , 141 S.E.2d 738, 1965 Va. LEXIS 167 (1965).

    The term “other party” as used in this section refers to those third parties against whom an employee may rightfully bring a common-law action. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    An employee has no cause of action against another party for injuries received while working for his employer unless that other party is a stranger to the business and the work being done. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    Underlying the principle that a general contractor is not an “other party” under this section is the concept of “statutory employer” under former § 65.1-40 (now § 65.2-307 ). Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    The language in this section and former § 65.1-103 (now § 65.2-800 ) has been uniformly interpreted to allow a common-law negligence action for injuries against an “other party,” that, although performing work or providing services for the employer, is a “stranger” to the employer’s normal work. Farish v. Courion Indus., Inc., 722 F.2d 74, 1983 U.S. App. LEXIS 14855 (4th Cir. 1983).

    A corporation is an “other party” if, at the time of the accident, plaintiff and his employer were not performing work that was part of the corporation’s trade, business or occupation. Stevens v. Ford Motor Co., 226 Va. 415 , 309 S.E.2d 319, 1983 Va. LEXIS 299 (1983).

    Allegedly injured driver was not precluded by the Virginia Workers’ Compensation Act, § 65.2-100 et seq., from maintaining a tort action against a corporation; the corporation was an “other party” within the meaning of § 65.2-309 , as the driver was not engaged in the trade or business of the corporation, but only of the driver’s employer. The unloading of freight from the driver’s trailer was the sole responsibility of the corporation. Crocker v. Riverside Brick & Supply Co., 273 Va. 235 , 639 S.E.2d 214, 2007 Va. LEXIS 22 (2007).

    If employee’s injury is caused by the negligent act of a party who is a stranger to the trade, occupation, or business of his employer, the employee may maintain an action at law against the “other party.” Conlin v. Turner's Express, Inc., 229 Va. 557 , 331 S.E.2d 453, 1985 Va. LEXIS 231 (1985).

    Defendant must be stranger to work in order for employee to maintain action. —

    In order for an injured employee to maintain a common-law action against the person causing his injuries, the defendant must be a stranger to the trade, occupation, or business in which the employee was involved. Whalen v. Dean Steel Erection Co., 229 Va. 164 , 327 S.E.2d 102, 1985 Va. LEXIS 189 (1985).

    Whether defendant was a stranger to work is factual question. —

    The facts of each case must be analyzed to determine whether the defendant in a common-law action brought by an injured employee was, at the time of the employee’s injury, a stranger to the work in which the employee was engaged. If the defendant was “no stranger,” then he was not an “other party” within this section, and the common-law action against him would be barred by former § 65.1-40 (now § 65.2-307 ). Whalen v. Dean Steel Erection Co., 229 Va. 164 , 327 S.E.2d 102, 1985 Va. LEXIS 189 (1985).

    Whether a third party is engaged in the trade, occupation, or business of the employer depends upon the facts and circumstances in each case, and for that reason the question does not readily yield to categorical or absolute standards. Conlin v. Turner's Express, Inc., 229 Va. 557 , 331 S.E.2d 453, 1985 Va. LEXIS 231 (1985).

    Airline as “other party.” —

    While the death of decedent did occur while he was on a mission for his company, and arose out of and during the course of his employment, his death was occasioned by the crash of an airplane under the control of the airline, and was therefore due solely to its wrongful act, neglect, default and breach of duty. The party responsible for the death of the decedent is the airline, and as such it is “the other party” contemplated by this section. Sheris v. Sheris Co., 212 Va. 825 , 188 S.E.2d 367, 1972 Va. LEXIS 278, cert. denied, 409 U.S. 878, 93 S. Ct. 132, 34 L. Ed. 2d 132, 1972 U.S. LEXIS 1673 (1972).

    “Any other party” can only be one who is not engaged in the execution or performance of the work. Bristow v. Safway Steel Prods., 327 F.2d 608, 1964 U.S. App. LEXIS 6723 (4th Cir. 1964).

    And he is one not required to pay, or not entitled to receive, compensation under the Act. Bristow v. Safway Steel Prods., 327 F.2d 608, 1964 U.S. App. LEXIS 6723 (4th Cir. 1964).

    Thus, a fellow employee is not an “other party” or third party as contemplated by this section. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947).

    “Any other party,” as used in this section, does not necessarily include a coemployee or a fellow servant. It certainly includes a third party, a stranger in the field of that employment. Feitig v. Chalkley, 185 Va. 96 , 38 S.E.2d 73, 1946 Va. LEXIS 183 (1946).

    An employee of a business covered by the Virginia Workmen’s (now Workers’) Compensation Act cannot maintain a suit against a fellow servant for injuries caused by the latter’s negligence. Doane v. E.I. DuPont de Nemours & Co., 209 F.2d 921, 1954 U.S. App. LEXIS 3683 (4th Cir. 1954).

    And an injured employee cannot maintain action against coemployee. —

    The Workmen’s (now Workers’) Compensation Act prohibits an injured employee from maintaining an action at law against his coemployee for negligence causing his injury. Coker v. Gunter, 191 Va. 747 , 63 S.E.2d 15, 1951 Va. LEXIS 133 (1951).

    An award under the Workmen’s (now Workers’) Compensation Act is the exclusive remedy where an employee subject to the Act is injured by a fellow employee. Phillips v. Brinkley, 194 Va. 62 , 72 S.E.2d 339, 1952 Va. LEXIS 207 (1952).

    Or against one who is his statutory fellow employee under former § 65.1-29 (now § 65.2-302 ). —

    Where two independent contractors were engaged in work which was part of the “trade, business or occupation” of the owner, the employees of the two contractors, all being statutory employees of the owner under former § 65.1-29 (now § 65.2-302 ), were statutory fellow servants, and an employee of one contractor was precluded from maintaining an action at law against the negligent employees of the other who caused his injury. Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    Because he is not a stranger to the employment, an allegedly negligent employee of one contractor, engaged in the same business or project of an owner as an injured employee of another contractor, is not an “other party” amenable to suit under this section therefore, although not a statutory employer, a fellow statutory employee is still entitled to such immunity. Evans v. Hook, 239 Va. 127 , 387 S.E.2d 777, 6 Va. Law Rep. 1081, 1990 Va. LEXIS 22 (1990).

    Statutory employer not “other party.” —

    Because statutory employers are not strangers to the employment and work of the owner, they are not “other parties” under the provisions of this section; therefore, even though they are independent contractors and are not the injured employees’ common-law employers, they are under the canopy of the act and entitled to the immediate employers’ statutory immunity from common-law actions provided by former § 65.1-40 (now § 65.2-307 ). Evans v. Hook, 239 Va. 127 , 387 S.E.2d 777, 6 Va. Law Rep. 1081, 1990 Va. LEXIS 22 (1990).

    Persons who function solely as suppliers and deliverers of goods have been held “other parties.” Burroughs v. Walmont, Inc., 210 Va. 98 , 168 S.E.2d 107, 1969 Va. LEXIS 203 (1969).

    Liability of contractor’s supplier. —

    Widow’s wrongful death action against a supplier of building materials was not barred by the workers’ compensation exclusivity provision, as the supplier’s mere delivery and stacking of drywall was not within the trade, business, or occupation of the contractor for whom the widow’s husband was working at the time of his accidental death. Giordano v. McBar Indus., 284 Va. 259 , 729 S.E.2d 130, 2012 Va. LEXIS 138 (2012).

    Subcontractor engaged in essential part of work of principal contractor is not “other party” within the meaning of this section. Rea v. Ford, 198 Va. 712 , 96 S.E.2d 92, 1957 Va. LEXIS 129 (1957).

    The defendant subcontractor was not an “other party,” where its duties required it to design and erect a massive, complex, 14-level scaffolding system, which included an equipment and materials hoist and a stair tower to the roof of the building, where it was required to provide two working deck levels at all times, and where, in fulfilling its contractual obligations, including those imposed by change orders, it performed 16 full deck moves and 13 half deck moves and provided over 5,000 man-hours of labor. Peck v. Safway Steel Prods., Inc., 262 Va. 522 , 551 S.E.2d 328, 2001 Va. LEXIS 88 (2001).

    Subcontractor and subcontractor’s employee were not other parties. Injured employee, working for the general contractor, could sue for personal injuries after he sustained injuries when the subcontractor’s employee backed his vehicle into the vehicle the injured employee was driving, as the subcontractor and subcontractor’s employee were not strangers to the general contractor’s trade, business, or occupation, and thus, the injured employee’s exclusive remedy was to recover benefits under the workers’ compensation law. Anderson v. Dillow, 262 Va. 797 , 553 S.E.2d 526, 2001 Va. LEXIS 121 (2001).

    Trucking subcontractor was a statutory employee of a paving contractor for purposes of the exclusivity provisions of the Virginia Workers’ Compensation Act, § 65.2-100 et seq., where the trucking subcontractor was not merely delivering its own independently manufactured parts, but was hauling asphalt millings to the contractor’s plant and delivering the recycled asphalt from the plant back to the road project to be used in new paving, which were essential parts of the work that the contractor was required to perform under its contract; as a sweeping subcontractor was unquestionably a statutory fellow employee of the contractor, a negligence suit brought by an injured trucking subcontractor’s employee against the sweeping subcontractor and its employee was barred since all parties were statutory fellow employees of the contractor and were not other parties under § 65.2-309 for purposes of the exclusivity provisions of the Act. Clean Sweep Prof'l Parking Lot Maint., Inc. v. Talley, 267 Va. 210 , 591 S.E.2d 79, 2004 Va. LEXIS 17 (2004).

    Suit by contractor’s employee against subcontractor barred. —

    Where the defendant in a suit brought by an injured employee of a general contractor was a subcontractor engaged in an essential part of the work which the general contractor had to do, so that defendant was no stranger to the work in which plaintiff’s employer was engaged, but was, on the contrary, performing an essential part of it, defendant was under the canopy of the Workers’ Compensation Act, and the trial court correctly ruled that the action was barred. Whalen v. Dean Steel Erection Co., 229 Va. 164 , 327 S.E.2d 102, 1985 Va. LEXIS 189 (1985).

    The administratrix of a deceased employee of the principal contractor could not maintain an action at law against a subcontractor, engaged in an essential part of the work of the principal contractor, for death of the employee. Rea v. Ford, 198 Va. 712 , 96 S.E.2d 92, 1957 Va. LEXIS 129 (1957).

    Denial of right to sue subcontractor not unconstitutional. —

    The fact that the Workers’ Compensation Act deprived an employee of a general contractor injured on the job of the right to sue a subcontractor did not deny him due process, equal protection of the laws, or the right of trial by jury. Whalen v. Dean Steel Erection Co., 229 Va. 164 , 327 S.E.2d 102, 1985 Va. LEXIS 189 (1985).

    Subcontractor’s employee cannot maintain action against general contractor. —

    The employee of a subcontractor engaged in the same trade, business or occupation as the general contractor cannot maintain a common-law action against the general contractor for an injury arising out of and in the course of his employment. The general contractor is not an “other party” within the meaning of this section. Sykes v. Stone & Webster Eng’r Corp., 186 Va. 116 , 41 S.E.2d 469 (1947). But see McGann v. Moss, 50 F. Supp. 573 (W.D. Va. 1943). As to liability of general contractor to pay compensation to employee of subcontractor, see former §§ 65.1-29 through 65.1-34 (now §§ 65.2-302 through 65.2-304 ).

    The employee of a subcontractor engaged in the same trade, business or occupation as a general contractor cannot maintain a common-law action against the general contractor for an injury arising out of and in the course of his employment; that is, a general contractor is not an “other party” within the meaning of this section. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    Nor can employee of owner sue contractor engaged in trade, business or occupation of owner. —

    Where a contractor, at the time of the accident, was engaged in work which was a part of the trade, business or occupation of the owner, and both the contractor and the owner were subject to the Workmen’s (now Workers’) Compensation Act, the contractor was not amenable to an action at law brought by the owner’s employee, who was injured, allegedly because of the negligence of the contractor, while engaged in the same work. Williams v. Gresham Co., Inc., 201 Va. 457 , 111 S.E.2d 498, 1959 Va. LEXIS 249 (1959).

    In determining whether an injured employee may maintain an action against an independent contractor under the “stranger to the work” test, the test is not whether the owner, by engaging the independent contractor to perform some part of his business, thereby engages in the business of the independent contractor but whether the independent contractor is performing work that is part of the trade, business or occupation of the owner. If he is, and in doing the work injures an employee of the owner, then the independent contractor, in the same fashion as any other employee of the owner, is not a third party against whom the injured employee’s right of action is preserved; but the employee so injured is limited to the compensation provided by the workers’ compensation law. Fowler v. International Cleaning Serv., Inc., 260 Va. 421 , 537 S.E.2d 312, 2000 Va. LEXIS 136 (2000).

    If contractor is performing trade, business or occupation of owner. —

    The test is not whether the owner, by engaging an independent contractor to perform some part of his business, thereby engages in the business of the independent contractor. It is whether the independent contractor is performing work that is part of the trade, business or occupation of the owner. If he is, and in doing the work injures an employee of the owner, then the independent contractor, in the same fashion as any other employee of the owner, is not a third party against whom the injured employee’s right of action is preserved. Floyd v. Mitchell, 203 Va. 269 , 123 S.E.2d 369, 1962 Va. LEXIS 138 (1962); Bosher v. Jamerson, 207 Va. 539 , 151 S.E.2d 375, 1966 Va. LEXIS 256 (1966).

    Right of employee of one contractor to sue another contractor. —

    Former § 65.1-40 (now § 65.2-307 ) and this section bar common-law actions between fellow statutory employees, while allowing an injured employee of one contractor to proceed in an action at law against another contractor where the two contractors are not engaged in a part of the trade, business, or occupation of the owner. Smith v. Horn, 232 Va. 302 , 351 S.E.2d 14, 3 Va. Law Rep. 1265, 1986 Va. LEXIS 257 (1986).

    Action by employee of one independent contractor against another independent contractor. —

    An independent contractor was not an “other party” within the meaning of this section and subject to an action at law for damages for personal injuries to a second independent contractor’s employee, where both contractors were engaged in the trade, business or occupation of the owner, for neither contractor was a stranger to the employment and the work, and both, as well as the owner, were under the canopy of the Workmen’s (now Workers’) Compensation Act. Anderson v. Thorington Constr. Co., 201 Va. 266 , 110 S.E.2d 396, 1959 Va. LEXIS 221 (1959).

    An employee of the seller of an air compressor, who was injured while supervising the installation of the compressor on the premises of the purchaser, a shipyard, could not maintain a common-law action against either the shipyard or an independent contractor engaged in constructing a foundation for the compressor, since the installation of the compressor, of which the foundation was an integral part, was part of the trade, business or occupation of the shipyard, and thus neither the seller’s employee nor the independent contractor could be considered a “stranger to the business” of the shipyard. McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    Action by employee of subcontractor against independent contractor. —

    An action to recover for death by wrongful act because of injuries received by an employee of a subcontractor against an alleged third party wrongdoer, an independent contractor performing services on the same building project, is limited to a claim under the Virginia Workmen’s (now Workers’) Compensation Act. Beall v. Standard Elec. Co., 404 F.2d 881, 1968 U.S. App. LEXIS 4356 (4th Cir. 1968).

    Defendant held supplier of material, not subcontractor, and “other party” within meaning of this section. Garrett v. Tubular Prods., Inc., 176 F. Supp. 101, 1959 U.S. Dist. LEXIS 2765 (D. Va. 1959).

    Where transporting machinery and parts from one plant to another was an essential element of employer’s business, a motor carrier performing this service under contract with the employer was engaged in employer’s trade, business, or occupation, and was not an “other party” whom an injured employee could sue. Conlin v. Turner's Express, Inc., 229 Va. 557 , 331 S.E.2d 453, 1985 Va. LEXIS 231 (1985).

    Cleaning service not stranger to retailer’s work. —

    An independent contractor’s provision of cleaning and janitorial services to a retail furniture store was a part of the owner’s trade, business or occupation in that the combined efforts of the defendant and owner were designed to accomplish the owner’s goal of making its store clean, attractive, and safe and, by its participation in those efforts, the defendant was performing an essential part of the owner’s business and was not a stranger to the owner’s business who could be sued by one of the owner’s employees. Fowler v. International Cleaning Serv., Inc., 260 Va. 421 , 537 S.E.2d 312, 2000 Va. LEXIS 136 (2000).

    Cleaning service not stranger to work. —

    As appellees’ provision of cleaning and janitorial services was not part of an employer’s business of operating a call center, appellees were strangers to that business and were thus subject to an employee’s action for damages as “other parties” under subsection A of § 65.2-309 . Napper v. ABM Janitorial Servs. - Mid Atl., 284 Va. 55 , 726 S.E.2d 313, 2012 Va. LEXIS 130 (2012).

    Jury question as to status as “other party.” —

    If reasonable men could infer from the facts proved that an allegedly negligent person was employee of the “other party” the question is one for the jury’s determination. Stevens v. Ford Motor Co., 226 Va. 415 , 309 S.E.2d 319, 1983 Va. LEXIS 299 (1983).

    Employer has no duty to preserve property beneficial to employee who seeks to prosecute a civil action against a third party. Austin v. Consolidation Coal Co., 256 Va. 78 , 501 S.E.2d 161, 1998 Va. LEXIS 83 (1998).

    CIRCUIT COURT OPINIONS

    No equitable right to subrogation. —

    Right of subrogation does not depend upon equitable principles; it is purely statutory and arises when the conditions specified in the Virginia subrogation statutes are met. Va. Mun. Group Self-Insurance Ass'n v. Crawford, 66 Va. Cir. 236, 2004 Va. Cir. LEXIS 310 (Fairfax County Nov. 24, 2004).

    Subrogation rights limited to claims against third parties actually causing injury or death. —

    An assignment to the employer of any right to recover damages that the injured employee may have had “against any other party for such injury or death” is allowed. Va. Mun. Group Self-Insurance Ass'n v. Crawford, 66 Va. Cir. 236, 2004 Va. Cir. LEXIS 310 (Fairfax County Nov. 24, 2004).

    No right of subrogation against legal malpractice suit proceeds. —

    Claimant settled a malpractice suit against his attorney, who failed to timely sue a tortfeasor for causing the injury that led to the claimant’s workers’ compensation award; neither §§ 65.2-309 and 65.2-310 , nor principles of unjust enrichment, entitled the carrier to subrogation from the settlement proceeds. Va. Mun. Group Self-Insurance Ass'n v. Crawford, 66 Va. Cir. 236, 2004 Va. Cir. LEXIS 310 (Fairfax County Nov. 24, 2004).

    Employer and its workers’ compensation insurer were not entitled to a lien against the verdict that an employee obtained in a medical malpractice suit against a doctor because the employer and insurer were compelled to provide workers’ compensation benefits as a result of the on-the-job accident and not as a result of the doctor’s medical negligence; the employer was required to provide compensation benefits to the employee or on his behalf, but the award orders of the Workers’ Compensation Commission conclusively established that those benefits were for the employee’s broken leg, not for damages caused by a third party. Thompson v. Alhadeff, 2011 Va. Cir. LEXIS 137 (Roanoke Oct. 11, 2011).

    Assignment to employer of injured employee’s right to recover damages. —

    Pursuant to this section, an injured worker’s claim against his employer, which the employer paid through its insurer, operated as an assignment to the employer of any right to recover damages which the injured employee may have had against any other party. Guardian Realty Mgmt., Inc. v. Otis Elevator Co., 2006 Va. Cir. LEXIS 40 (Fairfax County Jan. 5, 2006).

    Separation of powers. —

    If further rights are to be accorded employers and their workers’ compensation carriers under the workers’ compensation subrogation statutes, it is solely within the purview of the legislative branch of government to grant such additional rights; a court cannot create such rights through judicial fiat. Va. Mun. Group Self-Insurance Ass'n v. Crawford, 66 Va. Cir. 236, 2004 Va. Cir. LEXIS 310 (Fairfax County Nov. 24, 2004).

    Intervention not allowed. —

    Because a workers’ compensation carrier sought to join an injured employee in asserting a single claim against the defendants, and because the carrier was subjected to the employee’s rights under § 65.2-309 , intervention was prohibited by Va. Sup. Ct. R. 3:14. Lusk v. Huynh, 72 Va. Cir. 142, 2006 Va. Cir. LEXIS 199 (Fairfax County Oct. 10, 2006).

    Claim not barred. —

    Truck driver’s action to recover damages for injuries he sustained while unfolding a tarp was not barred because pursuant to the Normal Work Test, a company could not be designated as a statutory employer for purposes of the exclusivity provision of the Virginia Workers’ Compensation Act since tarping was not an activity in its normal course of business carried on by its employees; there was no evidence the company’s employees held a responsibility to assist contracted drivers in tarping loads. Pack v. Georgia-Pacific LLC, 95 Va. Cir. 351, 2017 Va. Cir. LEXIS 74 (Roanoke Apr. 6, 2017).

    Claim barred. —

    Where a subcontractor was, at the time of the injury, a statutory employee, he was barred from pursuing a common law claim by application of the Virginia Code. Ferreira v. Boeing Serv. Co., 60 Va. Cir. 237, 2002 Va. Cir. LEXIS 279 (Fairfax County Oct. 17, 2002).

    Injured party’s cause of action against defendants, a garbage company and individuals, was barred under the exclusivity provision of the Virginia Workers’ Compensation Act, § 65.2-307 ; the city which employed the injured party was authorized by state and local statutes to provide garbage collection and disposal, to provide and operate waste management facilities, and to contract with other entities to provide these services, and defendants were statutory employees of the city, as they performed an essential part of the city’s garbage collection business, and were therefore not “other parties” pursuant to § 65.2-309 . Hanner v. Clark, 60 Va. Cir. 485, 2001 Va. Cir. LEXIS 510 (Richmond Nov. 8, 2001).

    Accident victim’s claim against a contracting elevator company that maintained city elevators was barred by the exclusive remedy provision, § 65.2-307 , of the Virginia Workers’ Compensation Act, § 65.2-100 et seq., as: (1) the victim was a statutory employee of the city; (2) the mandate of the city included the improvement, repair, and maintenance of public buildings; (3) the work delegated by the city to the elevator contracting company, and performed by its employees, was part of the trade, business, or occupation of the city; and (4) the elevator contracting company was not an “other party” against whom the victim could maintain a suit in tort, under § 65.2-309 . Brooks v. Blueridge Gen., Inc., 67 Va. Cir. 274, 2005 Va. Cir. LEXIS 46 (Portsmouth May 9, 2005).

    Injured employee for a subcontractor on a construction project was barred from bringing suit against the general contractor and two other subcontractors for the construction project because the employee was performing work for the employee’s employer, a subcontractor, that was part of the work the general contractor was to perform for the owner of the project and the two subcontractors were likewise performing work that was part of the work the general contractor was to perform for the owner of the project. Aguilar v. Diaz, 88 Va. Cir. 44, 2014 Va. Cir. LEXIS 6 (Loudoun County Feb. 10, 2014).

    Stranger to employment. —

    Injured party was employed by a security firm to assist in controlling the crowd at an auto race when the injured party was hit by a piece of debris that fell from a hydraulic lift operated by a broadcasting company. The injured party was a statutory employee of racetrack by means of the subcontracted fraction exception, and therefore workers’ compensation was the exclusive remedy as to the racetrack. There was no evidence that the racing league that sponsored the event was in the business of broadcasting, and because the broadcasting company was a stranger to the work of the racing league and not engaged in the racing league’s trade, business, or occupation, the broadcasting company was not a statutory employee of the racing league under the Virginia Workers’ Compensation Act, nor a fellow statutory employee with the injured party, and therefore those defendants were “other parties” as defined by § 65.2-309 and were subject to suit. Lincoln v. Int'l Speedway Corp., 59 Va. Cir. 133, 2002 Va. Cir. LEXIS 333 (Richmond May 29, 2002).

    Exclusive remedy provisions of the Virginia Workers’ Compensation Act did not prevent, plaintiff, subcontractor 1’s employee, from suing defendant subcontractor 2 under subsection A of § 65.2-309 for injuries plaintiff received on the job site while painting a coal loader, because plaintiff was a stranger to the owner’s work and not a statutory employee of the owner for purposes of subsection A of § 65.2-302 . Applying the normal work test, the court held that the highly specialized and infrequently performed painting project was not a part of the owner’s trade, business, or occupation. Masterson v. Am. Heavy Indus., 84 Va. Cir. 432, 2012 Va. Cir. LEXIS 126 (Norfolk Apr. 12, 2012).

    Exclusivity provision of the Virginia Workers’ Compensation Act found in § 65.2-307 , barred a retail store employee’s claim against an independent contractor and a subcontractor who contracted to remove snow and ice from the premises of the retail store because they were not strangers to the work and as such were not the other parties contemplated by § 65.2-309 . Young v. Pleasant View Lawn & Home Care, Inc., 88 Va. Cir. 28, 2013 Va. Cir. LEXIS 141 (Waynesboro Nov. 6, 2013).

    Other party. —

    Because contractors did not have an employer in common with the decedent, they were not statutory co-employees, and none of the self-described statutory co-employees were employed by the decedent’s actual employer; thus, the contractors were “other parties,” and the exclusivity provision of the Virginia Workers’ Compensation Act did not apply to the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Whether employees from two separate contractors or subcontractors can sue each other depends on whether they have a common statutory employer; to avoid being an “other party,” you need to be the employee’s actual employer, statutory employer, or a person employed by either the decedent’s actual employer or statutory employer. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Holding company was not the decedent’s statutory employer because it manufactured and sold tissue paper, and converting a copy paper plant into a tissue paper plant was an essential preliminary step to allow the holding company to manufacture and sell tissue paper, but the business of the decedent’s employer was manufacturing, not converting plants; thus, the holding company was an “other party,” and the exclusivity provision did not apply in the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Application:

    Widow and dependents of deceased worker filed suit in North Carolina to eliminate employer’s lien against any settlement or judgment obtained in a third-party action. North Carolina court ordered employer to continue paying workers’ compensation death benefits, an appeal of which order is pending in North Carolina. Employer filed an application with the Commission to terminate payment of death benefits. Commission reversed deputy commissioner’s suspension of death benefits finding that claimants had not impaired employer’s subrogation rights or lien where case is pending and there is no final order. Employer’s laches in failing to prosecute third-party action in Virginia bars equitable remedy. Wilkerson v. Boston Concrete Prods., VWC File No. 192-10-10 (Dec. 17, 2004), aff’d, No. 0164-05-3 (Ct. App. Va., May 10, 2005).

    If the employee makes a claim for workers’ compensation benefits, the claim operates as an assignment to the employer of any right to recover damages in his own name or in the name of the injured employee. Thus, making a claim for workers’ compensation benefits works as an assignment of the employee’s right to recover damages from the tort-feasor. Burrell v. Atlantic Coast Express, 78 O.W.C. 120 (1999).

    Section 65.2-310 governs the means by which the employer’s subrogation interest is protected in the event the claimant files suit against a negligent third party. While not explicitly stated, it is obvious that the section is meant to be read in conjunction with § 65.2-309 , which statutes are conjointly designed to protect the subrogation rights of the employer. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    Section 65.2-309 of the Code gives to the employer a right of subrogation to recover claims for damages that the injured employee may have against any third party causing the injury. The purpose of the section is to reimburse an employer for the negligence of a third party and to prevent an employee from obtaining a double recovery. Artrip v. Kerns Bakeries, Inc., 75 O.W.C. 207 (1996), aff’d, No. 1370-96-3 (Va. Ct. App. Dec. 10, 1996).

    This section is applicable where the third party tort feasor causes the original compensable injury or a later aggravation of the work injury. Artrip v. Kerns Bakeries, Inc., 75 O.W.C. 207 (1996), aff’d, No. 1370-96-3 (Va. Ct. App. Dec. 10, 1996).

    The subrogation right given to the employer against “such other party” is exclusively against those persons who are strangers to the employment, and does not include those who have accepted the Act, such as co-employees. Bosher v. Jamerson, 207 Va. 539 , 151 S.E.2d 375, 1966 Va. LEXIS 256 (1966); Lucas v. Biller, 204 Va. 309 , 130 S.E.2d 582, 1963 Va. LEXIS 149 (1963); Ferrell v. Beddow, 203 Va. 472 , 125 S.E.2d 196, 1962 Va. LEXIS 170 (1962); Floyd v. Mitchell, 203 Va. 269 , 123 S.E.2d 369, 1962 Va. LEXIS 138 (1962); Williams v. Gresham Co., Inc., 201 Va. 457 , 111 S.E.2d 498, 1959 Va. LEXIS 249 (1959).

    Another subcontractor was an “other party” and tort action not barred. Hipp v. Sadler Materials Corp., 211 Va. 710 , 180 S.E.2d 501, 1971 Va. LEXIS 247 (1971).

    This section and § 65.1-112 (now § 65.2-812 ) create a statutory right in favor of employer and employer’s insurer who have paid or are paying pursuant to an award compensation benefits to workman or his dependents. Shook Co. v. Barksdale, 206 Va. 45 , 141 S.E.2d 738, 1965 Va. LEXIS 167 (1965).

    Liability of third party tort-feasor is determined under the common law, not the Workmen’s Compensation Act. United States Fid. & Guar. Co. v. Blue Diamond Coal Co., 161 Va. 373 , 170 S.E. 728 , 1933 Va. LEXIS 327 (1933).

    Right of Employer to Claim Offset:

    The language of § 65.2-313 refers to “total third-party recovery” and “gross recovery” to indicate that calculation of the offset amount is based upon the total amount of subrogation recovery under § 65.2-309 or § 65.2-310 . There is no indication or basis in the statute to conclude that § 65.2-313 provides the employer with a right to claim an offset for the claimant’s recovery of funds upon which the employer had no right to claim a subrogation interest at the outset. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    Jurisdiction:

    This section does not create in the employer or his compensation insurer any right to sue other than that of employee at time of injury. Allen v. Allen, Inc., 36 O.I.C. 333 (1954).

    The employer is not subrogated to employee’s rights under private insurance policy of hospitalization. Morehead v. Myers Contracting Co., 49 O.I.C. 235 (1967).

    After a final determination has been made that the amount of a third-party recovery satisfies the employer’s obligation to the employee, no further action for the purpose of establishing or terminating benefits is within the jurisdiction of the Commission. Betts v. Great Coastal Express, 64 O.I.C. 48 (1985).

    The Commission does not have jurisdiction to adjudicate the priority of liens or compel disbursement of the proceeds of the recovery from a third-party action. Besley v. Chesterfield County Fire Dept., 69 O.I.C. 259 (1990).

    Effect of Third Party Settlement:

    Employer’s application properly rejected where claimant released two of several defendants from a civil third party action without the employer/insurer’s consent but had not yet settled the entire civil case. The employer/insurer’s claim of impaired subrogation rights was premature. May v. Progress Press, Inc., JCN 2339489 (Aug. 14, 2012).

    Defendants entitled to breakdown of disbursements of third party settlement funds to allow calculation of their responsibilities under Act. Benson v. Abbit Mgmt., Inc., VWC File No. 192-08-58 (Aug. 2, 2006).

    Commission did not have authority to compel claimant to agree to employer’s settlement of third-party action, but employer seeking approval of settlement permitted to present evidence showing claimant gave implied consent to settlement or unreasonably withheld approval. If so found, Commission may determine whether approval of settlement was appropriate. Anderson v. County of Washington School Bd., VWC File No. 201-94-28 (Oct. 29, 2004).

    Employer bears the burden of proving that claimant impaired its subrogation rights by settling a third-party claim without its consent. Oliver v. Honeywell Int’l, Inc., VWC File No. 215-24-79 (Oct. 29, 2004).

    Employer allowed to conduct discovery despite employee’s request that claim be considered “inactive” while third-party lawsuit pursued; evidence showed that third-party lawsuit ripe for settlement and employer requested discovery to assist in decision on approval thereof. Viar v. Raytheon Constructors, Inc., VWC File No. 189-75-51 (Apr. 4, 2003).

    If the employer’s statutory right of subrogation is impaired by the act of the employee, the employee’s right to compensation is thereby barred. An employee may not pursue his common law remedy in such a manner or settle his claim to the prejudice of the employer’s subrogation right and thereafter continue to receive workers’ compensation benefits. Burrell v. Atlantic Coast Express, 78 O.W.C. 120 (1999).

    When an employer is not notified, nor its consent requested, the settlement is deemed to be without its approval. When an employer’s right to subrogation is defeated by an employee’s settlement with a third party without the knowledge or consent of the employer, the employee’s benefits under the Workers’ Compensation Act are terminated. Burrell v. Atlantic Coast Express, 78 O.W.C. 120 (1999).

    Compensation benefits were terminated to an employee who settled a third-party suit without the consent or knowledge of the employer or insurer. It is irrelevant that the employee did not receive any of the proceeds of the settlement or that the employer filed no pleading in the third-party tort action. Ball v. C.D.W. Enterprises, Inc., 13 Va. App. 470, 413 S.E.2d 66 (1992); 70 O.I.C. 261 (1991) [same case].

    The employee necessarily prejudices his employer’s subrogation rights and, thus, is barred from obtaining or continuing to receive benefits under a workers’ compensation award when an employee settles a third-party tort claim without notice, or without making a claim for workers’ compensation benefits, or without obtaining the consent of the employer. Burrell v. Atlantic Coast Express, 78 O.W.C. 120 (1999).

    Claimant settled a third party suit after his injury was denied by carrier. He subsequently filed a claim for workers’ compensation benefits but was barred by § 65.2-309 from receiving benefits. An employer’s rights relate back and are same as rights of employee at time of injury. Miller v. Hall Auto Hall, 73 O.W.C. 219 (1994).

    The claimant settled his case against all potential third parties without the carrier’s knowledge or consent. The Commission held that the settlement prejudiced the carrier’s subrogation rights, finding that the bankruptcy of one of the five defendants and the fact that the full amount of insurance was allotted in the settlement was immaterial, because the other defendants were not adjudged bankrupt and the employer’s right of subrogation is not limited to a tort-feasor’s insurance policy. The Commission noted that creditors have rights even after a bankruptcy discharge, and settlement of the third party claim without the employer’s knowledge and consent deprived the employer of the right to participate in the post-bankruptcy proceedings. Also, the employer’s subrogation rights against non-bankrupt tort-feasors were impaired by the unauthorized settlement. Burrell v. Atlantic Coast Express, 78 O.W.C. 120 (1999).

    If the right of subrogation is prejudiced by an employee’s release of a third party without the knowledge and consent of the employer, the employee’s benefits under the Act are terminated. The employer’s right of subrogation is prejudiced if it is denied the opportunity to obtain full reimbursement for benefits it is obliged to pay for the injury. This section is not applicable where exacerbation caused by a subsequent accident is so minor that the settlement does not prejudice the employer. Artrip v. Kerns Bakeries, Inc., 75 O.W.C. 207 (1996), aff’d, No. 1370-96-3 (Va. Ct. App. Dec. 10, 1996).

    Where the Commission finds that an employee’s second non-work related automobile accident did not prolong an employee’s recovery from a compensable workers’ compensation injury, the employee’s settlement of the claim against the negligent third-party without the knowledge or consent of the employer/carrier does not preclude continuation of compensation benefits. An employer can only assert a lien against the third-party for any medical benefits it paid related to the non-compensable accident. City of Newport News v. Blankenship, 10 Va. App. 704, 396 S.E.2d 145, 7 Va. Law Rep. 231, 1990 Va. App. LEXIS 149 (1990).

    Asserting Lien:

    If an employee elects to pursue a claim against a third party with proper notice to the employer, the employer is not required to file a motion with the Court in order to assert its lien but may rely on claimant’s counsel to recognize the lien and pay the amount owed out of the judgment. Barbour v. Residential Electric, Inc., 68 O.I.C. 242 (1989).

    An employer/carrier is not required to file a Petition or Motion prior to the verdict in a third-party action in order to protect its compensation lien. Section 65.1-41 (now § 65.2-309 ), automatically provides the employer/carrier with a priority lien. Ball v. CDW Enterprises, Inc., 70 O.I.C. 261 (1991) (see also Ball v. C.D.W. Enterprises, Inc., 13 Va. App. 470, 413 S.E.2d 66, 8 Va. Law Rep. 1656, 1992 Va. App. LEXIS 5 (1992).

    Amount of Lien:

    Note: See entries under § 65.2-313 .

    In reversing the Court of Appeals, the Supreme Court set forth the method to be employed in calculating the amount of indemnity and the structure of the order suspending benefits when there has been a third party settlement. Henrico County School Board v. Bohle, 246 Va. 30 , 431 S.E.2d 924 (1993) (reversing 14 Va. App. 801, 421 S.E.2d 8 (1992)).

    The employer’s subrogation rights to a structured settlement with payments to be made to the claimant over time is equivalent to the present value of the settlement, i.e. , the cost of an annuity that would guarantee payment of the full amount in the manner negotiated by the parties to the third party litigation. Kern v. Logistics Express, Inc., 74 O.W.C. 106 (1995).

    A carrier’s expenses for a medical examination under § 65.1-91 (now § 65.2-607 ) is not a proper item to be included in the subrogation recovery where the employee had made a third party settlement. Lockwood v. Automatic Control of Tidewater, 63 O.I.C. 219 (1984).

    In determining a carrier’s lien in a third-party settlement the cost of job searches, medical management, coordination and appointment arrangements between prospective employers and injured workers by a private rehabilitation group may not be included or reimbursed to the carrier. Washington v. Miller & Rhoads, 68 O.I.C. 250 (1989).

    In this case, the civil trial judge awarded the claimant $500,000, but only $150,000 was recovered - $25,000 from the tortfeasor’s carrier, and $125,000 from the uninsured motorists policies of the claimant and his parent. Therefore, the judge awarded employer’s carrier the sum of $16,609.92, allowing for attorney’s fees and costs. The Commission held that the only amount recovered from “any other party”, as contemplated by § 65.2-309 , was the $25,000.00 recovered from the tortfeasor’s liability carrier, and the employer could not recover any further set off against the amounts recovered from the uninsured motorists coverage of the claimant (and his parents). Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    Uninsured Motorists Coverage:

    Note: See also Code § 65.2-309.1 which creates lien and subrogation rights in employer who provided and paid for uninsured or underinsured motorist insurance policy and establishes priority if employee entitled to coverage under more than one underinsured motorist policy.

    On July 1, 1995 § 38.2-2206 became effective allowing a set off between uninsured coverage and compensation benefits in certain circumstances.

    Uninsured Motorists Coverage is additional coverage of which the employer’s workers’ compensation insurance carrier cannot become a third-party contract beneficiary upon recovery of the proceeds. However, the carrier may assert a subrogation lien against any other third-party recovery for the amount actually paid to the employee under the Workers’ Compensation Act. Fishel v. Sears, Roebuck and Co., 65 O.I.C. 338 (1986).

    By its express language, § 65.2-313 requires first that a recovery be effected against a third-party by the claimant or his personal representative pursuant to § 65.2-310 , or by the employer’s action for subrogation under § 65.2-309 . Section 65.2-309 governs the employer’s right to claim subrogation, and the procedure for collecting directly from a responsible third party tortfeasor. Pursuant to legislation passed in 1994, the General Assembly provided employers with a limited right to claim a subrogation interest in the proceeds of an uninsured motorist policy, i.e., the right to claim a subrogation interest in recoveries from uninsured or underinsured motorist policies carried by or at the expense of the employer. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    The employer is not subrogated under uninsured motorist provision of claimant’s liability policy. Graves v. Impulse Elec. Co., Inc., 59 O.I.C. 159, 162 (1980).

    Claim under uninsured motorist provisions is irrelevant to deciding workers’ compensation claim. Garner v. Petroleum Transit Corp. of Va., 49 O.I.C. 121 (1967).

    The employer/carrier has no subrogation rights against an employee’s recovery under her own uninsured motorists coverage where the motor vehicle accident was caused by an uninsured, stranger to the employment. Bailey v. Charles City County/Dept. of Public Works, 70 O.I.C. 264 (1991).

    Section 65.2-313 expressly requires that a recovery first be effected pursuant to either § 65.2-309 or § 65.2-310 . Therefore, § 65.2-313 is predicated on a recovery under the provisions, and limitations, of those sections. Accordingly, the “recovery” and potential set off that would be subject to subrogation by the employer is that amount paid by the tortfeasor and the tortfeasor’s liability carrier, i.e., the “other party” for purposes of § 65.2-309 , but not funds recovered by the employee through a claim against the private uninsured motorist coverage carried by the employee (or his parents). Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    The Virginia Supreme Court has instructed that the uninsured motorist law does not provide coverage for the uninsured vehicle or the uninsured motorist, but its object is to afford the insured additional compensation protection for the claimant. The claimant’s employer does not become a third party beneficiary under the private insurance contract, which the claimant (or his parents) chose to provide, at their own expense. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    Second Accident:

    If a claimant suffers a non-work related accident while still incapacitated from an industrial accident and the second accident does not prolong his recovery, the employer may not assert a lien against the third party for compensation benefits but may be entitled to reimbursement for medical expenses incurred as the result of the intervening accident. Crews v. Professional Janitorial Service, 65 O.I.C. 334 (1986).

    Where the commission finds that an employee’s second non-work related automobile accident did not prolong an employee’s recovery from a compensable workers’ compensation injury, the employee’s settlement of the claim against the negligent third-party without the knowledge or consent of the employer/carrier does not preclude continuation of compensation benefits. An employer can only assert a lien against the third-party for any medical benefits it paid related to the non-compensable accident. City of Newport News v. Blankenship, 10 Va. App. 704, 396 S.E.2d 145, 7 Va. Law Rep. 231, 1990 Va. App. LEXIS 149 (1990).

    Attorney Fee/Expenses:

    See notes to § 65.2-311 for cases on attorney’s fees and expenses.

    § 65.2-309.1. Creation of lien and subrogation of employer to employee’s rights to recover uninsured or underinsured motorist benefits pursuant to insurance coverage carried by and at the expense of employer.

    1. A claim against an employer under this title for injury or death benefits shall create a lien and right of subrogation on behalf of the employer, as set forth in § 65.2-309 , against proceeds recovered by the injured employee pursuant to the uninsured or underinsured motorist provisions of a policy of motor vehicle insurance carried by and at the expense of the employer. In any action by an employee against any person other than the employer, the court shall, after reasonable notice to the parties and the employer, ascertain the amount of compensation paid and expenses for medical, surgical and hospital attention and supplies, and funeral expenses incurred by the employer under the provisions of this title and deduct therefrom a proportionate share of such amounts as are paid by the plaintiff for reasonable expenses and attorney’s fees as provided in § 65.2-311 ; and, in the event of judgment against such person other than the employer, the court shall, in its order, require that the judgment debtor pay such compensation and expenses of the employer, less said share of expenses and attorney’s fees, so ascertained by the court out of the amount of the judgment, so far as sufficient, and the balance, if any, to the judgment creditor.
    2. If an injured employee is entitled to underinsured motorist coverage under more than one policy, the order of priority shall be as provided by subsection B of § 38.2-2206 .

    History. 1995, c. 267; 2004, cc. 914, 941.

    The 2004 amendments.

    The 2004 amendments by cc. 914 and 941 are identical, and in subsection A, inserted “as set forth in § 65.2-309 ” and substituted “after reasonable notice to the parties and the employer” for “on petition or motion of the employer at any time prior to verdict.”

    CASE NOTES

    This section and § 65.2-1204 distinguished. —

    While this section expressly grants the employer the right of subrogation against proceeds recovered by the injured employee under the uninsured motorist coverage of a policy of insurance provided and paid for by the employer, § 65.2-1204 , which defines the fund’s right of subrogation, makes no reference to claims arising from uninsured motorist coverage. Jeneary v. Commonwealth, 262 Va. 418 , 551 S.E.2d 321, 2001 Va. LEXIS 106 (2001).

    Applicability of section to rights under § 65.2-1204 . —

    The language of this section neither expressly nor by implication places the fund in the same position as an employer; rather, when the fund is ordered to pay compensation benefits, its right of subrogation extends to claims the employee may have against “the employer or any other party.” Accordingly, this section is inapplicable to the fund’s subrogation rights under § 65.2-1204 . Jeneary v. Commonwealth, 262 Va. 418 , 551 S.E.2d 321, 2001 Va. LEXIS 106 (2001).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Employer was entitled to credit under § 65.2-309.1 against future benefits to be paid to employee, who had received third-party recovery under an uninsured motorists insurance policy; although §§ 65.2-311 & 65.2-313 did not mention § 65.2-309.1 , employer’s right to credit derived from § 65.2-309.1 and not § 65.2-311 or 65.2-313 . Pickel v. Department of State Police, VWC File No. 201-47-97 (Aug. 12, 2003).

    § 65.2-310. Protection of employer when employee sues third party.

    In any action by an employee, his personal representative or other person against any person other than the employer, the court shall, after reasonable notice to the parties and the employer, ascertain the amount of compensation paid and expenses for medical, surgical and hospital attention and supplies, and funeral expenses incurred by the employer under the provisions of this title and deduct therefrom a proportionate share of such amounts as are paid by the plaintiff for reasonable expenses and attorney’s fees as provided in § 65.2-311 ; and, in event of judgment against such person other than the employer, the court shall in its order require that the judgment debtor pay such compensation and expenses of the employer, less said share of expenses and attorney’s fees, so ascertained by the court out of the amount of the judgment, so far as sufficient, and the balance, if any, to the judgment creditor.

    History. Code 1950, § 65-39; 1956, c. 534; 1960, c. 89; 1968, c. 660, § 65.1-42; 1991, c. 305; 2004, cc. 914, 941.

    The 2004 amendments.

    The 2004 amendments by cc. 914 and 941 are identical, and substituted “after reasonable notice to the parties and the employer” for “on petition or motion of the employer at any time prior to verdict.”

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For article, “Effect of Virginia Workmen’s (now Workers’) Compensation Act Upon the Right of a Third-Party Tortfeasor to Obtain Contribution From an Employer Whose Concurrent Negligence Causes Employee’s Death or Injury,” see 13 U. Rich. L. Rev. 117 (1978).

    For comment, “Workers’ Compensation Third Party Actions and Subrogation: Should Virginia Recognize Workers’ Settlements Comprising Only Pain and Suffering Damages?,” see 6 G.M.U. L. Rev. 273 (1983).

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    Michie’s Jurisprudence.

    For related discussion, see 5A M.J. Costs, § 3; 6A M.J. Divorce and Alimony, §§ 35, 59, 72.2, 78; 14A M.J. Parent and Child, § 17.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under prior law.

    Section contemplates action by employee against third party. —

    This section clearly contemplates that the injured employee, after accepting certain benefits from the employer under the Workmen’s (now Workers’) Compensation Act, may institute an action against a negligent third party. However, in such an action, it permits or authorizes the employer, who has paid the stated benefits, to join in the action for the purpose of recovering the amount he has already paid to his employee or his beneficiary for injuries resulting from the same accident. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    Full recovery against the tort-feasor is permitted. Haw v. Liberty Mut. Ins. Co., 180 F.2d 18, 85 U.S. App. D.C. 86, 86 U.S. App. D.C. 86, 1950 U.S. App. LEXIS 2359 (D.C. Cir. 1950).

    And determination of compensation benefits paid is mandatory only if requested. —

    While determination of compensation benefits paid is still provided for, it apparently is mandatory only when requested by the person who paid the compensation, being designed for his benefit. Haw v. Liberty Mut. Ins. Co., 180 F.2d 18, 85 U.S. App. D.C. 86, 86 U.S. App. D.C. 86, 1950 U.S. App. LEXIS 2359 (D.C. Cir. 1950).

    But it is mandatory to require the judgment debtor to pay medical expenses out of the judgment. Barnhart v. AMOCO, 237 F. Supp. 492, 1965 U.S. Dist. LEXIS 9737 (E.D. Va. 1965), aff'd, 354 F.2d 659, 1966 U.S. App. LEXIS 7570 (4th Cir. 1966).

    Section does not affect insurance clause excluding coverage of employer’s statutory liability. —

    Reimbursement of the employer under this section did not affect the applicability of a clause in a group medical expense insurance policy which excluded coverage of “expense occasioned by injury . . . to the extent it is the statutory liability of the employer.” The exclusionary clause was effective notwithstanding the reimbursement of workmen’s (now workers’) compensation payments. Cash v. American Health Ins. Corp., 203 Va. 719 , 127 S.E.2d 119, 1962 Va. LEXIS 211 (1962).

    Express contract of indemnity would not be invalidated by the Virginia Workmen’s (now Workers’) Compensation Act. Burnette v. GE Co., 389 F. Supp. 1317, 1975 U.S. Dist. LEXIS 13862 (W.D. Va. 1975).

    Employer entitled to reimbursement and release from future liability. —

    If an employee sues the person responsible for his injury, the employer is entitled to be reimbursed for compensation already paid and to be discharged from liability for future payments to the extent that the judgment against the wrongdoer is sufficient to satisfy the compensation award. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Balance of the award may be retained by the employee. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Modifications of this section and former § 65.1-41 (now § 65.2-309 ) by the 1960 amendment are procedural. They are designed to ensure that the attorneys’ fees shall be apportioned in accordance with the substantive changes made in former § 65.1-43 (now § 65.2-311 ) when the proceeds of the judgment against the wrongdoer are disbursed. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    This section simply authorizes a deduction of a proportionate share of the fee from the reimbursement payable to the employer as provided in former § 65.1-43 (now § 65.2-311 ). Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    The plain language of former §§ 65.1-42 and 65.1-43 does not direct the trial court to apportion attorney’s fees based only on the amount actually paid by the employer at the time of apportionment. Circuit City Stores, Inc. v. Bower, 243 Va. 183 , 413 S.E.2d 55, 8 Va. Law Rep. 1891, 1992 Va. LEXIS 151 (1992).

    Thus, this section is not a limitation on former § 65.1-43 (see now § 65.2-300 ). It does not deal expressly or by implication with the employer’s obligation for attorneys’ fees arising out of the release of future payments that would have been due under the compensation award were it not for the employee’s successful suit. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Scope of employer’s right of recovery. —

    The language of §§ 65.2-309 and 65.2-310 does not restrict an employer’s right to obtain reimbursement of benefits paid to the amount that an individual beneficiary has recovered in a third-party action. In the absence of statutory language to that effect, there is no basis for placing such limits on an employer’s right of recovery under the statutory lien created by § 65.2-309 . Liberty Mut. Ins. Co. v. Fisher, 263 Va. 78 , 557 S.E.2d 209, 2002 Va. LEXIS 15 (2002) (overruling ACB Trucking, Inc. v. Griffin, 5 Va. App. 542, 365 S.E.2d 334 (1988), to the extent that its holding is inconsistent).

    Despite the fact that an employer’s petition seeking subrogation was filed prior to a verdict in the employee’s third party lawsuit against the tortfeasor, at the time the employer filed its petition to enforce its right of subrogation, the employee had already entered into a compromise settlement of his claims in exchange for a complete and absolute release of third party from any liability on those claims; thus, the employer no longer had a viable right to subrogation. Yellow Freight Sys., Inc. v. Courtaulds Performance Films, Inc., 266 Va. 57 , 580 S.E.2d 812, 2003 Va. LEXIS 62 (2003).

    Virginia Workers’ Compensation Commission properly held that an employer was entitled to pay 30 percent towards a workers’ compensation claimant’s future entitlements until it recovered the claimant’s total settlement with a third party, even though the employer had not perfected its subrogation lien prior to the settlement with the third party, as the compensation and medical benefits for which the employer sought a credit had not yet accrued when the claimant received the distribution and they were not within the definition of “employer’s compensation lien,” but were “further entitlements.” Suggs v. Suggs Carpet Installation, 2006 Va. App. LEXIS 115 (Va. Ct. App. Mar. 28, 2006).

    An employer may safeguard a statutory claim for benefits paid or anticipated under the workers’ compensation act by petitioning the court for a lien against the third-party judgment in the amount of the compensation and other benefits the employer has paid. Henry's Wrecker Serv. Co. v. Smoot, 35 Va. App. 365, 545 S.E.2d 551, 2001 Va. App. LEXIS 225 (2001).

    Trial court erred in barring an employer from recovering, under a workers’ compensation lien, as part of settlement of third-party wrongful death action, benefits paid to persons who did not participate in the settlement of the wrongful death action. Liberty Mut. Ins. Co. v. Fisher, 263 Va. 78 , 557 S.E.2d 209, 2002 Va. LEXIS 15 (2002).

    CIRCUIT COURT OPINIONS

    No right of subrogation against legal malpractice suit proceeds. —

    Claimant settled a malpractice suit against his attorney, who failed to timely sue a tortfeasor for causing the injury that led to the claimant’s workers’ compensation award; neither §§ 65.2-309 and 65.2-310 , nor principles of unjust enrichment entitled the carrier to subrogation from the settlement proceeds. Va. Mun. Group Self-Insurance Ass'n v. Crawford, 66 Va. Cir. 236, 2004 Va. Cir. LEXIS 310 (Fairfax County Nov. 24, 2004).

    Section 65.2-309 allows for an assignment to the employer of any right to recover damages which the injured employee may have had “against any other party for such injury or death”; it does not provide a right of recovery from any other source. Va. Mun. Group Self-Insurance Ass'n v. Crawford, 66 Va. Cir. 236, 2004 Va. Cir. LEXIS 310 (Fairfax County Nov. 24, 2004).

    No equitable right to subrogation. —

    Right of subrogation does not depend upon equitable principles; it is purely statutory and arises when the conditions specified in the Virginia subrogation statutes are met. Va. Mun. Group Self-Insurance Ass'n v. Crawford, 66 Va. Cir. 236, 2004 Va. Cir. LEXIS 310 (Fairfax County Nov. 24, 2004).

    Separation of powers. —

    If further rights are to be accorded employers and their workers’ compensation carriers under the workers’ compensation subrogation statutes it is solely within the purview of the legislative branch of government to grant such additional rights; a court cannot create such rights through judicial fiat. Va. Mun. Group Self-Insurance Ass'n v. Crawford, 66 Va. Cir. 236, 2004 Va. Cir. LEXIS 310 (Fairfax County Nov. 24, 2004).

    Workers’ compensation carrier’s failure to file a motion or petition under this section did not deprive it of the right to a portion of the proceeds of a tort judgment obtained by a worker against a third-party tortfeasor. Sellers v. Lucas, 54 Va. Cir. 181, 2000 Va. Cir. LEXIS 569 (Roanoke Nov. 28, 2000).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The Commission does not have jurisdiction to compel disbursements of proceeds of recovery from a third party action. This question must be addressed to a court of law in the forum in which the third party case arose. The claimant’s settlement of his third party claim without the consent of the employer extinguishes the workers’ compensation claim, but it does not confer on the Commission the authority to enter a judgment against the claimant. Sicilia v. Inner View, Ltd., 78 O.W.C. 274 (1999).

    Section 65.2-310 governs the means by which the employer’s subrogation interest is protected in the event the claimant files suit against a negligent third party. While not explicitly stated, it is obvious that the section is meant to be read in conjunction with § 65.2-309 , which statutes are conjointly designed to protect the subrogation rights of the employer. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    Section 65.2-313 expressly requires that a recovery first be effected pursuant to either § 65.2-309 or § 65.2-310 . Therefore, § 65.2-313 is predicated on a recovery under the provisions, and limitations, of those sections. Accordingly, the “recovery” and potential set off that would be subject to subrogation by the employer is that amount paid by the tortfeasor and the tortfeasor’s liability carrier, i.e., the “other party” for purposes of § 65.2-309 , but not funds recovered by the employee through a claim against the private uninsured motorist coverage carried by the employee (or his parents). Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    The language of § 65.2-313 refers to “total third-party recovery” and “gross recovery” to indicate that calculation of the offset amount is based upon the total amount of subrogation recovery under § 65.2-309 or § 65.2-310 . There is no indication or basis in the statute to conclude that § 65.2-313 provides the employer with a right to claim an offset for the claimant’s recovery of funds upon which the employer had no right to claim a subrogation interest at the outset. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    The Virginia Supreme Court has instructed that the uninsured motorist law does not provide coverage for the uninsured vehicle or the uninsured motorist, but its object is to afford the insured additional compensation protection for the claimant. The claimant’s employer does not become a third party beneficiary under the private insurance contract, which the claimant (or his parents) chose to provide, at their own expense. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    In this case, the civil trial judge awarded the claimant $500,000, but only $150,000 was recovered - $25,000 from the tortfeasor’s carrier, and $125,000 from the uninsured motorists policies of the claimant and his parent. Therefore, the judge awarded employer’s carrier the sum of $16,609.92, allowing for attorney’s fees and costs. The Commission held that the only amount recovered from “any other party”, as contemplated by § 65.2-309 , was the $25,000.00 recovered from the tortfeasor’s liability carrier, and the employer could not recover any further set off against the amounts recovered from the uninsured motorists coverage of the claimant (and his parents). Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    See notes to § 65.2-309 and § 65.2-311 .

    § 65.2-311. Expenses and attorney’s fees in action under § 65.2-309 or § 65.2-310.

    1. Except as provided in subsection B, in any action, or claim for damages, by an employee, his personal representative or other person against any person other than the employer, and in any such action brought, or claim asserted, by the employer under his right of subrogation provided for in § 65.2-309 , if a recovery is effected, either by judgment or voluntary settlement, the reasonable expenses and reasonable attorney’s fees of such claimants shall be apportioned pro rata between the employer and the employee, his personal representative or other person, as their respective interests may appear.
    2. If the employer is required to institute an action against any party to recover some or all of its lien pursuant to subsection D of § 65.2-309 , the employer shall not be required to pay any share of the reasonable expenses and reasonable attorney’s fees associated with that portion of its lien that is not preserved by the employee, his personal representative or other person.

    History. Code 1950, § 65-39.1; 1960, c. 89; 1968, c. 660, § 65.1-43; 1991, c. 355; 2004, cc. 914, 941.

    The 2004 amendments.

    The 2004 amendments by cc. 914 and 941 are identical, and added “A. Except as provided in subsction B” to the beginning of the existing paragraph and added subsection B.

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    Michie’s Jurisprudence.

    For related discussion, see 5A M.J. Costs, § 3; 6A M.J. Divorce and Alimony, §§ 35, 59, 72.2, 78; 14A M.J. Parent and Child, § 17.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-43 or prior law.

    This section is constitutional; it is not repugnant either to the contract clauses of the federal and state Constitutions, or to the due process clause of the Fourteenth Amendment of the federal Constitution.Stancil v. United States, 200 F. Supp. 36, 1961 U.S. Dist. LEXIS 4117 (E.D. Va. 1961).

    And applies retroactively and prospectively. —

    The language of this section permits of no ambiguity and it is plain that it was intended to apply retroactively and prospectively as to all actions or claims for damages in which a recovery had not yet been effected, either by judgment or voluntary settlement. Stancil v. United States, 200 F. Supp. 36, 1961 U.S. Dist. LEXIS 4117 (E.D. Va. 1961).

    While the “right” to institute an action against a third party may accrue to the employer as of the date of the injury, the method and manner of obtaining such recovery constitutes only a procedural right or, at best, a right affecting merely a form of the remedy. For these reasons the enactment of this section and the 1960 amendments to former §§ 65-38 and 65-39 (now §§ 65.2-309 and 65.2-310 ) manifestly touched upon the rights of a compensation insurance carrier of an employer as to all cases pending when the changes became effective. Whatever rights the carrier had prior to 1960 were not protected from legislative abrogation. Stancil v. United States, 200 F. Supp. 36, 1961 U.S. Dist. LEXIS 4117 (E.D. Va. 1961).

    It merely places upon the employer the burden of the counsel fee payable for service rendered in the third party action to his ultimate profit. The regulation of this incidental phase of the compensation statute cannot reasonably be said to impair the obligation of the basic contract. Stancil v. United States, 200 F. Supp. 36, 1961 U.S. Dist. LEXIS 4117 (E.D. Va. 1961).

    Which was formerly not deductible from reimbursements to compensation carrier. —

    Prior to the enactment of this section, and the amendments to former §§ 65-38 and 65-39 (now §§ 65.2-309 and 65.2-310 ), on Feb. 25, 1960, reimbursement payments to the compensation carrier were not subject to deduction for reasonable expenses and attorney’s fees incurred by any plaintiff in seeking a recovery against a third party. Stancil v. United States, 200 F. Supp. 36, 1961 U.S. Dist. LEXIS 4117 (E.D. Va. 1961).

    Amount of indemnity due employer. —

    Once the net third-party recovery of an employee was determined, she was entitled to payment of no further compensation or medical expenses after the date of the Commission’s suspension order until she could establish that further benefit entitlements exceeded the net amount received from the third-party recovery. Thus, the Commission did not foreclose the payment of attorney’s fees in increments as medical expenses and compensation benefits accrued during the suspension period, and the suspension order did not allow the employee a double recovery. After the employer was reimbursed the money paid as compensation benefits to the date of the suspension, the employer was excused from making payments during the suspension period to the extent the employee was otherwise entitled to continued medical or compensation benefits. 246 Va. 30 , 431 S.E.2d 36 (1993) (decided under former § 65.1-43).

    This section apportions attorneys’ fees between the employer and employee as their respective interests may appear regardless of who instituted the suit. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    An employer who benefits from an employee’s third-party tort settlement, by recouping or being relieved of paying worker’s compensation benefits, is required to pay its pro rata share of a claimant’s reasonable expenses and attorney’s fees in effecting the recovery. Wood v. Caudle-Hyatt, Inc., 18 Va. App. 391, 444 S.E.2d 3, 10 Va. Law Rep. 1373, 1994 Va. App. LEXIS 293 (1994); Mich. Mut. Ins. Co. v. Smoot, 183 F. Supp. 2d 806, 2001 U.S. Dist. LEXIS 24839 (E.D. Va. 2001).

    Former § 65.1-42 (now § 65.2-310 ) is not a limitation on this section, since it does not deal expressly or by implication with the employer’s obligation for attorneys’ fees arising out of the release of future payments that would have been due under the compensation award were it not for the employee’s successful suit. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    1960 change in section implemented by modifications of former §§ 65.1-41 and 65.1-42 (now §§ 65.2-309 and 65.2-310 ). —

    To carry out the substantive change in this section made by the 1960 amendment, that amendment modified former §§ 65.1-41 and 65.1-42 (now §§ 65.2-309 and 65.2-310 ), dealing respectively with suits brought by the employer and suits brought by the employee. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    The procedural modifications of former §§ 65.1-41 and 65.1-42 (now §§ 65.2-309 and 65.2-310 ) made by the 1960 amendment to those sections are designed to ensure that the attorneys’ fees shall be apportioned in accordance with the substantive changes made in this section when the proceeds of the judgment against the tort-feasor are disbursed. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Apportionment must be based on the full liability of the employer. —

    The compensation it has paid in the past and the amount that it would be required to pay in the future were it not for the employee’s successful suit. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    There is no rational distinction between the benefit an employer enjoys from being reimbursed for compensation payments already made and the benefit of being released from the obligation to make further compensation payments. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    There is nothing in this section to indicate that when the legislature directed proration of the fees as the interests of the parties may appear, it intended that only part of the interest of the compensation carrier should be taken into account. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    The plain language of former §§ 65.1-42 and 65.1-43 does not direct the trial court to apportion attorney’s fees based only on the amount actually paid by the employer at the time of apportionment. Circuit City Stores, Inc. v. Bower, 243 Va. 183 , 413 S.E.2d 55, 8 Va. Law Rep. 1891, 1992 Va. LEXIS 151 (1992).

    Trial court did not err where it ruled that the employer’s share of attorney’s fees and expenses should be based on full 500-week award, rather than on the employer’s actual payments to claimant. Circuit City Stores, Inc. v. Bower, 243 Va. 183 , 413 S.E.2d 55, 8 Va. Law Rep. 1891, 1992 Va. LEXIS 151 (1992).

    Employee’s right to apportionment should not be defeated by modifying awards. —

    While some compensation awards may be modified with respect to future payments, the employee’s right of apportionment should not be defeated. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Prospect of modification, however, is a factor that a court should consider in light of the contingency that may affect the award. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Section not applicable. —

    Sections 65.2-311 and 65.2-313 did not apply where the workers’ compensation insurer did not benefit from a third-party settlement secured by the claimant, but instead, the insurer exercised its lien, without any assistance or involvement of the claimant or her counsel. Williams v. Capital Hospice & Companion Prop. & Cas. Ins. Co., 66 Va. App. 161, 783 S.E.2d 67, 2016 Va. App. LEXIS 91 (2016).

    Carrier allowed deduction for expenditures to perfect right of subrogation. —

    Where the workmen’s (now workers’) compensation insurance carrier benefited by the employee’s suit against the tort-feasor and must pay its share of the fee, but where it also had to spend its own money when the employee assumed an adversary position on the issue of subrogation, the district court should allow as a deduction from the fee that the carrier would otherwise owe, the amount it reasonably expended to perfect its right of subrogation to fulfill the mandate of the statute requiring consideration of the interests of both parties. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    Reimbursement denied. —

    Statutory beneficiaries of an employee who was killed in an automobile accident were not entitled to reimbursement by the employer and its insurer of their attorney’s fees and costs arising out of a third-party wrongful death action, where the beneficiaries failed to advise the employer or obtain consent prior to settling third-party claim. Skelly v. Hertz Equip. Rental Corp., 35 Va. App. 689, 547 S.E.2d 551, 2001 Va. App. LEXIS 369 (2001).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Note: See entries under § 65.2-313 .

    Defendants entitled to breakdown of disbursements of third party settlement funds to allow calculation of their responsibilities under Act. Benson v. Abbit Mgmt., Inc., VWC File No. 192-08-58 (Aug. 2, 2006).

    The penalty provisions of § 65.2-524 are inapplicable to reimbursement of attorney fees and costs pursuant to § 65.2-311 because the payments are not compensation, but rather are reimbursements of the defendants’ pro rata share of the attorney fees and costs incurred by the claimant in settling his third party action. Sheets v. J G Sheets & Sons, Inc., VWC File No. 208-23-77 (June 17, 2005).

    Employer was entitled to credit under § 65.2-309.1 against future benefits to be paid to employee, who had received third-party recovery under an uninsured motorists insurance policy; although §§ 65.2-311 and 65.2-313 did not mention § 65.2-309.1 , employer’s right to credit derived from § 65.2-309.1 and not § 65.2-311 or 65.2-313 . Pickel v. Department of State Police, VWC File No. 201-47-97 (Aug. 12, 2003).

    The authority to approve attorney’s fees for representation in third party cases rests with the court before which the third party claim is litigated or settled. The Commission has jurisdiction to determine the pro rata share of costs and fees to be paid by the employer for that portion for which it has a subrogation lien or credit, although it usually accepts the third party court’s judgment regarding litigation expenses. Kern v. Logistics Express, Inc., 74 O.W.C. 106 (1995).

    In reversing the Court of Appeals, the Supreme Court set forth the method to be employed in calculating the amount of indemnity and the structure of the order suspending benefits when there has been a third party settlement. Henrico County School Board v. Bohle, 246 Va. 30 , 431 S.E.2d 924 (1993) (reversing 14 Va. App. 801, 421 S.E.2d 8 (1992)).

    A claimant is not entitled to present reimbursement or credit from the employer of attorney’s fees and costs for all benefits it will potentially realize from a third party settlement since such future workers’ compensation benefits are speculative. It is obligated to pay a pro rata share of attorney’s fees and costs only for those benefits actually realized as they accrue. Kern v. Logistics Express, Inc., 74 O.W.C. 106 (1995).

    Where a change in circumstance occurs after attorney’s fees and the cost of a third-party settlement are apportioned, the Commission may modify by subsequent award a carrier’s pro-rata share when evidence of specific liquidated liabilities or benefit information are furnished. Dalton v. North Brothers, 68 O.I.C. 239 (1989).

    In determining the pro rata share of attorney’s fees the Commission is not bound by any contingency agreement between the employee and counsel. Lambert v. Valley Cleaning Service, 67 O.I.C. 249 (1988).

    An employee who settles a third party claim prior to the filing of a workers’ compensation case and without the approval of the employer is not entitled to have the employer pay a pro rata share of attorney’s fees. Jones v. International Terminal Operations Corp., 71 O.W.C. 302 (1992).

    A carrier is not required to pay a pro rata share of attorney’s fees incurred in a third party settlement when, at the time of the settlement, workers’ compensation benefits had neither been awarded nor paid. Streich v. Tidewater Dock & Structures, Inc., 14 Va. App. 779, 418 S.E.2d 913, 8 Va. Law Rep. 3616, 1992 Va. App. LEXIS 180 (1992).

    Where prior to the entry of an award under the Virginia Workers’ Compensation Act a third party settlement is reached in excess of any compensation benefits awardable under the Act, the claimant has received on full recovery and is not entitled to an award for State benefits. There is no basis for an award of attorney’s fees pursuant to § 65.1-43 (now § 65.2-311 ). Townsend v. Stone & Webster Co., 67 O.I.C. 243 (1988).

    Where prior to obtaining counsel an employee reached an agreement with the liability carrier for the maximum amount under the policy and the attorney only negotiated an additional settlement from the employer’s uninsured motorists coverage, the compensation carrier is not required to pay a pro rata share of the attorney’s fee since it had no subrogation rights against the uninsured coverage. Oleson v. Seasons Greetings, 69 O.I.C. 204 (1990).

    Va. Code Ann. § 38.2-2206 provides that the subrogation provisions of the Workers’ Compensation Act, as they apply to pro rata reimbursement of attorney’s fees, are not applicable in cases involving an employee’s recovery from a self-insured employer that is acting as the uninsured motorist provider for the vehicle that the employee was driving at the time of the accident. A self-insured employer that is acting as the uninsured motorist provider for the vehicle that the employee was driving at the time of the accident is entitled to full recovery of the subrogation amount, without a setoff for an attorney’s fee. Blankenship v. City of Newport News Police Dept., 76 O.W.C. 38 (1997).

    § 65.2-312. False statements, representations, etc., in connection with an award; penalties.

    1. It shall be unlawful for any person to knowingly make, file or use any writing or document knowing the same to contain any materially false, fictitious or fraudulent statement or entry in connection with an award under this title. It shall also be unlawful for any person to aid or abet another in a violation of this section.
    2. A violation of this section shall be punishable as a Class 6 felony.
    3. Any person convicted of a violation of this section who is licensed to practice any of the healing arts as defined in § 54.1-2900 or to practice law pursuant to Chapter 39 (§ 54.1-3900 et seq.) of Title 54.1, and who committed the violation while engaged in such practice, may have such license suspended or revoked in accordance with the provisions of Chapter 29 (§ 54.1-2900 et seq.) and Chapter 39 (§ 54.1-3900 et seq.) of Title 54.1, respectively.
    4. Venue for the prosecution of a violation of this section shall lie in the county or city wherein the injury occurred.

    History. 1993, c. 792; 1994, cc. 11, 366.

    Cross references.

    As to punishment for Class 6 felonies, see § 18.2-10 .

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The claimant, in the country illegally, filed a claim using a false name, and also gave false answers under oath to discovery interrogatories as to his name, date of birth, and social security number. In a subsequent deposition, the claimant provided his real name and date of birth. The Commission upheld the Deputy Commissioner’s dismissal with prejudice of the claimant’s claim, holding the claimant knowingly used a false name and forged documents to work in the U.S. The Commission accepted as a new claim a letter subsequently filed by claimant’s counsel which contained the claimant’s real name, date of birth, and other identifying information needed to constitute a claim. Rodriguez v. Pivaral Mendoza Corporation, VWC File No. 238-05-01 (Feb. 3, 2011).

    § 65.2-313. Method of determining employer’s offset in event of recovery under § 65.2-309 or § 65.2-310.

    In any action or claim for damages by an employee, his personal representative or other person against any person other than the employer under § 65.2-310 , or in any action brought, or claim asserted, by the employer under his right of subrogation provided for in § 65.2-309 , if a recovery is effected, the employer shall pay to the employee a percentage of each further entitlement as it is submitted equal to the ratio the total attorney’s fees and costs bear to the total third-party recovery until such time as the accrued post-recovery entitlement equals that sum which is the difference between the gross recovery and the employer’s compensation lien. In ordering payments under this section, the Commission shall take into account any apportionment made pursuant to § 65.2-311 .

    For the purposes of this section, “entitlement” means compensation and expenses for medical, surgical and hospital attention and funeral expenses to which the claimant is entitled under the provisions of this title, which entitlements are related to the injury for which the third-party recovery was effected.

    History. 1994, c. 586.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 54.

    CASE NOTES

    Applicability. —

    Where an agreement between an employer and an employee did not deal with the unpaid medical bills, § 65.2-701 did not apply to determine whether the employer was entitled to a credit for an unpaid medical bills. Emberton v. White Supply & Glass Co., 43 Va. App. 452, 598 S.E.2d 772, 2004 Va. App. LEXIS 307 (2004).

    Sections §§ 65.2-311 and 65.2-313 did not apply where the workers’ compensation insurer did not benefit from a third-party settlement secured by the claimant, but instead, the insurer exercised its lien, without any assistance or involvement of the claimant or her counsel. Williams v. Capital Hospice & Companion Prop. & Cas. Ins. Co., 66 Va. App. 161, 783 S.E.2d 67, 2016 Va. App. LEXIS 91 (2016).

    “Total . . . Recovery” and “gross recovery” are the same; this interpretation of the statute is consistent with the plain purpose of the statutory scheme providing the employer an offset for a third party recovery. Eghbal v. Boston Coach Corp., 23 Va. App. 634, 478 S.E.2d 732, 1996 Va. App. LEXIS 787 (1996).

    Commission lacked authority to modify order where failure to meet time requirement. —

    Where commission awarded claimant temporary total disability benefits in 1989 but suspended that award in 1991 because of his third-party recovery, and in 1996, claimant applied for a new offset calculation based on this section, if an application for review of a final order of the commission is not made within twenty days of the date of the order, the commission has no jurisdiction to review the matter unless the petitioning party alleges fraud or mistake in the procurement of the award. Because claimant failed to meet this time requirement and had not alleged fraud or mistake, the commission correctly found that it lacked authority to modify the 1991 order. Robinson v. Trego Stone Corp., 26 Va. App. 97, 493 S.E.2d 389, 1997 Va. App. LEXIS 718 (1997).

    Extent of court’s jurisdiction. —

    Under this section the court’s jurisdiction extends only to the point where it determines the amount of compensation benefits, as opposed to attorney’s fees and costs, actually paid by the employer. Hawkins v. Commonwealth/Southside Va. Training Ctr., 255 Va. 261 , 497 S.E.2d 839, 1998 Va. LEXIS 53 (1998).

    This section does not permit apportionment of future benefits and expenses. —

    Circuit court, in ruling on employer’s petition for reimbursement of compensation benefits paid after employee 4recovered from a 3rd-party tortfeasor a sum greater than the amount of past benefits, did not have jurisdiction to apply the apportionment percentage to workers’ compensation benefits to be paid and medical expenses to be incurred in the future until such time as benefits and expenses equaled the difference between the gross third-party recovery and the employer’s lien on the amount of recovery. Hawkins v. Commonwealth/Southside Va. Training Ctr., 255 Va. 261 , 497 S.E.2d 839, 1998 Va. LEXIS 53 (1998).

    Extent of permissible apportionment. —

    This section permits the circuit court to apportion attorney’s fees and costs based on the amount of benefits paid in the past, and benefits to be paid in the future until the accrued post-recovery entitlement equals that sum which is the difference between the gross recovery and the employer’s compensation lien. Hawkins v. Commonwealth/Southside Va. Training Ctr., 255 Va. 261 , 497 S.E.2d 839, 1998 Va. LEXIS 53 (1998).

    Where an employer had not paid an employee’s medical bill prior to the employee’s settlement with a liable third party, the employer’s lien did not encompass the unpaid medical bills, and the employer was entitled to an apportioned credit against the unpaid medical bills. Emberton v. White Supply & Glass Co., 43 Va. App. 452, 598 S.E.2d 772, 2004 Va. App. LEXIS 307 (2004).

    Employer entitled to offset. —

    Workers’ compensation claimant’s employer was entitled to an offset for post-settlement indemnity and medical payments made on behalf of the claimant where a third-party settlement did not exceed the employer’s compensation lien prior to its compromise. Purpose of § 65.2-313 prevented claimant from acquiring for a single injury two separate remedies, one in tort against a third party tort-feasor, and another in contract under the Workmen’s Compensation Act. McKnight v. Work Env't Assocs. & Travelers, 43 Va. App. 189, 596 S.E.2d 573, 2004 Va. App. LEXIS 249 (2004).

    Virginia Workers’ Compensation Commission properly held that an employer was entitled to pay 30 percent towards a workers’ compensation claimant’s future entitlements until it recovered the claimant’s total settlement with a third party, even though the employer had not perfected its subrogation lien prior to the settlement with the third party, as the compensation and medical benefits for which the employer sought a credit had not yet accrued when the claimant received the distribution and they were not within the definition of “employer’s compensation lien,” but were “further entitlements.” Suggs v. Suggs Carpet Installation, 2006 Va. App. LEXIS 115 (Va. Ct. App. Mar. 28, 2006).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Health care provider not entitled to direct payments from insurer while claimant’s benefits offset due to a 3rd party settlement. Johnson v. Tidewater Community College, JCN 1991617 (March 30, 2019).

    Va. Code § 65.2-313 plainly contemplates reimbursement to the claimant after his entitlements are submitted. This interpretation fulfills the purpose of the statute, its purpose, which was to allow reimbursement as workers’ compensation entitlements were incurred. If the legislature wanted the employer and claimant to pay their proportions of further compensation entitlements simultaneously, it would have so stated. Dodson v. Page Cnty., JCN VA00000422711 (Sept. 15, 2017).

    Defendants entitled to breakdown of disbursements of third party settlement funds to allow calculation of their responsibilities under Act. Benson v. Abbit Mgmt., Inc., VWC File No. 192-08-58 (Aug. 2, 2006).

    The right to subrogation of previously paid benefits originates in §§ 65.2-309 and 65.2-310 and the separate right to reduction of future entitlements is found in § 65.2-313 ; adjudication of issues under the former is not res judicata as to remedy sought under the latter. Suggs v. Suggs Carpet Installation, VWC File No. 174-62-27 (May 18, 2005).

    Employer was entitled to credit under § 65.2-309.1 against future benefits to be paid to employee, who had received third-party recovery under an uninsured motorists insurance policy; although §§ 65.2-311 and 65.2-313 did not mention § 65.2-309.1 , employer’s right to credit derived from § 65.2-309.1 and not § 65.2-311 or 65.2-313 . Pickel v. Department of State Police, VWC File No. 201-47-97 (Aug. 12, 2003).

    Section 65.2-313 specifies the manner by which an employer shall obtain its offset credit from an employee’s third party recovery and apply it against future workers’ compensation entitlements, and also provides that the employer shall reimburse the employee for the third party litigation costs as it realizes the offset benefits. The “gross recovery” term used in § 65.2-313 is the total third party recovery before the deduction of attorney’s fees or costs. The “employer’s compensation lien” is the total amount expended by the employer for compensation benefits without deduction for attorney’s fees or costs. Eghbal v. Boston Coach Corporation, 75 O.W.C. 147 (1996), aff’d, No. 1370-96-3 (Va. Ct. App. Dec. 10, 1996).

    The employer’s subrogation rights to a structured settlement with payments to be made to the claimant over time is equivalent to the present value of the settlement, i.e. , the cost of an annuity that would guarantee payment of the full amount in the manner negotiated by the parties to the third party litigation. Kern v. Logistics Express, Inc., 74 O.W.C. 106 (1995).

    After calculating the claimant’s future claim entitlement pursuant to § 65.2-313 , the Commission noted that the carrier was entitled to a credit in that amount against the liability for additional compensation payments and medical expenses, after which responsibility to make payment would resume. The claimant must be incrementally reimbursed for the pro-rata share of attorney’s fees and costs as the carrier reduces the credit. Such reimbursement should be made directly to the claimant on a quarterly basis. Lance v. School for Contemporary Education, 73 O.W.C. 209 (1994).

    The Commission directed quarterly payments by the employer on its pro rata share of third party fees and costs to the extent the employer realized benefits each quarter for credit taken in lieu of payment of compensation or other benefits for which it would be liable. Kern v. Logistics Express, Inc., 74 O.W.C. 106 (1995).

    A claimant is not entitled to present reimbursement or credit from the employer of attorney’s fees and costs for all benefits it will potentially realize from a third party settlement since such future workers’ compensation benefits are speculative. It is obligated to pay a pro rata share of attorney’s fees and costs only for those benefits actually realized as they accrue. Kern v. Logistics Express, Inc., 74 O.W.C. 106 (1995).

    Section 38.2-2206 provides that the subrogation provisions of the Workers’ Compensation Act, as they apply to pro rata reimbursement of attorney’s fees, are not applicable in cases involving an employee’s recovery from a self-insured employer that is acting as the uninsured motorist provider for the vehicle that the employee was driving at the time of the accident. A self-insured employer that is acting as the uninsured motorist provider for the vehicle that the employee was driving at the time of the accident is entitled to full recovery of the subrogation amount, without a setoff for an attorney’s fee. Blankenship v. City of Newport News Police Dept., 76 O.W.C. 38 (1997).

    The language of section 65.2-313 refers to “total third-party recovery” and “gross recovery” to indicate that calculation of the offset amount is based upon the total amount of subrogation recovery under §§ 65.2-309 or 65.2-310 . There is no indication or basis in the statute to conclude that § 65.2-313 provides the employer with a right to claim an offset for the claimant’s recovery of funds upon which the employer had no right to claim a subrogation interest at the outset. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    Section 65.2-313 expressly requires that a recovery first be effected pursuant to either § 65.2-309 or 65.2-310 . Therefore, § 65.2-313 is predicated on a recovery under the provisions, and limitations, of those sections. Accordingly, the “recovery” and potential set off that would be subject to subrogation by the employer is that amount paid by the tortfeasor and the tortfeasor’s liability carrier, i.e., the “other party” for purposes of § 65.2-309 , but not funds recovered by the employee through a claim against the private uninsured motorist coverage carried by the employee (or his parents). Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    The Virginia Supreme Court has instructed that the uninsured motorist law does not provide coverage for the uninsured vehicle or the uninsured motorist, but its object is to afford the insured additional compensation protection for the claimant. The claimant’s employer does not become a third party beneficiary under the private insurance contract, which the claimant (or his parents) chose to provide, at their own expense. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    In this case, the civil trial judge awarded the claimant $500,000, but only $150,000 was recovered - $25,000 from the tortfeasor’s carrier, and $125,000 from the uninsured motorists policies of the claimant and his parent. Therefore, the judge awarded employer’s carrier the sum of $16,609.92, allowing for attorney’s fees and costs. The Commission held that the only amount recovered from “any other party”, as contemplated by § 65.2-309 , was the $25,000.00 recovered from the tortfeasor’s liability carrier, and the employer could not recover any further set off against the amounts recovered from the uninsured motorists coverage of the claimant (and his parents). Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    Where the municipality employer is self insured for workers’ compensation but is not self insured for motor vehicle liability insurance, it is not entitled to a set-off against third-party recovery from the uninsured-motorist settlement. The term “self-insured employer” in § 38.2-2206 I applies only to employers self insured for motor-vehicle liability not workers’ compensation insurance. Leiston v. Town of Dumfries, 73 O.W.C. 213 (1994).

    By its express language, § 65.2-313 requires first that a recovery be effected against a third-party by the claimant or his personal representative pursuant to § 65.2-310 , or by the employer’s action for subrogation under § 65.2-309 . Section 65.2-309 governs the employer’s right to claim subrogation, and the procedure for collecting directly from a responsible third party tortfeasor. Pursuant to legislation passed in 1994, the General Assembly provided employers with a limited right to claim a subrogation interest in the proceeds of an uninsured motorist policy, i.e., the right to claim a subrogation interest in recoveries from uninsured or underinsured motorist policies carried by or at the expense of the employer. Lumb v. McLane Food Center, 79 O.W.C. 159 (2000).

    The method for calculating third party settlements was set forth. Shipp v. Nuckols Enterprises, Inc., 73 O.W.C. 216 (1994).

    Chapter 4. Occupational Diseases.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 2, 20, 21, 24, 26, 66.

    § 65.2-400. “Occupational disease” defined.

    1. As used in this title, unless the context clearly indicates otherwise, the term “occupational disease” means a disease arising out of and in the course of employment, but not an ordinary disease of life to which the general public is exposed outside of the employment.
    2. A disease shall be deemed to arise out of the employment only if there is apparent to the rational mind, upon consideration of all the circumstances:
      1. A direct causal connection between the conditions under which work is performed and the occupational disease;
      2. It can be seen to have followed as a natural incident of the work as a result of the exposure occasioned by the nature of the employment;
      3. It can be fairly traced to the employment as the proximate cause;
      4. It is neither a disease to which an employee may have had substantial exposure outside of the employment, nor any condition of the neck, back or spinal column;
      5. It is incidental to the character of the business and not independent of the relation of employer and employee; and
      6. It had its origin in a risk connected with the employment and flowed from that source as a natural consequence, though it need not have been foreseen or expected before its contraction.
    3. Hearing loss and the condition of carpal tunnel syndrome are not occupational diseases but are ordinary diseases of life as defined in § 65.2-401 .

    History. Code 1950, § 65-42; 1952, c. 603; 1968, c. 660, § 65.1-46; 1970, c. 470; 1986, c. 378; 1991, c. 355; 1997, cc. 15, 405.

    Law Review.

    For survey of Virginia law on torts for the year 1969-1970, see 56 Va. L. Rev. 1419 (1970).

    For article discussing workers’ compensation in the context of toxic substances litigation, see 16 U. Rich. L. Rev. 247 (1982).

    For note on the ordinary disease exclusion in Virginia’s Workers’ Compensation Act in light of Ashland Oil Co. v. Bean, 225 Va. 1 , 300 S.E.2d 739 (1983).

    see 18 U. Rich. L. Rev. 161 (1983).

    For article, “Workers’ Compensation for Disease in Virginia: The Exception Swallows the Rule,” see 20 U. Rich. L. Rev. 161 (1985).

    For comment, “Do Recent Virginia Supreme Court Decisions Leave the Workers’ Compensation Claimant in No-Man’s Land?” see 20 U. Rich. L. Rev. 209 (1985).

    For 1995 survey of workers’ compensation, see 29 U. Rich. L. Rev. 1199 (1995).

    For an article, “Workers’ Compensation,” see 31 U. Rich. L. Rev. 1283 (1997).

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    Research References.

    Larson’s Workers’ Compensation Law (Matthew Bender). § 52.03 Definition of “Occupational Disease.” Larson and Larson.

    CASE NOTES

  • Analysis
  • I.In General.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-46 or prior law.

    The legislature intended that the Industrial (now Workers’ Compensation) Commission decide these claims on a case by case basis, adhering to the strict proof that is required in this section. Ingersoll-Rand Co. v. Musick, 7 Va. App. 684, 376 S.E.2d 814, 5 Va. Law Rep. 1726, 1989 Va. App. LEXIS 16 (1989).

    Legislature did not intend by this chapter to provide a general system of health insurance. It provided compensation only for occupational diseases and carefully spelled out what was required to fill that description. Van Geuder v. Commonwealth, 192 Va. 548 , 65 S.E.2d 565, 1951 Va. LEXIS 202 (1951).

    To be compensable, condition must qualify as disease. —

    To be compensable as an occupational disease, a condition must first qualify as a disease. Vanity Fair Corp. v. Monger, 21 Va. App. 59, 461 S.E.2d 429, 12 Va. Law Rep. 182, 1995 Va. App. LEXIS 683 (1995).

    A plain reading of this section requires that the condition for which compensation is sought as an occupational disease must first qualify as a disease. Merillat Industries, Inc. v. Parks, 246 Va. 429 , 436 S.E.2d 600, 10 Va. Law Rep. 464, 1993 Va. LEXIS 139 (1993).

    Job-related impairments resulting from cumulative trauma caused by repetitive motion, however labeled or however defined, are, as a matter of law, not compensable under the present provisions of the Workers’ Compensation Act. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    An impairment resulting from cumulative trauma caused by repetitive motion is an impairment which must be classified as an injury, not a disease, and is not compensable. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Definition of “disease.” —

    For purposes of the Workers’ Compensation Act, the definition of “disease” cannot be “so broad as to encompass any bodily ailment of whatever origin.” Vanity Fair Corp. v. Monger, 21 Va. App. 59, 461 S.E.2d 429, 12 Va. Law Rep. 182, 1995 Va. App. LEXIS 683 (1995).

    Just because a doctor opines that a particular impairment is a “disease” does not necessarily make it so. Whether a claimant suffers from a disease within the contemplation of the Workers’ Compensation Act is a mixed question of law and fact. Whether a proper definition has been used to test the authenticity of a doctor’s opinion is strictly a legal question. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    An employee has a compensable disease when he proves that his disease was, in fact, developed at work as a result of the usual conditions to which he was exposed by his employment and if the evidence shows a recognizable link between the disease and some distinctive feature of the claimant’s job or work environment, and if other qualifications are met, the legislature intended recovery. Ingersoll-Rand Co. v. Musick, 7 Va. App. 684, 376 S.E.2d 814, 5 Va. Law Rep. 1726, 1989 Va. App. LEXIS 16 (1989).

    In considering whether to proceed under this section or § 65.2-401 , the commission must determine whether the condition is one to which the general public is exposed outside of the employment. If the evidence shows that the general public is not exposed to traumatic stress reaction outside of the employment, this section applies. If, however, traumatic stress reaction is a condition to which the general public is exposed outside of the employment, the condition must be reviewed under § 65.2-401 . Marcus v. Arlington County Bd. of Supvrs., 15 Va. App. 544, 425 S.E.2d 525, 9 Va. Law Rep. 694, 1993 Va. App. LEXIS 4 (1993).

    An ordinary disease of life may be compensable as an occupational disease if the requirements of § 65.2-401 are satisfied. Marcus v. Arlington County Bd. of Supvrs., 15 Va. App. 544, 425 S.E.2d 525, 9 Va. Law Rep. 694, 1993 Va. App. LEXIS 4 (1993).

    Ordinary disease of life aggravated by work environment is not compensable. Perrin v. Brunswick Corp., 333 F. Supp. 221, 1971 U.S. Dist. LEXIS 10927 (W.D. Va. 1971); Genie Co. v. Hammer, 32 Va. App. 257, 527 S.E.2d 470, 2000 Va. App. LEXIS 300 (2000).

    Question of whether a condition or disease is an ordinary disease of life is essentially a medical issue to be decided by the trier of fact based on the evidence presented. Knott v. Blue Bell, Inc., 7 Va. App. 335, 373 S.E.2d 481, 5 Va. Law Rep. 795, 1988 Va. App. LEXIS 119 (1988).

    Disease caused by conditions peculiar to employment is medical issue. —

    Whether a condition or a disease is caused by conditions peculiar to employment of the claimant is essentially a medical issue to be decided by the trier of fact based on the evidence presented. Personnel v. Hillman, No. 1761-89-4 (Ct. of Appeals Sept. 11, 1990).

    Sudden onset not prerequisite to occupational disease. —

    There is no language in this section requiring a sudden onset or manifestation as a condition of a disease being occupational. Knott v. Blue Bell, Inc., 7 Va. App. 335, 373 S.E.2d 481, 5 Va. Law Rep. 795, 1988 Va. App. LEXIS 119 (1988).

    The phrase “peculiar to the employment” means unique to the conditions in which the claimant actually worked, not the normal working conditions to which other workers in the same industry were exposed. Ingersoll-Rand Co. v. Musick, 7 Va. App. 684, 376 S.E.2d 814, 5 Va. Law Rep. 1726, 1989 Va. App. LEXIS 16 (1989).

    Disease must be traced to employment. —

    While the claimant is not required to show the time, place and circumstances of her exposure, as if her claim was based on injury by accident, it is nevertheless required under this section that her evidence demonstrate to the rational mind that her disease is fairly to be traced to her employment as the proximate cause. Van Geuder v. Commonwealth, 192 Va. 548 , 65 S.E.2d 565, 1951 Va. LEXIS 202 (1951).

    Though it need not have originated in employment of employer who is made liable. —

    While this section requires that an employee establish that his occupational disease arose “out of and in the course of his employment,” yet he is not required to prove that its incipiency took place or that it originated while he was working for the employer who is made liable to him. This is true because former § 65.1-50 (now § 65.2-404 ) expressly limits his right of action to the employer in whose employment he was last injuriously exposed to the hazards of the disease. Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951).

    Where there is a direct causal connection between the employee’s several employments and his disability resulting from silicosis, so that the occupational disease is in effect a single injury caused in part at least by injuries incurred in employment of the several employers, the occupational disease is compensable as “arising out of and in the course of employment.” Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951).

    “Employment” defined. —

    “Employment” as used in this section is not used as it is elsewhere in the Act to describe the relation between employer and employee. In this section the word refers to the work or process in which the employee has been engaged and not to his contract with an employer to engage in it. Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951).

    Limitation of action regarding first diagnosis has no bearing on claim based on later diagnosis. —

    Once an employee receives a communication of an occupational disease, it is incumbent upon that employee to file a claim. Once a claim is filed, it is the duty of the Commission to determine: (1) Whether the disease is in fact an “occupational disease” as defined in this section, and if so, (2) whether that occupational disease is compensable. If the Commission determines that the claimant does not have an occupational disease, or that his occupational disease is not compensable, then the statute of limitations in regard to the first communication of the diagnosis forming the basis of that claim has no bearing on a subsequent diagnosis and a claim filed as a result of the communication of that diagnosis. Parris v. APCO, 2 Va. App. 219, 343 S.E.2d 455, 1986 Va. App. LEXIS 262 (1986).

    Burden of proof. —

    The burden is on the claimant and this section sets forth what must be proved to sustain that burden. Van Geuder v. Commonwealth, 192 Va. 548 , 65 S.E.2d 565, 1951 Va. LEXIS 202 (1951).

    If the evidence shows that it is just as probable that the disability resulted from a cause which is not compensable, as it is that it resulted from one which is compensable, the claimant has not sustained the burden of proof. Van Geuder v. Commonwealth, 192 Va. 548 , 65 S.E.2d 565, 1951 Va. LEXIS 202 (1951).

    The burden of proof rests with claimant to show that he contracted an occupational disease and that the incapacity is attributable thereto. Perrin v. Brunswick Corp., 333 F. Supp. 221, 1971 U.S. Dist. LEXIS 10927 (W.D. Va. 1971).

    As a general rule, a claimant has the burden of proving by a preponderance of the evidence that his disease is occupationally related — that it arose out of and in the course of his employment. Virginia Dep't of State Police v. Talbert, 1 Va. App. 250, 337 S.E.2d 307, 1985 Va. App. LEXIS 94 (1985).

    Claimant was entitled to recover medical benefits as the claimant established that the claimant had coal workers’ pneumoconiosis; although the workers’ compensation law did not specifically define “occupational disease” generally, the claimant was able to show, and the employer conceded, that the claimant was last injured while being exposed to the hazards of coal dust while working for the employer. Clinchfield Coal Co. v. Reed, 40 Va. App. 69, 577 S.E.2d 538, 2003 Va. App. LEXIS 123 (2003).

    Claimant was required to prove by clear and convincing evidence that her carpal tunnel syndrome arose out of and in the course of employment, and did not result from causes outside of employment; the workers’ compensation commission’s decision that she did not meet her burden of proof was supported by credible evidence in the record, especially evidence that she did not tell a doctor she consulted about her activities apart from work that might have caused the carpal tunnel syndrome, and, thus, the decision to deny her application for workers’ compensation benefits was affirmed. Cottrell v. Deroyal Indus., 2005 Va. App. LEXIS 351 (Va. Ct. App. Sept. 13, 2005).

    Claimant clearly and convincingly proved through the claimant’s medical records, the claimant’s testimony, and the opinions of the claimant’s treating physicians that the claimant’s reactive airway disease, an ordinary disease of life, was caused by the claimant’s exposure to fumes emanating from a backup battery in the computer system during the course of the claimant’s employment. Following the exposure, the claimant, who had not previously been diagnosed with reactive airway disease or another lung ailment, developed the disease. Bath v. Olinger, 2016 Va. App. LEXIS 365 (Va. Ct. App. Dec. 27, 2016).

    Employee was not entitled to workers’ compensation benefits because the employee failed to establish that the employee’s alleged occupational disease arose out of the employee’s exposure to a bat at work. Iglesias v. QVC Suffolk, Inc., 2019 Va. App. LEXIS 86 (Va. Ct. App. Apr. 16, 2019).

    Res judicata. —

    Where a prior claim is dismissed due to failure of the medical evidence to disclose the existence of an occupational disease, res judicata does not operate to bar a second claim based on a later determination from different medical evidence that such a disease subsequently exists. Childress v. Beatrice Pocahontas Co., 6 Va. App. 88, 366 S.E.2d 722, 4 Va. Law Rep. 2334, 1988 Va. App. LEXIS 22 (1988).

    II.Specific Diseases.

    Heart disease. —

    Virginia Workers’ Compensation Commission properly awarded benefits to a claimant for occupational heart disease, as the employer failed to rebut the presumption; since the claimant’s physician’s statements were conflicting, the commission was entitled to conclude that no medical evidence established that job stress caused or contributed to the development of heart disease. Amherst County Sheriff's Office v. Goodwin, 2003 Va. App. LEXIS 113 (Va. Ct. App. Mar. 4, 2003).

    Tenosynovitis not compensable. —

    Tenosynovitis, a condition gradually incurred on account of repeated, work-related trauma, held not to be compensable as an occupational disease under the Workers’ Compensation Act. Western Elec. Co. v. Gilliam, 229 Va. 245 , 329 S.E.2d 13, 1985 Va. LEXIS 298 (1985).

    Photosensitivity not compensable. —

    Claimant’s photosensitivity, although caused by cumulative exposure to airport fluorescent lights, was a noncompensable gradually incurring injury and not an industrial disease covered under the Workers’ Compensation Act. United Airlines v. Walter, 24 Va. App. 394, 482 S.E.2d 849, 1997 Va. App. LEXIS 141 (1997), limited, A New Leaf, Inc. v. Webb, 26 Va. App. 460, 495 S.E.2d 510, 1998 Va. App. LEXIS 52 (1998).

    Tendonitis compensable where caused by other compensable injury. —

    Where an admittedly compensable injury to the claimant’s right knee was the cause of tendonitis subsequently diagnosed in his left knee, claimant was entitled to compensation for the tendonitis. He was not barred from compensation therefor on grounds that tendonitis is an ordinary disease of life, since it was a consequence of treatment rendered for other admittedly compensable injuries. Washington Metro. Area Transit Auth. v. Medley, 1 Va. App. 113, 335 S.E.2d 845, 1985 Va. App. LEXIS 72 (1985).

    Carpal tunnel syndrome. —

    The Compensation Commission could find that a worker’s bilateral carpal tunnel syndrome was an occupational disease as defined in this section, where the worker’s physician’s report specifically concluded that each of the six conditions required by this section was satisfied and no evidence was introduced to rebut the report. Knott v. Blue Bell, Inc., 7 Va. App. 335, 373 S.E.2d 481, 5 Va. Law Rep. 795, 1988 Va. App. LEXIS 119 (1988).

    In enacting the current statutory scheme, the legislature intended that carpal tunnel syndrome, when it develops gradually as the body’s response to overuse or cumulative motion, be treated as a disease. Rocco Turkeys, Inc. v. Lemus, 21 Va. App. 503, 465 S.E.2d 156, 1996 Va. App. LEXIS 1 , vacated, 22 Va. App. 395, 470 S.E.2d 574, 1996 Va. App. LEXIS 385 (1996).

    Claimant was not entitled to an award for carpal tunnel syndrome, where he had used his motorcycle as his sole means of transportation to and from work, which required substantial repetitive use of the left hand. Strahan v. Automotive Indus. of Va., Inc., No. 0615-89-3 (Ct. of Appeals May 8, 1990).

    Evidence was insufficient to show that golf course groundskeeper’s carpal tunnel syndrome followed as an incident of occupational disease, where there was no medical evidence of any repetitive movements or activities which are usually found in the development of carpal tunnel syndrome. Mathews v. Cavalier Golf & Yacht Club, No. 0472-90-1 (Ct. of Appeals Oct. 16, 1990).

    Because there was no evidence of substantial exposure to the causative hazards of carpal tunnel syndrome outside of claimant’s employment, the commission properly considered claimant’s claim under the provisions of this section rather than § 65.2-401 . Brockway v. Berry, 1995 Va. App. LEXIS 941 (Va. Ct. App. Dec. 29, 1995).

    Decision awarding claimant compensation for her left carpal tunnel syndrome was supported by credible evidence. Personnel v. Hillman, No. 1761-89-4 (Ct. of Appeals Sept. 11, 1990).

    Carpal tunnel syndrome is characteristic of employment involving the type of repetitious movement required of a production seamstress, and employee’s carpal tunnel syndrome was caused by conditions peculiar to her work. Tultex Corp. v. Turley, 1994 Va. App. LEXIS 504 (Va. Ct. App. July 26, 1994).

    Where the Workers’ Compensation Commission assumed but failed to find that worker’s carpal tunnel syndrome, which resulted from repetitive activity, was a disease, the Court of Appeals remanded this case for the Commission to make a factual finding whether worker’s carpal tunnel syndrome was a disease within the meaning of that term in this section. Virginia Supermarkets v. George, 18 Va. App. 452, 445 S.E.2d 156, 10 Va. Law Rep. 1410, 1994 Va. App. LEXIS 338 (1994).

    Credible evidence existed to support the Virginia Workers’ Compensation Commission’s decision that an employee’s pre-existing right side carpal tunnel syndrome was compensable because it was aggravated by his compensable injury by accident to his right arm when the employee slipped at work. Blue Ridge Mkt. of Va., Inc. v. Patton, 39 Va. App. 592, 575 S.E.2d 574, 2003 Va. App. LEXIS 16 (2003).

    Credible evidence showed properly that claimant’s carpal tunnel syndrome arose out of and in the course of his employment as an auto body repairman for 15 years and that his injury did not result from causes outside his employment. Kern Motor Co. v. Buckley, 2003 Va. App. LEXIS 44 (Va. Ct. App. Feb. 4, 2003).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s causation finding where a physician answered questions tracking the language of subsection B of § 65.2-400 , which confirmed his opinion that a workers’ compensation claimant’s carpal tunnel syndrome was caused by her work, the claimant’s symptoms began about a year after she began her work on a machine involving repetitive motions, and the claimant was not involved in any non-work activities where she constantly made the same motions. Tex Tech Indus. v. Ellis, 44 Va. App. 497, 605 S.E.2d 759, 2004 Va. App. LEXIS 598 (2004).

    Opinion of a workers’ compensation claimant’s treating physician that, based on the claimant’s history and examination, there were no other probable causes for the claimant’s carpal tunnel syndrome aside from repetitive trauma occurring while he was butcher with the employer was sufficient to support the Virginia Workers’ Compensation Commission’s finding of causation because it permitted the reasonable inference that the physician had investigated any other possible causes for the claimant’s carpal tunnel syndrome, in addition to his industrial accident and, thus, had the requisite knowledge of the claimant’s activities outside his employment. The fact that the record did not contain any specific information regarding the claimant’s reports to the physician concerning the claimant’s outside activities did not prevent the Commission from drawing this inference from the evidence before it. Giant Food, Inc. v. Marcum, 2005 Va. App. LEXIS 141 (Va. Ct. App. Apr. 12, 2005).

    In an appeal pursuant to subsection A of § 65.2-706 , it was determined that a workers’ compensation commission properly denied a worker claim for workers’ compensation benefits based on carpal tunnel syndrome, as the worker failed to show that pre-existing blood disorders did not contribute to the development of the carpal tunnel syndrome. Leuthner v. Can. Dry Potomac Corp., 2005 Va. App. LEXIS 331 (Va. Ct. App. Aug. 30, 2005).

    While both the treating physicians could have opined that the claimant’s disease was caused by her work, the commission was certainly free to disregard those opinions because they were not supported by the evidence and the employer’s doctors stated that based on the claimant’s job duties her carpal tunnel syndrome was not cause by her employment. Harris v. Goodyear Tire & Rubber Co., 2009 Va. App. LEXIS 547 (Va. Ct. App. Dec. 8, 2009).

    Bronchitis is an ordinary disease of life to which the general public is exposed. Perrin v. Brunswick Corp., 333 F. Supp. 221, 1971 U.S. Dist. LEXIS 10927 (W.D. Va. 1971).

    Hearing loss is an ordinary disease of life suffered by much of the population for a variety of reasons, including but not limited to noise exposure both on and off the job, by gradual injury, by infection, and the aging process. Noise exposure is inescapably connected to modern living. We are constantly subjected to loud noises, including but not limited to sirens, horns, and engines which may be heard daily about the streets. Belcher v. City of Hampton, 1 Va. App. 312, 338 S.E.2d 654, 1986 Va. App. LEXIS 200 (1986).

    Hearing loss caused by prolonged exposure to noise at work is a noncompensable gradually incurred injury. Allied Fibers v. Rhodes, 23 Va. App. 101, 474 S.E.2d 829, 1996 Va. App. LEXIS 584 (1996).

    Where employee showed that his hearing loss was a result of industrial noise which was a distinctive feature of his work environment and he was continuously exposed to loud banging and clanging in the building where he worked, there was credible evidence to support the commission’s finding that the loss was characteristic of the employment and caused by the conditions peculiar to the employment. Ingersoll-Rand Co. v. Musick, 7 Va. App. 684, 376 S.E.2d 814, 5 Va. Law Rep. 1726, 1989 Va. App. LEXIS 16 (1989).

    When hearing loss qualifies as ordinary disease of life. —

    The provision under subsection C including hearing loss as an ordinary disease of life did not apply to causes of action that accrued prior to July 1, 1997. Adams v. Alliant Techsystems, Inc., 261 Va. 594 , 544 S.E.2d 354, 2001 Va. LEXIS 57 (2001).

    Post traumatic stress disorder. —

    Post traumatic stress disorder (PTSD), may be compensable as an “injury by accident” or as an “occupational disease,” depending on how it develops. When based upon a single physical injury or obvious sudden shock or fright, PTSD may be considered an injury by accident, when it is suffered as a result of ongoing stress, it qualifies as a disease. Mottram v. Fairfax County Fire & Rescue, 35 Va. App. 85, 542 S.E.2d 811, 2001 Va. App. LEXIS 102 (2001), aff'd in part and rev'd in part, 263 Va. 365 , 559 S.E.2d 698, 2002 Va. LEXIS 45 (2002).

    While posttraumatic stress disorder may be compensable as an injury by accident in some cases and in other cases the disorder may be an occupational disease, credible evidence established that a paramedic’s posttraumatic stress disorder resulting from repeated exposure to traumatic stressors was an occupational disease to which the paramedic was entitled workers’ compensation benefits. Fairfax County Fire & Rescue Dep't v. Mottram, 263 Va. 365 , 559 S.E.2d 698, 2002 Va. LEXIS 45 (2002).

    Workers’ compensation commission award of benefits for a fireman’s post traumatic stress disorder (PTSD) was proper; substantial evidence (medical experts and the fireman) of constant exposure to multiple stressful events (rather than a particular event), symptoms, lack of non-work medical history of illness that would cause the same symptoms, and post-retirement improvement indicated PTSD was compensable work-related, occupational disease under § 65.2-400 or an ordinary disease of life under § 65.2-401 to be treated as a § 65.2-400 occupational disease. Petersburg Fire & Rescue v. Wells, 2004 Va. App. LEXIS 477 (Va. Ct. App. Oct. 5, 2004).

    Ailment diagnosed as post traumatic stress disorder may be classified as either a disease or an injury by accident under the Virginia Workers’ Compensation Act, depending on the facts of each case, but if a claimant proves the ailment did not occur as a result of a specific injury, the Virginia Workers’ Compensation Commission may, without further proof, infer that it is a disease under the act, absent evidence to the contrary. Petersburg Fire & Rescue v. Wells, 2004 Va. App. LEXIS 477 (Va. Ct. App. Oct. 5, 2004).

    Where credible medical evidence established that an employee’s post traumatic stress disorder (PTSD) was intimately related to his service-connected activities and no evidence indicated that the employee had been exposed to traumatic events outside his employment, under § 65.2-706 an appeals court was to (and did) affirm the Virginia Workers’ Compensation Commission’s conclusion that the PTSD was an occupational disease under § 65.2-400 . Petersburg Fire & Rescue v. Wells, 2004 Va. App. LEXIS 477 (Va. Ct. App. Oct. 5, 2004).

    While the expert opinions of medical providers that a claimant’s work-related experiences in a career as a firefighter paramedic caused the claimant’s post-traumatic stress disorder (PTSD) constituted credible evidence that the claimant’s PTSD was a result of work-related stresses, remand for factual finding as to whether the claimant’s post-Hurricane Katrina relief effort activities was the same work or process of a firefighter paramedic was necessary to determine whether the claimant’s PTSD was an occupational disease. City of Norfolk v. Munker, 2018 Va. App. LEXIS 5 (Va. Ct. App. Jan. 9, 2018).

    When post traumatic stress disorder qualifies as a disease. —

    Post traumatic stress disorder qualifies as a disease when incurred from repeated exposure to traumatic stressors, which causes reactions in the individual’s neurobiological systems. Petersburg Fire & Rescue v. Wells, 2004 Va. App. LEXIS 477 (Va. Ct. App. Oct. 5, 2004).

    Florist’s allergic contact dermatitis. —

    Allergic contact dermatitis is a reaction of the body’s immune system to the substance to which that person is sensitive. Where the chemicals in flowers triggered a dermatological reaction in a florist, which is distinct from the wear and tear resulting from a repetitive motion, the florist’s allergic contact dermatitis was a compensable occupational disease within the meaning of this section. A New Leaf, Inc. v. Webb, 257 Va. 190 , 511 S.E.2d 102, 1999 Va. LEXIS 10 (1999).

    Asbestos evidence sufficient. —

    Claimant’s testimony regarding the white dust she frequently encountered in her work environment, the testimony and opinions of the expert, an industrial hygienist, the opinions of claimant’s physicians, and the documents reflecting that friable asbestos was located above the acoustical ceiling tiles on every floor of the building and in the building’s air handling system, constituted ample credible evidence to support the commission’s finding that claimant acquired mesothelioma as a direct result of her exposure to asbestos during her thirteen years of working for employer in the building. Department of Health/Commonwealth v. Keene, No. 1732-96-1 (Ct. of Appeals Jan. 7, 1997).

    Repetitive trauma injuries are not compensable under the Workers’ Compensation Act. Vanity Fair Corp. v. Monger, 21 Va. App. 59, 461 S.E.2d 429, 12 Va. Law Rep. 182, 1995 Va. App. LEXIS 683 (1995).

    Lumbosacral strain of gradual development is not an occupational disease as defined in this section. Holly Farms/Federal Co. v. Yancey, 228 Va. 337 , 321 S.E.2d 298, 1984 Va. LEXIS 206 (1984).

    Infection was caused by work and was natural incident of work. —

    The uncontradicted evidence, that helicobacter pylori is a waterborne bacterium of fecal origin, that its usual intrusion into the body is by the fecal-oral route, that claimant was daily immersed in an ever-changing and ever-replenished pool of raw fecal matter, that his well water at home was uncontaminated, that no other member of his family suffered from the infection, and that no other possible source of infection could be disclosed, compelled the conclusion that the infection was directly caused by the conditions of claimant’s work, followed as a natural incident of the work, and was fairly traceable to the employment. Wells v. Commonwealth, DOT, 15 Va. App. 561, 425 S.E.2d 536, 9 Va. Law Rep. 705, 1993 Va. App. LEXIS 3 (1993).

    Methicillin-resistant staphylococcus aureus infection. —

    Credible evidence supported the Virginia Workers’ Compensation Commission’s finding that an employee proved by clear and convincing evidence that her Methicillin-Resistant Staphylococcus Aureus (MRSA) infection constituted a compensable ordinary disease of life under § 65.2-401 because an infectious disease specialist’s opinion that the employee’s MRSA was “most likely” acquired at a hospital could reasonably provide the Commission with a firm belief that the primary source of the employee’s MRSA infection was her employment at the hospital and that her MRSA was directly and proximately caused by that employment; because the specialist and the employee’s treating physician explained why they found a direct causal connection between the employee’s MRSA and her employment, their opinions were sufficient for the Commission to form a firm belief or conviction as to the cause of the employee’s MRSA. Cent. State Hospital v. Beckner, 2008 Va. App. LEXIS 142 (Va. Ct. App. Mar. 25, 2008).

    Rotator cuff tear. —

    Because rotator cuff tear suffered by employee was classified as an injury, not a disease, the cuff tear was not a compensable occupational disease. Merillat Industries, Inc. v. Parks, 246 Va. 429 , 436 S.E.2d 600, 10 Va. Law Rep. 464, 1993 Va. LEXIS 139 (1993).

    Tuberculosis. —

    Where claimant, a deputy sheriff, worked at a city jail since 1985, evidence was sufficient to support the commission’s finding that claimant’s tuberculosis was an ordinary disease of life rather than an occupational disease. Lindenfeld v. Richmond Sheriff's Office, 25 Va. App. 775, 492 S.E.2d 506, 1997 Va. App. LEXIS 651 (1997).

    Eczema not compensable. —

    This section requires that the disease be incidental to the character of the business and, thus, where the claimant’s treating physician opined that the claimant’s hand eczema was not an occupational disease and was not characteristic of her employment but, instead, wrote that her condition was a “disease of life,” the claimant’s condition was not an occupational disease for which she could recover compensation. Genie Co. v. Hammer, 32 Va. App. 257, 527 S.E.2d 470, 2000 Va. App. LEXIS 300 (2000).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Note: Also see Notes in § 65.2-401 . Citations in that section may apply.

    General:

    Employee, who developed reactive airways disease as a result of workplace exposure to chemical fumes and was restricted from returning to pre-injury work because of this condition, entitled to total disability benefits upon showing of adequate marketing, despite employer’s argument that employee’s restrictions were not based upon any disability but only upon a susceptibility to disease; Commission found that employee had not returned to baseline, pre-injury status, but had a decreased physical capacity because of the injury. Thomas v. Honeywell, Inc., VWC File No. 207-73-32 (Sept. 8, 2003).

    In denying benefits for carpal tunnel syndrome, the Court held that “job-related impairments resulting from cumulative trauma caused by repetitive motion, however labeled or however defined, are, as a matter of law, not compensable under the present provisions of the Act.” Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    The Virginia Supreme Court in Stenrich Group v. Jemmott ruled that “job-related impairments resulting from cumulative trauma caused by repetitive motion . . . are, as a matter of law, not compensable under the present provisions of the Act.” One of the cases decided in Jemmott involved an employee who developed “trigger thumbs” as a result of her employment. Following Jemmott, the Virginia General Assembly amended the Act to specifically include carpal tunnel syndrome as an “ordinary disease of life.” After the amendments, carpal tunnel syndrome may be compensable; trigger thumb, however, remains outside the scope of the Act, when the condition results from repetitive trauma. Henssler v. Hair World, Inc., 78 O.W.C. 126 (1999).

    A claim for an occupational disease condition is not barred by The Stenrich Group v. Jemmott , which involved cumulative trauma injuries caused by repetitive motion. Saunders v. Outsource Resource, 76 O.W.C. 439 (1997).

    Nothing in The Stenrich Group v. Jemmott , precluded an award for a compensable occupational disease and disability resulting from a condition caused by cumulative exposure to fumes or gases. Musik v. Pinnacle Painting, 76 O.W.C. 168 (1997).

    Occupational diseases caused by inhaling noxious fumes are not foreclosed by The Stenrich Group v. Jemmott , which involved repetitive motion activities, nor by Allied Fibers v. Rhodes and United Airlines, Inc. v. Walter , which involved cumulative trauma resulting from exposure to sound waves and light rays. Keefover v. Ridgeview Country Club, 76 O.W.C. 269 (1997).

    The employee does not have to prove that injurious work exposure was the cause of his occupational disease. The employee need prove only sufficient exposure that results in actual causation or aggravation of the disease. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    The amendment and enactment of §§ 65.1-46 and 65.1-46.1 (now § 65.2-400 and § 65.2-401 ) do not overrule the Virginia Supreme Court’s finding in Ashland Oil Co. v. Bean , 225 Va. 1 , 300 S.E.2d 739 (1983), that an ordinary disease of life aggravated by the worker’s environment is not compensable as an occupational disease. Head v. Newport News City Police Department, 65 O.I.C. 166 (1986).

    An occupational disease which is an aggravation of a pre-existing disease is not compensable. Alexander v. Russell Stover Candies, 76 O.W.C. 448 (1997).

    Where a pre-existing condition has been successfully treated with full recovery, a subsequent occupational disease is not an aggravation of a pre-existing condition that precludes the award of benefits. McDermott v. United Airlines, 70 O.I.C. 166 (1991).

    Once the evidence established that the claimant had recovered from fibromyalgia and that continuing work restrictions were imposed only to prevent a reoccurrence of the problem, the claimant no longer remained entitled to benefits. Cooper v. Ethan Allen, 73 O.W.C. 110 (1994).

    Medical restrictions from returning to the workplace that are shown to be causing the employee’s compensable allergic reaction are analogous to a release with restrictions that prevent a return to pre-injury work, and establishes continuing partial impairment. Simpson v. Department of Social Services, 75 O.W.C. 105 (1996).

    An employee, whose claim for an injury by accident from an electrical shock was settled by Petition and Order, is not precluded from filing a claim for the occupational disease of carpal tunnel syndrome. An application for benefits for an occupational disease is a distinct and different cause of action from an application for an injury by accident. White v. Planters Peanuts, 70 O.I.C. 150 (1991).

    The Hearing Determination Chart, the Snellens Chart, and the Pneumoconiosis Guide are merely guidelines and cannot take precedence over § 65.1-56 (now § 65.2-503 ) which they are designed to implement. Specifically, the Commission has not adopted any substantive rule requiring the use of the ANSI standard for measuring hearing loss. Bader v. Norfolk Redevelopment & Hous. Auth., 10 Va. App. 697, 396 S.E.2d 141, 7 Va. Law Rep. 204, 1990 Va. App. LEXIS 152 (1990). [ Note: Effective January 1, 1994, Rule 11 (Pneumoconiosis), Rule 12 (Hearing Loss) and Rule 13 (Snellen Chart) were adopted] .

    The purpose of weekly death benefits, based on the decedent’s average weekly wage, is to replace the wages lost to the dependents as a result of the death. No indemnity benefits should be awarded if the decedent had no income for the 52 weeks preceding the communication of the diagnosis of an occupational heart disease. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Where there was a complete absence of earnings during the 52 weeks preceding death or communication of a diagnosis of an occupational heart disease, there are no earnings upon which an average weekly wage can be established to award weekly compensation benefits to statutory beneficiaries. The Commission distinguished Roller v. Basic Construction Company , 238 Va. 321 , 384 S.E.2d 323 (1989), as a case applying a statutory amendment to § 65.2-406 (C) pertinent only to asbestos claims. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Diagnosis/Disease:

    Claim for Lyme disease/post-Lyme syndrome denied where evidence failed to establish disease or syndrome causing claimant’s symptoms. Commission could not determine if claimant suffered from occupational disease or ordinary disease since totality of evidence did not establish specific disease afflicting her. Allen v. City of Chesapeake, JCN VA000001029349 (Feb. 12, 2016).

    For appellate decisions relating to whether a condition is a disease see:.Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996); Merillat Industries, Inc. v. Parks, 246 Va. 429 , 436 S.E.2d 600, 10 Va. Law Rep. 464, 1993 Va. LEXIS 139 (1993); Piedmont Mfg. Co. v. East, 17 Va. App. 499, 438 S.E.2d 769, 10 Va. Law Rep. 681, 1993 Va. App. LEXIS 642 (1993), disapproved, Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996); Department of State Police v. Haga, 18 Va. App. 162, 442 S.E.2d 765 (1994).

    Section 65.2-400 defines an occupational disease as a disease arising out of and in the course of employment, but not an ordinary disease of life to which the general public is exposed outside of the employment. Saunders v. Outsource Resource, 76 O.W.C. 439 (1997).

    Section 65.2-403 provides that the date on which an occupational disease is diagnosed and first communicated to the employee is treated as the date of injury and as the happening of an injury by accident. The rights and liabilities of the parties vest and accrue on that date. Hansford v. Ford Motor Company, 76 O.W.C. 395 (1997); Turner v. Sky Chefs, 76 O.W.C. 356 (1997).

    Where the employee was diagnosed with carpal tunnel syndrome on July 7, 1996, prior to amendment to Va. Code Ann. § 65.2-400 , her claim for carpal tunnel syndrome is noncompensable, because the law in effect on the date of accident [date of diagnosis of occupational disease] controls. Turner v. Sky Chefs, 76 O.W.C. 356 (1997); Hansford v. Ford Motor Company, 76 O.W.C. 395 (1997).

    Although the claimant’s fibromyalgia was not accurately identified initially, such a precise diagnosis of the disease is not required if there is sufficient evidence to establish a communication that the claimant’s condition was causally related to her work. Cooper v. Ethan Allen, 73 O.W.C. 110 (1994).

    The majority found that epicondylitis was a disease based on the doctor’s agreement with the dictionary definition. A dissent found that the definition blurred the distinction between injury and disease and was inconsistent with Merillat . Lingenfelter v. Rocco Further Processing, 73 O.W.C. 116 (1994).

    Precise medical terminology is not required to communicate a diagnosis of an occupational disease. It is sufficient if the physician advises the claimant that her condition is caused by her work, although he did not advise that it was a “disease.” Bell v. Sara Lee Knit Products, 74 O.W.C. 67 (1995).

    Where the claimant is unable to establish the occurrence of an injury by accident, and where there has been no diagnosis of an occupational disease, the employer is not responsible for the cost of prophylactic treatment, even for a work-related condition. Blanks v. Battlefield Veterinary Clinic, 76 O.W.C. 41 (1997).

    See City of Alexandria v. Cronin , 20 Va. App. 503, 458 S.E.2d 314 (1995) affirmed per curiam June 7, 1996, concerning who may provide a communication of an occupation disease.

    Specific Conditions:

    Asbestosis/Mesothelioma:

    Risk factors for employees with a very short but intense asbestos exposure are the same as for those with very long but low level exposure to asbestos. Flynt v. Davenport Insulation Co., 74 O.W.C. 25 (1995).

    Asbestosis is a progressive lung disease, i.e., each exposure aggravates and contributes to prior effects of the disease process. Accordingly, where the employee is exposed to asbestos at work, the last day of employment exposure is the date of last injurious exposure. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    The evidence established that the claimant’s death from mesothelioma was a result of exposure to asbestos which arose out of and in the course of his employment. Shank v. Newport News Shipbuilding and Dry Dock Company, 65 O.I.C. 181 (1986).

    Asthma/Bronchitis/Respiratory Conditions:

    Compensation benefits were awarded to an employee for occupational asthma/bronchitis incurred as a result of exposure to cardboard dust fumes. It was irrelevant that other employees did not develop the condition despite similar exposure. Castle v. Westvaco Container Division, 69 O.I.C. 118 (1990).

    Once the employee’s respiratory condition returned to normal, he is no longer entitled to benefits merely because of susceptibility to re-contract or reactivate the disease. Castle v. Westvaco Container Division, 69 O.I.C. 118 (1990).

    Carpal Tunnel Syndrome:

    Section 65.2-400 was amended effective July 1, 1997 to provide that carpal tunnel syndrome is not an occupational disease, but is an ordinary disease of life as defined in § 65.2-401 . The Commission has held that the July 1, 1997 amendment is not retroactive. Hansford v. Ford Motor Company, 76 O.W.C. 395 (1997); Turner v. Sky Chefs, 76 O.W.C. 356 (1997).

    Chemical Exposure:

    Evidence that the general public can be exposed to insecticides is not sufficient to show that the general public is exposed to such chemicals on a routine basis. Musik v. Pinnacle Painting, 76 O.W.C. 168 (1997).

    Where the evidence established the claimant would not have been exposed to the causes of his occupational asthma had he not been painting in an enclosed structure where the chemicals had been used a short time earlier, he proves the exposure was incidental to the character of his employment. Musik v. Pinnacle Painting, 76 O.W.C. 168 (1997).

    The evidence established that the claimant’s “dementia” was a result of chemical intoxication and not an ordinary disease of life. Barnes v. Ivie Cleaners, Inc., 65 O.I.C. 176 (1986).

    The claimant, a cytotechnologist who used chemical solvents in her work, received a diagnosis and communication of an occupational disease when she was advised by her physician that she had a chemical and nutritional hypersensitivity secondary to exposure to toxic chemicals. The claimant’s condition was not an ordinary disease of life and was therefore compensable upon the establishment of the elements of § 65.1-46 (now § 65.2-400 ). Rice v. Virginia Beach General Hospital, 68 O.I.C. 128 (1989).

    The Commission found that the claimant’s exposure to fertilizers while employed as a groundskeeper caused his occupational disease. Keefover v. Ridgeview Country Club, 76 O.W.C. 269 (1997).

    The claimant worked in a cocoa bean warehouse, where she was exposed to contact with pesticides that were sprayed during early morning hours by an automatic fumigation system. The evidence showed that she was symptomatic while at work, and her symptoms decreased away from the workplace. Although OSHA inspectors detected no airborne presence of the chemical, her medical evidence established the chemical could be absorbed through the skin. The Commission held that the claimant’s organophosphate toxicity was a compensable occupational disease. Saunders v. Outsource Resource, 76 O.W.C. 439 (1997).

    Dermatitis:

    Claimant who developed dermatitis after exposure to formaldehyde was awarded benefits. Entitlement ceased once the condition was cured even if she was precluded from returning to work because of a predisposition for recurrence. Allman v. Bassett Chair Co., 66 O.I.C. 66 (1987).

    Fibromyalgia:

    Compensation benefits were awarded to the claimant, a furniture assembler, who was found to suffer from work related fibromyalgia. Cooper v. Ethan Allen, 73 O.W.C. 110 (1994).

    Frostbite:

    Compensation benefits were awarded to the claimant who suffered frostbite during extensive exposure to extreme cold temperatures. Burrell v. Washington Metropolitan Area, 71 O.W.C. 168 (1992).

    Note: Also see cases under § 65.2-101 , “Arising out of and in the Course of Employment.”

    Hearing loss:

    Relying on Stenrich Group v. Jemmott , 251 Va. 186 , 199, 467 S.E.2d 795, 802 (1996), the Court held that hearing loss was not compensable under the Act. Franklin City Public Works v. Haywood Riddick, Record No. 0397-96-3 (June 25, 1996) (Unpublished Memorandum Opinion). See also, Tara K Coal Company v. Glenn Collier , Record No. 1327-95-3 (April 25, 1996).

    The Virginia Court of Appeals on September 3, 1996 held that a hearing loss caused by prolonged exposure to noise at work is a noncompensable gradually incurred injury. Although the General Assembly changed the law so that hearing loss caused by cumulative trauma may be compensable as of July 1, 1997, that law was not made retroactive. Jost v. Pohanka Acura, 76 O.W.C. 106 (1997).

    Hepatitis:

    Employee failed to prove that Hepatitis C was caused by her employment; evidence showed that employee, a nurse who worked for employer approximately fifteen years, exposed to patients’ blood and bodily fluids at work, but there was no evidence that any patients that were treated suffered from Hepatitis C; evidence showed no needle-sticks since 1995, and thus any possible exposure from needle-sticks more than five years from filing of claim in 2002. Holbrook v. Phoebe’s Physicians, VWC File No. 210-58-69 (Feb. 14, 2004).

    Hernia:

    The Commission held that a hernia is not an occupational disease as contemplated by the Act. Sams v. The Goodyear Tire & Rubber Company, 73 O.W.C. 124 (1994).

    Impingement Syndrome/Rotator Cuff:

    The Supreme Court held that conditions such as impingement syndrome and rotator cuff tear are not diseases and therefore are not compensable under the Workers’ Compensation Act as an occupational disease. Merillat Industries, Inc. v. Parks, 246 Va. 429 , 436 S.E.2d 600, 10 Va. Law Rep. 464, 1993 Va. LEXIS 139 (1993) (reversing 15 Va. App. 44, 421 S.E.2d 867 (1992); 70 O.I.C, 158 (1991). The effect of this case is also to reverse).Holly Farms Foods, Inc. v. Carter, 15 Va. App. 29, 422 S.E.2d 165, 9 Va. Law Rep. 191, 1992 Va. App. LEXIS 231 (1992) and Stancil v. Ford Motor Company, 15 Va. App. 54, 421 S.E.2d 872 (1992) See also. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Nerve Palsy:

    The Commission found that the evidence failed to establish that the claimant’s nerve palsy was a compensable occupational disease. Campbell v. Shenandoah Teleservice, Inc., 73 O.W.C. 119 (1994).

    Pneumoconiosis:

    Stipulations are binding on a party. Parties who enter into stipulations may not set aside those stipulations except in very limited circumstances. Where a claimant, by counsel, agrees to accept the reading of the Pulmonary Committee as the binding classification regarding his claim for coal workers pneumoconiosis, he is thereafter bound by the findings of the Committee. Short v. Island Creek Coal Company, 78 O.W.C. 137 (1999).

    Tuberculosis:

    Claimant, firefighter paramedic for employer, proved compensable occupational disease of PTSD after experiencing traumatic incidents while engaged in post-Hurricane Katrina relief efforts with FEMA in New Orleans. On remand from Court of Appeals, Commission awarded benefits holding that claimant’s service in New Orleans was the same work or process that he had been engaged in for employer, namely labor as a firefighter paramedic, and his exposure to traumatic events while so working was not exposure outside of his employment. Munker v. City of Norfolk, JCN VA00001035404 (May 17, 2018).

    In awarding benefits to a mental health technician, who was exposed to a patient with active pulmonary tuberculosis, subsequently tested positive and has been treated with medication, the Commission held that a person does not have to have active tuberculosis to qualify for benefits if the evidence establishes that the pathogenic bacteria have been introduced into the body and have caused an immune response. Young v. Chesapeake General Hospital, 73 O.W.C. 122 (1994).

    Compensation was awarded pursuant to § 65.2-400 on the basis that the health care worker was not exposed to tuberculosis outside of her employment and her employment in a hospital put her peculiarly at risk to exposure to the disease. Young v. Chesapeake General Hospital, 73 O.W.C. 122 (1994).

    Vision:

    The claimant’s myopia and astigmatism condition were not an occupational disease as defined by the statute. Head v. Newport News City Police Department, 65 O.I.C. 166 (1986).

    Other:

    Benefits were awarded where the Commission found that the employee’s ganglion cyst was not an ordinary disease of life and was related to her specific work activities as a deli clerk. Beiler v. Farm Fresh Supermarkets, 70 O.I.C. 176 (1991).

    The medical evidence established that the claimant’s right hand trigger finger developed as a result of repetitive trauma to her fingers. Although the employer, before Jemmott, had accepted liability for a similar condition of the left hand, the General Assembly has chosen not to recognize trigger thumb resulting from repetitive activity as a compensable condition under the Act, and the Commission held that the right hand trigger finger was not compensable. Henssler v. Hair World, Inc., 78 O.W.C. 126 (1999).

    NOTE: The following cases were decided before the October 1, 1991 recodification and before the enactment of § 65.1-46.1 (now § 65.2-401 )..

    General:

    Until a diagnosis is made, the nature of the disease determined, and the diagnosis communicated to employee, the statute of limitations does not begin to run. Advice to change jobs and that a malady may be related to the work is not a diagnosis. Sisler v. Safeway Stores, Inc., 44 O.I.C. 234 (1962).

    The Act makes no provision for compensation of a preexisting condition in the context of an occupation disease. Hatfield v. Safeway Stores, Inc., 60 O.I.C. 192 (1981).

    It must be made apparent to the rational mind that there is direct causal connection between the conditions of work and the disease; that the disease was contracted as a result of exposure occasioned by the employment, and can fairly be traced to the employment as the proximate cause. The burden is on the claimant to establish causal connection. Van Geuder v. Commonwealth, 192 Va. 548 , 65 S.E.2d 565, 1951 Va. LEXIS 202 (1951).

    Whether disease is occupational must be determined by the peculiar characteristics of each employment, the type of work in which employee is engaged, and the effect it has on the individual. Where claimant suffered a deep peroneal nerve injury as the result of working in a squatting position for extended periods of time he sustained an occupational disease within the purview of this section. Brisson v. Bateson Co., Inc., 42 O.I.C. 18 (1960).

    Specific Conditions:

    Arthritis:

    Compensation denied where evidence shows that the employee’s arthritic condition is an aggravation of an ordinary disease of life by work exposure. Hatfield v. Safeway Stores, Inc., 60 O.I.C. 192 (1981).

    Asbestos/Mesothelioma:

    Exposure to asbestos for as little as 5% of work time was compensable. Daniel v. Porter Hayden Co., 58 O.I.C. 76 (1978); Mixon v. Caudle-Hyatt, Inc., 220 Va. 645 , 260 S.E.2d 193 (1979).

    Lung carcinoma causally related to injurious exposure to causative hazards of asbestosis was compensable. Park v. Natkin & Co., et al., 56 O.I.C. 241 (1975) (affd. on review, appeal denied); Brooks v. AC&S, etc., 57 O.I.C. 56 (1976).

    Cancer of throat not proven related to asbestos exposure. Buckner v. Conumat Systems, Inc., 59 O.I.C. 42 (1981).

    Mesothelioma occurring after a first stage rating was awarded as a new accident. Brooks v. AC&S, etc., 57 O.I.C. 56 (1976).

    Asthma/Broncitis/Emphysema:

    Asthma is an ordinary disease of life and absent requisite causal connection to work environment is not compensable. Swiggard v. City of Alexandria, 60 O.I.C. 435 (1981) (see also Lawson v. Blue Diamond Co., 36 O.I.C. 105 (1954); Watkins v. Newport News S.B. & Dry Dock, 32 O.I.C. 106 (1950)).

    Bronchitis caused by exposure to ink fumes and chemicals at work was compensable. Berberick v. Beacon Press, Inc., 54 O.I.C. 11 (1972).

    Bronchitis and pharyngitis caused by inhalation of pain fumes was compensable. Tucker v. Porter Co. Inc., 52 O.I.C. 264 (1970).

    Emphysema is compensable if it may be fairly traced to the employment. Williams v. Chesapeake, 57 O.I.C. 387 (1976).

    Emphysema held compensable. Williams v. Chesapeake, 57 O.I.C. 387 (1976).

    Emphysema was not compensable. Raynes v. Rockingham County School Board, 46 O.I.C. 194 (1964); Clark v. Appalachian Mfg. Corp., 46 O.I.C. 47 (1964).

    Byssinosis:

    Disability was probably due to a non-compensable cause and byssinosis. Simpkins v. Dan River, Inc., 59 O.I.C. 276 (1980).

    Compensation benefits for byssinosis were denied. Caskey v. Dan River Mills, Inc., 225 Va. 405 , 302 S.E.2d 507 (1983), 60 O.I.C. 81 (1981); Barrington v. Dan River Mills, Inc., 225 Va. 240 , 302 S.E.2d 505 (1983), 60 O.I.C. 32 (1981); Adkins v. Dan River Mills, Inc., 60 O.I.C. 9 (1981), 3 Va. App. 320, 349 S.E.2d 667; Smith v. Fieldcrest Mills, Inc., 224 Va. 24 , 294 S.E.2d 805, 1982 Va. LEXIS 267 (1982).

    Carpal Tunnel/Epicondylitis/Tendonitis:

    Carpal tunnel syndrome of right wrist was awarded. Rohertson v. Westvaco Corp., 53 O.I.C. 309 (1971); Taylor v. Taylor, 48 O.I.C. 246 (1966).

    Epicondylitis (tennis elbow) was compensable. Colonial Village Apts., Inc., 34 O.I.C. 220 (1952).

    Tendonitis was characteristic of and peculiar to the employment. Wade v. Kay Jewelry Stores, Inc., 38 O.I.C. 17 (1956).

    Tendonitis held a compensable occupational disease. Hackler v. Hanes Corporation, 60 O.I.C. 176 (1981).

    Tenosynovitis held compensable. Wilkinson v. Beachum Ponbeach Constr. Corp., 42 O.I.C. 139 (1960).

    Chemical Exposure/Lead Poisoning:

    Benefits were awarded for lead poisoning or intoxication. Head v. Beaver Valley Painting Co., 49 O.I.C. 147 (1967).

    Lung disease not caused by chemicals and dust inhaled in employment. Taylor v. Allied Chemical Corp., 47 O.I.C. 321 (1965).

    Chronic lung inflammation was not causally related. Lambert v. National Carbide Corp., 31 O.I.C. 187 (1949).

    Leukopenia and granulocytopenia due to inhalation of cleaning fluid fumes. Lewis v. Crossroads Cleaners & Dyers, 54 O.I.C. 222 (1972).

    Malignant hypertension as a result of carbon disulfied poisoning awarded. White v. FMC Corp., 57 O.I.C. 373 (1977).

    Dermatitis:

    Dermatitis is compensable if it resulted from exposure in the employment. Hayward v. Piping & Equip. Co., 34 O.I.C. 289 (1952); Justice v. Daniels Plumbing & Heating Co. Inc., 50 O.I.C. 220 (1968) (exposure to fiberglass insulation).

    Compensation benefits were awarded where fluorescent lighting at work resulted in erythematous dermatitis of left side of claimant’s face. Coleman v. Central Telephone Company of Virginia, 60 O.I.C. 103 (1981). But see United Airlines v. Walter, 24 Va. App. 394, 482 S.E.2d 849, 1997 Va. App. LEXIS 141 (1997), limited, A New Leaf, Inc. v. Webb, 26 Va. App. 460, 495 S.E.2d 510, 1998 Va. App. LEXIS 52 (1998) (holding that photosensitivity is a cumulative injury rather than a disease.).

    Dermatitis from lime poisoning found to be compensable. Kimmer v. Canon Constr. Corp., 47 O.I.C. 185 (1965); Hayward v. Piping & Equip. Co., 34 O.I.C. 289 (1952).

    Atopic dermatitis is not compensable is there is no causal relationship to a hazard of employment. Raines v. Hercules Powder Co., 36 O.I.C. 284 (1954).

    When an employee, incapacitated by occupational dermatitis, is completely cured of his condition, his right to compensation ceases, nothwithstanding that he cannot be re-employed in his former position for fear of reactivation. Susceptibility to dermatitis following complete cure of acute condition cannot be basis for compensation. Walters v. Reynolds Metals Co., 43 O.I.C. 110 (1961).

    Susceptibility to dermatitis from paint irritants following complete cure of acute condition, was not compensable. Ennis v. Dowling Co., Inc., 49 O.I.C. 97 (1967).

    Susceptibility to chemical pneumonitis from paint spraying following a cure of an acute condition is not compensable. McConchie v. Johnson, Inc., 52 O.I.C. 171 (1970).

    If dermatitis is a recurring disability that is never cured but is due to a new exposure, a change in condition exists rather than a new accident. McDaniel v. Folker, 49 O.I.C. 201 (1967), affirmed by Supreme Court of Virginia under style of Hawkeye-Security Ins. Co. v. McDaniel, 210 Va. 209 , 169 S.E.2d 582 (1969); Durham v. Walker Machine & Foundry Co., 52 O.I.C. 90 (1970).

    Hearing:

    Hearing loss found compensable. Mullins v. Clinchfield Coal Co. et al. (appeal denied), 58 O.I.C. 253 (1978).

    Heart/Circulation:

    Calcification of coronary arteries is not occupational heart disease. Stephenson v. Henrico County Police Dept., 58 O.I.C. 337 (1979).

    Benefits for “effort thrombosis” of the left axillary veins of the shoulder caused by prolonged vigorous effort of carpenter were awarded. Moats v. Hengen-Cavalier Constr. Corp., 52 O.I.C. 182 (1970).

    Award made for repeated trauma to hands causing numbness and loss of circulation. Ferguson v. Dixie Container Corp., 52 O.I.C. 99 (1970).

    Hepatitis:

    Claimant who was directly exposed to hepatitis in hospital work was awarded benefits. Noe v. Hopewell Hospital Authority, 56 O.I.C. 235 (1974).

    Infectious hepatitis found to be compensable. Bullock v. Petersburg Training School & Hospital, 54 O.I.C. 40 (1972); Hutchens v. County of Fairfax Dept. of Public Works, 59 O.I.C. 140 (1980).

    Hepatitis-B contracted in claimant’s work at a sewage plant held compensable. Hutchin v. County of Fairfax/Department of Public Works, 60 O.I.C. 221 (1981).

    Hepatitis not proved contracted in employment in hospital. Tuck v. Roanoke Memorial Hospital, 52 O.I.C. 261 (1970).

    Meatwrappers Conditions:

    Evidence held insufficient to establish causation between asthmatic bronchitis (meatwrapper’s disease) and occupation. Esque v. Giant Food, Inc., 56 O.I.C. 104 (1975).

    Reynaud’s Syndrome from working in cold moist conditions as meatwrapper was found to be compensable. Hux v. Ukrop’s Super Market Inc., 53 O.I.C. 150 (1971).

    Brucellosis contracted from occupation exposure to raw meat held compensable. Delk v. Smithfield Packing Co., 60 O.I.C. 139 (1981); Wells v. Gwaltney, Inc., 49 O.I.C. 331 (1967).

    Meatwrapper’s disease, bronchial asthma, pulmonary fibrosis was compensable. Good v. Great A & P Tea Co., 52 O.I.C. 112 (1970); Robertson v. A & P, 57 O.I.C. 306 (1978); Smith v. A & P, 52 O.I.C. 239 (1970).

    Pneumoconiosis:

    Pneumoconiosis is a generic term defined as a chronic fibrous reaction in the lungs to the inhalation of dust. Claimant found not to have coal worker’s pneumoconiosis. Powers v. Clinchfield Coal Co., 52 O.I.C. 200 (1970) (appeal denied).

    Pneumoconiosis is a generic term for a group of pulmonary abnormalities from inhalation of dust particles including silicosis, siderosis, coal workers’ pneumoconiosis. The specific occupational disease (silicosis or coal worker’s pneumoconiosis) must be predicated on history of exposure. Shepherd v. Clinchfield Coal Co., 53 O.I.C. 329 (1971).

    Pneumoconiosis is detectable in life only be chest x-ray and occupational history. Brown v. Big Branch Coal Co., 53 O.I.C. 23 (1971); Burke v. Buckles Trucking Co., 53 O.I.C. 31 (1971).

    Claimant has burden of proving existence of coal worker’s pneumoconiosis by competent evidence. Smith v. Lester, 52 O.I.C. 242 (1970).

    Minimal fibrosis is an ordinary disease of life that is not covered under Act and is not a basis for diagnosis of occupational pneumoconiosis. Phipps v. Double E. Coal Co., 54 O.I.C. 306 (1972).

    Psychological Conditions:

    Where compensable tuberculosis infection required inoculation which, in turn, necessitated discontinuation of medication used to treat claimant’s psychological condition, the resulting mental problem from such discontinuation was attributable to the occupational disease and compensable. Logan v. Sleepy Hollow Manor Nursing Home, 60 O.I.C. 289 (1981).

    Schizophrenia was not compensable. Hopkins v. Va. Hot Springs, Inc., 50 O.I.C 196 (1968); Pulliam v. State Police, 45 O.I.C. 192 (1963).

    Occupational stress and heart condition not causally related. Cash v. County of Chesterfield, 58 O.I.C. 52 (1978).

    Silicosis:

    Diagnosis of silicosis cannot be made if x-ray findings are not compatible with the disease. As a general rule, radiologists’ interpretation of x-rays prevail over reading of chest films by general practitioner. Smith v. Lester, 52 O.I.C. 242 (1970).

    Silicosis found to be compensable. Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951).

    Silicosis related to employment as tombstone cutter was compensable. DeLoach v. Baer & Son Memorials, 56 O.I.C. 88 (1978).

    Silicosis claims were denied. Miller v. Galax Mirror Co., Inc., 36 O.I.C. 265 (1954); Aker v. Brunswick-Balke-Collender Co., 32 O.I.C. 1 (1950); McDaniel v. Lynchburg Foundry, 57 O.I.C. 240 (1977).

    Tuberculosis:

    Tuberculosis found compensable. Boothe v. Catawha Sanatorium, 43 O.I.C. 4 (1977).

    Tuberculosis of spine was not related to back strain. Miller v. Plantation Nursery, 47 O.I.C. 229 (1965).

    Claimant has the burden of establishing that tuberculosis was contracted as result of work. Motley v. Memorial Hospital, 55 O.I.C. 245 (1973).

    Other:

    Employment did not contribute in any peculiar or unusual way to the occurrence of the allergic reaction nor to the development of the allergic sensitivity. Beck v. Lawyer’s Title Insurance Corp., 60 O.I.C. 39 (1981).

    Amyotrophic lateral sclerosis of unknown etiology was not compensable. Janosik v. Hercules, Inc., 53 O.I.C. 154 (1971).

    Anthracosis found to be compensable. Blue Diamond Coal Company v. Pannell, 203 Va. 49 , 122 S.E.2d 666, 1961 Va. LEXIS 219 (1961).

    Bryssinosis causally related to inhalation of fiber dust in garment manufacturing was found to be compensable. Maness v. Miss Va., Inc., 55 O.I.C. 235 (1973).

    Cirrhosis of liver was not compensable. Parrish v. Horne Co., 31 O.I.C. 198 (1949).

    Delirium tremens caused by removal of alcohol from use by claimant following hospitalization from carbon monoxide poisoning in employment was compensable. Showalter v. Woody Chevrolet Sales, 34 O.I.C. 327 (1952).

    Repeated acts of trauma causing indentation of thigh were determined to be compensable.Ewing v. Fletcher’s, Inc., 48 O.I.C. 78 (1966).

    Repeated operation of foot treadle causing march fracture of metatarsal bone. Rankin v. Crompton-Shenandoah Co., 54 O.I.C. 310 (1972).

    Injured knee cartilage without an accident was not awarded. Robleder v. Richmond Eng. Co., Inc., 36 O.I.C. 390 (1954).

    Infectious jaundice was not compensable. Haas v. City of Waynesboro, 38 O.I.C. 8 (1956).

    An award for spontaneous pneumothorax was denied. Perrin v. Brunswick Corp., 51 O.I.C. 212 (1969).

    Psittacosis (parrot fever) was not compensable. Holland-McClung v. Cardinal Stores, 49 O.I.C. 159 (1967).

    Undulant fever denied. Sanford v. Commonwealth, 35 O.I.C. 417 (1953).

    Varicose veins denied. Loftis v. Robbins Mills, Inc., 38 O.I.C. 78 (1956).

    OPINIONS OF THE ATTORNEY GENERAL

    Covid-19. —

    If COVID-19 is an upper respiratory disease, it falls under the heart and lung presumption of the Act for first responders, however the statutory presumption applies only to a limited class of first responders under certain circumstances and, therefore, would not have broad applicability to all or most of the first responders whose official duties regularly place them at far greater risk of contracting COVID-19 than the general public following social distancing guidelines. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A first responder who has the benefit of a presumption, has the initial burden of producing evidence to trigger the presumption (evidence of the disease, and evidence of disability or death caused by the disease); once the presumption is triggered, the burden shifts to the employer to rebut the presumption (that the disease was not caused by the employment and that there is a non-work-related cause). See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A presumption could be created that would benefit first responders who contract COVID-19 because the nature of their duties place them at greater risk for contracting the disease. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    § 65.2-401. “Ordinary disease of life” coverage.

    An ordinary disease of life to which the general public is exposed outside of the employment may be treated as an occupational disease for purposes of this title if each of the following elements is established by clear and convincing evidence, (not a mere probability):

    1. That the disease exists and arose out of and in the course of employment as provided in § 65.2-400 with respect to occupational diseases and did not result from causes outside of the employment, and
    2. That one of the following exists:
      1. It follows as an incident of occupational disease as defined in this title; or
      2. It is an infectious or contagious disease contracted in the course of one’s employment in a hospital or sanitarium or laboratory or nursing home as defined in § 32.1-123 , or while otherwise engaged in the direct delivery of health care, or in the course of employment as emergency rescue personnel and those volunteer emergency rescue personnel referred to in § 65.2-101 ; or
      3. It is characteristic of the employment and was caused by conditions peculiar to such employment.

    History. 1986, c. 378, § 65.1-46.1; 1989, c. 502; 1991, c. 355; 1997, cc. 15, 405.

    Law Review.

    For article, “Workers’ Compensation for Disease in Virginia: The Exception Swallows the Rule,” see 20 U. Rich. L. Rev. 161 (1985).

    For an article, “Workers’ Compensation,” see 31 U. Rich. L. Rev. 1283 (1997).

    Research References.

    Larson’s Workers’ Compensation Law (Matthew Bender). § 52.03 Definition of “Occupational Disease.” Larson and Larson.

    CASE NOTES

  • Analysis
  • I.In General.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-46.1 or prior law.

    In considering whether to proceed under this section or § 65.2-400 , the commission must determine whether the condition is one to which the general public is exposed outside of the employment. If the evidence shows that the general public is not exposed to traumatic stress reaction outside of the employment, § 65.2-400 applies. If, however, traumatic stress reaction is a condition to which the general public is exposed outside of the employment, the condition must be reviewed under this section. Marcus v. Arlington County Bd. of Supvrs., 15 Va. App. 544, 425 S.E.2d 525, 9 Va. Law Rep. 694, 1993 Va. App. LEXIS 4 (1993).

    An ordinary disease of life is one to which the general public is exposed outside of employment, but it may be treated as a compensable occupational disease if it is established by clear and convincing evidence, to a reasonable degree of medical certainty, that it arose out of and in the course of employment as provided in § 65.2-400 and did not result from causes outside of the employment. Greif Cos. v. Sipe, 16 Va. App. 709, 434 S.E.2d 314, 10 Va. Law Rep. 83, 1993 Va. App. LEXIS 245 (1993).

    Central question is whether condition was caused by the employment. —

    In determining whether a disease is compensable, the central question is whether the condition was caused by the employment. Marcus v. Arlington County Bd. of Supvrs., 15 Va. App. 544, 425 S.E.2d 525, 9 Va. Law Rep. 694, 1993 Va. App. LEXIS 4 (1993).

    For ordinary disease of life to be compensable under this section, the claimant must establish by clear and convincing evidence, to a reasonable medical certainty, that the disease: (1) arose out of and in the course of employment; (2) did not result from causes outside of the employment; and (3) follows as an incident of an occupational disease, is an infectious disease or contagious disease contracted in the course of employment, or is characteristic of the employment, and was caused by conditions peculiar to the employment. Island Creek Coal Co. v. Breeding, 6 Va. App. 1, 365 S.E.2d 782, 4 Va. Law Rep. 1900, 1988 Va. App. LEXIS 29 (1988).

    Under the Workers’ Compensation Act, an occupational disease is not compensable until a diagnosis of such has been communicated to the employee. The date of the first communication of the diagnosis is treated as the happening of an injury by accident. The right to compensation in cases of accidental injury is governed by the law in effect at the time of the injury. In this case, employee’s injury occurred on July 31, 1986, the date his occupational hearing loss was first communicated to him. The law in effect on that date was that an ordinary disease of life is compensable if sufficiently connected to a claimant’s employment. Island Creek Coal Co. v. Breeding, 6 Va. App. 1, 365 S.E.2d 782, 4 Va. Law Rep. 1900, 1988 Va. App. LEXIS 29 (1988).

    The purpose of this statute was to revert the law to its state prior to Western Elec. Co. v. Gilliam, 229 Va. 245 , 329 S.E.2d 13 (1985). Island Creek Coal Co. v. Breeding, 6 Va. App. 1, 365 S.E.2d 782, 4 Va. Law Rep. 1900, 1988 Va. App. LEXIS 29 (1988).

    For an ordinary disease of life to be treated as a compensable occupational disease, claimant had to prove, by clear and convincing evidence, to a reasonable degree of medical certainty, that her asthma arose out of and in the course of her employment, did not result from causes outside of her employment, is characteristic of her employment, and was caused by the conditions peculiar to her employment. Marley Mouldings, Inc. v. Rotenberry, 1996 Va. App. LEXIS 305 (Va. Ct. App. Apr. 23, 1996).

    In order to prove a compensable ordinary disease of life under this section, the claimant must establish by clear and convincing evidence, to a reasonable medical certainty, that his injury arose out of and in the course of his employment. Gwaltney of Smithfield, Ltd. v. Cypress, 2000 Va. App. LEXIS 304 (Va. Ct. App. Apr. 25, 2000).

    For an ordinary disease of life to be treated as a compensable occupational disease, the claimant is required to prove, by clear and convincing evidence, to a reasonable degree of medical certainty, that the disease arose out of and in the course of the employment; did not result from causes outside of the employment; is characteristic of the employment; and was caused by conditions peculiar to the employment. Beverly v. UPS of Am., 1994 Va. App. LEXIS 762 (Va. Ct. App. Dec. 27, 1994).

    The requirement that a claimant must establish the source of the disease means she must point not to a single source of the disease to the complete exclusion of all other sources, but to the primary source as determined by reasonable medical certainty. Such a determination must be based on evidence that it is at least more probable than not that the disease arose out of and in the course of employment. Marcus v. Arlington County Bd. of Supvrs., 15 Va. App. 544, 425 S.E.2d 525, 9 Va. Law Rep. 694, 1993 Va. App. LEXIS 4 (1993).

    While this section does not require that a single source of the claimant’s disease be pinpointed, it does require that the primary source be determined by reasonable medical certainty. Chanin v. Eastern Va. Medical Sch., 20 Va. App. 587, 459 S.E.2d 523, 12 Va. Law Rep. 28, 1995 Va. App. LEXIS 593 (1995).

    Section 65.2-401 does not require a claimant prove one single source for an ordinary disease of life, but instead must link the disease to a primary source arising out of working conditions. Lanning v. Va. DOT, 2003 Va. App. LEXIS 81 (Va. Ct. App. Feb. 19, 2003).

    This section does not require complete absence of other possible contributing causes. Rather, the work activity must be determined, by a reasonable degree of medical certainty, to be the primary source of the ordinary disease of life. First Am. Metro Corp./First Am. Bankshares v. Dredske, 1993 Va. App. LEXIS 589 (Va. Ct. App. Nov. 30, 1993).

    Where the origin of an ordinary disease of life cannot be traced to the employment as its proximate cause, aggravation of the disease is not compensable as an occupational disease. Beverly v. UPS of Am., 1994 Va. App. LEXIS 762 (Va. Ct. App. Dec. 27, 1994).

    Ordinary diseases of life compensable in same manner as occupational diseases. —

    This section makes ordinary diseases of life compensable in the same manner as occupational diseases if they are sufficiently connected to a claimant’s employment. Via v. Citicorp Mtg., Inc., 10 Va. App. 572, 394 S.E.2d 505, 7 Va. Law Rep. 47, 1990 Va. App. LEXIS 128 (1990).

    Section not applied retroactively to certain diseases. —

    The legislature did not intend that this section be applied retroactively to ordinary diseases of life contracted and discovered prior to the effective date of the statute but not previously litigated. Foster v. Smithfield Packing Co., Inc., 10 Va. App. 144, 390 S.E.2d 141 (1990).

    Burden of proof. —

    A claimant must prove the existence of an occupational disease by a preponderance of the evidence. Moreover, one seeking to establish that an ordinary disease of life is employment-related, and should be treated as an occupational disease, bears the burden of producing clear and convincing evidence in support of that claim. White v. Planters Peanuts/Nabisco Brands, Inc., No. 0313-92-1 (Ct. of Appeals Oct. 13, 1992).

    This section does not require that the claimant prove that the occupational activity caused her tendinitis to the complete exclusion of any other contributing outside factor. Greif Cos. v. Sipe, 16 Va. App. 709, 434 S.E.2d 314, 10 Va. Law Rep. 83, 1993 Va. App. LEXIS 245 (1993).

    Where Workers’ Compensation Commission considered claimant’s condition an ordinary disease of life, claimant had the burden of producing clear and convincing evidence that her ordinary disease of life was employment related. Piedmont Mfg. Co. v. East, 17 Va. App. 499, 438 S.E.2d 769, 10 Va. Law Rep. 681, 1993 Va. App. LEXIS 642 (1993), disapproved, Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Retired firefighter-medic failed to prove any entitlement to medical benefits because he did not prove that his coronary artery disease constituted an occupational disease; the deputy commissioner found that the firefighter-medic failed to sustain his burden of proving, by clear and convincing evidence, that his coronary artery disease was a compensable ordinary disease of life, and because the firefighter-medic did not request review of that finding, the deputy commissioner’s determination was final. Lipscomb v. City of Lynchburg, 2014 Va. App. LEXIS 210 (Va. Ct. App. May 27, 2014).

    Employee was not entitled to workers’ compensation benefits because the employee failed to establish that the employee’s alleged occupational disease arose out of the employee’s exposure to a bat at work. Iglesias v. QVC Suffolk, Inc., 2019 Va. App. LEXIS 86 (Va. Ct. App. Apr. 16, 2019).

    Burdens of persuasion and production altered. —

    When the General Assembly adopted this section, it altered not only the burden of persuasion but also the burden of production on the issue of whether an occupational disease arose out of and in the course of employment. For a claimant to meet his burden of persuasion on this issue, the trier of fact must conclude that the issue was proved by clear and convincing evidence. To meet his burden of production on this issue, the claimant must introduce evidence “to a reasonable medical certainty” that the disease arose out of and in the course of employment. Westmoreland Coal Co. v. Campbell, 7 Va. App. 217, 372 S.E.2d 411, 5 Va. Law Rep. 423, 1988 Va. App. LEXIS 105 (1988), limited, Bayliss v. Woodrum, 33 Va. Cir. 338, 1994 Va. Cir. LEXIS 862 (Winchester Mar. 31, 1994).

    Weighing of conflicting medical evidence. —

    In cases of conflicting medical evidence, the general rule is that when an attending physician is positive in his diagnosis, great weight will be given by the courts to his opinion. Sunnyside Presbyterian Home v. Shifflett, 1995 Va. App. LEXIS 821 (Va. Ct. App. Nov. 7, 1995).

    The phrase “did not result from causes outside of the employment” does not preclude recovery in every instance where some other factor, other than those related to a claimant’s work duties, may have contributed in some degree to the claimant’s condition. Ross Laboratories v. Barbour, 13 Va. App. 373, 412 S.E.2d 205, 8 Va. Law Rep. 1557, 1991 Va. App. LEXIS 311 (1991) (decided under former 65.1-46.1).

    Implicit in the standard that such a determination be made “with reasonable medical certainty” is the recognition that pinpointing a single source for an ordinary disease of life will often be a difficult if not an impossible assignment; thus, the very standard on which application of the language “did not result from causes outside of the employment” turns points not to a single source, to the complete exclusion of all other sources, but to the primary source as determined by “reasonable medical certainty.” Ross Laboratories v. Barbour, 13 Va. App. 373, 412 S.E.2d 205, 8 Va. Law Rep. 1557, 1991 Va. App. LEXIS 311 (1991) (decided under former 65.1-46.1).

    Use of the terms “precipitating” or “aggravating.” —

    Physician’s use of the terms “precipitating” or “aggravating” did not indicate that plaintiff had a preexisting disease. Rather, the use of the terminology described the effect that the repetitive motion at work had upon causing or “precipitating” or “aggravating” the disease process. Great E. Resort Corp. v. Gordon, 31 Va. App. 608, 525 S.E.2d 55, 2000 Va. App. LEXIS 132 (2000).

    The term “to a reasonable medical certainty” has no precise meaning under Virginia law. Westmoreland Coal Co. v. Campbell, 7 Va. App. 217, 372 S.E.2d 411, 5 Va. Law Rep. 423, 1988 Va. App. LEXIS 105 (1988), limited, Bayliss v. Woodrum, 33 Va. Cir. 338, 1994 Va. Cir. LEXIS 862 (Winchester Mar. 31, 1994).

    Reasonable degree of medical certainty requires only that it is at least more probable than not that the disease arose out of and in the course of employment. Thus, the mere possibility that the claimant’s condition might have been influenced in some degree by another, nonwork-related activity is not enough to undermine the finding that it was more likely than not that the occupational activity caused the ordinary disease of life. Greif Cos. v. Sipe, 16 Va. App. 709, 434 S.E.2d 314, 10 Va. Law Rep. 83, 1993 Va. App. LEXIS 245 (1993).

    Expert testimony that a fact is “consistent” with a particular cause is not the equivalent of expert testimony “to a reasonable medical certainty,” and if expert medical witnesses cannot testify that it is at least more probable than not that the disease arose out of and in the course of employment, compensation must and should be denied, not because the law requires more of medicine than it can produce, but because the law requires more than simply proof that the disease “might” have been caused by a particular result. Westmoreland Coal Co. v. Campbell, 7 Va. App. 217, 372 S.E.2d 411, 5 Va. Law Rep. 423, 1988 Va. App. LEXIS 105 (1988), limited, Bayliss v. Woodrum, 33 Va. Cir. 338, 1994 Va. Cir. LEXIS 862 (Winchester Mar. 31, 1994).

    Whether a disease is causally related to the employment and not causally related to other factors is a finding of fact. Ross Laboratories v. Barbour, 13 Va. App. 373, 412 S.E.2d 205, 8 Va. Law Rep. 1557, 1991 Va. App. LEXIS 311 (1991) (decided under former 65.1-46.1).

    Clear and convincing evidence standard. —

    The elements required to prove a compensable ordinary disease of life must be established by clear and convincing evidence, which has been defined as that measure or degree of proof which will produce in the mind of the trier of facts a firm belief or conviction as to the allegations sought to be established; it is intermediate, being more than a mere preponderance, but not to the extent of such certainty as is required beyond a reasonable doubt as in criminal cases and it does not mean clear and unequivocal. Dan River, Inc. v. Hairston, 2000 Va. App. LEXIS 277 (Va. Ct. App. Apr. 11, 2000).

    Sufficiency of evidence. —

    Claimant clearly and convincingly proved through the claimant’s medical records, the claimant’s testimony, and the opinions of the claimant’s treating physicians that the claimant’s reactive airway disease, an ordinary disease of life, was caused by the claimant’s exposure to fumes emanating from a backup battery in the computer system during the course of the claimant’s employment. Following the exposure, the claimant, who had not previously been diagnosed with reactive airway disease or another lung ailment, developed the disease. Bath v. Olinger, 2016 Va. App. LEXIS 365 (Va. Ct. App. Dec. 27, 2016).

    Claim based on a change in the statute. —

    An employer, having acquired a vested right by a noncompensability determination on an occupational disease claim, may assert the doctrine of collateral estoppel to prevent the claimant from asserting that the settled claim becomes compensable based upon a change in the statute. Clinchfield Coal Co. v. Barton, 6 Va. App. 576, 371 S.E.2d 39, 5 Va. Law Rep. 163, 1988 Va. App. LEXIS 81 (1988).

    Claim litigated before and after passage of this section. —

    Where an employee did not prevail in a hearing loss claim litigated prior to the passage of a new occupational disease statute, his recovery upon subsequent litigation was limited to his loss suffered after the claim. Clinchfield Coal Co. v. Barton, 6 Va. App. 576, 371 S.E.2d 39, 5 Va. Law Rep. 163, 1988 Va. App. LEXIS 81 (1988).

    Commission applied section prospectively. —

    Since this section was effective before the first communication to claimant of his occupational disease, the Commission simply applied the law prospectively, not retroactively in applying this section. DD & M Mining, Inc. v. Helton, No. 0530-87-2 (Ct. of Appeals March 22, 1988).

    Claim not precluded by collateral estoppel. —

    Collateral estoppel did not preclude a claimant from receiving benefits for his occupationally-induced hearing loss under a new statute when a similar previous claim had earlier been denied under prior statutory provisions, and the new claim was based on a different cause of action, additional injurious exposure, different evidence and a second diagnosis of an occupational disease, and the grounds of relief offered by the new statute were not an issue in the original cause. Clinchfield Coal Co. v. Barton, 6 Va. App. 576, 371 S.E.2d 39, 5 Va. Law Rep. 163, 1988 Va. App. LEXIS 81 (1988).

    Commission acted properly in turning to other medical opinions in order to resolve what otherwise might have been an internal conflict among diagnoses of claimant’s attending physician. Holly Farms Foods, Inc. v. Carter, 15 Va. App. 29, 422 S.E.2d 165, 9 Va. Law Rep. 191, 1992 Va. App. LEXIS 231 (1992).

    Commission’s conclusion claimant not entitled to award not disturbed. —

    Commission’s conclusion that the claimant was not entitled to an award for carpal tunnel syndrome under this section would not be disturbed, where neither the claimant nor the employer or carrier claimed that the claimant was disabled by an ordinary disease of life, and no evidence was introduced to satisfy the requirements of this section. Strahan v. Automotive Indus. of Va., Inc., No. 0615-89-3 (Ct. of Appeals May 8, 1990).

    Where the commission has concluded that the disease flowed from the claimant’s occupational activity, the mere possibility that the claimant’s condition might have been influenced in some degree by another, non-work-related activity is not enough to undermine that finding of fact. Ross Laboratories v. Barbour, 13 Va. App. 373, 412 S.E.2d 205, 8 Va. Law Rep. 1557, 1991 Va. App. LEXIS 311 (1991) (decided under former 65.1-46.1).

    The mere possibility that the claimant’s condition might have been influenced in some degree by another, non-work-related activity is not enough to undermine the Virginia Workers’ Compensation Commission’s determination that the worker’s condition was caused by the employment. Newport News Shipbuilding & Dry Dock Co. v. Gatling, 2002 Va. App. LEXIS 79 (Va. Ct. App. Feb. 5, 2002).

    Disease arose out of employment and did not result from outside causes. —

    The commission was justified in concluding that claimant’s disease “arose out of an in the course of her employment” and “did not result from causes outside of the employment” where a doctor opined, to a reasonable degree of medical certainty, that claimant most likely contracted the HIV when she was splashed with the blood in 1987. Potomac Hosp. v. Parsons, No. 1205-92-4 (Ct. of Appeals March 23, 1993).

    Finding will not be disturbed on appeal. —

    Whether an ordinary disease of life is causally related to a claimant’s employment and not related to outside factors is a factual finding that will not be disturbed on appeal if there is credible evidence to support it. Greif Cos. v. Sipe, 16 Va. App. 709, 434 S.E.2d 314, 10 Va. Law Rep. 83, 1993 Va. App. LEXIS 245 (1993).

    “‘Whether a disease is causally related to the employment and not causally related to other factors is . . . a finding of fact.’ When there is credible evidence to support it, such a finding of fact is ‘conclusive and binding’ on the Court.” The existence of “contrary evidence in the record is of no consequence if there is credible evidence to support the commission’s finding.” Marley Mouldings, Inc. v. Rotenberry, 1996 Va. App. LEXIS 305 (Va. Ct. App. Apr. 23, 1996).

    II.Specific Conditions.

    Asthma. —

    Evidence did not sustain claimant’s burden of proving that his asthma constituted a compensable occupational disease. Carper v. National Wildlife Fed'n, 2000 Va. App. LEXIS 101 (Va. Ct. App. Feb. 15, 2000).

    Because the Workers’ Compensation Commission considered a claimant’s accident theory and implicitly rejected that theory, and because the claimant’s evidence did not sustain the claimant’s burden of proving a compensable injury by accident, the Commission properly determined that the claimant’s asthma was not compensable. Haussmann v. Univ. of Va. Hospital, 2008 Va. App. LEXIS 426 (Va. Ct. App. Sept. 23, 2008).

    Tuberculosis. —

    Where claimant, a deputy sheriff, worked at a city jail since 1985, evidence was sufficient to support the commission’s finding that claimant’s tuberculosis was an ordinary disease of life rather than an occupational disease. Lindenfeld v. Richmond Sheriff's Office, 25 Va. App. 775, 492 S.E.2d 506, 1997 Va. App. LEXIS 651 (1997).

    Where claimant, a deputy sheriff, worked at a city jail since 1985, commission did not err when it concluded that claimant’s tuberculosis was not compensable as an ordinary disease of life under this section. Lindenfeld v. Richmond Sheriff's Office, 25 Va. App. 775, 492 S.E.2d 506, 1997 Va. App. LEXIS 651 (1997).

    Employee’s hepatitis was compensable under this section where the medical experts involved in the case unanimously agreed that the employee contracted his hepatitis due to the environment in which he worked. Fairfax County v. Espinola, 11 Va. App. 126, 396 S.E.2d 856, 7 Va. Law Rep. 538, 1990 Va. App. LEXIS 172 (1990).

    Causation not shown in HIV claim. —

    Based upon the lack of any medical opinion relating claimant’s HIV infection with any reasonable degree of medical certainty to the 1987 needle stick at the city jail, and taking into account the other possible sources of her infection which existed outside of her employment, the appellate court could not say as a matter of law that claimant’s evidence sustained her burden of proving causation by clear and convincing evidence. Barnes v. Correctional Medical Sys., No. 1035-94-1 (Ct. of Appeals Dec. 6, 1994).

    Methicillin-resistant staphylococcus aureus infection. —

    Credible evidence supported the Virginia Workers’ Compensation Commission’s finding that an employee proved by clear and convincing evidence that her Methicillin-Resistant Staphylococcus Aureus (MRSA) infection constituted a compensable ordinary disease of life under § 65.2-401 because an infectious disease specialist’s opinion that the employee’s MRSA was “most likely” acquired at a hospital could reasonably provide the Commission with a firm belief that the primary source of the employee’s MRSA infection was her employment at the hospital and that her MRSA was directly and proximately caused by that employment. Cent. State Hospital v. Beckner, 2008 Va. App. LEXIS 142 (Va. Ct. App. Mar. 25, 2008).

    Right lateral epicondylitis (tennis elbow). —

    Claimant suffered from a compensable occupational disease in right lateral epicondylitis (tennis elbow). Neighbors v. Digangi, 1995 Va. App. LEXIS 679 (Va. Ct. App. Sept. 12, 1995).

    Tendinitis of left hand originated with employment. —

    Credible evidence was present to support commission’s finding that claimant satisfied her burden of proof that her ordinary disease of life was employment related where her physician testified that diagnosis of tendinitis of the left hand originated with her 24 year employment where she worked as a machinist sustaining repetitive trauma syndrome of the left hand and wrist. Piedmont Mfg. Co. v. East, 17 Va. App. 499, 438 S.E.2d 769, 10 Va. Law Rep. 681, 1993 Va. App. LEXIS 642 (1993), disapproved, Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Post traumatic stress disorder. —

    While post traumatic stress disorder (PTSD) may be compensable as an injury by accident in some cases and in other cases the disorder may be an occupational disease, credible evidence established that a paramedic’s PTSD resulting from repeated exposure to traumatic stressors was an occupational disease to which the paramedic was entitled workers’ compensation benefits. Fairfax County Fire & Rescue Dep't v. Mottram, 263 Va. 365 , 559 S.E.2d 698, 2002 Va. LEXIS 45 (2002).

    Workers’ compensation commission award of benefits for a fireman’s post traumatic stress disorder (PTSD) was proper; substantial evidence (medical experts and the fireman) of constant exposure to multiple stressful events (rather than a particular event), symptoms, lack of non-work medical history of illness that would cause the same symptoms, and post-retirement improvement indicated PTSD was compensable work-related, occupational disease under § 65.2-400 or an ordinary disease of life under § 65.2-401 to be treated as a § 65.2-400 occupational disease. Petersburg Fire & Rescue v. Wells, 2004 Va. App. LEXIS 477 (Va. Ct. App. Oct. 5, 2004).

    While the expert opinions of medical providers that a claimant’s work-related experiences in a career as a firefighter paramedic caused the claimant’s post-traumatic stress disorder (PTSD) constituted credible evidence that the claimant’s PTSD was a result of work-related stresses, remand for factual finding as to whether the claimant’s post-Hurricane Katrina relief effort activities was the same work or process of a firefighter paramedic was necessary to determine whether the claimant’s PTSD was an occupational disease. City of Norfolk v. Munker, 2018 Va. App. LEXIS 5 (Va. Ct. App. Jan. 9, 2018).

    Eczema not compensable. —

    A claimant was not entitled to compensation for hand eczema where the evidence failed to show that the claimant’s hand eczema arose out of and in the course of her employment pursuant to the causation criteria specified in § 65.2-400 B. Genie Co. v. Hammer, 32 Va. App. 257, 527 S.E.2d 470, 2000 Va. App. LEXIS 300 (2000).

    Hearing loss not compensable absent actual aggravation. —

    Virginia Workers’ Compensation Commission’s award of benefits for hearing loss as an occupational disease under § 65.2-401 was reversed where, although there was conclusive evidence that the workers’ compensation claimant’s hearing loss arose out of and in the course of his coal mining employment and did not arise from causes of the employment, there was not clear and convincing evidence that the claimant suffered injurious exposure from industrial noise while working for the employer; the only evidence supporting the Commission’s finding of actual aggravation was the claimant’s testimony that his work environment with the employer was “as noisy” as other work environments he had been exposed to in the past, and his doctor’s advice to avoid future noise exposure. Red Baron Coal Co. v. Hess, 2003 Va. App. LEXIS 525 (Va. Ct. App. Oct. 21, 2003).

    Carpal tunnel syndrome. —

    In enacting the current statutory scheme, the legislature intended that carpal tunnel syndrome, when it develops gradually as the body’s response to overuse or cumulative motion, be treated as a disease. Rocco Turkeys, Inc. v. Lemus, 21 Va. App. 503, 465 S.E.2d 156, 1996 Va. App. LEXIS 1 , vacated, 22 Va. App. 395, 470 S.E.2d 574, 1996 Va. App. LEXIS 385 (1996).

    Carpal tunnel syndrome may qualify as an “injury by accident” under § 65.2-101 or as an “occupational disease” under this section depending upon its pathology or how it is incurred. Ogden Aviation Servs. v. Saghy, 32 Va. App. 89, 526 S.E.2d 756, 2000 Va. App. LEXIS 253 (2000).

    School employee proved, through medical evidence and testimony, a causal connection between her carpal tunnel syndrome and her employment, and that her employment duties, which included cooking, stocking, washing, mopping, shoveling coal, mowing grass, using a weed eater, and managing furnace, were the primary source of injury for compensation under the Workers’ Compensation Act. Lee County Sch. Bd. v. Miller, 38 Va. App. 253, 563 S.E.2d 374, 2002 Va. App. LEXIS 291 (2002).

    Where the claimant showed that her condition was peculiar to her duties and started after she began those duties, she met her burden of proving that her carpal tunnel syndrome was causally related to her work and did not result from causes outside of her work. Hardees of Norton No. 2849 v. Stephens, 2002 Va. App. LEXIS 557 (Va. Ct. App. Sept. 17, 2002).

    The Virginia Code allows compensation for carpal tunnel syndrome as an ordinary disease of life if each of the following elements is established by clear and convincing evidence, (not a mere probability): (1) that the disease exists and arose out of and in the course of employment as provided in § 65.2-400 with respect to occupational diseases and did not result from causes outside of the employment, and (2) that one of the following exists: (a) it follows as an incident of occupational disease as defined in this title; or (b) it is an infectious or contagious disease; or (c) it is characteristic of the employment and was caused by conditions peculiar to such employment. Lanning v. Va. DOT, 2003 Va. App. LEXIS 81 (Va. Ct. App. Feb. 19, 2003).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s causation finding where a physician answered questions tracking the language of § 65.2-400 , which confirmed his opinion that a workers’ compensation claimant’s carpal tunnel syndrome was caused by her work, the claimant’s symptoms began about a year after she began her work on a machine involving repetitive motions, and the claimant was not involved in any non-work activities in which she constantly made the same motions. Tex Tech Indus. v. Ellis, 44 Va. App. 497, 605 S.E.2d 759, 2004 Va. App. LEXIS 598 (2004).

    Opinion of a workers’ compensation claimant’s treating physician that, based on the claimant’s history and examination, there were no other probable causes for the claimant’s carpal tunnel syndrome aside from repetitive trauma occurring while he was butcher with the employer was sufficient to support the Virginia Workers’ Compensation Commission’s finding of causation because it permitted the reasonable inference that the physician had investigated any other possible causes for the claimant’s carpal tunnel syndrome, in addition to his industrial accident and, thus, had the requisite knowledge of the claimant’s activities outside his employment. The fact that the record did not contain any specific information regarding the claimant’s reports to the physician concerning the claimant’s outside activities did not prevent the Commission from drawing this inference from the evidence before it. Giant Food, Inc. v. Marcum, 2005 Va. App. LEXIS 141 (Va. Ct. App. Apr. 12, 2005).

    In an appeal pursuant to subsection A of § 65.2-706 , it was determined that a workers’ compensation commission properly denied a worker claim for workers’ compensation benefits based on carpal tunnel syndrome, as the worker failed to show that pre-existing blood disorders did not contribute to the development of the carpal tunnel syndrome. Leuthner v. Can. Dry Potomac Corp., 2005 Va. App. LEXIS 331 (Va. Ct. App. Aug. 30, 2005).

    Claimant was required to prove by clear and convincing evidence that her carpal tunnel syndrome arose out of and in the course of employment, and did not result from causes outside of employment; the workers’ compensation commission’s decision that she did not meet her burden of proof was supported by credible evidence in the record, especially evidence that she did not tell a doctor she consulted about her activities apart from work that might have caused the carpal tunnel syndrome, and, thus, the decision to deny her application for workers’ compensation benefits was affirmed. Cottrell v. Deroyal Indus., 2005 Va. App. LEXIS 351 (Va. Ct. App. Sept. 13, 2005).

    Virginia Workers’ Compensation Commission’s finding that a workers’ compensation claimant proved causation by clear and convincing evidence was supported by credible evidence as: (1) the claimant’s physician knew the claimant had engaged in repetitive motion with her hands at her job and that the claimant had no such medical problems prior to working for the employer, and opined that her carpal tunnel syndrome (CTS) was work-related, and (2) the claimant testified that the continuous use of her hands as a scaler resulted in CTS and that she had no such problem prior to her employment. Gwaltney of Portsmouth v. Pelham, 2006 Va. App. LEXIS 483 (Va. Ct. App. Oct. 31, 2006).

    As an employee’s carpal tunnel syndrome was classified as an “ordinary disease of life” by § 65.2-401 , he had to establish by clear and convincing evidence, not merely by a preponderance, that the injury arose in the course of the employment. As the parties’ agreement to pay benefits did not mention this injury, the Virginia Workers’ Compensation Commission could not have exercised its equitable powers to alter the agreement that the parties actually made. UPS v. Ilg, 54 Va. App. 366, 679 S.E.2d 545, 2009 Va. App. LEXIS 329 (2009).

    Claimant’s diagnosed carpal tunnel syndrome was not compensable under this section where there was evidence that her condition may have resulted from causes outside of her employment, such as wringing clothes. Vassal v. Lane Co., No. 0831-89-3 (Ct. of Appeals May 1, 1990).

    Meat cutter, who was diagnosed as having carpal tunnel syndrome in her left arm, failed to prove her condition was causally related to her employment, in the light of a physician’s answer to an interrogatory: “I cannot state that this patient’s carpal tunnel syndrome can be fairly traced to the claimant’s employment as a meat cutter as the proximate cause.” Nichols v. H.P. Beale & Sons, No. 0824-91-4 (Ct. of Appeals Oct. 29, 1991).

    Claimant was not entitled to receive workers’ compensation benefits for her carpal tunnel syndrome that was diagnosed, as she did not prove by clear and convincing evidence that such “ordinary disease of life” was not caused by activities outside her employment. Her testimony that she had no activities outside of her employment was not sufficient to show by the required clear and convincing evidence that the myriad of her life activities outside her employment were not the cause of that disease. Steadman v. Liberty Fabrics, Inc., 41 Va. App. 796, 589 S.E.2d 465, 2003 Va. App. LEXIS 643 (2003).

    Claimant’s carpal tunnel syndrome compensable. —

    A claimant’s carpal tunnel syndrome was compensable as an ordinary disease of life where the only medical evidence was the opinion of the claimant’s treating physician that, based on the number of years the claimant had been employed at her job and the repetitive nature of the job, there was a high probability that the carpal tunnel was the result of her work environment. National Fruit Prod. Co. v. Staton, 28 Va. App. 650, 507 S.E.2d 667, 1998 Va. App. LEXIS 655 (1998), aff'd, 259 Va. 271 , 526 S.E.2d 266, 2000 Va. LEXIS 32 (2000).

    See Great E. Resort Corp. v. Gordon, 31 Va. App. 608, 525 S.E.2d 55, 2000 Va. App. LEXIS 132 (2000).

    Although the employer presented expert medical testimony to the contrary, the testimony of the claimant’s treating physician was sufficient where he testified that there was a direct causal link between the conditions under which the claimant performed her work and her carpal tunnel syndrome, that the claimant’s condition was characteristic of the job she was doing as a seamstress with repetitive motions of the hand, fingers and wrist and that claimant had no history of other activities in her normal life or other illnesses or injuries which could have caused the carpal tunnel syndrome. Dan River, Inc. v. Hairston, 2000 Va. App. LEXIS 277 (Va. Ct. App. Apr. 11, 2000).

    A claimant’s carpal tunnel syndrome was compensable where the claimant’s treating physician diagnosed the condition and unequivocally indicated that it arose out of and in the course of the claimant’s employment in a meat packing plant, where there was other medical evidence confirming the diagnosis and concluding that it was due to cumulative trauma, where the only conflicting medical evidence came from a doctor who evaluated the claimant after she had been off work for several months and her condition had improved and where the claimant did not engage in any non-work related activities that could have caused her condition and had not had any problems with her hands or wrists before working for the employer. Gwaltney of Smithfield, Ltd. v. Cypress, 2000 Va. App. LEXIS 304 (Va. Ct. App. Apr. 25, 2000).

    Credible evidence showed properly that claimant’s carpal tunnel syndrome arose out of and in the course of his employment as an auto body repairman for 15 years and that his injury did not result from causes outside his employment. Kern Motor Co. v. Buckley, 2003 Va. App. LEXIS 44 (Va. Ct. App. Feb. 4, 2003).

    Reviewing court found that a doctor’s records and opinions, coupled with the employee’s testimony, constituted credible evidence that the employee’s employment caused her right carpal tunnel syndrome under the criteria established by § 65.2-401 so that the carpal tunnel syndrome constituted a compensable ordinary disease of life. Lanning v. Va. DOT, 2003 Va. App. LEXIS 81 (Va. Ct. App. Feb. 19, 2003).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    See Notes to § 65.2-400 .

    General:

    A police officer seeking a medical only award for hypertension is not entitled to the presumption of § 65.2-402 and must meet the clear and convincing standard of § 65.2-401 by proving that his employment was the “primary source” or significant or “deciding” cause of his condition. Showing that that his work contributed to developing hypertension is not sufficient. Mullins v. City of Norton, VWC File No. 221-83-78 (Jan. 30, 2006).

    This section is substantive in nature and, therefore, may not be applied retroactively. Conner v. Deutsches-Haus Automotive Specialists, 65 O.I.C. 164 (1986) (see also Foster v. Smithfield Packing Co., Inc., 10 Va. App. 144, 390 S.E.2d 141 (1990).

    Although the claimant’s exposure to industrial noise was prior to the enactment of § 65.1-46.1, (now § 65.2-401 ), this section was properly applied because the date of communication which determines the law to be applied occurred after enactment. Ingersoll-Rand Co. v. Musick, 7 Va. App. 684, 376 S.E.2d 814, 5 Va. Law Rep. 1726, 1989 Va. App. LEXIS 16 (1989).

    Section 65.2-403 provides that the date on which an occupational disease is diagnosed and first communicated to the employee is treated as the date of injury and as the happening of an injury by accident. The rights and liabilities of the parties vest and accrue on that date. Turner v. Sky Chefs, 76 O.W.C. 356 (1997); Hansford v. Ford Motor Company, 76 O.W.C. 395 (1997).

    The amendment and enactment of § 65.1-46 (now § 65.2-400 ) and § 65.1-46.1 (now § 65.2-401 ) do not overrule the Virginia Supreme Court’s finding in Ashland Oil Co. v. Bean, 225 Va. 1 , 300 S.E.2d 739 (1983), that an ordinary disease of life aggravated by the workers’ environment is not compensable as an occupational disease. Head v. Newport News City Police Department, 65 O.I.C. 166 (1986).

    The claimant developed nausea, headaches, listlessness, fatigue and left eye problems when she returned to work in January 1996 after new carpeting was installed. Medical records show that she had received periodic treatment for upper respiratory infections, viral syndrome, and allergic rhinitis since 1986. Allergen sensitivity tests showed that the claimant was sensitive to three types of grasses, ragweed, dust, cat hair, and eight types of molds. No physician said that the claimant’s employment was the primary cause of her problems, only that her condition resulted from both “allergic and non-allergic factors.” The Commission held that while the claimant’s symptoms had increased at work, this was insufficient to prove that her condition resulted from her work, and not from causes outside of the employment. At most, the claimant had shown that the workplace aggravated a pre-existing allergic condition, which is not compensable. Armstrong v. Bernard C. Harris Publishing, 76 O.W.C. 321 (1997).

    With the exception of indemnity benefits for a pneumoconiosis pursuant to § 65.1-56 (20) (now § 65.2-503 (17)), an occupational disease is not per se compensable but must produce a disability resulting in loss of earning capacity. Hampton v. Kentucky-Virginia Stone Company, 62 O.I.C. 203 (1983).

    The claimant does not have to prove a single source of his disabling occupational disease. The claimant’s burden is to prove that the employment was the primary source. Soltow v. Fairfax County Board of Supervisors, 77 O.W.C. 154 (1998).

    It is not necessary that the employee exclude all other nonwork-related potential causes of his disease, only those that represent a significant factor in the development of the occupational disease condition. Ruiz v. Abbotts Upholstery, 75 O.W.C. 213 (1996).

    For an ordinary disease of life to be compensable, the claimant must establish by clear and convincing evidence, to a reasonable medical certainty, that the disease: (1) arose out of and in the course of her employment; (2) did not result from causes outside of the employment; (3) follows as an incident of an occupational disease; or, (4) is an infectious or contagious disease contracted in the course of employment; or, (5) is characteristic of the employment; and, (6) was caused by conditions peculiar to the employment. The claimant must also prove that it is more probable than not that her disease arose out of and in the course of the employment. The claimant need not prove the employment was the single source of her disease, but that it was the primary source. Armstrong v. Bernard C. Harris Publishing, 76 O.W.C. 321 (1997).

    The Commission has defined clear and convincing evidence as that measure or degree of proof “which will produce in the mind of the trier of facts a firm belief or conviction as to the allegation sought to be established . . . . It does not mean clear and unequivocal.” Hairston v. Dan River, Inc., 78 O.W.C. 204 (1999).

    The statutory requirement to establish proof by clear and convincing evidence is not satisfied by medical opinions that merely state the condition is “compatible” or “related” to the work. Proof by clear and convincing evidence is established where medical opinions state that the condition is “due to” the work, or that there is a “high probability” of causation. Hairston v. Dan River, Inc., 78 O.W.C. 204 (1999).

    Burden of proof is not on the employer to eliminate all possibilities of the manner in which hepatitis was contracted other than at the work place. Matchett v. District Board of Augusta, 63 O.I.C. 223 (1984).

    In awarding compensation benefits for carpal tunnel syndrome the Court held that the phrase “did not result from causes outside of the employment” does not preclude recovery in every instance where factors unrelated to the work duties may have contributed to the condition. Ross Laboratories v. Barbour, 13 Va. App. 373, 412 S.E.2d 205, 8 Va. Law Rep. 1557, 1991 Va. App. LEXIS 311 (1991).

    Where a pre-existing condition has been successfully treated with full recovery, a subsequent occupational disease is not an aggravation of a pre-existing condition that precludes the award of benefits. McDermott v. United Airlines, 70 O.I.C. 166 (1991).

    Medical restrictions from returning to the workplace that are shown to be causing the employee’s compensable allergic reaction are analogous to a release with restrictions that prevent a return to pre-injury work, and establishes continuing partial impairment. Simpson v. Department of Social Services, 75 O.W.C. 105 (1996).

    The Hearing Determination Chart, the Snellens Chart, and the Pneumoconiosis Guide are merely guidelines and cannot take precedence over Code § 65.1-56 (now § 65.2-503 ) which they are designed to implement. Specifically, the Commission has not adopted any substantive rule requiring the use of the ANSI standard for measuring hearing loss. Bader v. Norfolk Redevelopment & Hous. Auth., 10 Va. App. 697, 396 S.E.2d 141, 7 Va. Law Rep. 204, 1990 Va. App. LEXIS 152 (1990).

    Specific Conditions:

    Asthma/Bronchitis:

    Claimant’s asthmatic condition compensable as ordinary disease of life where some type of airborne irritant was present in or around the area of her classroom which caused her and others to experience coughing and other symptoms, several classes evacuated the building during this time period, work was being done on the drop ceiling outside her classroom, no evidence showed exposure to causes of her condition outside the employment, and she did not suffer from breathing problems prior to the workplace exposure. Joy v. Arlington (County of) School Bd., VWC File No. 211-98-10 (Dec. 29, 2004).

    Even though the claimant’s past medical history made him more susceptible to contracting asthmatic bronchitis, the Commission found that at the time of his exposure at work the disease was not active and, therefore, Ashland Oil Company v. Bean, 225 Va. 1 , 300 S.E.2d 739 (1983), did not apply. Redding v. Dynalectric Company, 67 O.I.C. 112 (1988).

    Bunion:

    In denying compensation benefits to a ramp service attendant who was required to wear steel toed shoes, the Commission found that her ordinary disease of life, a bunion, apparently was caused by conditions peculiar to her employment, but was not characteristic of the employment. McDermott v. United Airlines, 70 O.I.C. 166 (1991).

    Carpal Tunnel:

    Both medical evidence and the testimony of the claimant may be utilized to establish that the claimant’s occupational disease arose from his/her employment. St. John v. BCBG Max Azria Group, Inc., JCN 00000603618 (Sept. 16, 2013).

    Where the claimant testified that she did not engage in any non-work activities or conditions that could cause her carpal tunnel syndrome, she was not required to obtain medical evidence specifically negating non-work-related causes. The claimant’s testimony and the doctor’s statement of “work-related-using keyboard and sign making machine” was sufficient to prove an compensable ordinary disease of life. Collier v. City of Charlottesville, VWC File No. 225-93-97 (Nov. 8, 2006).

    In denying benefits for carpal tunnel syndrome, the Court held that “job-related impairments resulting from cumulative trauma caused by repetitive motion, however labeled or however defined, are, as a matter of law, not compensable under the present provisions of the Act.” Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Claimant’s carpal tunnel syndrome was compensable ordinary disease of life where she did not notice symptoms until after the employer’s conveyor belt broke and she was compelled to perform more lifting, she described both her work and home activities to her doctors before the condition was diagnosed and before they rendered opinions indicating that it was related to her employment, and she offered detailed testimony denying any hobbies involving the extensive use of her hands outside of the workplace. Washington v. Crystal Valet Cleaners, VWC File No. 215-71-56 (March 14, 2005).

    Section 65.2-400 was amended effective July 1, 1997 to provide that carpal tunnel syndrome is not an occupational disease, but is an ordinary disease of life as defined in § 65.2-401 . The Commission has held that the July 1, 1997 amendment is not retroactive. Hansford v. Ford Motor Company, 76 O.W.C. 395 (1997); Turner v. Sky Chefs, 76 O.W.C. 356 (1997).

    Where the employee was diagnosed with carpal tunnel syndrome on July 7, 1996, prior to amendment to Va. Code Ann. § 65.2-400 , her claim for carpal tunnel syndrome is noncompensable, because the law in effect on the date of accident [date of diagnosis of occupational disease] controls. Turner v. Sky Chefs, 76 O.W.C. 356 (1997); Hansford v. Ford Motor Company, 76 O.W.C. 395 (1997).

    The claimant’s carpal tunnel syndrome was found to be an occupational disease as defined by the statute. Davis v. Pannill Knitting Company, Inc., 66 O.I.C. 71 (1987).

    The fact that other employees in the same employment have not contracted carpal tunnel syndrome does not negate the contention that the disease was characteristic of the employment and caused by conditions peculiar to such employment. Lonas v. Wrangler, 67 O.I.C. 108 (1988).

    The employee’s evidence concerning her carpal tunnel syndrome failed to satisfy the proof requirements of § 65.1-46.1 (now § 65.2-401 ). Wood v. Allison Apparel Marketing, Inc., 11 Va. App. 352, 398 S.E.2d 110, 7 Va. Law Rep. 1038, 1990 Va. App. LEXIS 216 (1990).

    Benefits for carpal tunnel syndrome were denied where the Commission found that the evidence failed to establish that the employee’s condition was caused by his occupation as a heavy equipment operator. Wenzel v. City of Hampton, 70 O.I.C. 172 (1991).

    An application for carpal tunnel syndrome as a result of an industrial accident, and an application for the same condition as an occupational disease are not barred by res judicata since they set forth different causes of actions derived from different circumstances, medical diagnoses and involved legal foundations and are not barred by the doctrine of res judicata. .Wood v. Allison Apparel Marketing, Inc., 11 Va. App. 352, 398 S.E.2d 110, 7 Va. Law Rep. 1038, 1990 Va. App. LEXIS 216 (1990).

    An employee’s right and left carpal tunnel syndrome were causally related to her employment and that her claim was not barred by either the statute of limitations or res judicata because her 1990 injury was not related to a 1987 injury. Chase Packaging Corporation v. Dorsey, 15 Va. App. 248, 421 S.E.2d 907, 9 Va. Law Rep. 413, 1992 Va. App. LEXIS 259 (1992).

    Medical evidence establishing that the injured worker’s carpal tunnel syndrome was either directly related to her employment, or significantly and adversely affected by her employment, was insufficient to satisfy the burden of proof under § 65.2-401 . Such an ambiguous causal statement may mean that the work aggravated, exacerbated or merely contributed to the condition. The claimant must establish by clear and convincing evidence that the work actually caused the condition. Calabro v. Super Cuts, Inc., VWC File No. 202-69-44 (January 31, 2002).

    Cardiomyopathy:

    The Commission found that a public health nurse established by clear and convincing evidence that her cardiomyopathy, an ordinary disease of life, was causally related to the small pox vaccine she received through work and was a compensable occupational disease. Jackson v. Dept. of Health/Commonwealth of Virginia, VWC File No. 223-17-91 (March 16, 2007).

    Chemical Exposure:

    The evidence established that the claimant’s “dementia” was a result of chemical intoxication and not an ordinary disease of life. Barnes v. Ivie Cleaners, Inc., 65 O.I.C. 176 (1986).

    Deep Vein Thrombosis:

    The Commission found that claimant’s deep vein thrombosis which was the result of his work driving a truck for periods of four to five hours was a compensable ordinary disease of life. Rutherford v. J.B. Hunt Transport, VWC File No. 225-29-08 (Sept. 27, 2006).

    Frostbite:

    Compensation benefits were awarded to the claimant who suffered frostbite during extensive exposure to extreme cold temperatures. Burrell v. Washington Metropolitan Area, 71 O.W.C. 168 (1992).

    Note: Also see cases under § 65.2-101 , “Arising out of and in the Course of Employment.”

    Hearing Loss:

    The claimant who sustained hearing loss testified that he was exposed to loud noises outside the work environment but did not recall discussing his outside activities of hunting, boating, lawn care activities, and use of power tools with his doctor. The Commission found that in order to establish by clear and convincing evidence that his hearing loss did not arise from causes outside his employment, it was necessary that the doctor would have had to have been aware of the other potentially causative exposures. Chitwood v. Department of Game and Inland Fisheries, VWC File No. 234-30-19 (July 23, 2008).

    Relying on Stenrich Group v. Jemmott, 251 Va. 186 , 199, 467 S.E.2d 795, 802 (1996), the Court held that hearing loss was not compensable under the Act. Franklin City Public Works v. Haywood Riddick, Record No. 0397-96-3 (June 25, 1996) (Unpublished Memorandum Opinion). See also Tara K Coal Company v. Glenn Collier, Record No. 1327-95-3 (April 25, 1996).

    The Virginia Court of Appeals on September 3, 1996 held that a hearing loss caused by prolonged exposure to noise at work is a noncompensable gradually incurred injury. Although the General Assembly changed the law so that hearing loss caused by cumulative trauma may be compensable as of July 1, 1997, that law was not made retroactive. Jost v. Pohanka Acura, 76 O.W.C. 106 (1997).

    Compensation benefits were denied to a flight attendant because her ear blockage was an ordinary disease of life whose causation was not peculiar to the employment but, at best was aggravated by the change in air pressure. Whiteley v. American, 70 O.I.C. 169 (1991).

    The fitting of the claimant with a hearing aid in 1982 by an individual other than a physician cannot be considered a medical diagnosis. Therefore, the first diagnosis and communication of an occupational hearing loss was made by an otolaryngologist after the amendment to § 65.1-46.1 (now § 65.2-401 ). Musick v. Ingersoll-Rand Company, 67 O.I.C. 131 (1988). 7 Va. App. 684, 376 S.E.2d 814 (Affirmed on appeal on other issues 1989).

    The doctrine of res judicata is applicable where a claimant’s initial application for hearing loss was denied under the principles Belcher v. City of Hampton and a second application was filed after July 1, 1986 but there was no evidence of additional exposure to noise in the work environment between the first and second claim. Neece v. Clinchfield Coal Company, 66 O.I.C. 81 (1987).

    Where a claimant experiences additional exposure to noise in the work environment after a determination by the Commission that the hearing loss was barred, the principle of res judicata does not apply and compensation benefits may be awarded pursuant to a diagnosis and communication of an occupational disease after July 1, 1986. The claimant’s compensation benefits will include all medically established hearing loss related to his work environment and not be limited to any hearing loss that occurred after July 1, 1986. Matney v. Island Creek Coal Company, 66 O.I.C. 84 (1987).

    The conclusive presumption of injurious exposure after ninety work shifts set forth in § 65.1-52 (now § 65.2-404 ) applies only to pneumoconiosis and is not applicable to hearing loss or other occupational diseases. Dawson v. R.B.J. Coal Company, Inc., 67 O.I.C. 133 (1988).

    To establish a hearing loss by clear and convincing evidence the claimant does not have to exclude the possibility that something outside the work place may have caused the injury where the doctor’s report establishes the causal connection to industrial noise and other evidence negates the possibility of exposure to loud noise outside the employment. Ingersoll-Rand Co. v. Musick, 7 Va. App. 684, 376 S.E.2d 814, 5 Va. Law Rep. 1726, 1989 Va. App. LEXIS 16 (1989).

    Hepatitis:

    The employee, a medical technician for the Police Department responsible for administering blood and breathalyzer tests, established by clear and convincing evidence that his hepatitis condition met the requirements of Code § 65.1-46.1 (now § 65.2-401 ). It was proper to determine that the last injurious exposure to hepatitis occurred on the employee’s last day of employment in view of the regular contact with blood products from numerous subjects. Therefore the claim was filed within five years from the date of last injurious exposure. Fairfax County v. Espinola, 11 Va. App. 126, 396 S.E.2d 856 (1989); 68 O.I.C. 122 .

    The Commission found that the evidence was not clear and convincing that the claimant’s Hepatitis A, an ordinary disease of life, arose from his unsanitary working conditions rather than causes outside of the employment. Roberts v. Hyponex Corp., 70 O.I.C. 162 (1991).

    Histoplasma:

    The claimant, a loader operator, established that his histoplasma was a compensable occupational disease under § 65.1-46.1 (now § 65.2-401 ). Johnson v. Suburban Grading & Utilities, Inc., 68 O.I.C. 134 (1989).

    Lyme Disease:

    Claim for Lyme disease/post-Lyme syndrome denied where evidence failed to establish disease or syndrome causing claimant’s symptoms. Commission could not determine if claimant suffered from occupational disease or ordinary disease since totality of evidence did not establish specific disease afflicting her. Allen v. City of Chesapeake, JCN VA000001029349 (Feb. 12, 2016).

    The claimant, a surveyor, failed to establish by clear and convincing evidence that he contracted Lyme disease from a tick bite as a result of his employment and not from his residential environment. Hogg v. Granville Hogg, Jr., Land Surveyors, 67 O.I.C. 117 (1988).

    The claimant testified to profuse exposure to deer ticks while working at a specific work site, and to actually being bitten. That testimony was corroborated by other employees. Medical evidence showed that it was “overwhelmingly likely” that the claimant’s medical problems were secondary to Lyme disease, and the Commission found the claimant had proved a compensable occupational disease. Blevins v. Ross France & Ratliff, Ltd., 79 O.W.C. 32 (2000).

    Neuralgia/Neuritis:

    Neuralgia or neuritis was not compensable because it was a result of cumulative trauma caused by repetitive motion. Collier v. City of Charlottesville, VWC File No. 225-93-97 (Nov. 8, 2006).

    Psychological:

    The claimant had multiple stressful events in her work as a police officer, and was diagnosed with post traumatic stress disorder (PTSD). The Commission ruled that the claimant’s testimony and the medical evidence supported a finding that the PTSD was a compensable ordinary disease of life. Spencer v. Town of Christiansburg Police, VWC File No. 235-35-48 (Oct. 7, 2008).

    Benefits were denied for a traumatic stress reaction with physical manifestations. While the employment stress was identifiable and uncommon, it did not have its origin in the work environment. Marcus v. Arlington County Board of Supervisors, 15 Va. App. 544, 425 S.E.2d 525 (1993); 71 O.I.C. 159 (1992).

    Compensation benefits were denied to the employee on the basis that numerous sources of stress outside of the employment contributed to his condition. At best, the evidence only established that his employment aggravated his condition. Teasley v. Montgomery Ward & Company, Inc., 14 Va. App. 45, 415 S.E.2d 596, 8 Va. Law Rep. 2327, 1992 Va. App. LEXIS 77 (1992).

    The claimant was denied compensation benefits on the basis that his emotional problem was an ordinary disease of life that was not characteristic of his employment as an automobile salesman. Welch v. Berglund Chevrolet, Inc., 66 O.I.C. 74 (1987).

    The claimant who had a pre-existing personality defect failed to establish that her depression, an ordinary disease of life, met the requirements of § 65.1-46.1 (now § 65.2-401 ). Foutz v. Lewis Gale Hospital, 68 O.I.C. 137 (1989).

    Vision:

    The claimant’s myopia and astigmatism condition were not an occupational disease as defined by the statute. Head v. Newport News City Police Department, 65 O.I.C. 166 (1986).

    Other:

    Herpetic whitlow was found to be a compensable ordinary disease of life incurred as a result of employment as a nurse. August v. Arlington Hospital Foundation, 71 O.W.C. 165 (1992).

    “Sick building syndrome” is an ordinary disease of life, that is, one to which the general public is exposed outside of the employment. Armstrong v. Bernard C. Harris Publishing, 76 O.W.C. 321 (1997).

    OPINIONS OF THE ATTORNEY GENERAL

    Covid-19. —

    If COVID-19 is an upper respiratory disease, it falls under the heart and lung presumption of the Act for first responders, however the statutory presumption applies only to a limited class of first responders under certain circumstances and, therefore, would not have broad applicability to all or most of the first responders whose official duties regularly place them at far greater risk of contracting COVID-19 than the general public following social distancing guidelines. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A first responder who has the benefit of a presumption, has the initial burden of producing evidence to trigger the presumption (evidence of the disease, and evidence of disability or death caused by the disease); once the presumption is triggered, the burden shifts to the employer to rebut the presumption (that the disease was not caused by the employment and that there is a non-work-related cause). See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A presumption could be created that would benefit first responders who contract COVID-19 because the nature of their duties place them at greater risk for contracting the disease. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    § 65.2-402. Presumption as to death or disability from respiratory disease, hypertension or heart disease, cancer.

    1. Respiratory diseases that cause (i) the death of volunteer or salaried firefighters or Department of Emergency Management hazardous materials officers or (ii) any health condition or impairment of such firefighters or Department of Emergency Management hazardous materials officers resulting in total or partial disability shall be presumed to be occupational diseases, suffered in the line of duty, that are covered by this title unless such presumption is overcome by a preponderance of competent evidence to the contrary.
    2. Hypertension or heart disease causing the death of, or any health condition or impairment resulting in total or partial disability of any of the following persons who have completed five years of service in their position as (i) salaried or volunteer firefighters, (ii) members of the State Police Officers’ Retirement System, (iii) members of county, city or town police departments, (iv) sheriffs and deputy sheriffs, (v) Department of Emergency Management hazardous materials officers, (vi) city sergeants or deputy city sergeants of the City of Richmond, (vii) Virginia Marine Police officers, (viii) conservation police officers who are full-time sworn members of the enforcement division of the Department of Wildlife Resources, (ix) Capitol Police officers, (x) special agents of the Virginia Alcoholic Beverage Control Authority appointed under the provisions of Chapter 1 (§ 4.1-100 et seq.) of Title 4.1, (xi) for such period that the Metropolitan Washington Airports Authority voluntarily subjects itself to the provisions of this chapter as provided in § 65.2-305 , officers of the police force established and maintained by the Metropolitan Washington Airports Authority, (xii) officers of the police force established and maintained by the Norfolk Airport Authority, (xiii) sworn officers of the police force established and maintained by the Virginia Port Authority, (xiv) campus police officers appointed under Article 3 (§ 23.1-809 et seq.) of Chapter 8 of Title 23.1 and employed by any public institution of higher education, and (xv) salaried or volunteer emergency medical services personnel, as defined in § 32.1-111.1 , when such emergency medical services personnel is operating in a locality that has legally adopted a resolution declaring that it will provide one or more of the presumptions under this subsection, shall be presumed to be occupational diseases, suffered in the line of duty, that are covered by this title unless such presumption is overcome by a preponderance of competent evidence to the contrary.
    3. Leukemia or pancreatic, prostate, rectal, throat, ovarian, breast, colon, brain, or testicular cancer causing the death of, or any health condition or impairment resulting in total or partial disability of, any volunteer or salaried firefighter, Department of Emergency Management hazardous materials officer, commercial vehicle enforcement officer or motor carrier safety trooper employed by the Department of State Police, or full-time sworn member of the enforcement division of the Department of Motor Vehicles having completed five years of service shall be presumed to be an occupational disease, suffered in the line of duty, that is covered by this title, unless such presumption is overcome by a preponderance of competent evidence to the contrary. For colon, brain, or testicular cancer, the presumption shall not apply for any individual who was diagnosed with such a condition before July 1, 2020.
    4. The presumptions described in subsections A, B, and C shall only apply if persons entitled to invoke them have, if requested by the private employer, appointing authority or governing body employing them, undergone preemployment physical examinations that (i) were conducted prior to the making of any claims under this title that rely on such presumptions, (ii) were performed by physicians whose qualifications are as prescribed by the private employer, appointing authority or governing body employing such persons, (iii) included such appropriate laboratory and other diagnostic studies as the private employer, appointing authorities or governing bodies may have prescribed, and (iv) found such persons free of respiratory diseases, hypertension, cancer or heart disease at the time of such examinations.
    5. Persons making claims under this title who rely on such presumptions shall, upon the request of private employers, appointing authorities or governing bodies employing such persons, submit to physical examinations (i) conducted by physicians selected by such employers, authorities, bodies or their representatives and (ii) consisting of such tests and studies as may reasonably be required by such physicians. However, a qualified physician, selected and compensated by the claimant, may, at the election of such claimant, be present at such examination.
    6. Whenever a claim for death benefits is made under this title and the presumptions of this section are invoked, any person entitled to make such claim shall, upon the request of the appropriate private employer, appointing authority or governing body that had employed the deceased, submit the body of the deceased to a postmortem examination as may be directed by the Commission. A qualified physician, selected and compensated by the person entitled to make the claim, may, at the election of such claimant, be present at such postmortem examination.
    7. Volunteer law-enforcement chaplains, auxiliary and reserve deputy sheriffs, and auxiliary and reserve police are not included within the coverage of this section.
    8. For purposes of this section, “firefighter” includes special forest wardens designated pursuant to § 10.1-1135 and any persons who are employed by or contract with private employers primarily to perform firefighting services.

    History. 1975, c. 330, § 65.1-4.1; 1976, cc. 187, 772, § 65.1-47.1; 1977, cc. 326, 620; 1978, c. 761; 1983, c. 357; 1987, c. 308; 1991, cc. 354, 355; 1994, cc. 791, 960; 1997, c. 714; 1999, cc. 581, 597, 602, 604, 607; 2000, c. 1013; 2001, cc. 330, 581; 2002, cc. 309, 737, 789; 2007, cc. 143, 616; 2009, c. 515; 2012, c. 776; 2015, cc. 38, 502, 503, 730; 2020, cc. 498, 499, 958; 2021, Sp. Sess. I, cc. 436, 437.

    Cross references.

    As to the purchase of continued health insurance coverage by the surviving spouse and any dependents of an active or retired local law-enforcement officer, firefighter, etc., through the Department of Human Resource Management, see § 2.2-1205 .

    As to the Line of Duty Act, see § 9.1-400 .

    As to continued health insurance coverage for disabled persons, their spouses and dependents, and for the surviving spouse and dependents of certain deceased law-enforcement officers, firefighters, see § 9.1-401 .

    As to payments to beneficiaries of certain deceased law-enforcement officers, firefighters and retirees, see § 9.1-402 .

    Editor’s note.

    At the direction of the Virginia Code Commission, in clause (viii) of subsection B, “conservation police officers” was substituted for “game wardens” to conform to the name change made by Acts 2007, c. 87.

    Acts 2015, cc. 38 and 730, cl. 4, as amended by Acts 2017, cc. 698 and 707, cl. 2, provides: “That the provisions of this act shall become effective on January 15, 2018, except that the provisions of the (i) thirteenth, fourteenth, and fifteenth enactments of this act shall become effective on July 1, 2015; (ii) third enactment of this act shall become effective on July 1, 2018; and (iii) eleventh enactment of this act shall become effective on January 1, 2019.”

    At the direction of the Virginia Code Commission, “Article 3 (§ 23.1-809 et seq.) of Chapter 8 of Title 23.1” was substituted for “Chapter 17 (§ 23-232 et seq.) of Title 23” in subsection B to conform to the recodification of Title 23 by Acts 2016, c. 588, effective October 1, 2016.

    Acts 2021, Sp. Sess. I, cc. 436 and 437, cl. 2 provides: “That the provisions of this act shall not apply to any individual who was diagnosed with hypertension or heart disease before July 1, 2021.”

    The 1999 amendments.

    The 1999 amendments by cc. 581 and 607 are identical, and in subsection C, substituted “causing the death of, or any health condition or impairment resulting in total or partial disability of, any” for “that is caused by a documented contact with a toxic substance that a,” and substituted “who has a contact with a toxic substance encountered in the line of duty” for “has encountered in the line of duty and that causes (i) the death of such person or (ii) any health condition or impairment of such person resulting in total or partial disability.”

    The 1999 amendment by c. 597, in subsection B, deleted “and” preceding “(vi)” and inserted “and (vii) Virginia Marine Patrol officers.”

    The 1999 amendment by c. 602, in subsection B, deleted “and” preceding “(vii),” and inserted “and (viii) game wardens who are full-time sworn members of the enforcement division of the Department of Game and Inland Fisheries.”

    The 1999 amendment by c. 604, in subsection B, deleted “and” preceding “(viii),” and inserted “and (ix) Capitol Police officers.”

    The 2000 amendments.

    The 2000 amendment by c. 1013, in subsection C, deleted “or” preceding “throat” and inserted “ovarian or breast” near the beginning of the first sentence and near the end of the second sentence.

    The 2001 amendments.

    The 2001 amendment by c. 330 deleted the last sentence of subsection A, which formerly read: “For purposes of this section, the term ‘firefighter’ shall include persons who are employed by or contract with private employers primarily to perform firefighting services,” and added subsection H.

    The 2001 amendment by c. 581, in subsection B, deleted “and” preceding “(ix),” and inserted “and (x) special agents of the Department of Alcoholic Beverage Control appointed under the provisions of Chapter 1 (§ 4.1-100 et seq.) of Title 4.1.”

    The 2002 amendments.

    The 2002 amendment by c. 309, in subsection B, deleted “and” at the end of clause (ix), added “and” at the end of clause (x), and added clause (xi).

    The 2002 amendment by c. 737, in the first sentence of subsection C, deleted “or” following “firefighter” and inserted “commercial vehicle enforcement officer or motor carrier safety trooper employed by the Department of State Police, or full-time sworn member of the enforcement division of the Department of Motor Vehicles” following “hazardous materials officer”; and added “and any persons who are employed by or contract with private employers primarily to perform firefighting services” at the end of subsection H.

    The 2002 amendment by c. 789 substituted “Virginia Marine Police” for “Virginia Marine Patrol” in clause (vii) of subsection B.

    The 2007 amendments.

    The 2007 amendments by cc. 143 and 616 are identical, and inserted clause (xii) in subsection B, and made a related change.

    The 2009 amendments.

    The 2009 amendment by c. 515, in subsection B, inserted clause (xiii) and made related changes.

    The 2012 amendments.

    The 2012 amendment by c. 776 added clause (xiv) in subsection B and made a related change.

    The 2015 amendments.

    The 2015 amendments by cc. 38 and 730, effective January 15, 2018, are identical, and substituted “Virginia Alcoholic Beverage Control Authority” for “Department of Alcoholic Beverage Control” in clause (x) of subsection B and substituted “12” for “twelve” in subsection C.

    The 2015 amendments by cc. 502 and 503 are identical, and substituted “emergency medical services personnel” for “lifesaving and rescue squad members” in subsection G; substituted “’firefighter’ includes” for “the term ‘firefighter’ shall include” in subsection H and substituted “12” for “twelve” in subsection C.

    The 2020 amendments.

    The 2020 amendments by cc. 498 and 499 are identical, and in subsection B, inserted “any of the following persons who have completed five years of service in their position as” in the introductory wording; in subsection C, substituted “ovarian, breast, colon, brain, or testicular” for “ovarian or breast” and “five years of service” for “12 years of continuous service who has a contact with a toxic substance encountered in the line of duty” in the first sentence, and substituted “For colon, brain, or testicular cancer, the presumption shall not apply for any individual who was diagnosed with such a condition before July 1, 2020” for “For the purposes of this section, a ‘toxic substance’ is one which is a known or suspected carcinogen, as defined by the International Agency for Research on Cancer, and which causes, or is suspected to cause, leukemia or pancreatic, prostate, rectal, throat, ovarian or breast cancer” at the end.

    The 2020 amendment by c. 958 substituted “Department of Wildlife Resources” for “Department of Game and Inland Fisheries” in subsection B.

    The 2021 Sp. Sess. I amendments.

    The 2021 amendments by Sp. Sess. I, cc. 436 and 437, effective July 1, 2021, are identical, and in subsection B, added clause (xv) and made related changes; and in subsection G, deleted “‘Volunteer emergency medical services personnel” at the beginning. For applicability clause, see Editor’s note.

    Law Review.

    For survey of Virginia law on governmental services and social welfare for the year 1978-1979, see 66 Va. L. Rev. 301 (1980).

    For an article relating to the most significant developments in the law of workers’ compensation since September, 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    Research References.

    Larson’s Workers’ Compensation Law (Matthew Bender). § 52.07 Continuing Legislative Expansion of Coverage. Larson and Larson.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 21, 26, 59, 65, 66, 72.

    CASE NOTES

  • Analysis
  • I.In General.

    Editor’s note.

    Some of the cases annotated below were decided under prior law.

    This section must be given complete effect beginning July 1, 1976. County of Amherst Bd. of Supvrs. v. Brockman, 224 Va. 391 , 297 S.E.2d 805, 1982 Va. LEXIS 308 (1982).

    The language of § 27-40.1 mirrors and forms the basis for this section. City of Waynesboro v. Harter, 222 Va. 564 , 281 S.E.2d 911, 1981 Va. LEXIS 344 (1981).

    Amendment of 1977 unconstitutional. —

    The 1977 amendment which provided that the presumption that hypertension or heart disease suffered by firemen and policemen was an occupational disease covered by the Workers’ Compensation Act would now apply to state police officers whose death or condition or impairment of health occurred on or after Jan. 1, 1974, violated paragraph (3) of Va. Const., Art. IV, § 14, as it applied to claims based upon disability which occurred prior to July 1, 1976, the effective date of the 1976 act creating the presumption. Commonwealth, Dep't of State Police v. Hines, 221 Va. 626 , 272 S.E.2d 210, 1980 Va. LEXIS 283 (1980).

    Constitutionality of presumption. —

    A rational relationship exists between a fire fighter’s disability due to respiratory illness and a presumption that such illness constitutes an occupational disease compensable under the Workers’ Compensation Act. In this respect this section does not violate the employer’s constitutional rights. County Fire & Rescue Servs. v. Newman, 222 Va. 535 , 281 S.E.2d 897, 1981 Va. LEXIS 340 (1981).

    The legislature’s conclusion that a fire fighter who contracts a respiratory disease after he has started work suffers from an occupational disease is a reasonable and logical deduction. Thus, a “natural and rational nexus” exists between the occupation and the disease. County Fire & Rescue Servs. v. Newman, 222 Va. 535 , 281 S.E.2d 897, 1981 Va. LEXIS 340 (1981).

    Because at least some members of the medical community believe stress is a factor in the development of heart disease, a natural and rational nexus exists between occupation as a law enforcement officer and the disease, rendering this section constitutional on its face. Town of Purcellville Police v. Bromser-Kloeden, 35 Va. App. 252, 544 S.E.2d 381, 2001 Va. App. LEXIS 181 (2001).

    The presumption established by this section was constitutional as applied to a police officer where a natural and rational nexus existed between the claimant’s duties as a police officer and cardiomyopathy, the specific heart disease from which he suffered. The claimant presented testimony accepted by the Commission that his virally induced cardiomyopathy was work-related because it was more likely than not that he contracted it during close interpersonal contact required by his employment and because the stress inherent in his job made him more susceptible to contracting the virus. Town of Purcellville Police v. Bromser-Kloeden, 35 Va. App. 252, 544 S.E.2d 381, 2001 Va. App. LEXIS 181 (2001).

    Purpose of the rebuttable presumption is to establish by law, in the absence of evidence, a causal connection between death or disability from certain diseases and the occupation of a fire fighter. Page v. City of Richmond, 218 Va. 844 , 241 S.E.2d 775, 1978 Va. LEXIS 236 (1978).

    At present, evidence tending to either prove or disprove employment-related causation of cardio-pulmonary disease is frequently nonexistent. In light of this situation, the General Assembly formulated this section to benefit and protect the employee. It is of no constitutional significance that the present state of medical science and the healing arts places a greater burden on the employer. County Fire & Rescue Servs. v. Newman, 222 Va. 535 , 281 S.E.2d 897, 1981 Va. LEXIS 340 (1981).

    The fact that the etiology of a pulmonary disease is unknown does not render the presumption under this section irrebuttable. County Fire & Rescue Servs. v. Newman, 222 Va. 535 , 281 S.E.2d 897, 1981 Va. LEXIS 340 (1981).

    The legislature’s decision to cast the ultimate risk of non-persuasion upon the employer infringes no constitutional right because the employer may introduce evidence to overcome the statutory presumption; the employer’s right of due process is not violated by requiring it to produce a preponderance of the evidence in accordance with the two-part test requiring the employer to show both that the claimant’s disease was not caused by his employment and that there was a non-work-related cause of the disease. Bass v. City of Richmond Police Dep't, 258 Va. 103 , 515 S.E.2d 557, 1999 Va. LEXIS 81 (1999).

    A disease is any deviation from or interruption of the normal structure or function of any part, organ, or system (or combination thereof) of the body that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown. Commonwealth/Dep't of State Police v. Haga, 18 Va. App. 162, 442 S.E.2d 424, 10 Va. Law Rep. 1136, 1994 Va. App. LEXIS 200 (1994).

    This section has long been recognized as a remedial statute, enacted by the legislature to overcome the difficulty that a firefighter would otherwise have in proving causation. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    Statute resolves conflict in opinion as to causes of heart disease. —

    By enacting the statutory presumption set forth in this section, the General Assembly resolved the split in medical opinions regarding the impact of stress and work environment on heart disease in favor of the employee and adopted the presumption that the stress of working as a law enforcement officer causes or contributes to the development of such disease. City of Waynesboro Police v. Coffey, 35 Va. App. 264, 544 S.E.2d 860, 2001 Va. App. LEXIS 195 (2001).

    Legislature is presumed cognizant of courts’ interpretation of statute. —

    The legislature is presumed cognizant of the interpretation this statute has been given by the Court of Appeals and the Supreme Court of Virginia, and of the commission’s application of Virginia precedent. Accordingly, such construction is presumed consistent with the legislative intent, particularly in the absence of any changes to the rebuttal standard in the recent amendments and recodification of Title 65.1. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    Evidence rebutting premise of statute regarding causation not probative. —

    Testimony which merely refutes the premise of the legislatively enacted presumption embodied in this section does not constitute proper evidence in rebuttal. Where the general assembly has concluded that there is a causal link between stress and heart disease, it is not for the commission or the courts to reconsider the issue for to do so would defeat the intentions of the legislature. Bristol City Fire Dep't v. Maine, 35 Va. App. 109, 542 S.E.2d 822, 2001 Va. App. LEXIS 114 (2001).

    Evidence that merely rebuts generally the underlying premise of this statute, which establishes a causal link between stress and heart disease, is not probative evidence for purposes of overcoming the presumption. Medlin v. County of Henrico Police, 34 Va. App. 396, 542 S.E.2d 33, 2001 Va. App. LEXIS 85 (2001).

    Workers’ Compensation Commission erred in relying on physician’s opinion that deputy sheriff’s heart disease was not caused by his employment, since it was not probative evidence for purposes of overcoming the statutory presumption. Patton v. Loudoun County Bd. of Supervisors, 36 Va. App. 392, 551 S.E.2d 6, 2001 Va. App. LEXIS 491 (2001).

    Workers’ Compensation Commission erred in case involving a deputy sheriff with heart disease in relying on the opinions of doctors to the extent that they opined, in general, that there was no scientific link between occupational stress and heart disease in violation of a statutory presumption. Goodwin v. Amherst County Sheriff's Office, 2002 Va. App. LEXIS 39 (Va. Ct. App. Jan. 29, 2002).

    Medical opinions impermissibly attempting to rebut the legislative presumption embodied in this section by negating any causal link between occupational stress and heart disease are not probative rebuttal evidence. City of Waynesboro Police v. Coffey, 35 Va. App. 264, 544 S.E.2d 860, 2001 Va. App. LEXIS 195 (2001).

    Testimony refuting premise of presumption not proper evidence in rebuttal. —

    By enacting the statutory presumption, the General Assembly resolved the split in medical opinions in favor of the employee and adopted the presumption that the stress of working as a law enforcement officer or firefighter causes or contributes to the development of heart disease; evidence that merely rebuts generally the underlying premise of the statute, which establishes a causal link between stress and heart disease, is not probative evidence for purposes of overcoming the presumption. Godfrey v. City of Portsmouth Fire Dep't, 2001 Va. App. LEXIS 188 (Va. Ct. App. Apr. 10, 2001).

    Employer’s expert testimony failed to rebut the presumption that the hypertension or heart disease the claimant suffered was not an occupational disease; the expert testimony that there was no causal link between the claimant’s work as a police officer and his coronary artery diseases was a general attempt to refute the statutory presumption and lacked probative value to overcome the presumption as it did not point to what else might have caused claimant’s coronary artery disease. County of Henrico Police v. Medlin, 37 Va. App. 756, 561 S.E.2d 60, 2002 Va. App. LEXIS 187 (2002).

    This section provides a rebuttable presumption that, absent a preponderance of competent evidence to the contrary, a causal connection exists between an individual’s employment as a salaried fire fighter and certain diseases. The effect of the presumption is to eliminate the need for a claimant to prove a causal connection between his disease and his employment. In the absence of competent evidence to the contrary, the statutory presumption controls and the claimant prevails. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992) (decided under former 65.1-47.1).

    Under this section, a heart disease incurred by a deputy sheriff is presumed to be an occupational disease, suffered in the line of duty, that is covered by the section unless such presumption is overcome by a preponderance of competent evidence to the contrary. City of Portsmouth Sheriff's Dep't v. Clark, 30 Va. App. 545, 518 S.E.2d 342, 1999 Va. App. LEXIS 521 (1999).

    Effect of the presumption is to eliminate the necessity for proof by the claimant of causal connection. Page v. City of Richmond, 218 Va. 844 , 241 S.E.2d 775, 1978 Va. LEXIS 236 (1978).

    The effect of the presumption is to eliminate the need for a claimant to prove a causal connection between his disease and his employment. In the absence of competent evidence to the contrary, the statutory presumption controls, and the claimant prevails. Fairfax County Fire and Rescue Department v. Mitchell, 14 Va. App. 1033, 421 S.E.2d 668, 9 Va. Law Rep. 132, 1992 Va. App. LEXIS 224 (1992) (decided under former § 65.1-47.1).

    Presumption not irrebuttable. —

    The presumption of causation established by this section was not irrebuttable, so as to infringe upon employer’s due process rights, where the employer’s inability to rebut the presumption resulted from the shortcomings of medical science, i.e., the difficulties inherent in trying to pinpoint the precise source from which one has contracted a virus and in determining the impact of job stress on the ability of one’s immune system to resist such a virus. Town of Purcellville Police v. Bromser-Kloeden, 35 Va. App. 252, 544 S.E.2d 381, 2001 Va. App. LEXIS 181 (2001).

    Workers’ Compensation Commission decision was in error as the commission failed to follow the plain language of subsection A of § 65.2-402 by creating a conclusive presumption, thereby denying the employer its statutory right to rebut the presumption that a firefighter’s lung cancer was due to his job rather than his smoking. Henrico County Div. of Fire v. Estate of Woody, 39 Va. App. 322, 572 S.E.2d 526, 2002 Va. App. LEXIS 720 (2002).

    Causation presumption does not relieve burden to prove disease. —

    While the causation presumption under this section eliminates the need for a claimant who is a fire fighter to establish that his employment caused his disease, it does not relieve a claimant of the initial burden to prove the existence of a heart or respiratory disease that causes a disability. Delaney v. City of Fairfax Fire & Rescue, 1994 Va. App. LEXIS 336 (Va. Ct. App. May 31, 1994).

    In order to establish a prima facie case, the claimant need only prove his occupation and his disability from one of the diseases identified by statute. The presumption shifts the burden of going forward with the evidence from the claimant to the employer. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    Proof of causation. —

    Claimant was not entitled to statutory presumption of occupational disease without proof that exposure to toxic substance caused his prostate cancer. Whitehead v. City of Portsmouth Fire Dep't, 1999 Va. App. LEXIS 460 (Va. Ct. App. July 27, 1999) (decided prior to 1999 amendment).

    “Suspect” is defined as to be true or probable; thus, a carcinogen is a suspected cause of a particular cancer if it is probably, or more likely than not, the cause of that cancer, but it cannot be said that a carcinogen that is a contributing risk factor in the development of a particular cancer is more likely than not the cause of that cancer. Whiting v. City of Charlottesville Fire & Rescue, 2015 Va. App. LEXIS 243 (Va. Ct. App. Aug. 11, 2015).

    Determination of legal causation is factual finding not disturbed on appeal. —

    A determination of legal causation by the commission is a factual finding that will not be disturbed on appeal if there is credible evidence to support it. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    In its role as finder of fact, the commission determines whether the employer has met its burden to overcome the statutory presumption; on appeal, the reviewing court is not charged with determining anew whether the employer’s evidence of causation should be accorded sufficient weight to constitute a preponderance of the evidence, but must assess whether there is credible evidence to support the commission’s award. Bass v. City of Richmond Police Dep't, 258 Va. 103 , 515 S.E.2d 557, 1999 Va. LEXIS 81 (1999).

    Claimant’s knowledge of the presumption relevant to issue of when period for filing claim began. —

    Where evidence showed that employee who worked for a county fire department was diagnosed with high blood pressure as early as 1995, that he knew high blood pressure and hypertension were the same condition, and that even though his physician did not tell him his condition was work-related until January 1998, he knew about the statutory presumption that hypertension was an occupational disease, the employee’s claim for benefits, filed more than two years after the employee’s obligation to file the claim arose, was untimely. Owens v. York Fire & Rescue, 38 Va. App. 354, 564 S.E.2d 150, 2002 Va. App. LEXIS 321 (2002).

    The fact that there is contrary evidence in the record is of no consequence if there is credible evidence to support the commission’s finding. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    Policeman’s claim of disability due to heart disease was not entitled to the statutory presumption provided in this section, where the weight of the expert evidence pointed to obesity and medication as the causes of fatigue and sleeplessness, which the policeman assigned as the primary reasons for his disability. City of Bristol Police Dep't v. Broome, 7 Va. App. 161, 372 S.E.2d 204, 5 Va. Law Rep. 400, 1988 Va. App. LEXIS 108 (1988).

    Court of Appeals did not disturb Commission’s finding that evidence rebutted the applicable presumption regarding heart disease. One of the physicians, whose opinion was presented into evidence before the Commission, stated that he believed police officer’s coronary heart disease occurred as a consequence of known risk factors of family history, hypercholesterolemia, hypertension, and tobacco abuse. The doctor’s testimony was credible, not inconsistent with other reports he rendered, and supported the Commission’s finding that medical evidence sufficiently established that the employee’s heart disease was caused by known risks outside the employment. Bream v. Commonwealth, No. 0886-92-4 (Ct. of Appeals Feb. 23, 1993).

    Construction with other law. —

    Because the evidence presented by a surviving spouse failed to prove the required subsection A of § 9.1-402 condition precedent that the decedent’s performance of his law enforcement duty was the direct or proximate cause of his death, and there was simply no nexus between a § 65.2-402 presumption of a statutory medical condition as a cause of death and whether the death was the proximate result of the performance of a duty, a $75,000 award to the spouse thereunder was reversed. But, she was entitled to $25,000 pursuant to subsection B of § 9.1-402 , as well as an award of health insurance benefits. Commonwealth v. Barker, 275 Va. 529 , 659 S.E.2d 502, 2008 Va. LEXIS 48 (2008).

    II.Rebuttable Presumption.
    A.In General.

    When presumption applicable. —

    When read and considered together with §§ 27-40.1 and 27-40.1:1 , it is clear that the General Assembly intended the presumption created in this section to apply in those instances where an examination conducted under the direction and control of the employer fails to make a positive finding of the disease which subsequently brings about the disability or death of the fire fighter. Berry v. County of Henrico, 219 Va. 259 , 247 S.E.2d 389, 1978 Va. LEXIS 186 (1978); Garrison v. Prince William County Bd. of Supvrs., 220 Va. 913 , 265 S.E.2d 687, 1980 Va. LEXIS 184 (1980).

    Presumption inapplicable. —

    Although this section provides a rebuttable presumption that, absent a preponderance of evidence to the contrary, a causal connection exists between certain public service jobs and hypertension, the diagnosis of “probable” hypertension at claimant’s pre-employment physical examination supported the conclusion that claimant was not free of hypertension at the time he was hired. Therefore, the presumption afforded under this section was not applicable. Brown v. Loudoun County Bd. of Supvrs., 1997 Va. App. LEXIS 207 (Va. Ct. App. Apr. 1, 1997).

    Record supported the Virginia Workers’ Compensation Commission’s judgment that a firefighter who filed a claim for workers’ compensation benefits in 1997 was not entitled to the presumption contained in subsection A of § 65.2-402 because the firefighter was able to work and continued working after the firefighter was diagnosed with a mild form of asthma in 1995. Tomes v. James City Fire, 39 Va. App. 424, 573 S.E.2d 312, 2002 Va. App. LEXIS 755 (2002).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s finding that a firefighter’s leukemia did not result in a disability because he was still capable of performing his full duties; the firefighter did not establish a prima facie case necessary to secure the benefit of the rebuttable presumption because he failed to prove that his leukemia had reached a stage that prevented him from performing his work efficiently, thereby making him disabled as a result of his disease. Samartino v. Fairfax County Fire & Rescue, 64 Va. App. 499, 769 S.E.2d 692, 2015 Va. App. LEXIS 84 (2015).

    Credible evidence supported the Workers’ Compensation Commission’s finding that an employee had not been exposed to a toxic substance that caused or was suspected to cause prostate cancer because although a doctor opined that the employee’s exposure to certain substances at work could have been possible risk factors in the development of his prostate cancer, a “possible risk factor” was not synonymous to the “cause” or “suspected to cause” language in subsection C. Whiting v. City of Charlottesville Fire & Rescue, 2015 Va. App. LEXIS 243 (Va. Ct. App. Aug. 11, 2015).

    Credible evidence supported the Workers’ Compensation Commission’s finding that an employee had not been exposed to a toxic substance that caused or was suspected to cause prostate cancer because the employee did not satisfactorily prove that the known or suspected carcinogen caused or was suspected to cause prostate cancer. Whiting v. City of Charlottesville Fire & Rescue, 2015 Va. App. LEXIS 243 (Va. Ct. App. Aug. 11, 2015).

    Workers’ Compensation Commission did not err in declining to apply the rebuttable presumption provided for in subsection C because it properly interpreted the statute to require an employee to show that he had been exposed to a known or suspected carcinogen and that the known or suspected carcinogen caused or was suspected to cause a particular type of cancer; the employee stipulated that he would not have a viable claim absent the presumption. Whiting v. City of Charlottesville Fire & Rescue, 2015 Va. App. LEXIS 243 (Va. Ct. App. Aug. 11, 2015).

    When presumption applicable. —

    All that is required to invoke the statutory presumption is proof of the disease and proof of a disability resulting from that disease; a right to economic indemnity is only one factor that a fact finder may consider in determining if a person is disabled as a result of his or her illness, in other words, whether he or she has reached the stage when the disease prevents the employee from performing his or her work efficiently. Samartino v. Fairfax County Fire & Rescue, 64 Va. App. 499, 769 S.E.2d 692, 2015 Va. App. LEXIS 84 (2015).

    Proof of entitlement to economic indemnity may be used to support a finding that a claimant is disabled, however its absence is not dispositive of a finding that a claimant is not disabled. Samartino v. Fairfax County Fire & Rescue, 64 Va. App. 499, 769 S.E.2d 692, 2015 Va. App. LEXIS 84 (2015).

    If preemployment physical does not find disease, benefit cannot be denied. —

    A claimant who has undergone a preemployment physical examination failing to make a positive finding of the disease cannot be denied the benefit of the presumption merely because subsequent examinations conducted several years after his employment as a police officer or fire fighter result in such a finding. Garrison v. Prince William County Bd. of Supvrs., 220 Va. 913 , 265 S.E.2d 687, 1980 Va. LEXIS 184 (1980).

    The police officer could properly involve the presumption set forth in this section, where he was a member of a city police department, his disability was caused by heart disease, and he was found to be free from heart disease by a prior physical examination conducted under the direction and control of his employer. Estate of Montgomery v. City of Portsmouth Police Dep't, 4 Va. App. 525, 358 S.E.2d 762, 4 Va. Law Rep. 218, 1987 Va. App. LEXIS 209 (1987).

    But if it so finds disease claimant not entitled to benefit. —

    If prior to making a claim under this section, the preemployment physical examination of the claimant by the employer revealed a positive finding of hypertension but the claimant was nevertheless deemed qualified for duty, the claimant would not be entitled to benefit from the statutory presumption set forth in this section. Garrison v. Prince William County Bd. of Supvrs., 220 Va. 913 , 265 S.E.2d 687, 1980 Va. LEXIS 184 (1980).

    Physical examination by employer required. —

    This section required city to conduct a physical examination of claimant deputy sheriff, just as §§ 27-40.1 and 27-40.1:1 require examinations of new fire fighters, and when it failed to do so, claimant was entitled to the presumption that his heart attack was an occupational disease suffered in the line of duty. City of Waynesboro v. Harter, 222 Va. 564 , 281 S.E.2d 911, 1981 Va. LEXIS 344 (1981).

    If § 27-40.1 makes an examination mandatory on the part of a city, this section, which contains the same language, must contain the same mandate. City of Waynesboro v. Harter, 222 Va. 564 , 281 S.E.2d 911, 1981 Va. LEXIS 344 (1981).

    Presumption applied even though physical conducted several years after employment. See Medlin v. County of Henrico Police, 34 Va. App. 396, 542 S.E.2d 33, 2001 Va. App. LEXIS 85 (2001).

    Period of limitations. —

    There is no indication in this section itself, or in former § 65.1-99 (now § 65.2-708 ), which indicates that the General Assembly intended this section to override limitation periods otherwise applicable. If the General Assembly intended for claims filed under this section to have no time limitation at all, they could have expressly said so. City of Waynesboro Sheriff's Dep't v. Harter, 1 Va. App. 265, 337 S.E.2d 901, 1985 Va. App. LEXIS 97 (1985).

    A claimant, who is entitled to the presumption of this section, is subject to the time limitation contained in former § 65.1-99 (now § 65.2-708 ) when he suffers additional disability from the same occupational disease. City of Waynesboro Sheriff's Dep't v. Harter, 1 Va. App. 265, 337 S.E.2d 901, 1985 Va. App. LEXIS 97 (1985).

    To rebut the statutory presumption the employer must adduce competent medical evidence of a nonwork-related cause of the disabling disease. Page v. City of Richmond, 218 Va. 844 , 241 S.E.2d 775, 1978 Va. LEXIS 236 (1978) (decided prior to 1978 amendment, which changed the amount of evidence required to rebut the presumption to a preponderance of competent evidence).Cook v. City of Waynesboro Police Dep't, 225 Va. 23 , 300 S.E.2d 746, 1983 Va. LEXIS 188 (1983).

    For purposes of rebutting the statutory presumption, a statement by an expert medical witness that the claimant’s condition is generally thought to be a congenital anomaly could be properly construed as a positive statement of belief and the Commission could fairly infer that the belief was held generally by those in the medical discipline conversant with such condition. Cook v. City of Waynesboro Police Dep't, 225 Va. 23 , 300 S.E.2d 746, 1983 Va. LEXIS 188 (1983).

    An expert medical witness’ statement is not insufficient to rebut the statutory presumption because the word “probably,” used with reference to the presence of congenital defect, connotes nothing more than supposition or speculation. A statement that a certain condition is probably present means there is reasonable likelihood of the condition’s existence, and this is sufficient to permit a trier of fact to accord the statement probative weight. Cook v. City of Waynesboro Police Dep't, 225 Va. 23 , 300 S.E.2d 746, 1983 Va. LEXIS 188 (1983).

    In order to rebut the presumption, it is not sufficient that the employer merely adduce evidence that the heart disease was not caused by the employment; the employer must establish by competent medical evidence a nonwork-related cause to rebut or overcome the statutory presumption that causation exists. Virginia Dep't of State Police v. Talbert, 1 Va. App. 250, 337 S.E.2d 307, 1985 Va. App. LEXIS 94 (1985).

    An employer may rebut the presumption of this section by proving by a preponderance of the evidence that: (1) The claimant’s disease was not caused by his or her employment and (2) there was a non-work-related cause of the disease. City of Portsmouth Sheriff's Dep't v. Clark, 30 Va. App. 545, 518 S.E.2d 342, 1999 Va. App. LEXIS 521 (1999); Medlin v. County of Henrico Police, 34 Va. App. 396, 542 S.E.2d 33, 2001 Va. App. LEXIS 85 (2001).

    To overcome the statutory presumption, the employer must show, by a preponderance of the evidence, both that: (1) the claimant’s disease was not caused by his employment, and (2) there was a non-work-related cause of the disease; if the employer does not prove by a preponderance of the evidence both parts of this two-part test, the employer has failed to overcome the statutory presumption. Bass v. City of Richmond Police Dep't, 258 Va. 103 , 515 S.E.2d 557, 1999 Va. LEXIS 81 (1999).

    In providing that the statutory presumption of an occupational disease may be overcome by a preponderance of the evidence to the contrary, § 65.2-402 B implicitly directs the Virginia Workers’ Compensation Commission (commission) as finder of fact to consider all evidence on the issue of causation presented by a claimant, as well as by the employer; when the commission determines that the employer has failed to overcome the statutory presumption, the claimant is entitled to an award of benefits. Amherst County Sheriff's Office v. Goodwin, 2003 Va. App. LEXIS 113 (Va. Ct. App. Mar. 4, 2003).

    To overcome presumption contained in subsection B, employer must show, by a preponderance of the evidence, both that: (1) the employee’s disease was not caused by his or her employment; and (2) there was a non-work-related cause of the disease. Thus, if the employer does not prove by a preponderance of the evidence both parts of the two-part test, the employer has failed to overcome the statutory presumption. City of Richmond Fire Dep't v. Dean, 30 Va. App. 306, 516 S.E.2d 709, 1999 Va. App. LEXIS 450 (1999).

    In order to rebut the presumption, it is not sufficient that the employer merely adduce evidence that the heart disease was not caused by the employment; the employer must establish by competent medical evidence a nonwork-related cause to rebut or overcome the statutory presumption that causation exists. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    The principle is now well established that to overcome the presumption the employer must show, by a preponderance of the evidence, both that: (1) the claimant’s disease was not caused by his employment; and (2) there was a non-work-related cause of the disease. Godfrey v. City of Portsmouth Fire Dep't, 2001 Va. App. LEXIS 188 (Va. Ct. App. Apr. 10, 2001).

    Burden of proof under subsection C. —

    It is not enough, for purposes of subsection C, for a claimant to show that he or she was exposed to a carcinogen and then developed a particular cancer; instead, the claimant must show that he or she was exposed to carcinogen(s) and that such carcinogens caused or are suspected of causing the particular type of cancer from which the claimant suffers. Whiting v. City of Charlottesville Fire & Rescue, 2015 Va. App. LEXIS 243 (Va. Ct. App. Aug. 11, 2015).

    Difference between a claimant’s evidentiary burden in subsections A and B on the one hand, and subsection C on the other hand, is significant; the General Assembly certainly could have written subsection C in the same way it wrote subsections A and B if it had chosen to do so. Whiting v. City of Charlottesville Fire & Rescue, 2015 Va. App. LEXIS 243 (Va. Ct. App. Aug. 11, 2015).

    In the absence of evidence, the statutory presumption prevails and controls. Page v. City of Richmond, 218 Va. 844 , 241 S.E.2d 775, 1978 Va. LEXIS 236 (1978) (decided prior to the 1978 amendment, which changed the amount of evidence required to rebut the presumption to a preponderance of competent evidence).

    Where employer offered no evidence of a nonwork-related cause of claimant’s pulmonary sarcoidosis, the employer did not meet its burden of proof to overcome the presumption under this section. County Fire & Rescue Servs. v. Newman, 222 Va. 535 , 281 S.E.2d 897, 1981 Va. LEXIS 340 (1981).

    The presumption of causation provided by this section is overcome by a preponderance of the evidence to the contrary, and in the absence of competent evidence to the contrary, the statutory presumption controls and the claimant prevails. Duffy v. Commonwealth of Virginia/Dept. of State Police, 22 Va. App. 245, 468 S.E.2d 702, 1996 Va. App. LEXIS 245 (1996).

    B.Respiratory Diseases.

    Failure to rebut presumption as to cause of respiratory disease. —

    Where the doctor failed to give his opinion as to the cause of the fire fighter’s disabling respiratory disease, or to state affirmatively that the evidence disproved any causal connection between the disease and his occupation, and merely reported that he had found no evidence of such a connection, the evidence was insufficient to rebut the presumption under this section. Page v. City of Richmond, 218 Va. 844 , 241 S.E.2d 775, 1978 Va. LEXIS 236 (1978) (decided prior to 1978 amendment).

    Because employer’s evidence failed to exclude work-related exposure as a cause of the decedent’s disease, the employer’s evidence did not rebutt the statutory presumption provided under subsection A. James City County Fire Dep’t v. Thomas, No. 1647-96-4 (Ct. of Appeals Jan. 7, 1997).

    Evidence that condition was hereditary sufficient to overcome presumption. —

    The opinion of a specialist in diseases of the chest, following a review of medical records and a physical examination, that a fire fighter’s condition of wheezing and coughing was “more than likely a hereditary phenomenon,” concurred in by the treating physician, was sufficient to overcome the statutory presumption of occupational disease. Doss v. Fairfax County Fire & Rescue Dep't, 229 Va. 440 , 331 S.E.2d 795, 1985 Va. LEXIS 220 (1985).

    C.Heart Disease and Hypertension.

    Failure to rebut presumption as to heart disease or hypertension. —

    The employer failed to rebut the statutory presumption where it merely introduced evidence that the heart disease was not caused by the employment. Estate of Montgomery v. City of Portsmouth Police Dep't, 4 Va. App. 525, 358 S.E.2d 762, 4 Va. Law Rep. 218, 1987 Va. App. LEXIS 209 (1987).

    Where the presumption established that claimant’s heart disease was caused by his employment, and the medical evidence failed to rebut that presumption, the fact that there may have been other risk factors that contributed to causation did not overcome the presumption. City of Roanoke v. Witt, No. 1283-92-3 (Ct. of Appeals March 16, 1993).

    Where the employer’s rebuttal evidence fails to exclude a work-related factor as a cause of an illness, the finding of the commission that the employer failed to rebut the presumption in favor of the claimant is conclusive and binding on appeal. Duffy v. Commonwealth of Virginia/Dept. of State Police, 22 Va. App. 245, 468 S.E.2d 702, 1996 Va. App. LEXIS 245 (1996).

    Where the evidence demonstrated that multiple factors, including job stress, contributed to the development of the police officers’ heart disease, the employer was required to exclude work-related stress as a contributing factor to rebut the presumption of causation; here the employer’s evidence failed to exclude job stress as a contributing factor. Duffy v. Commonwealth of Virginia/Dept. of State Police, 22 Va. App. 245, 468 S.E.2d 702, 1996 Va. App. LEXIS 245 (1996).

    An employer failed to rebut the presumption that a police officer’s heart disease was caused by a virus in that the mere fact that claimant could have contracted the virus which caused his cardiomyopathy from a source unrelated to his employment was insufficient to establish that the cause was, in fact, non-work-related; further, evidence before the Commission indicated that the nature of the claimant’s work as a police officer in fact increased his risk of contracting the type of “community acquired” virus which caused his heart condition, because it both placed him in greater contact with the public and with their various bodily fluids and increased the overall level of stress in his life, thereby rendering him more susceptible to all viruses. Town of Purcellville Police v. Bromser-Kloeden, 35 Va. App. 252, 544 S.E.2d 381, 2001 Va. App. LEXIS 181 (2001).

    Where a doctor’s arguably conflicting statements entitled a workers’ compensation commission to determine that the doctor did not give an opinion, the employer failed to rebut presumption that a worker’s employment was a cause of the worker’s heart disease; therefore, credible evidence supported the commission’s award of disability and medical benefits. Wytheville Law Enforcement v. Wheeler, 2003 Va. App. LEXIS 208 (Va. Ct. App. Apr. 8, 2003).

    Employer failed to rebut the statutory presumption contained in subsection B of § 65.2-402 of occupational disease, and doctors’ opinions and the claimant’s testimony regarding the stress he encountered in his work as a firefighter supported the workers’ compensation award. Metro. Wash. Airports Auth. v. Bispo, 2003 Va. App. LEXIS 442 (Va. Ct. App. Aug. 19, 2003).

    Where a doctor’s evidence that a claimant’s heart disease was not the cause of disability was couched in possibilities and not probabilities, it was insufficient to rebut the presumption that the claimant’s disease was not caused by his employment. Amherst County Sheriff's Dep't v. Martin, 2004 Va. App. LEXIS 253 (Va. Ct. App. June 1, 2004).

    Police officer was properly awarded workers’ compensation benefits based on the presumption that the officer’s heart disease was an occupational disease under subsection B of § 65.2-402 because: (1) the employer failed to conduct a preemployment physical examination; and (2) the General Assembly did not plainly express an intention to substantively change former § 65.1-47.1 when it was recodified as § 65.2-402 . Town of Waverly Law Enforcement v. Owens, 51 Va. App. 277, 657 S.E.2d 161, 2008 Va. App. LEXIS 79 (2008).

    Workers’ Compensation Commission properly awarded a police officer benefits for heart disease under the statutory presumption because credible evidence supports the Commission’s finding that heart disease caused his disability and chronic cardiac issues. City of Newport News v. Kahikina, 71 Va. App. 536, 838 S.E.2d 70, 2020 Va. App. LEXIS 49 (2020).

    Evidence sufficient to rebut. —

    The medical evidence in the record rebutted the presumption that the claimant’s idiopathic cardiomyopathy was a disease condition related to his employment as a police officer and that obesity and other causes not occupational in their origins were the source of his condition. Estate of Montgomery v. City of Portsmouth Police Dep't, 4 Va. App. 525, 358 S.E.2d 762, 4 Va. Law Rep. 218, 1987 Va. App. LEXIS 209 (1987).

    Denial of the workers’ compensation benefits to the employee was appropriate because the employer overcame the presumption in subsection B of § 65.2-402 . The evidence proved that although the doctors were unable to exclude the possibility that the employee’s heart disease was work-related, a fair reading of their medical records and depositions indicated that in their opinions, his employment was probably not a cause of his heart disease. Coble v. Henrico (County Of) Fire, 2011 Va. App. LEXIS 110 (Va. Ct. App. Mar. 29, 2011).

    Failure to prove non-work cause of heart disease. —

    Employer failed to rebut the presumption under § 65.2-402 , that the employee’s hypertension and heart disease were compensable as occupational diseases, because the employer did not establish a non-work-related cause for the employee’s condition by relying solely on the employee’s family history, obesity and high cholesterol. Metro. Wash. Airports Auth. v. Bailey, 2002 Va. App. LEXIS 463 (Va. Ct. App. Aug. 13, 2002).

    Virginia Workers’ Compensation Commission properly awarded benefits to a claimant for occupational heart disease, as the employer failed to rebut the presumption; since the claimant’s physician’s statements were conflicting, the commission was entitled to conclude that no medical evidence established that job stress caused or contributed to the development of heart disease. Amherst County Sheriff's Office v. Goodwin, 2003 Va. App. LEXIS 113 (Va. Ct. App. Mar. 4, 2003).

    Finding by the Virginia Workers’ Compensation Commission that non-work-related risk factors, including obesity, diabetes, hypertension, elevated cholesterol, smoking history, and a generally sedentary lifestyle caused a fire department employee’s coronary artery disease, did not overcome the statutory presumption of compensability, set forth in § 65.2-402 , as the finding did not necessarily establish that the disease was not caused by the employment, which also had to be proven to overcome the presumption; the Commission weighed the testimony given by all the physicians as well as other medical evidence, and gave credence and weight to the opinions of the claimant’s treating cardiologist and another, while discounting the “general denials” in the opinions of three other doctors, and the Commission’s ultimate finding that the employer failed to rebut the statutory presumption was supported by credible evidence. Metro. Wash. Airports Auth. v. Lusby, 41 Va. App. 300, 585 S.E.2d 318, 2003 Va. App. LEXIS 436 (2003).

    Where there were conflicting doctor reports, because credible evidence in the record supported the Commission’s determination that an employer met its burden to demonstrate that a worker’s cardiac issues were not caused by his employment and had another non-work-related, i.e. genetic, cause, the court was bound by that determination on appeal. Woods v. Henrico County Div. of Fire, 2012 Va. App. LEXIS 41 (Va. Ct. App. Feb. 14, 2012).

    Disease caused by a nonwork-related factor not shown. —

    Credible evidence supported the Workers’ Compensation Commission’s finding that employer failed to prove by a preponderance of the evidence that claimant’s heart disease and myocardial infarction were caused by a nonwork-related factor. Commonwealth v. Dyer, 1993 Va. App. LEXIS 343 (Va. Ct. App. Aug. 10, 1993).

    Where the record established that the claimant smoked cigarettes for over 35 years, but no evidence was admitted concerning the actual effect of claimant’s smoking on his cardiovascular health, employer failed to rebut the statutory presumption. In order to rebut the presumption, employer was required to produce affirmative evidence of a non-work-related cause of claimant’s orthostatic hypertension. City of Portsmouth Sheriff's Dep't v. Clark, 30 Va. App. 545, 518 S.E.2d 342, 1999 Va. App. LEXIS 521 (1999).

    The showing of “risk factors,” such as smoking and gender, alone does not rebut the statutory presumption and does not establish competent medical evidence of a nonwork-related cause of the disabling disease. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    To overcome the presumption that heart disease is an occupational disease, the employer must show, by a preponderance of the evidence, both that the claimant’s disease was not caused by his employment and that there was a non-work related cause of the disease. Bristol City Fire Dep't v. Maine, 35 Va. App. 109, 542 S.E.2d 822, 2001 Va. App. LEXIS 114 (2001).

    The presumption shifts the burden of going forward with evidence from the claimant to his employer. Page v. City of Richmond, 218 Va. 844 , 241 S.E.2d 775, 1978 Va. LEXIS 236 (1978).

    If rebuttal evidence under this section fails to exclude work-related factor as causing the heart disease or if there are conflicting medical opinions as to whether the employment caused the disease, the finding of the Commission as to causation is conclusive and binding on appeal. Virginia Dep't of State Police v. Talbert, 1 Va. App. 250, 337 S.E.2d 307, 1985 Va. App. LEXIS 94 (1985).

    Burden of excluding possibility stress may have been contributing factor. —

    Nothing in the statute or the several decisions of this court dealing with rebuttal of the presumption in subsection B suggests that the employer has the burden of excluding the “possibility” that job stress may have been a contributing factor to heart disease. Augusta County Sheriff's Dep't v. Overbey, 254 Va. 522 , 492 S.E.2d 631, 1997 Va. LEXIS 129 (1997).

    Where there exist conflicting medical opinions as to whether the heart disease was caused by the claimant’s employment, the finding of the Compensation Commission as to causation is binding on appeal. Estate of Montgomery v. City of Portsmouth Police Dep't, 4 Va. App. 525, 358 S.E.2d 762, 4 Va. Law Rep. 218, 1987 Va. App. LEXIS 209 (1987).

    Evidence failed to exclude work-related stress as cause of disease. —

    Where the employer presented rebuttal evidence pointing to causes of claimant’s condition other than work, but nonetheless failed to exclude work-related stress as a factor causing claimant’s heart disease, the statutory presumption was not rebutted. Fairfax County Fire and Rescue Department v. Mitchell, 14 Va. App. 1033, 421 S.E.2d 668, 9 Va. Law Rep. 132, 1992 Va. App. LEXIS 224 (1992) (decided under former § 65.1-47.1).

    In light of the opinions of two physicians and the lack of evidence that the employee had heart disease before he began his stressful employment, the commission, in its role as fact finder, was entitled to give little weight to the contrary opinion of the physician. City of Richmond Fire & Emergency Servs. v. Shuler, 1997 Va. App. LEXIS 9 (Va. Ct. App. Jan. 28, 1997).

    Although deputy sheriff’s use of nicotine, caffeine and alcohol contributed to origination and continuation of his cardiac arrhythmia, employer failed to exclude employee’s job stress as a factor in his condition. Henrico County Sheriff's Office v. McQuay, 1999 Va. App. LEXIS 503 (Va. Ct. App. Aug. 17, 1999).

    Evidence that job-related stress is one of several factors contributing to a claimant’s heart disease, if found credible by commission, is sufficient to prevent employer from proving first prong required to rebut presumption of compensability. Tazewell County Sheriff's Office v. Owens, 1999 Va. App. LEXIS 405 (Va. Ct. App. June 29, 1999).

    Actual economic loss not shown because of retirement. —

    Virginia Workers’ Compensation Commission did not err in concluding that a claimant was not entitled to wage indemnity benefits because the claimant did not suffer an actual economic loss due to the claimant’s heart condition, as the claimant was voluntarily retired and not receiving wages during the time of the claimant’s hospitalization and total temporary disability. Shaver v. Dep't of State Police, 2014 Va. App. LEXIS 207 (Va. Ct. App. May 27, 2014).

    Deputy sheriff entitled to presumption of compensability. —

    All full-time, duly sworn deputy sheriffs are entitled to the presumption of compensability contained in subsection B of this section regardless of their designation as primarily courtroom security, correctional or law-enforcement officers, and thus Workers’ Compensation Commission properly awarded claimant who was a deputy sheriff occupational disease benefits for the heart attack she suffered while working for employer as a correctional officer. County of Augusta Jail v. Cook, 16 Va. App. 247, 430 S.E.2d 546, 9 Va. Law Rep. 1257, 1993 Va. App. LEXIS 92 (1993).

    Virginia Workers’ Compensation Commission properly found that a claimant sustained compensable heart disease from employment as a deputy sheriff because the claimant was entitled from medical records to the presumption that the claimant’s heart disease was an occupational disease, suffered in the line of duty. Further, the claimant’s pre-existing hypertension did not bar the claimant’s entitlement to the presumption, while the employer failed to rebut the presumption based on the claimant’s risk factors for heart disease. Cty. of Henrico & Va. Ass'n of Counties Grp. Self-Insurance Risk Pool v. Cobb, 2018 Va. App. LEXIS 344 (Va. Ct. App. Dec. 11, 2018).

    Fire fighter’s claim of disability due to heart disease was not entitled to the statutory presumption. —

    Although claimant had an irregular heartbeat for 30 minutes, which episode resulted in his being absent from work for one day, he failed to establish that he had a disease, health condition, or impairment that rendered him totally or partially disabled. He was paid his salary for the one day he did not work and this one day that he did not work was a precautionary measure, rather than a period of disability. Therefore, having presented no evidence that proved that he was totally or partially disabled from performing his work as a fire fighter other than during the 30 minutes of temporary arrhythmia, nor showing that he lost any earnings, the Commission’s holding that the presumption in this section had no application to claimant’s situation was not error. Delaney v. City of Fairfax Fire & Rescue, 1994 Va. App. LEXIS 336 (Va. Ct. App. May 31, 1994).

    Firefighter, who was placed on restriction pending further testing which resulted in a finding that he did not have a heart condition, failed to prove that he was totally or partially disabled in a way that prevented him from continuing work for the fire department and proved no loss of wages; therefore, he was not entitled to the presumption under subsection B of § 65.2-402 and, therefore, not entitled to an award of workers’ compensation benefits. Lussen v. City of Roanoke Fire & EMS, 2003 Va. App. LEXIS 652 (Va. Ct. App. Dec. 16, 2003).

    Though there is a statutory presumption that a fire fighter’s hypertension is occupationally related, and an emergency medical technician proved that he suffered from hypertension, as he presented no evidence that his stroke resulted from his hypertension, he was not entitled to the presumption because he offered no proof that his hypertension resulted in his disability. Snellings v. Stafford County Fire & Rescue Dep't, 62 Va. App. 568, 750 S.E.2d 223, 2013 Va. App. LEXIS 332 (2013).

    Workers’ Compensation Commission did not err in finding that a retired firefighter-medic failed to prove that he suffered from a “disability” as a result of his heart disease and, therefore, the presumption in the statute did not apply, because the firefighter-medic did not introduce any evidence that tended to show his entitlement to economic indemnity for the period of his hospitalization or afterwards. Lipscomb v. City of Lynchburg, 2014 Va. App. LEXIS 210 (Va. Ct. App. May 27, 2014).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Claimant entitled to the cancer presumption of subsection C where claimant sufficiently established exposure to asbestos and that exposure to asbestos is suspected to cause rectal cancer. Manning v. City of Newport News, JCN VA00001492636 (Aug. 30, 2019).

    “Diseases” of postural orthostatic tachycardia syndrome and inappropriate tachycardia did not meet the requirements to invoke the presumption of § 65.2-402 , because they arose from a disorder of the autonomic nervous system, not a heart condition or disease of the cardiovascular/circulatory system. The term “heart disease” limits the presumption of compensability to diseases of the heart and excludes other diseases of the body that tangentially affect the heart. Bunting v. Suffolk (City of) Fire, VWC File No. 219-09-56 (Nov. 2, 2005).

    A police officer seeking a medical only award for hypertension is not entitled to the presumption of § 65.2-402 and must meet the clear and convincing standard of § 65.2-401 by proving that his employment was the “primary source” or significant or “deciding” cause of his condition. Showing that that his work contributed to developing hypertension is not sufficient. Mullins v. City of Norton, VWC File No. 221-83-78 (Jan. 30, 2006).

    Section 65.2-402 creates a rebuttable presumption that certain diseases suffered by police officers and other public servants are occupational diseases suffered in the line of duty. Soltow v. Fairfax County Board of Supervisors, 77 O.W.C. 154 (1998).

    Counsel in workers’ compensation cases under § 65.2-402 (involving the presumption as to death or disability from respiratory disease, hypertension, or heart disease in regard to certain workers) are entitled to discover underlying facts and assumptions upon which an expert opinion is based in such cases, but the physician-patient confidentiality must also be protected. The Commission held that an expert witness identified in the case was required to produce, pursuant to a subpoena duces tecum, all opinion reports issued in cases before the Virginia Workers’ Compensation Commission during the period from January 1, 1998 to the present, with the claimants’ names redacted, in which the report was requested by a claimant or an employer and in which the expert witness was not the treating physician. Brandon v. City of Richmond Fire Department, 78 O.W.C. 216 (1999).

    In order to bring himself within the purview of § 65.1-47.1, (now § 65.2-402 ) the claimant must first establish that he suffers from one of the conditions named in the statute. Arnold v City of Richmond Bureau of Fire, 60 O.I.C. 24 (1981).

    The initial determination in Heart-Lung presumption cases, usually referred to as the claimant’s prima facia case, is whether the claimant is eligible for the presumption. To prove this, the employee must prove his occupation and his disability from the diseases identified in Code § 65.2-402 . Once the claimant has proven entitlement to the presumption, the burden shifts to the employer to adduce competent medical evidence of a non-work-related cause of the disabling disease. Once the employer has introduced sufficient evidence to rebut the presumption, a claimant, who had exposure to the causative condition outside of work, has the burden under Code § 65.2-401 to show by clear and convincing evidence that his heart disease arose out of and in the course of employment. Soltow v. Fairfax County Board of Supervisors, 77 O.W.C. 154 (1998).

    In order to receive benefits under § 65.2-402 , the employee need only prove his occupation and that his disability results from one of the diseases identified by the statute. The presumption then shifts the burden of going forward with the evidence to his employer. Coleman v. Town of Lebanon Police Dept., 75 O.W.C. 231 (1996).

    A firefighter who retired based on years of service and subsequently required open heart surgery is entitled to the presumption. The Act does not require that the employee be employed at the time that he becomes partially or totally incapacitated to be entitled to the presumption. Revard v. Fairfax County Board of Supervisors, 70 O.I.C. 154 (1991).

    A claimant who voluntarily retired and was unemployed for the preceding 52 weeks may not receive compensation for wage loss. Arlington County Fire Dept. v. Stebbins, 21 Va. App. 570, 466 S.E.2d 124, 1996 Va. App. LEXIS 55 (1996).

    A claimant who worked in the supply room but was classified as a firefighter was entitled to the presumption that his hypertension arose out of the employment. Injurious exposure as defined by § 65.1-52 (now § 65.2-404 ) was not a condition of entitlement to the presumption and only has probative value in determining causation or rebutting the allegation. Rogers v. Fairfax County Fire & Rescue, 68 O.I.C. 53 (1989). (Affirmed by Court of Appeals 4/3/90).

    A State Trooper assigned to the less strenuous task of overseeing drivers’ examinations is entitled to the statutory presumption. Link v. Va. Dept. of State Police, 71 O.W.C. 143 (1992).

    An employee who is sworn as a deputy sheriff/corrections officer but assigned duties as a dispatcher/matron is entitled to the statutory presumption. Cook v. County of Augusta Jail, 71 O.W.C. 146 (1992).

    A jailer who is neither classified, trained or sworn as a deputy sheriff is not entitled to the statutory presumption. Wallace v. Piedmont Regional Jail, 71 O.W.C. 148 (1992).

    This section was not intended to include personnel such as a dispatcher who did not receive any law enforcement training but worked at the police department. Fisher v. City of Williamsburg, 58 O.I.C. 125 (1979).

    Hypertension is defined as a persistently high pressure of the blood against the arterial walls, the diagnosis of which is based on at least three consecutive daily or weekly blood pressure readings. Marshall v. Commonwealth of Virginia, Department of State Police, 61 O.I.C. 288 (1982).

    A diagnosis of atrial fibrillation is not a diagnosis of hypertension sufficient to commence the statute of limitations. Link v. Va. Dept. of State Police, 71 O.W.C. 143 (1992).

    The claimant does not have to prove a single source of his disabling occupational disease. The claimant’s burden is to prove that the employment was the primary source. Soltow v. Fairfax County Board of Supervisors, 77 O.W.C. 154 (1998).

    This section is not a substitute for an opinion on causal relation in the case of a mere diagnosis of hypertension. Miller v. Virginia State Police, 61 O.I.C. 297 (1982).

    Disabling heart condition held to be compensable occupational disease. Griffin v. City of Chesapeake, 57 O.I.C. 145 (1977); Hawkins v Comm. of Va. Dept. of State Police, 59 O.I.C. 119 (1980); Nelson v. Fairfax County Fire & Rescue Services, 59 O.I.C. 230 (1980).

    Inflammatory mass found in lung of career firefighter resulting in diagnosis of “restrictive lung disease” held compensable under this section. Burch v. City of Richmond Fire Department, 61 O.I.C. 84 (1982).

    Condition Existed Prior to Enactment or Employment:

    Communication of diagnosis of hypertension in 1974 barred claim since section was not enacted until 1976. Fisher v. City of Williamsburg Dept. of Police, 58 O.I.C. 125 (1979).

    Claimant who was free of hypertension when his employment began but developed the condition prior to enactment of this section is entitled to the benefit of the presumption. Bourne v. County of Henrico, Board of Supervisors, 61 O.I.C. 51 (1982).

    Where the medical evidence proves that the employee firefighter suffered from a respiratory disease prior to his employment, he is not entitled to benefit from the statutory presumption of § 65.1-47.1 (now § 65.2-402 ). Johnson v. Henrico County Division of Fire, 60 O.I.C. 234 (1981).

    Pre-employment Physical:

    Presumption applies where exam conducted under direction and control of employer fails to make a positive finding of disease which brings about disability. Garrison v. Pr. Wm. Cty. Bd. of Supervisors, 59 O.I.C. 89 (1980).

    Deputy sheriff was entitled to presumption where the city failed to administer a pre-employment physical examination even though the statute was not enacted until after the claimant was hired. Bell v. Page County Sheriff ’s Department, 61 O.I.C. 31 (1982).

    Where the examiner performing the preemployment physical is not told of a preexisting heart condition, and his conclusion that the employee was free of any heart disease was therefore based on erroneous information, the threshold requirements to invoke the presumption are not met and the employee is not entitled to the presumption. Dizon v. City of Norfolk Sheriff Dept., 75 O.W.C. 122 (1996).

    Diagnosis and Communication:

    It is not necessary for a claimant entitled to § 65.1-47.1 (now § 65.2-402 ) presumption to receive a diagnosis and communication of occupational disease in order to make a claim and receive compensation for a disabling heart condition. Pennington v. Commonwealth of Virginia, Department of State Police, 61 O.I.C. 322 (1982).

    An employee who qualifies for the presumption of § 65.1-47.1 (now § 65.2-402 ) is not required to present evidence of a communication of a diagnosis that his condition is a result of his employment. Such a requirement would defeat the purpose for which the presumption was enacted. Revard v. Fairfax County Board of Supervisors, 70 O.I.C. 154 (1991).

    Where the employee asks his physician whether his disease is work-related and the physician answers only that it is not compensable, there has been no communication of a diagnosis of an occupational disease to trigger the statute of limitations. The diagnosis of a disease absent a communication that the disease is work-related, does not trigger the statute of limitations. Asbury v. Town of Bluefield, 75 O.W.C. 99 (1996).

    Whether or not the presumption of § 65.2-402 applies, in an occupational disease case, an employee’s compensation benefits may not commence before the date on which the employee learns that the condition is an occupational disease for which compensation may be awarded. The employee was diagnosed with heart disease on September 14, 1996, when he sought emergency medical treatment. He testified, however, that he did not become aware that his condition might be an occupational disease before consulting with an attorney on or about October 15, 1996. The Commission held that the latter date was the first for which compensation benefits could be awarded. Wallace v. Farmville (Town of) Police, VWC File No. 183-37-58 (April 23, 2001).

    Rebutting Presumption:

    Medical evidence that the claimant’s cigarette smoking contributed to the development of his lung cancer and his condition was not caused by work as a firefighter was sufficient to meet both prongs of the Bass test. Snyder et al. v. County of York Fire, VWC File No. 190-67-18 (Oct. 22, 2004), aff’d, No. 2714-04-1 (Ct. App. Va., March 15, 2005) (Unpublished Opinion).

    In order to rebut the presumption of § 65.2-402 , it is not sufficient that the employer merely adduce evidence that the heart disease was not caused by the employment; the employer must establish by competent medical evidence a non-work-related cause to rebut or overcome the statutory presumption. Coleman v. Town of Lebanon Police Dept., 75 O.W.C. 231 (1996).

    An employer overcomes the statutory presumption of § 65.2-402 by showing both that the claimant’s disease was not caused by his employment, and that there was a non-work related cause of the disease. Undisputed evidence of non-work-related causes of heart disease is not sufficient as a matter of law to overcome the statutory presumption. The Commission’s role is that of finder of fact in determining whether the employer has shown by a preponderance of evidence both parts of the two-part standard. Tirpak v. City of Hopewell, 79 O.W.C. 38 (2000).

    The employer did not adduce sufficient competent medical evidence of a non-work-related cause of death from heart disease to rebut the presumption available under § 65.2-402 , where all of the physicians agreed the police officer employee had a congenital defect of the aortic valve, but where the persuasive medical evidence established that defect was an incidental finding and not the primary cause of death, and that stressful police work was more probably the only significant cause of death from ventricular arrhythmia. Soltow v. Fairfax County Board of Supervisors, 77 O.W.C. 154 (1998).

    Where evidence demonstrates multiple causes for stress, the employer to overcome the presumption must excluded work related stress as a contributing factor. Duffy v. Commonwealth of Virginia/Dept. of State Police, 22 Va. App. 245, 468 S.E.2d 702, 1996 Va. App. LEXIS 245 (1996).

    Where the employer has not excluded the synergistic effect of multiple exposures, including work-related toxic exposures, the employer has not rebutted the statutory presumption of § 65.2-402 . Thomas, et al. v. James City Co. Fire Dept., 75 O.W.C. 251 (1996).

    Where the employer fails to present evidence that excludes job-related stress as a possible contributing cause of the claimant’s heart disease, the employer has not rebutted the statutory presumption of § 65.2-402 . Coleman v. Town of Lebanon Police Dept., 75 O.W.C. 231 (1996).

    The aggravation or exacerbation of an occupational disease is not compensable, since that implies that the disease was pre-existing, that the employment did not cause the disease, but merely increased its severity. On the other hand, a physician’s use of the term “acceleration” of an occupational disease only implies that the condition or disease was brought about sooner, and suggests that the disease was not in existence prior to the accelerating factors. A claimant’s susceptibility to the development of a disease, even if it pre-dates the claimant’s employment, does not negate work being a cause of the disease where work accelerates its development. Thus, evidence that job stress accelerated the development of the claimant’s heart disease implicates job stress as a cause of the disease. Tirpak v. City of Hopewell, 79 O.W.C. 38 (2000).

    Where the claimant’s treating heart surgeon testified that stress was a factor in the development of coronary artery disease, that the claimant was exposed in his employment to significant job stress, and that job stress probably accelerated the claimant’s heart disease, the Commission found that the employer had not rebutted the heart-lung presumption. Tirpak v. City of Hopewell, 79 O.W.C. 38 (2000).

    An employee firefighter who contracts hypertension is entitled to the benefit of a presumption of work related disability set forth in § 65.1-47.1 (now § 65.2-402 ) when he has established that he was free of the disease at the time of his employment. In order to rebut the presumption, the employer must adduce competent medical evidence of a non-work related cause of the disease. Simcoe v. Fairfax County Fire and Rescue Services, 60 O.I.C. 394 (1981).

    When the essential foundation for the presumption has been established by the evidence, .Ashland Oil Co. v. Bean, 225 Va. 1 , 300 S.E.2d 739 (1983). may not be used to overcome the presumption, in that the rebuttable presumption is based on the concept that the disease arose out of and in the course of the employment and had its origin in the employment. Witt v. City of Roanoke-Sheriff ’s Dept., 71 O.W.C. 154 (1992).

    In order to rebut the presumption, it is not sufficient that the employer merely adduce evidence that the heart disease was not caused by the employment; the employer must establish by competent medical evidence a non-work-related cause to rebut or overcome the statutory presumption that causation exists. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    The showing of “risk factors” alone does not rebut the statutory presumption and does not establish competent medical evidence of a non-work-related cause of the disabling heart disease. City of Norfolk v. Lillard, 15 Va. App. 424, 424 S.E.2d 243, 9 Va. Law Rep. 630, 1992 Va. App. LEXIS 294 (1992).

    To rebut the presumption of this section, it is not sufficient for the employer to prove the claimant had one or more of the risk factors commonly associated with heart disease. Rather, there must be competent evidence that the condition was caused by something other than the employment. Non-work-related risk factors may be sufficient to rebut the presumption. Soltow v. Fairfax County Board of Supervisors, 77 O.W.C. 154 (1998).

    The employer presented evidence sufficient to rebut the presumption that the claimant’s coronary artery disease was a result of his employment as a deputy sheriff. Kirby v. Rockbridge County Board of Supervisors, 71 O.W.C. 150 (1992).

    Evidence that a congenital defect probably caused the occupational disease is sufficient to rebut the statutory presumption of Code § 65.2-402 . Jones v. City of Richmond Police Department, 74 O.W.C. 30 (1995).

    Presumption rebutted where evidence established the absence of a causal connection between a firefighter’s death from a heart attack at home and his occupation. Barbour v. Roanoke, 57 O.I.C. 10 (1977) (affd. on review; appeal denied).

    The statutory presumption is not rebutted when the employer presented evidence of causes of the claimant’s coronary condition other than work but such evidence failed to exclude work related stress as a factor causing the heart disease. Fairfax County Fire and Rescue Department v. Mitchell, 14 Va. App. 1033, 421 S.E.2d 668, 9 Va. Law Rep. 132, 1992 Va. App. LEXIS 224 (1992).

    Presumption of work related disability is not rebutted by medical specialist’s failure to find a causal connection between claimant’s occupation and his disability. Fulgham v. City of Norfolk, Police Department, 60 O.I.C. 165 (1981); Taylor v. City of Richmond, Bureau of Fire, 60 O.I.C. 441 (1981).

    Conflict of medical evidence and inability to reach a medical conclusion regarding causation is not sufficient to overcome the presumption. Hurst v. County of Fairfax Fire & Rescue Services, 59 O.I.C. 138 (1980).

    Medical evidence was insufficient to rebut the presumption that a lung carcinoma was a respiratory disease compensable under this section. Smith v. City of Richmond, Bureau of Fire, 58 O.I.C. 333 (1978).

    Disability Required:

    Noncompensable period of disability suffered prior to the date of communication was suffi- cient to invoke the presumption of subsection B. Leftwich v. City of Roanoke, JCN VA00001204016 (Oct. 2, 2019).

    While indemnity benefits are dependent on a loss of wages attributable to a compensable medical condition, for the purposes of the presumption, disability may be proven without a corresponding wage loss. Kresovich v. City of Norfolk, JCN VA02000016715 (Sept. 11, 2015).

    The presumption may only be applied when an occupational disease results in “total or partial disability.” A claimant is not entitled to the presumption where the only award sought is for medical benefits. Watkins v. Commonwealth of Virginia, Dept. of State Police, 64 O.I.C. 329 (1985).

    The presumption does not apply unless partial or total disability is established. Revard v. Fairfax County Board of Supervisors, 70 O.I.C. 154 (1991).

    Where a claimant is physically able to perform employment duties but it is medically in his best interest not to do so the statutory requirement that he must be totally or partially disabled from hypertension has not been met. Hollingsworth v. Arlington County Fire Department, 66 O.I.C. 90 (1987).

    To be eligible for the statutory presumption an employee does not have to prove a compensable disability that extends for a period of more than seven days. Link v. Va. Dept. of State Police, 71 O.W.C. 143 (1992).

    Claim for compensation was denied where medical evidence failed to establish a disabling lung disease. Buckner v. City of Richmond, Fire Department, 61 O.I.C. 83 (1982).

    The purpose of weekly death benefits, based on the decedent’s average weekly wage, is to replace the wages lost to the dependents as a result of the death. No indemnity benefits should be awarded if the decedent had no income for the 52 weeks preceding the communication of the diagnosis of an occupational heart disease. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Where there was a complete absence of earnings during the 52 weeks preceding death or communication of a diagnosis of an occupational heart disease, there are no earnings upon which an average weekly wage can be established to award weekly compensation benefits to statutory beneficiaries. The Commission distinguished Roller v. Basic Construction Company, 238 Va. 321 , 384 S.E.2d 323 (1989, as a case applying a statutory amendment to § 65.2-406 (C) pertinent only to asbestosis claims. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    OPINIONS OF THE ATTORNEY GENERAL

    Covid-19. —

    If COVID-19 is an upper respiratory disease, it falls under the heart and lung presumption of the Act for first responders, however the statutory presumption applies only to a limited class of first responders under certain circumstances and, therefore, would not have broad applicability to all or most of the first responders whose official duties regularly place them at far greater risk of contracting COVID-19 than the general public following social distancing guidelines. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A first responder who has the benefit of a presumption, has the initial burden of producing evidence to trigger the presumption (evidence of the disease, and evidence of disability or death caused by the disease); once the presumption is triggered, the burden shifts to the employer to rebut the presumption (that the disease was not caused by the employment and that there is a non-work-related cause). See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    A presumption could be created that would benefit first responders who contract COVID-19 because the nature of their duties place them at greater risk for contracting the disease. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    If a first responder dies as a result of COVID-19, he and his survivors will qualify for Line of Duty Act (LODA) benefits if they meet the eligibility criteria, including satisfying the definitions of “deceased person,” “eligible dependent” and “eligible spouse,” and that death occurred in the line of duty as defined in LODA, including any of the presumptions provided by §§ 27-40.1 , 51.1-813 , and 65.2-402 . See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    § 65.2-402.1. (Effective until July 1, 2022) Presumption as to death or disability from infectious disease.

    1. Hepatitis, meningococcal meningitis, tuberculosis or HIV causing the death of, or any health condition or impairment resulting in total or partial disability of, any (i) salaried or volunteer firefighter, or salaried or volunteer emergency medical services personnel; (ii) member of the State Police Officers’ Retirement System; (iii) member of county, city, or town police departments; (iv) sheriff or deputy sheriff; (v) Department of Emergency Management hazardous materials officer; (vi) city sergeant or deputy city sergeant of the City of Richmond; (vii) Virginia Marine Police officer; (viii) conservation police officer who is a full-time sworn member of the enforcement division of the Department of Wildlife Resources; (ix) Capitol Police officer; (x) special agent of the Virginia Alcoholic Beverage Control Authority appointed under the provisions of Chapter 1 (§ 4.1-100 et seq.) of Title 4.1; (xi) for such period that the Metropolitan Washington Airports Authority voluntarily subjects itself to the provisions of this chapter as provided in § 65.2-305 , officer of the police force established and maintained by the Metropolitan Washington Airports Authority; (xii) officer of the police force established and maintained by the Norfolk Airport Authority; (xiii) conservation officer of the Department of Conservation and Recreation commissioned pursuant to § 10.1-115 ; (xiv) sworn officer of the police force established and maintained by the Virginia Port Authority; (xv) campus police officer appointed under Article 3 (§ 23.1-809 et seq.) of Chapter 8 of Title 23.1 and employed by any public institution of higher education; (xvi) correctional officer as defined in § 53.1-1 ; or (xvii) full-time sworn member of the enforcement division of the Department of Motor Vehicles who has a documented occupational exposure to blood or body fluids shall be presumed to be occupational diseases, suffered in the line of government duty, that are covered by this title unless such presumption is overcome by a preponderance of competent evidence to the contrary. For purposes of this subsection, an occupational exposure occurring on or after July 1, 2002, shall be deemed “documented” if the person covered under this subsection gave notice, written or otherwise, of the occupational exposure to his employer, and an occupational exposure occurring prior to July 1, 2002, shall be deemed “documented” without regard to whether the person gave notice, written or otherwise, of the occupational exposure to his employer. For any correctional officer as defined in § 53.1-1 or full-time sworn member of the enforcement division of the Department of Motor Vehicles, the presumption shall not apply if such individual was diagnosed with hepatitis, meningococcal meningitis, or HIV before July 1, 2020.
      1. COVID-19 causing the death of, or any health condition or impairment resulting in total or partial disability of, any health care provider, as defined in § 8.01-581.1 , who as part of the provider’s employment is directly involved in diagnosing or treating persons known or suspected to have COVID-19, shall be presumed to be an occupational disease that is covered by this title unless such presumptions are overcome by a preponderance of competent evidence to the contrary. For the purposes of this section, the COVID-19 virus shall be established by a positive diagnostic test for COVID-19 and signs and symptoms of COVID-19 that require medical treatment, as described in subdivision F 2. B. 1. COVID-19 causing the death of, or any health condition or impairment resulting in total or partial disability of, any health care provider, as defined in § 8.01-581.1 , who as part of the provider’s employment is directly involved in diagnosing or treating persons known or suspected to have COVID-19, shall be presumed to be an occupational disease that is covered by this title unless such presumptions are overcome by a preponderance of competent evidence to the contrary. For the purposes of this section, the COVID-19 virus shall be established by a positive diagnostic test for COVID-19 and signs and symptoms of COVID-19 that require medical treatment, as described in subdivision F 2.
      2. COVID-19 causing the death of, or any health condition or impairment resulting in total or partial disability of, any (i) firefighter, as defined in § 65.2-102 ; (ii) law-enforcement officer, as defined in § 9.1-101 ; (iii) correctional officer, as defined in § 53.1-1 ; or (iv) regional jail officer shall be presumed to be an occupational disease, suffered in the line of duty, as applicable, that is covered by this title unless such presumption is overcome by a preponderance of competent evidence to the contrary. For the purposes of this section, the COVID-19 virus shall be established by a positive diagnostic test for COVID-19, an incubation period consistent with COVID-19, and signs and symptoms of COVID-19 that require medical treatment.
    2. As used in this section:“Blood or body fluids” means blood and body fluids containing visible blood and other body fluids to which universal precautions for prevention of occupational transmission of blood-borne pathogens, as established by the Centers for Disease Control, apply. For purposes of potential transmission of hepatitis, meningococcal meningitis, tuberculosis, or HIV the term “blood or body fluids” includes respiratory, salivary, and sinus fluids, including droplets, sputum, saliva, mucous, and any other fluid through which infectious airborne or blood-borne organisms can be transmitted between persons.“Hepatitis” means hepatitis A, hepatitis B, hepatitis non-A, hepatitis non-B, hepatitis C, or any other strain of hepatitis generally recognized by the medical community.“HIV” means the medically recognized retrovirus known as human immunodeficiency virus, type I or type II, causing immunodeficiency syndrome.“Occupational exposure,” in the case of hepatitis, meningococcal meningitis, tuberculosis or HIV, means an exposure that occurs during the performance of job duties that places a covered employee at risk of infection.
    3. Persons covered under this section who test positive for exposure to the enumerated occupational diseases, but have not yet incurred the requisite total or partial disability, shall otherwise be entitled to make a claim for medical benefits pursuant to § 65.2-603 , including entitlement to an annual medical examination to measure the progress of the condition, if any, and any other medical treatment, prophylactic or otherwise.
      1. Whenever any standard, medically-recognized vaccine or other form of immunization or prophylaxis exists for the prevention of a communicable disease for which a presumption is established under this section, if medically indicated by the given circumstances pursuant to immunization policies established by the Advisory Committee on Immunization Practices of the United States Public Health Service, a person subject to the provisions of this section may be required by such person’s employer to undergo the immunization or prophylaxis unless the person’s physician determines in writing that the immunization or prophylaxis would pose a significant risk to the person’s health. Absent such written declaration, failure or refusal by a person subject to the provisions of this section to undergo such immunization or prophylaxis shall disqualify the person from any presumption established by this section. E. 1. Whenever any standard, medically-recognized vaccine or other form of immunization or prophylaxis exists for the prevention of a communicable disease for which a presumption is established under this section, if medically indicated by the given circumstances pursuant to immunization policies established by the Advisory Committee on Immunization Practices of the United States Public Health Service, a person subject to the provisions of this section may be required by such person’s employer to undergo the immunization or prophylaxis unless the person’s physician determines in writing that the immunization or prophylaxis would pose a significant risk to the person’s health. Absent such written declaration, failure or refusal by a person subject to the provisions of this section to undergo such immunization or prophylaxis shall disqualify the person from any presumption established by this section.
      2. The presumptions described in subdivision B 1 shall not apply to any person offered by such person’s employer a vaccine for the prevention of COVID-19 with an Emergency Use Authorization issued by the U.S. Food and Drug Administration, unless the person is immunized or the person’s physician determines in writing that the immunization would pose a significant risk to the person’s health. Absent such written declaration, failure or refusal by a person subject to the provisions of this section to undergo such immunization shall disqualify the person from the presumptions described in subdivision B 1.
      1. The presumptions described in subsection A shall only apply if persons entitled to invoke them have, if requested by the appointing authority or governing body employing them, undergone preemployment physical examinations that (i) were conducted prior to the making of any claims under this title that rely on such presumptions; (ii) were performed by physicians whose qualifications are as prescribed by the appointing authority or governing body employing such persons; (iii) included such appropriate laboratory and other diagnostic studies as the appointing authorities or governing bodies may have prescribed; and (iv) found such persons free of hepatitis, meningococcal meningitis, tuberculosis or HIV at the time of such examinations. The presumptions described in subsection A shall not be effective until six months following such examinations, unless such persons entitled to invoke such presumption can demonstrate a documented exposure during the six-month period. F. 1. The presumptions described in subsection A shall only apply if persons entitled to invoke them have, if requested by the appointing authority or governing body employing them, undergone preemployment physical examinations that (i) were conducted prior to the making of any claims under this title that rely on such presumptions; (ii) were performed by physicians whose qualifications are as prescribed by the appointing authority or governing body employing such persons; (iii) included such appropriate laboratory and other diagnostic studies as the appointing authorities or governing bodies may have prescribed; and (iv) found such persons free of hepatitis, meningococcal meningitis, tuberculosis or HIV at the time of such examinations. The presumptions described in subsection A shall not be effective until six months following such examinations, unless such persons entitled to invoke such presumption can demonstrate a documented exposure during the six-month period.
      2. The presumptions described in subdivision B 1 shall apply to any person entitled to invoke them for any death or disability occurring on or after March 12, 2020, caused by infection from the COVID-19 virus, provided that for any such death or disability that occurred on or after March 12, 2020, and prior to December 31, 2021, and;
        1. Prior to July 1, 2020, the claimant received a positive diagnosis of COVID-19 from a licensed physician, nurse practitioner, or physician assistant after either (i) a presumptive positive test or a laboratory-confirmed test for COVID-19 and presenting with signs and symptoms of COVID-19 that required medical treatment, or (ii) presenting with signs and symptoms of COVID-19 that required medical treatment absent a presumptive positive test or a laboratory-confirmed test for COVID-19; or
        2. On or after July 1, 2020, and prior to December 31, 2021, the claimant received a positive diagnosis of COVID-19 from a licensed physician, nurse practitioner, or physician assistant after a presumptive positive test or a laboratory-confirmed test for COVID-19 and presented with signs and symptoms of COVID-19 that required medical treatment.
      3. The presumptions described in subdivision B 2 shall apply to any person entitled to invoke them for any death or disability occurring on or after July 1, 2020, caused by infection from the COVID-19 virus, provided that for any such death or disability that occurred on or after July 1, 2020, and prior to December 31, 2021, the claimant received a diagnosis of COVID-19 from a licensed physician, after either a presumptive positive test or a laboratory confirmed test for COVID-19, and presented with signs and symptoms of COVID-19 that required medical treatment.
    4. Persons making claims under this title who rely on such presumption shall, upon the request of appointing authorities or governing bodies employing such persons, submit to physical examinations (i) conducted by physicians selected by such appointing authorities or governing bodies or their representatives and (ii) consisting of such tests and studies as may reasonably be required by such physicians. However, a qualified physician, selected and compensated by the claimant, may, at the election of such claimant, be present at such examination.

    History. 2002, c. 820; 2003, c. 842; 2007, cc. 87, 365; 2009, c. 417; 2011, c. 211; 2012, c. 776; 2015, cc. 38, 502, 503, 730; 2020, cc. 958, 1150, 1152; 2021, Sp. Sess. I, cc. 507, 526, 547.

    Editor’s note.

    Acts 2015, cc. 38 and 730, cl. 4, as amended by Acts 2017, cc. 698 and 707, cl. 2, provides: “That the provisions of this act shall become effective on January 15, 2018, except that the provisions of the (i) thirteenth, fourteenth, and fifteenth enactments of this act shall become effective on July 1, 2015; (ii) third enactment of this act shall become effective on July 1, 2018; and (iii) eleventh enactment of this act shall become effective on January 1, 2019.”

    At the direction of the Virginia Code Commission, “Article 3 (§ 23.1-809 et seq.) of Chapter 8 of Title 23.1” was substituted for “Chapter 17 (§ 23-232 et seq.) of Title 23” in subsection A to conform to the recodification of Title 23 by Acts 2016, c. 588, effective October 1, 2016.

    At the direction of the Virginia Code Commission, in order to more precisely capture the amendments made by Acts 2021, Sp. Sess. I, cc. 507, 526, and 547, in subdivision B 1, substituted “subdivision F 2” for “subsection F,” in subdivision E 2, substituted “subdivision B 1” for “subsection B” in two places, in subdivision F 2, substituted “subdivision B 1” for “subsection B” and added subdivision F 3.

    The 2003 amendments.

    The 2003 amendment by c. 842 added “unless such persons entitled to invoke such presumption can demonstrate a documented exposure during the six-month period” at the end of subsection E.

    The 2007 amendments.

    The 2007 amendment by c. 87 substituted “conservation police officer” for “game warden” in clause (viii) of subsection A.

    The 2007 amendment by c. 365, in subsection A, deleted “or” at the end of clause (ix), inserted “or” at the end of clause (x), and added clause (xi).

    The 2009 amendments.

    The 2009 amendment by c. 417, in subsection A, inserted clause (xii) and made related changes.

    The 2011 amendments.

    The 2011 amendment by c. 211, in subsection A, added clauses (xi) and (xii) and redesignated former clauses (xi) and (xii) as clauses (xiii) and (xiv), respectively.

    The 2012 amendments.

    The 2012 amendment by c. 776 added clause (xv) in subsection A and made a related change and made minor stylistic changes in subsection E.

    The 2015 amendments.

    The 2015 amendments by cc. 38 and 730, effective January 15, 2018, are identical, and substituted “Virginia Alcoholic Beverage Control Authority” for “Department of Alcoholic Beverage Control” in clause (x) of subsection A.

    The 2015 amendments by cc. 502 and 503 are identical, and in subsection A, and substituted “or salaried or volunteer emergency medical services personnel” for “paramedic or emergency medical technician” in the first sentence.

    The 2020 amendments.

    The 2020 amendment by c. 958, substituted “Department of Wildlife Resources” for “Department of Game and Inland Fisheries” in subsection A, first sentence, clause (viii).

    The 2020 amendments by cc. 1150 and 1152 are nearly identical, and in subsection A, deleted “or” preceding “(xv)” and deleted “any” thereafter, and inserted “(xvi) correctional officer as defined in § 53.1-1 , or (xvii) full-time sworn member of the enforcement division of the Department of Motor Vehicles.” Acts 2020, s. 1152 also added the last sentence of subsection A.

    The 2021 Sp. Sess. I amendments.

    The 2021 amendment by Sp. Sess. I, c. 507, effective July 1, 2021, substituted “subsection” for “section” in the next-to-last sentence of subsection A; inserted subsection B, and redesignated the remaining subsections accordingly; inserted the subdivision E 1 designation, and added subdivision E 2; and inserted the subdivision F 1 designation, and added subdivision F 2. Subsection B was subsequently redesignated as subdivision B 1 at the direction of the Virginia Code Commission.

    The 2021 amendment by Sp. Sess. I, cc. 526 and 547, effective July 1, 2021, are identical, and substituted “subsection” for “section” twice in the last sentence of subsection A; inserted subsection B, and redesignated the remaining subsections accordingly; added the F 1 designation, and added F 2; and made stylistic changes. Subsection B was subsequently redesignated as subdivision B 2 at the direction of the Virginia Code Commission.

    The section is set out in the form above at the direction of the Virginia Code Commission.

    The 2022 amendments.

    The 2022 amendment by c. 644 substituted “2022” for “2021” twice in subdivision F 2.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 21, 26, 59, 65, 66, 72.

    § 65.2-402.1. (Effective July 1, 2022) Presumption as to death or disability from infectious disease.

    1. Hepatitis, meningococcal meningitis, tuberculosis or HIV causing the death of, or any health condition or impairment resulting in total or partial disability of, any (i) salaried or volunteer firefighter, or salaried or volunteer emergency medical services personnel; (ii) member of the State Police Officers’ Retirement System; (iii) member of county, city, or town police departments; (iv) sheriff or deputy sheriff; (v) Department of Emergency Management hazardous materials officer; (vi) city sergeant or deputy city sergeant of the City of Richmond; (vii) Virginia Marine Police officer; (viii) conservation police officer who is a full-time sworn member of the enforcement division of the Department of Wildlife Resources; (ix) Capitol Police officer; (x) special agent of the Virginia Alcoholic Beverage Control Authority appointed under the provisions of Chapter 1 (§ 4.1-100 et seq.) of Title 4.1; (xi) for such period that the Metropolitan Washington Airports Authority voluntarily subjects itself to the provisions of this chapter as provided in § 65.2-305 , officer of the police force established and maintained by the Metropolitan Washington Airports Authority; (xii) officer of the police force established and maintained by the Norfolk Airport Authority; (xiii) conservation officer of the Department of Conservation and Recreation commissioned pursuant to § 10.1-115 ; (xiv) sworn officer of the police force established and maintained by the Virginia Port Authority; (xv) campus police officer appointed under Article 3 (§ 23.1-809 et seq.) of Chapter 8 of Title 23.1 and employed by any public institution of higher education; (xvi) correctional officer as defined in § 53.1-1 ; or (xvii) full-time sworn member of the enforcement division of the Department of Motor Vehicles who has a documented occupational exposure to blood or body fluids shall be presumed to be occupational diseases, suffered in the line of government duty, that are covered by this title unless such presumption is overcome by a preponderance of competent evidence to the contrary. For purposes of this subsection, an occupational exposure occurring on or after July 1, 2002, shall be deemed “documented” if the person covered under this subsection gave notice, written or otherwise, of the occupational exposure to his employer, and an occupational exposure occurring prior to July 1, 2002, shall be deemed “documented” without regard to whether the person gave notice, written or otherwise, of the occupational exposure to his employer. For any correctional officer as defined in § 53.1-1 or full-time sworn member of the enforcement division of the Department of Motor Vehicles, the presumption shall not apply if such individual was diagnosed with hepatitis, meningococcal meningitis, or HIV before July 1, 2020.
      1. COVID-19 causing the death of, or any health condition or impairment resulting in total or partial disability of, any health care provider, as defined in § 8.01-581.1 , who as part of the provider’s employment is directly involved in diagnosing or treating persons known or suspected to have COVID-19, shall be presumed to be an occupational disease that is covered by this title unless such presumptions are overcome by a preponderance of competent evidence to the contrary. For the purposes of this section, the COVID-19 virus shall be established by a positive diagnostic test for COVID-19 and signs and symptoms of COVID-19 that require medical treatment, as described in subdivision F 2. B. 1. COVID-19 causing the death of, or any health condition or impairment resulting in total or partial disability of, any health care provider, as defined in § 8.01-581.1 , who as part of the provider’s employment is directly involved in diagnosing or treating persons known or suspected to have COVID-19, shall be presumed to be an occupational disease that is covered by this title unless such presumptions are overcome by a preponderance of competent evidence to the contrary. For the purposes of this section, the COVID-19 virus shall be established by a positive diagnostic test for COVID-19 and signs and symptoms of COVID-19 that require medical treatment, as described in subdivision F 2.
      2. COVID-19 causing the death of, or any health condition or impairment resulting in total or partial disability of, any (i) firefighter, as defined in § 65.2-102 ; (ii) law-enforcement officer, as defined in § 9.1-101 ; (iii) correctional officer, as defined in § 53.1-1 ; or (iv) regional jail officer shall be presumed to be an occupational disease, suffered in the line of duty, as applicable, that is covered by this title unless such presumption is overcome by a preponderance of competent evidence to the contrary. For the purposes of this section, the COVID-19 virus shall be established by a positive diagnostic test for COVID-19, an incubation period consistent with COVID-19, and signs and symptoms of COVID-19 that require medical treatment.
    2. As used in this section:

      “Blood or body fluids” means blood and body fluids containing visible blood and other body fluids to which universal precautions for prevention of occupational transmission of blood-borne pathogens, as established by the Centers for Disease Control, apply. For purposes of potential transmission of hepatitis, meningococcal meningitis, tuberculosis, or HIV the term “blood or body fluids” includes respiratory, salivary, and sinus fluids, including droplets, sputum, saliva, mucous, and any other fluid through which infectious airborne or blood-borne organisms can be transmitted between persons.

      “Hepatitis” means hepatitis A, hepatitis B, hepatitis non-A, hepatitis non-B, hepatitis C, or any other strain of hepatitis generally recognized by the medical community.

      “HIV” means the medically recognized retrovirus known as human immunodeficiency virus, type I or type II, causing immunodeficiency syndrome.

      “Occupational exposure,” in the case of hepatitis, meningococcal meningitis, tuberculosis or HIV, means an exposure that occurs during the performance of job duties that places a covered employee at risk of infection.

    3. Persons covered under this section who test positive for exposure to the enumerated occupational diseases, but have not yet incurred the requisite total or partial disability, shall otherwise be entitled to make a claim for medical benefits pursuant to § 65.2-603 , including entitlement to an annual medical examination to measure the progress of the condition, if any, and any other medical treatment, prophylactic or otherwise.
      1. Whenever any standard, medically-recognized vaccine or other form of immunization or prophylaxis exists for the prevention of a communicable disease for which a presumption is established under this section, if medically indicated by the given circumstances pursuant to immunization policies established by the Advisory Committee on Immunization Practices of the United States Public Health Service, a person subject to the provisions of this section may be required by such person’s employer to undergo the immunization or prophylaxis unless the person’s physician determines in writing that the immunization or prophylaxis would pose a significant risk to the person’s health. Absent such written declaration, failure or refusal by a person subject to the provisions of this section to undergo such immunization or prophylaxis shall disqualify the person from any presumption established by this section. E. 1. Whenever any standard, medically-recognized vaccine or other form of immunization or prophylaxis exists for the prevention of a communicable disease for which a presumption is established under this section, if medically indicated by the given circumstances pursuant to immunization policies established by the Advisory Committee on Immunization Practices of the United States Public Health Service, a person subject to the provisions of this section may be required by such person’s employer to undergo the immunization or prophylaxis unless the person’s physician determines in writing that the immunization or prophylaxis would pose a significant risk to the person’s health. Absent such written declaration, failure or refusal by a person subject to the provisions of this section to undergo such immunization or prophylaxis shall disqualify the person from any presumption established by this section.
      2. The presumptions described in subdivision B 1 shall not apply to any person offered by such person’s employer a vaccine for the prevention of COVID-19 with an Emergency Use Authorization issued by the U.S. Food and Drug Administration, unless the person is immunized or the person’s physician determines in writing that the immunization would pose a significant risk to the person’s health. Absent such written declaration, failure or refusal by a person subject to the provisions of this section to undergo such immunization shall disqualify the person from the presumptions described in subdivision B 1.
      1. The presumptions described in subsection A shall only apply if persons entitled to invoke them have, if requested by the appointing authority or governing body employing them, undergone preemployment physical examinations that (i) were conducted prior to the making of any claims under this title that rely on such presumptions; (ii) were performed by physicians whose qualifications are as prescribed by the appointing authority or governing body employing such persons; (iii) included such appropriate laboratory and other diagnostic studies as the appointing authorities or governing bodies may have prescribed; and (iv) found such persons free of hepatitis, meningococcal meningitis, tuberculosis or HIV at the time of such examinations. The presumptions described in subsection A shall not be effective until six months following such examinations, unless such persons entitled to invoke such presumption can demonstrate a documented exposure during the six-month period. F. 1. The presumptions described in subsection A shall only apply if persons entitled to invoke them have, if requested by the appointing authority or governing body employing them, undergone preemployment physical examinations that (i) were conducted prior to the making of any claims under this title that rely on such presumptions; (ii) were performed by physicians whose qualifications are as prescribed by the appointing authority or governing body employing such persons; (iii) included such appropriate laboratory and other diagnostic studies as the appointing authorities or governing bodies may have prescribed; and (iv) found such persons free of hepatitis, meningococcal meningitis, tuberculosis or HIV at the time of such examinations. The presumptions described in subsection A shall not be effective until six months following such examinations, unless such persons entitled to invoke such presumption can demonstrate a documented exposure during the six-month period.
      2. The presumptions described in subdivision B 1 shall apply to any person entitled to invoke them for any death or disability occurring on or after March 12, 2020, caused by infection from the COVID-19 virus, provided that for any such death or disability that occurred on or after March 12, 2020, and prior to December 31, 2022, and;
        1. Prior to July 1, 2020, the claimant received a positive diagnosis of COVID-19 from a licensed physician, nurse practitioner, or physician assistant after either (i) a presumptive positive test or a laboratory-confirmed test for COVID-19 and presenting with signs and symptoms of COVID-19 that required medical treatment, or (ii) presenting with signs and symptoms of COVID-19 that required medical treatment absent a presumptive positive test or a laboratory-confirmed test for COVID-19; or
        2. On or after July 1, 2020, and prior to December 31, 2022, the claimant received a positive diagnosis of COVID-19 from a licensed physician, nurse practitioner, or physician assistant after a presumptive positive test or a laboratory-confirmed test for COVID-19 and presented with signs and symptoms of COVID-19 that required medical treatment.
      3. The presumptions described in subdivision B 2 shall apply to any person entitled to invoke them for any death or disability occurring on or after July 1, 2020, caused by infection from the COVID-19 virus, provided that for any such death or disability that occurred on or after July 1, 2020, and prior to December 31, 2021, the claimant received a diagnosis of COVID-19 from a licensed physician, after either a presumptive positive test or a laboratory confirmed test for COVID-19, and presented with signs and symptoms of COVID-19 that required medical treatment.
    4. Persons making claims under this title who rely on such presumption shall, upon the request of appointing authorities or governing bodies employing such persons, submit to physical examinations (i) conducted by physicians selected by such appointing authorities or governing bodies or their representatives and (ii) consisting of such tests and studies as may reasonably be required by such physicians. However, a qualified physician, selected and compensated by the claimant, may, at the election of such claimant, be present at such examination.

    History. 2002, c. 820; 2003, c. 842; 2007, cc. 87, 365; 2009, c. 417; 2011, c. 211; 2012, c. 776; 2015, cc. 38, 502, 503, 730; 2020, cc. 958, 1150, 1152; 2021, Sp. Sess. I, cc. 507, 526, 547; 2022, c. 644.

    § 65.2-403. Provisions in respect to injury by accident, etc., applicable to occupational disease.

    1. When the employer and employee are subject to the provisions of this title, first communication of the diagnosis of an occupational disease to the employee or death of the employee resulting from an occupational disease as herein listed and defined shall be treated as the happening of an injury by accident, and the employee or in case of his death his dependents shall be entitled to compensation as provided by this title.
    2. An employee who has an occupational disease that is covered by this title shall be entitled to the same hospital, medical and miscellaneous benefits as an employee who has a compensable injury by accident, except that the period during which the employer shall be required to furnish medical attention, including reasonably necessary diagnostic services, shall begin fifteen days prior to the date of first communication of the diagnosis of the occupational disease to the employee. In the event of death the same funeral benefits shall be paid as in the case of death from a compensable accident.

    History. Code 1950, § 65-46; 1966, c. 504; 1968, c. 660, § 65.1-49; 1984, c. 414; 1991, c. 355.

    Law Review.

    For survey of Virginia law on torts for the year 1969-1970, see 56 Va. L. Rev. 1419 (1970).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 41.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-49 or prior law.

    Law in effect at the time of the incapacity governs the rights of the parties, and not the law effective at the time the award is made or on the date of the death of the employee. Blue Diamond Coal Company v. Pannell, 203 Va. 49 , 122 S.E.2d 666, 1961 Va. LEXIS 219 (1961).

    “Injury by accident” and “date of injury.” —

    In enacting this section and former § 65.1-52 (now § 65.2-406 ), the legislature intended that the phrases “injury by accident” and “date of injury” be used to determine when a claimant’s right to assert a claim begins and the time limit within which the application for benefits must be filed with the commission. C & P Tel. Co. v. Williams, 10 Va. App. 516, 392 S.E.2d 846, 6 Va. Law Rep. 2775, 1990 Va. App. LEXIS 119 (1990).

    Date of injury. —

    The date on which the diagnosis of an occupational disease is made and first communicated to the employee is treated as the date of injury and as the happening of an injury by accident. The rights and liabilities of the parties vest and accrue on that date. C & P Tel. Co. v. Williams, 10 Va. App. 516, 392 S.E.2d 846, 6 Va. Law Rep. 2775, 1990 Va. App. LEXIS 119 (1990).

    Claim made before diagnosis received. —

    The fact that employee made a claim before he received a diagnosis that his condition arose out of his employment was irrelevant so long as he filed his claim within two years after that diagnosis. Lynchburg Foundry Co. v. Vest, No. 0848-92-3 (Ct. of Appeals Jan. 5, 1993).

    Date of accident, standing alone, does not identify employer liable. —

    In a claim based upon a disease, the date of the accident (fixed by this section as the date of the “first communication of the diagnosis”), standing alone, does not identify the employer liable on the claim. It is “otherwise provided” in former § 65.1-50 (now § 65.2-404 ) which adds another criterion. Cooper v. Mary E. Coal Corp., 215 Va. 806 , 214 S.E.2d 162, 1975 Va. LEXIS 230 (1975).

    Creation of “injury” date does not affect former § 65.1-52 (now § 65.2-406 ). —

    The creation of an “injury” date in this section was not intended to limit or otherwise affect the unambiguous provisions of former § 65.1-52. Those provisions contain fixed starting points and must be applied as they are plainly worded. Dan River, Inc. v. Adkins, 3 Va. App. 320, 349 S.E.2d 667, 3 Va. Law Rep. 1042, 1986 Va. App. LEXIS 367 (1986).

    No distinction between asbestosis and coal workers’ pneumoconiosis. —

    For purposes of an award of medical benefits for occupational diseases, the Virginia Workers’ Compensation Act, § 65.2-100 et seq., did not make a distinction between asbestosis and the claimant’s occupational disease, coal workers’ pneumoconiosis, and, thus, medical benefits were available for both of those occupational diseases; as a result, the workers’ compensation commission did not err in awarding medical benefits to the claimant. Clinchfield Coal Co. v. Reed, 40 Va. App. 69, 577 S.E.2d 538, 2003 Va. App. LEXIS 123 (2003).

    Section 65.2-403 permitted an award of medical benefits to employees who have an occupational disease covered by the Virginia Workers’ Compensation Act, § 65.2-100 et seq., and, thus, the workers’ compensation commission did not err in awarding benefits to the claimant who proved that the claimant had coal workers’ pneumoconiosis. Clinchfield Coal Co. v. Reed, 40 Va. App. 69, 577 S.E.2d 538, 2003 Va. App. LEXIS 123 (2003).

    Occupational disease need not qualify for permanent loss or disability compensation. —

    Since the claimant’s disease, coal workers’ pneumoconiosis, qualified as an occupational disease under the Virginia Workers’ Compensation Act, § 65.2-100 et seq. (Act), the claimant was entitled to recover medical benefits since nothing in the Act required that the occupational disease qualify for permanent loss or disability compensation before such benefits could be awarded. Clinchfield Coal Co. v. Reed, 40 Va. App. 69, 577 S.E.2d 538, 2003 Va. App. LEXIS 123 (2003).

    Occupational disease not compensable until diagnosis communicated to employee. —

    Under the Workers’ Compensation Act, an occupational disease is not compensable until a diagnosis of such has been communicated to the employee. The date of the first communication of the diagnosis is treated as the happening of an injury by accident. The right to compensation in cases of accidental injury is governed by the law in effect at the time of the injury. In this case, employee’s injury occurred on July 31, 1986, the date his occupational hearing loss was first communicated to him. The law in effect on that date was that an ordinary disease of life is compensable if sufficiently connected to a claimant’s employment. Island Creek Coal Co. v. Breeding, 6 Va. App. 1, 365 S.E.2d 782, 4 Va. Law Rep. 1900, 1988 Va. App. LEXIS 29 (1988).

    An occupational disease is compensable when a diagnosis of occupational disease is communicated to the employee. Tazewell County Sheriff's Office v. Owens, 1999 Va. App. LEXIS 405 (Va. Ct. App. June 29, 1999).

    Date complaint was filed governed where no communication was made. —

    Awarding a claimant disability benefits for heart disease before October 27, 1993 and medical benefits before October 12, 1993, was in contravention of § 65.2-403 , because the claimant’s complaint was filed on October 27, 1993, and no disability was established prior thereto. Amherst County Sheriff's Dep't v. Martin, 2004 Va. App. LEXIS 253 (Va. Ct. App. June 1, 2004).

    Provisions in respect to injury by accident. —

    Evidence supported the Workers’ Compensation Commission’s finding that a claimant’s depression was a compensable consequence of a compensable injury by accident where the claimant’s psychiatric symptoms developed after the work accident, as a consequence of his alleged back and neck injuries and his associated pain and distress. New Energy Bedrooms v. Flinchum, 2003 Va. App. LEXIS 191 (Va. Ct. App. Apr. 1, 2003).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s determination that a workers’ compensation claimant sustained an identifiable, work-related injury by accident to her left middle finger where: (1) the claimant injured her left finger at work when she was moving hangers off a rack and they got caught on her finger, (2) she immediately reported the injury to her employer whose records showed that the worker’s finger was swollen and discolored, (3) the swelling was still present the day after the injury, and the employer applied ice and a splint before referring the worker to a doctor, (4) that evening, the worker was diagnosed with acute pain in her left middle finger “of uncertain cause,” (5) she reported that the injury occurred when “they were hanging on my finger” at work the previous day, and (6) no evidence disputed her testimony regarding when or how the injury occurred or established a non-work-related cause. Marshalls, Inc. v. Deane, 2005 Va. App. LEXIS 531 (Va. Ct. App. Dec. 28, 2005).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Section 65.2-403 provides that the date on which an occupational disease is diagnosed and first communicated to the employee is treated as the date of injury and as the happening of an injury by accident. The rights and liabilities of the parties vest and accrue on that date. Turner v. Sky Chefs, 76 O.W.C. 356 (1997).

    Where the employee was diagnosed with carpal tunnel syndrome on July 7, 1996, prior to amendment to Va. Code Ann. § 65.2-400 , her claim for carpal tunnel syndrome is noncompensable, because the law in effect on the date of accident [date of diagnosis of occupational disease] controls. Turner v. Sky Chefs, 76 O.W.C. 356 (1997).

    Where a claimant is not mentally competent to understand the rights and obligations imposed by the Workers’ Compensation Act, communication of an occupational disease by the treating physician to the claimant’s wife and next friend is sufficient to meet the notice requirement. Likewise, communication to the claimant’s counsel through medical reports is sufficient to meet the statutory requirement. Barnes v. Ivie Cleaners, Inc., 65 O.I.C. 176 (1986).

    An impression or tentative diagnosis will not trigger the running of the limitations period or commence the employer’s responsibility for medical treatment. Atkins v. Arlington County Public Schools, 71 O.W.C. 171 (1992).

    Precise medical terminology is not required to communicate a diagnosis of an occupational disease. It is sufficient if the physician advises the claimant that her condition is caused by her work, although he did not advise that it was a “disease.” Bell v. Sara Lee Knit Products, 74 O.W.C. 67 (1995).

    Where there is a definitive diagnosis and communication of an occupational disease, it is not necessary to have the diagnosis subsequently confirmed by diagnostic studies. However, if the diagnosis is tenuous, there can be no communication until there is confirmation by diagnostic studies. Landers v. The Grief Companies/Genesco, Inc., 71 O.W.C. 174 (1992).

    Where a physician stated that toxic exposure was likely but indicated chronic viral infection had to be ruled out, a diagnosis of an occupational disease was not communicated to the claimant even if she believed that her problem was the result of exposure to solvents at work. Rice v. Virginia Beach General Hospital, 68 O.I.C. 128 (1989).

    Where the employee asks his physician whether his disease is work-related and the physician answers only that it is not compensable, there has been no communication of a diagnosis of an occupational disease to trigger the statute of limitations. The diagnosis of a disease absent a communication that the disease is work-related, does not trigger the statute of limitations. Asbury v. Town of Bluefield, 75 O.W.C. 99 (1996).

    An employee who qualifies for the presumption of § 65.1-47.1 (now § 65.2-402 ) is not required to present evidence of a communication of a diagnosis that his condition is a result of his employment. Such a requirement would defeat the purpose for which the presumption was enacted. Revard v. Fairfax County Board of Supervisors, 70 O.I.C. 154 (1991).

    Whether or not the presumption of Code § 65.2-402 applies, in an occupational disease case, an employee’s compensation benefits may not commence before the date on which the employee learns that the condition is an occupational disease for which compensation may be awarded. The employee was diagnosed with heart disease on September 14, 1996, when he sought emergency medical treatment. He testified, however, that he did not become aware that his condition might be an occupational disease before consulting with an attorney on or about October 15, 1996. The Commission held that the latter date was the first for which compensation benefits could be awarded. Wallace v. Farmville (Town of) Police, VWC File No. 183-37-58 (April 23, 2001).

    There is no prejudice to the employer resulting from a claimant’s failure to give prompt notice of an occupational disease [carpal tunnel syndrome] claim until after surgery is performed, where it subsequently denied the claim. Under such circumstances, the employer forfeits its right to require the claimant to choose a panel physician. It is of no moment that the employer’s disclaimer was after the treatment was rendered. Hairston v. Dan River, Inc., 78 O.W.C. 204 (1999).

    The carrier who has coverage at the time of the communication of the occupational disease, rather than the carrier at the time of the disability, is responsible for compensation and medical expenses provided the last injurious exposure occurred in that employment. Landers v. The Grief Companies/Genesco, Inc., 71 O.W.C. 174 (1992).

    Where the employer admits that the claimant complied with the “technical” requirements of the Act to give notice of her occupational disease [carpal tunnel syndrome] diagnosis within the time period prescribed therein, there is no basis to refuse medical coverage beginning 15 days before the diagnosis as set forth by the legislature, even if the claimant has already submitted to carpal tunnel surgery. Hairston v. Dan River, Inc., 78 O.W.C. 204 (1999).

    See § 65.2-405 for additional notes.

    § 65.2-404. What employer and carrier liability.

    1. When an employee has an occupational disease that is covered by this title, the employer in whose employment he was last injuriously exposed to the hazards of the disease and the employer’s insurance carrier, if any, at the time of the exposure, shall alone be liable therefor, without right to contribution from any prior employer or insurance carrier.
    2. For the purposes of this section, “injurious exposure” means an exposure to the causative hazard of such disease which is reasonably calculated to bring on the disease in question. Exposure to the causative hazard of pneumoconiosis for ninety work shifts shall be conclusively presumed to constitute injurious exposure.
    3. The operator of a coal mining business covered by this title who acquires the business or substantially all of the assets thereof is liable for, and must secure the payment of, all benefits which would have been payable by the prior operator under this section with respect to persons previously employed by such business if the acquisition had not occurred and the prior operator had continued to operate the business; and the prior operator of the business is not relieved of any liability under this section.

    History. Code 1950, §§ 65-47, 65-49; 1952, c. 205; 1960, c. 297; 1962, c. 588; 1968, c. 660, §§ 65.1-50, 65.1-52; 1970, c. 470; 1972, cc. 612, 619; 1974, c. 201; 1975, cc. 27, 471; 1979, cc. 80, 201; 1982, c. 82; 1983, c. 469; 1984, c. 411; 1985, c. 191; 1989, c. 502; 1990, c. 417; 1991 c. 355.

    Law Review.

    For survey of Virginia law on torts for the year 1969-1970, see 56 Va. L. Rev. 1419 (1970).

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 21, 51, 66.

    CASE NOTES

    Editor’s note.

    Most of the cases annotated below were decided under former §§ 65.1-50, 65.1-52, or prior law.

    Legislative intent. —

    Nothing in this section is intended to release employers from the duty of keeping themselves insured as required by § 65.2-801 or to exempt the Uninsured Employer’s Fund when the employer has breached its statutory obligation. Uninsured Employer's Fund v. Mounts, 24 Va. App. 550, 484 S.E.2d 140, 1997 Va. App. LEXIS 242 (1997), aff'd, 255 Va. 254 , 497 S.E.2d 464, 1998 Va. LEXIS 42 (1998).

    This section has no relevance to a change in condition, that is, the aggravation of an existing occupational disease for which compensation has been previously awarded. Rather, this section applies to a case where no diagnosis of an occupational disease has been made and communicated to the employee before he was last injuriously exposed to the hazards of the disease. In such a case, it is uncertain when the employee contracted the disease and, consequently, uncertain which of successive employers or successive insurance carriers should be liable for compensation. The statute resolves the doubt by imposing liability upon the employer for whom the employee was working at the time of the last injurious exposure to the hazards of the disease and by imposing liability upon the insurer who was then underwriting the risk. Hawkeye-Security Ins. Co. v. McDaniel, 210 Va. 209 , 169 S.E.2d 582, 1969 Va. LEXIS 225 (1969).

    Right of action limited to one employer and carrier. —

    Though an employee suffering from an occupational disease may have contracted it while in the employ of some other employer, or once contracted, the disease may have been augmented and aggravated while in the successive employ of several employers, yet this section restricts and limits his right of action to one employer and its insurance carrier. Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951) (decided prior to the 1972 amendment).

    Liability under this section attaches to the employer in whose employment a claimant was last injuriously exposed to the hazards of an occupational disease prior to “first communication of the diagnosis.” Cooper v. Mary E. Coal Corp., 215 Va. 806 , 214 S.E.2d 162, 1975 Va. LEXIS 230 (1975).

    Under this section, the employer on the date of the accident may be the employer liable but only if he is also the employer in whose employment claimant was last injuriously exposed to the hazards of the disease. Cooper v. Mary E. Coal Corp., 215 Va. 806 , 214 S.E.2d 162, 1975 Va. LEXIS 230 (1975).

    “Last injuriously exposed.” —

    In the construction of the phrase “last injuriously exposed,” a rule is adopted fixing liability upon the employer in whose employment the claimant was last injuriously exposed prior to or at the time of disability, the date on which entitlement to benefits accrued. Cooper v. Mary E. Coal Corp., 215 Va. 806 , 214 S.E.2d 162, 1975 Va. LEXIS 230 (1975).

    Critical date is the date of actual disability, the date entitlement to benefits accrues. Cooper v. Mary E. Coal Corp., 215 Va. 806 , 214 S.E.2d 162, 1975 Va. LEXIS 230 (1975).

    Burden is on claimant to show employment at time of last exposure. —

    The burden is on the claimant to establish by a preponderance of the evidence in whose employment he was last injuriously exposed. Blue Diamond Coal Company v. Pannell, 203 Va. 49 , 122 S.E.2d 666, 1961 Va. LEXIS 219 (1961).

    Burden of proof. —

    Employee was not entitled to workers’ compensation benefits because the employee failed to establish that the employee’s alleged occupational disease arose out of the employee’s exposure to a bat at work. Iglesias v. QVC Suffolk, Inc., 2019 Va. App. LEXIS 86 (Va. Ct. App. Apr. 16, 2019).

    Commission’s finding of last injurious exposure held binding on appeal. Blue Diamond Coal Company v. Pannell, 203 Va. 49 , 122 S.E.2d 666, 1961 Va. LEXIS 219 (1961).

    Section supplants common-law definition of “injurious exposure.” —

    The definition of “injurious exposure” in Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859 (1951) as “an exposure or contact with the dangers of the disease which proximately causes the malady, or augments or aggravates the preexisting disease” has been supplanted by the statutory definition of “injurious disease,” which is broader. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    Statutory definition of “injurious exposure” was intended to relieve claimants of the burden of establishing actual causation in cases where such proof is difficult, if not impossible. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    Not just any exposure to the causative hazards would be sufficient. Instead the claimant must show injurious exposure. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    How “injurious exposure” established. —

    A claimant can meet the statutory standard for “injurious exposure” either by establishing actual causation or aggravation of the disease, or by showing that the exposure was of such duration and intensity that it generally causes the disease in question, even though actual causation or aggravation cannot be established in the claimant’s case. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193 (1979); J.J. Henry Co. v. Justice, No. 0995-91-1 (Ct. of Appeals Oct. 29, 1991).

    An employee’s exposure to asbestos was injurious in that it was reasonably calculated to bring on the disease in question, within the meaning of this section, where all the medical testimony indicated that being exposed to asbestos for one month could result in a disease such as that sustained by the employee, and the testimony of his fellow workers showed that he had been exposed for at least one month. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    The employee’s exposure was of such duration and intensity over the years that a reasonable and rational determination could readily be made that his employment exposure proximately caused the disease, and therefore the employee’s last day of employment was the date of his last injurious exposure for purposes of this section. Fairfax County v. Espinola, 11 Va. App. 126, 396 S.E.2d 856, 7 Va. Law Rep. 538, 1990 Va. App. LEXIS 172 (1990).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Which Employer and Carrier is Liable:

    Operator acquiring coal mining business is liable for all benefits payable by prior operator. Lester v. Pigeon Branch Coal Co. Inc., 56 O.I.C. 198 (1974).

    The carrier who had coverage at the time of the communication of the occupational disease, rather than the carrier at the time of the disability, is responsible for compensation and medical expenses provided the last injurious exposure occurred in that employment. Landers v. The Grief Companies/Genesco, Inc., 71 O.W.C. 174 (1992).

    The employee is restricted and limited in his right of action to the employer in whose employment he was last injuriously exposed to the hazards of the disease. Shanahan v. Pocahontas Fuel Co., 194 Va. 303 , 72 S.E.2d 639, 1952 Va. LEXIS 232 (1952); Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951).

    Though claimant’s hearing loss gradually developed due to exposure with many employers, this section explicitly imposes liability upon the employer in whose employment claimant was last injuriously exposed without right to contribution from any prior employer or carrier. Cyphers v. Chestnut Ridge Fuel Corp., 61 O.I.C. 121 (1982).

    Compensation was awarded for hearing loss, a portion of which occurred in other employment, when the last injurious exposure and diagnosis occurred in the current employment. Lee v. Norfolk Gen. Hosp., 57 O.I.C. 226 (1977).

    The carrier during “last injurious exposure” is liable for compensation. Lawhorne v. Riverton Lime & Stone Co., 45 O.I.C. 139 (1963); Davis v. Bear Ridge Coal Co., 45 O.I.C. 61 (1963).

    Where during 90 days of last injurious exposure two carriers provided insurance coverage, the liability was pro-rated according to number of shifts each covered. Ball v. Centennial Development Co., 56 O.I.C. 18 (1974).

    The original insurer remained liable where dermatitis was never cured and each return to work aggravated the existing condition. Hawkeye-Security Ins. Co. v. McDaniel, 210 Va. 209 , 169 S.E.2d 582, 1969 Va. LEXIS 225 (1969).

    A self-employed person who elected to place himself under the Act may pursue the claim against the employer where he was last injuriously exposed, i.e., himself and his insurance carrier, when he receives a communication of an occupational disease. Fuller v. Ray Fuller Trucking, 71 O.W.C. 176 (1992).

    “Injurious Exposure”:

    “Injurious exposure” to pneumoconiosis means an exposure to the dangers of the disease which proximately causes the malady or aggravates a preexisting disposition. Mullins v. Beatrice Pocahontas Coal Company, 60 O.I.C. 313 (1981).

    If the employee has been exposed to the potential hazards of disease for more than 90 work shifts, there is no requirement that the employee also prove injurious exposure by other means. The presumption of injurious exposure necessarily follows from the prolonged work. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    “Occasional” exposure to breathing coal dust, estimated at perhaps one time per week over a period of two years is not sufficient to invoke the presumption of injurious exposure. Ray v. Royal Machine, 74 O.W.C. 167 (1995).

    An employee failed to establish injurious exposure to the hazards of the alleged occupational disease (byssinosis) while in the employment of the named employer defendant. Gale v. Zaban's Mattress & Box Spring Co., 191 Va. 610 , 62 S.E.2d 19, 1950 Va. LEXIS 244 (1950).

    Employee is not required to establish actual pathological change as result of exposure in last employment. Richardson v. W & R Coal Co., 49 O.I.C. 275 (1967).

    Conflicting medical evidence not sufficient to rebut conclusive presumption of injurious exposure where claimant has been exposed to asbestos for ninety work shifts. Mason v. Catalytic, Inc., 60 O.I.C. 300 (1981).

    The employee does not have to prove that injurious work exposure was the cause of his occupational disease. The employee need prove only sufficient exposure that results in actual causation or aggravation of the disease. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    While the claimant may have been exposed to asbestos to a lesser degree at his last employer than while working for an earlier employer, his last exposure was sufficient to be considered “injurious”. Shank v. Newport News Shipbuilding and Dry Dock Company, 65 O.I.C. 181 (1986).

    Asbestosis is a progressive lung disease, i.e., each exposure aggravates and contributes to prior effects of the disease process. Accordingly, where the employee is exposed to asbestos at work, the last day of employment exposure is the date of last injurious exposure. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    Asbestosis/Mesothelioma:

    Pneumoconiosis diseases as defined in Code § 65.2-503 specifically include silicosis and asbestosis. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    While the claimant may have been exposed to asbestos to a lesser degree at his last employer than while working for an earlier employer, his last exposure was sufficient to be considered “injurious”. The claimant’s death from mesothelioma was found to be a result of exposure to asbestos which arose out of and in the course of his employment. Shank v. Newport News Shipbuilding and Dry Dock Company, 65 O.I.C. 181 (1986).

    Risk factors for employees with a very short but intense asbestos exposure are the same as for those with very long but low level exposure to asbestos. Flynt v. Davenport Insulation Co., 74 O.W.C. 25 (1995).

    While installing insulation for 2-1 /2 months is sufficient period for last injurious exposure to asbestos, working only 8 days without a face mask was not enough. Miller v. Armstrong Contr. & Supply Corp., 54 O.I.C. 262 (1972).

    Exposure to asbestos for only 5% of work over required number of shifts is compensable. Daniel v. Porter Hayden Company, 58 O.I.C. 76 (1978).

    Asbestosis is defined in treatises relied upon by the Commission as a pneumoconiosis lung disease, and the presumption of injurious exposure from 90 work shifts in Code § 65.2-404 applies. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    The employee, in the absence of ninety work shifts of asbestos contact, failed to establish the duration and intensity that would meet the requirement of “exposure” envisioned by the Act. Stoots v. Great Barrier Insulation Co., et al., 71 O.W.C. 179 (1992).

    Mesothelioma is treated as the happening of a new accident or occupational disease, even though the claimant was previously awarded specific benefits for first stage asbestosis. Employer in whose employment claimant last injuriously exposed prior to diagnosis of mesothelioma held responsible. Brooks v. Caudle-Hyatt, 57 O.I.C. 56 (1976).

    Also see topic “injurious exposure” above for other cases.

    Coal Workers Pneumoconiosis and Silicosis:

    Pneumoconiosis diseases as defined in Code § 65.2-503 specifically include silicosis and asbestosis. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    Exposure to causative hazard of pneumoconiosis for 90 work shifts conclusively presumed to constitute injurious exposure. Brooks v. Sterling Coal Co., 56 O.I.C. 42 (1973) (appeal denied) Marano v. Transco, Inc., et al. (appeal denied); 58 O.I.C. 228 (1978).

    To constitute a conclusive presumption of injurious exposure, the 90 work shifts do not have to occur in the employ of a single employer. Vance v. Apache Coal Co., 71 O.W.C. 184 (1992).

    Conclusive presumption of injurious exposure after working total of 90 work shifts, though worked prior to effective date of amendment. Statute does not require that all exposure be within 5 years of the communication or that all 90 shifts be consecutive to establish liability of that employer. Barnes v. AC&S, Inc., 56 O.I.C. 22 (1974).

    A claimant who works less than 90 work shifts is not entitled to the presumption but may still be entitled to benefits if injurious exposure can be established. Hamilton v. Raider Coal, 73 O.W.C. 127 (1994).

    Injurious exposure not established when claimant worked total of 67 shifts. Smith v. Honey Camp Coal Co., 55 O.I.C. 321 (1973).

    Mere exposure to hazards of silicosis is not sufficient to impose liability upon an employer: there must be injurious exposure. Miller v. Southern Smokeless Coal Corp., 48 O.I.C. 169 (1966).

    Driving truck and unloading sand for building supply and construction company was not injurious exposure to silicosis. Neece v. McClure Lumber & Builders Supply Co., Inc., 53 O.I.C. 229 (1971).

    Dermatitis:

    Employer at time of last injurious exposure was alone liable for compensation benefits because the claimant’s pre-existing contact dermatitis caused by trees and/or sawdust exposure was not discovered to be occupational until after he commenced work with this employer. McLaughlin v. Hawthorne, 51 O.I.C. 173 (1969).

    Hypertension:

    A claimant who worked in the supply room but was classified as a firefighter was entitled to the presumption that his hypertension arose out of the employment. Injurious exposure as defined by § 65.1-52 (now § 65.2-404 ) was not a condition of entitlement to the presumption and only has probative value in determining causation or rebutting the allegation. Rogers v. Fairfax County Fire & Rescue, 68 O.I.C. 53 (1989). (Affirmed by Court of Appeals on 4/3/90).

    § 65.2-405. Notice to be given.

    1. Within sixty days after a diagnosis of an occupational disease is first communicated to the employee, he, or someone in his behalf, shall give written notice thereof to the employer in accordance with § 65.2-600 , but in no case shall the failure to give notice deprive the employee of his cause of action for an occupational disease, unless it be shown that such failure resulted in clear prejudice to the employer.
    2. The statute of limitations provided under subdivision A 1 of § 65.2-406 shall be tolled until the employer gives the employee notice in substantially the following form:
    3. The provisions of subsection B shall apply only to claims arising on or after July 1, 1991.

    NOTICE TO EMPLOYEE IN THE EVENT A DIAGNOSIS OF COAL MINERS’ PNEUMOCONIOSIS (INCLUDING BLACK LUNG, SILICOSIS, PNEUMOCONIOSIS, COAL WORKERS’ PNEUMOCONIOSIS, ROCK DUST, DUST, DUST ON YOUR LUNGS OR TERMS OF SIMILAR MEANING) IS COMMUNICATED TO YOU, YOU MAY HAVE A WORKERS’ COMPENSATION CLAIM. HOWEVER, SUCH CLAIM MAY BE LOST IF YOU DO NOT FILE IT WITH THE VIRGINIA WORKERS’ COMPENSATION COMMISSION WITHIN THE TIME LIMIT PROVIDED BY LAW. YOU MAY FIND OUT WHAT TIME LIMIT APPLIES TO YOUR CLAIM BY CONTACTING THE WORKERS’ COMPENSATION COMMISSION. THE FACT THAT YOU ARE TOLD THAT YOU HAVE COAL MINERS’ PNEUMOCONIOSIS WHICH HAS NOT REACHED THE COMPENSABLE LEVEL UNDER THE GUIDELINES OF THE WORKERS’ COMPENSATION COMMISSION OR THAT YOU ARE STILL ABLE TO WORK OR ARE WORKING DOES NOT STOP THE TIME FROM RUNNING OR OTHERWISE RELIEVE YOU OF YOUR DUTY TO FILE YOUR CLAIM WITH THE WORKERS’ COMPENSATION COMMISSION. Such notice shall also include the address and telephone number which the employee may use to contact the Commission.The employer shall post and keep posted, conspicuously, the above notice in, on, or about the mine operations in places usually frequented by employees.

    History. Code 1950, § 65-48; 1952, c. 205; 1958, c. 457; 1968, c. 660, § 65.1-51; 1970, c. 470; 1972, c. 619; 1991, cc. 301, 355.

    Law Review.

    For survey of Virginia law on workers’ compensation in the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    For article discussing workers’ compensation in the context of toxic substances litigation, see 16 U. Rich. L. Rev. 247 (1982).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 57, 82.

    CASE NOTES

    Provisions of former § 65.1-85 (now § 65.2-600 ) applicable to occupational diseases. —

    By former § 65.1-49 (now § 65.2-403 ) the saving provisions of former § 65.1-85, relative to when written notice need not be given when accidental injury is suffered, are made applicable to occupational diseases. Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951) (decided under prior law).

    Effect of failure to give notice where employer’s physician knew of disease. —

    Where the employee failed to give written notice of his occupational disease within 30 days (now 60 days) as required by this section, it was held that this was no bar to compensation, since the employer’s physician was fully aware of the fact within the required 30 days (now 60 days), and since under former § 65.1-85 (now § 65.2-600 ) the diseased is relieved of the necessity to give written notice when it is proved that an agent or representative of the employer had knowledge of the disease, and the Commission is satisfied that the employer has not been prejudiced by the failure to give written notice. Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951) (decided under prior law).

    Notice need not be given before treatment. —

    Where an employee gave notice within the time period specified by this section, such notice was sufficient even though the employee had already undergone surgery for the condition prior to giving notice. Dan River, Inc. v. Hairston, 2000 Va. App. LEXIS 277 (Va. Ct. App. Apr. 11, 2000).

    Notice given within time required. —

    See Pittston Co. v. Fulks, 201 Va. 128 , 109 S.E.2d 387, 1959 Va. LEXIS 202 (1959) (decided under prior law).

    Notice not given within time required. —

    See Lewis v. Lynchburg Foundry Co., 204 Va. 303 , 130 S.E.2d 429, 1963 Va. LEXIS 148 (1963) (decided under prior law).

    For cases construing former provisions of this section which required an employee to give notice after he experienced a “distinct manifestation” of an occupational disease, see Shanahan v. Pocahontas Fuel Co., 194 Va. 303 , 72 S.E.2d 639, 1952 Va. LEXIS 232 (1952) (decided under prior law).

    Employer’s failure to show prejudice from lack of notice. —

    Even if there was merit to an employer’s argument that the claimant had not given timely notice where she gave notice within the time period permitted by this section but not before undergoing treatment, the employer could not claim that it was prejudiced by being deprived of its right to offer the claimant a panel of physicians since it had denied the claim and an employer who denies a claim is not entitled to require a claimant to seek treatment from one of its panel physicians. Dan River, Inc. v. Hairston, 2000 Va. App. LEXIS 277 (Va. Ct. App. Apr. 11, 2000).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Communication/Diagnosis:

    Until a diagnosis is made, the nature of the disease determined, and the diagnosis communicated to employee, the statute of limitations does not begin to run. Good v. Great A & P Tea Co., 52 O.I.C. 112 (1970).

    Precise medical terminology is not required to communicate a diagnosis of an occupational disease. It is sufficient if the physician advises the claimant that her condition is caused by her work, although he did not advise that it was a “disease.” Bell v. Sara Lee Knit Products, 74 O.W.C. 67 (1995).

    Once an employee seeks a physician he is chargeable only with advice given by the physician. If he is not advised of the occupational nature of his disease, he should not be encouraged to override his physician and file claim for a compensable disease. Good v. Great A & P Tea Co., 52 O.I.C. 112 (1970); Clifton v. Jewell Ridge Coal Corp., 37 O.I.C. 151 (1955); Bowman v. Shenandoah Silica Co., 34 O.I.C. 499 (1952); Horton v. Raven Red Ash Coal Corp., 34 O.I.C. 448 (1952).

    Where a physician stated that toxic exposure was likely but indicated chronic viral infection had to be ruled out, a diagnosis of an occupational disease was not communicated to the claimant even if she believed that her problem was the result of exposure to solvents at work. Rice v. Virginia Beach General Hospital, 68 O.I.C. 128 (1989).

    Term “impression” does not constitute complete diagnosis. Hux v. Ukrop’s Super Market Inc., 53 O.I.C. 150 (1971).

    Verbiage employed in physician’s report was such that a layman would not construe the report to be a diagnosis of a occupational disease. Compensation was awarded based on a communication at a later date. Shelton v. Island Creek Coal Co., 57 O.I.C. 327 (1976).

    Medical certificate upon which waiver was based did not constitute communication of diagnosis. Cline v. Miller Creek Coal Co., 58 O.I.C. 63 (1978).

    Advice to change jobs and that a malady may be related to work is not a diagnosis. Sisler v. Safeway Stores, Inc., 44 O.I.C. 234 (1962).

    Statement “some would call it silicosis” is not sufficient to constitute diagnosis. Smith v. Westmoreland Coal Co., 53 O.I.C. 344 (1971).

    Communication Other Than to the Employee:

    Where a claimant is not mentally competent to understand the rights and obligations imposed by the Workers’ Compensation Act, communication of an occupational disease by the treating physician to the claimant’s wife and next friend is sufficient to meet the notice requirement. Likewise, communication to the claimant’s counsel through medical reports is sufficient to meet the statutory requirement. Barnes v. Ivie Cleaners, Inc., 65 O.I.C. 176 (1986).

    Notice of diagnosis to attorney does not constitute constructive notice of occupational disease to employee. Honaker v. Harman Mining Corp., 54 O.I.C. 181 (1972).

    Notice to Employer:

    Employee is relieved of necessity of giving written notice when agent or representative of employer has actual knowledge. Saving provisions of § 65.1-85 (now § 65.2-600 ) are applicable to occupational diseases. Pocahontas Fuel Co., Inc. v. Godbey, 192 Va. 845 , 66 S.E.2d 859 (1951); Lawhorne v. Riverton Lime & Stone Co., 45 O.I.C. 139 (1963).

    Lack of notice is not in itself sufficient for an employer to take advantage of this section; employer must show clear prejudice. Terrell v. White Packing Company, 61 O.I.C. 377 (1982).

    Claim will not be dismissed unless employer shows that failure to give notice resulted in “clear prejudice” to the employer. Purge v. White Packing Co., 59 O.I.C. 250 (1980).

    There is no prejudice to the employer resulting from a claimant’s failure to give prompt notice of an occupational disease [carpal tunnel syndrome] claim until after surgery is performed, where it subsequently denied the claim. Under such circumstances, the employer forfeits its right to require the claimant to choose a panel physician. It is of no moment that the employer’s disclaimer was after the treatment was rendered. Hairston v. Dan River, Inc., 78 O.W.C. 204 (1999).

    It was not necessary for the employee to give notice since the employer was fully appraised of the probable existence of silicosis prior to the employee being advised of his condition. Gray v. Lynchburg Foundry Corp., 44 O.I.C. 105 (1962).

    Where the employer admits that the claimant complied with the “technical” requirements of the Act to give notice of her occupational disease [carpal tunnel syndrome] diagnosis within the time period prescribed therein, there is no basis to refuse medical coverage beginning 15 days before the diagnosis as set forth by the legislature, even if the claimant has already submitted to carpal tunnel surgery. Hairston v. Dan River, Inc., 78 O.W.C. 204 (1999).

    Failure to give written notice within 60 days of receiving a communication of occupational disease does not bar the employee’s cause of action unless the employer is clearly prejudiced thereby. While the claimant admittedly submitted notice of her disease more than 60 days after the communication of her diagnosis, the employer failed to demonstrate that it was prejudiced by the delay. The employee remained incapable of any work, so evidence of light duty work the employer might have offered her was irrelevant and speculative. Since the employer denied the compensability of the claim, the employer forfeited its right to have the employee select a panel physician who could direct the employee’s medical care. Puffenbarger v. Rocco Turkeys, Inc., VWC File Nos. 196-33-49 & 198-09-23 (January 8, 2001).

    See Notes to § 65.2-406 .

    § 65.2-406. (Effective until July 1, 2022) Limitation upon claim; diseases covered by limitation.

    1. The right to compensation under this chapter shall be forever barred unless a claim is filed with the Commission within one of the following time periods:
      1. For coal miners’ pneumoconiosis, three years after a diagnosis of the disease, as category 1/0 or greater as classified under the current International Labour Office Classification of Radiographs of the Pneumoconiosis, is first communicated to the employee or the legal representative of his estate or within five years from the date of the last injurious exposure in employment, whichever first occurs;
      2. For byssinosis, two years after a diagnosis of the disease is first communicated to the employee or within seven years from the date of the last injurious exposure in employment, whichever first occurs;
      3. For asbestosis, two years after a diagnosis of the disease is first communicated to the employee;
      4. For symptomatic or asymptomatic infection with human immunodeficiency virus including acquired immunodeficiency syndrome, two years after a positive test for infection with human immunodeficiency virus;
      5. For diseases directly attributable to the rescue and relief efforts at the Pentagon following the terrorist attack of September 11, 2001, two years after a diagnosis of the disease is first communicated to the employee; or
      6. For all other occupational diseases, two years after a diagnosis of the disease is first communicated to the employee or within five years from the date of the last injurious exposure in employment, whichever first occurs.
    2. If death results from an occupational disease within any of such periods, the right to compensation under this chapter shall be barred, unless a claim therefor is filed with the Commission within three years after such death. The limitations imposed by this section as amended shall be applicable to occupational diseases contracted before and after July 1, 1962, and § 65.2-601 shall not apply to pneumoconiosis. The limitation on time of filing will cover all occupational diseases except:
      1. Cataract of the eyes due to exposure to the heat and glare of molten glass or to radiant rays such as infrared;
      2. Epitheliomatous cancer or ulceration of the skin or of the corneal surface of the eye due to pitch, tar, soot, bitumen, anthracene, paraffin, mineral oil, or their compounds, products or residues;
      3. Radium disability or disability due to exposure to radioactive substances and X-rays;
      4. Ulceration due to chrome compound or to caustic chemical acids or alkalies and undulant fever caused by the industrial slaughtering and processing of livestock and handling of hides;
      5. Mesothelioma due to exposure to asbestos; and
      6. Angiosarcoma of the liver due to vinyl chloride exposure.
    3. When a claim is made for benefits for a change of condition in an occupational disease, such as advance from one stage or category to another, a claim for change in condition must be filed with the Commission within three years from the date for which compensation was last paid for an earlier stage of the disease, except that a claim for benefits for a change in condition in asbestosis must be filed within two years from the date when diagnosis of the advanced stage is first communicated to the employee and no claim for benefits for an advanced stage of asbestosis shall be denied on the ground that there has been no subsequent accident. For a first or an advanced stage of asbestosis or mesothelioma, if the employee is still employed in the employment in which he was injuriously exposed, the weekly compensation rate shall be based upon the employee’s weekly wage as of the date of communication of the first or advanced stage of the disease, as the case may be. If the employee is unemployed, or employed in another employment, the weekly compensation rate shall be based upon the average weekly wage of a person of the same or similar grade and character in the same class of employment in which the employee was injuriously exposed and preferably in the same locality or community on the date of communication to the employee of the advanced stage of the disease or mesothelioma. The weekly compensation rates herein provided shall be subject to the same maximums and minimums as provided in § 65.2-500 .

    History. Code 1950, § 65-49; 1952, c. 205; 1960, c. 297; 1962, c. 588; 1968, c. 660, § 65.1-52; 1970, c. 470; 1972, c. 612; 1974, c. 201; 1975, cc. 27, 471; 1979, cc. 80, 201; 1982, c. 82; 1983, c. 469; 1984, c. 411; 1985, c. 191; 1989, c. 502; 1990, c. 417; 1991, c. 355; 1992, c. 475; 1995, c. 324; 2005, c. 433; 2011, c. 513.

    The 1995 amendment inserted “or the legal representative of his estate” in subdivision A 1.

    The 2005 amendments.

    The 2005 amendment by c. 433 inserted present subdivision A 5 and redesignated former subdivision A 5 as A 6; and made a related change.

    The 2011 amendments.

    The 2011 amendment by c. 513, in subdivision A 1, inserted “current” and deleted “(1980)” following “Pneumoconiosis.”

    The 2022 amendments.

    The 2022 amendments by cc. 497 and 498 are identical, and added subdivision A 6 and subsection C; redesignated accordingly; and made stylistic changes.

    Law Review.

    For article on compensation for black lung at the federal level, see 57 Va. L. Rev. 97 (1971).

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    for the year 1975-1976, see 62 Va. L. Rev. 1506 (1976).

    For article discussing workers’ compensation in the context of toxic substances litigation, see 16 U. Rich. L. Rev. 247 (1982).

    For article, “Workers’ Compensation for Disease in Virginia: The Exception Swallows the Rule,” see 20 U. Rich. L. Rev. 161 (1985).

    Research References.

    Larson’s Workers’ Compensation Law (Matthew Bender). § 53.04 Special Statute of Limitations Problems. Larson and Larson.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 21, 58.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-52 or prior law.

    Five-year limitation of former section was constitutional. —

    The five-year limitation of former § 65.1-52 (3) (now this section) on occupational disease claims did not contravene any of claimant’s rights to due process and equal protection. Miller v. Locher Silica Corp., 12 Va. App. 1213, 408 S.E.2d 566, 8 Va. Law Rep. 623, 1991 Va. App. LEXIS 223 (1991).

    General Assembly, in amending this section, recognized that asbestosis is a progressive disease which may manifest itself many years after the cessation of employment. Parris v. APCO, 2 Va. App. 219, 343 S.E.2d 455, 1986 Va. App. LEXIS 262 (1986).

    Filing of a claim within the statutory period is jurisdictional. Anderson v. Clinchfield Coal Co., 214 Va. 674 , 204 S.E.2d 257, 1974 Va. LEXIS 197 (1974); Hawks v. Henrico County School Bd., 7 Va. App. 398, 374 S.E.2d 695, 5 Va. Law Rep. 1131, 1988 Va. App. LEXIS 129 (1988).

    The requirement that such claim be filed within the statutory period is jurisdictional. Clinchfield Coal Co. v. Kincaid, 216 Va. 27 , 215 S.E.2d 638, 1975 Va. LEXIS 245 (1975).

    Because the filing of a claim within the limitation period of this section is jurisdictional, the claimant’s failure to file within five years of his last injurious exposure barred his claim. Musick v. Codell Constr. Co., 4 Va. App. 471, 358 S.E.2d 739, 4 Va. Law Rep. 144, 1987 Va. App. LEXIS 200 (1987).

    Provisions of former § 65.1-65 (now § 65.2-512 ) are made subject to this section. Winston v. City of Richmond, 196 Va. 403 , 83 S.E.2d 728, 1954 Va. LEXIS 234 (1954).

    “Injury by accident” and “date of injury.” —

    In enacting former § 65.1-49 (now § 65.2-403 ) and this section, the legislature intended that the phrases “injury by accident” and “date of injury” be used to determine when a claimant’s right to assert a claim begins and the time limit within which the application for benefits must be filed with the commission. C & P Tel. Co. v. Williams, 10 Va. App. 516, 392 S.E.2d 846, 6 Va. Law Rep. 2775, 1990 Va. App. LEXIS 119 (1990).

    Creation of “injury” date in former § 65.1-49 (now § 65.2-403 ) was not intended to limit or otherwise affect the unambiguous provisions of this section. Those provisions contain fixed starting points and must be applied as they are plainly worded. Dan River, Inc. v. Adkins, 3 Va. App. 320, 349 S.E.2d 667, 3 Va. Law Rep. 1042, 1986 Va. App. LEXIS 367 (1986).

    This section does not require that an employee receive communication from a physician that his disease is work related; rather, the statute only requires that the employee, simultaneously with or sometime after the diagnosis of his condition, learn that the condition is an occupational disease for which compensation may be awarded. City of Alexandria v. Cronin, 20 Va. App. 503, 458 S.E.2d 314, 1995 Va. App. LEXIS 525 (1995), aff'd, 252 Va. 1 , 471 S.E.2d 184, 1996 Va. LEXIS 63 (1996).

    Claimant must show that his claim was timely filed, for filing within the statutory period is jurisdictional. Blue Diamond Coal Company v. Pannell, 203 Va. 49 , 122 S.E.2d 666, 1961 Va. LEXIS 219 (1961).

    Burden is upon the claimant to prove that he complied with filing provisions of this section. Anderson v. Clinchfield Coal Co., 214 Va. 674 , 204 S.E.2d 257, 1974 Va. LEXIS 197 (1974); Island Creek Coal Co. v. Breeding, 6 Va. App. 1, 365 S.E.2d 782, 4 Va. Law Rep. 1900, 1988 Va. App. LEXIS 29 (1988); Hawks v. Henrico County School Bd., 7 Va. App. 398, 374 S.E.2d 695, 5 Va. Law Rep. 1131, 1988 Va. App. LEXIS 129 (1988).

    The burden is upon a claimant to prove that he has complied with this section. Clinchfield Coal Co. v. Kincaid, 216 Va. 27 , 215 S.E.2d 638, 1975 Va. LEXIS 245 (1975).

    Statutory period runs when claimant receives diagnosis. —

    Virginia Workers’ Compensation Commission did not err in concluding that a claim was not barred by the statute of limitations because there was evidence to support the Commission’s factual conclusion that no diagnosis of pneumoconiosis was communicated to the claimant when the claimant was presented by an employer with a waiver form pertaining to pneumoconiosis and nothing in the record compelled the opposite conclusion. Four \O\ Mining Corp. v. Deel, 2017 Va. App. LEXIS 158 (Va. Ct. App. June 27, 2017).

    Workers’ Compensation Commission properly awarded a police officer benefits for heart disease under the statutory presumption because his claim was timely where he found out years after his initial diagnosis that the condition was causally related to his employment. City of Newport News v. Kahikina, 71 Va. App. 536, 838 S.E.2d 70, 2020 Va. App. LEXIS 49 (2020).

    Filing requirement cannot be satisfied by mere consent or stipulation of parties, and therefore parties’ stipulation at evidentiary hearing that diagnosis and communication of occupational disease first occurred in Nov., 1986, was not determinative of when limitation period began to run. Hawks v. Henrico County School Bd., 7 Va. App. 398, 374 S.E.2d 695, 5 Va. Law Rep. 1131, 1988 Va. App. LEXIS 129 (1988).

    A claim for advancement to another stage or category of an occupational disease, when an award has been made for an earlier stage, is not a “new accident” subject to time limitations set forth in the first paragraph of this section. Top Notch Coal Co. v. Porter, 217 Va. 19 , 225 S.E.2d 357, 1976 Va. LEXIS 234 (1976).

    Once an award has been made for the disease, the last paragraph of this section bars any claim for its advancement unless asserted within three years from the date compensation was last paid for the earlier stage. Top Notch Coal Co. v. Porter, 217 Va. 19 , 225 S.E.2d 357, 1976 Va. LEXIS 234 (1976).

    Subsequent claims. —

    Not every occupational disease is immediately disabling, though one may certainly progress to the point that it is; a second claim may be compensable if the illness has reached the stage when the disease prevents the employee from performing his or her work efficiently. Samartino v. Fairfax County Fire & Rescue, 64 Va. App. 499, 769 S.E.2d 692, 2015 Va. App. LEXIS 84 (2015).

    In determining if a second claim is barred by the statute of limitations the question hinges on the meaning of “diagnosis,” which is broad enough to encompass not only the identification of the name of the disease but also the identification of the disease’s symptomatic progression and impact on quality of life and ability to perform tasks; if a patient’s symptoms change or worsen, he or she may be diagnosed with a more severe stage of a disease and trigger the beginning of a new filing period. Samartino v. Fairfax County Fire & Rescue, 64 Va. App. 499, 769 S.E.2d 692, 2015 Va. App. LEXIS 84 (2015).

    Although a claimant asserted that the claimant’s second claim for temporary total disability workers’ compensation benefits relating to an occupational heart disease was transmuted from a new claim into a change in condition claim, the new claims contained in the claimant’s filing were barred by the statute of limitations because the filing by the claimant was not a change in condition application, as there was not a de facto award in place during the relevant time period. Northampton County & Va. Ass'n of Counties Group Self-Insurance v. Somers, 2015 Va. App. LEXIS 294 (Va. Ct. App. Oct. 20, 2015).

    Claim of dependents after death of employee barred by employee’s failure to file claim. —

    A city employee died on Jan. 3, 1950, as a result of exposure to carbon monoxide gas in the course of his employment. Following the diagnosis of his disease in February of 1948 and during the period of incapacity preceding his death the city paid him over $4,000. He filed no claim under the workmen’s (now workers’) compensation laws. Because of his failure so to file, the claim of his dependent wife and infant son, filed with the Industrial Commission within one year of his death, was barred by the provisions of this section, unless the employee’s failure to file within one year after the diagnosis of his trouble could be excused by virtue of former § 65.1-79 (now § 65.2-528 ). Winston v. City of Richmond, 196 Va. 403 , 83 S.E.2d 728, 1954 Va. LEXIS 234 (1954) (decided prior to the 1972 amendment).

    Subsequent amendments to limitations period. —

    The running of the statute of limitations, standing alone, is a bar to subsequent claims. This is true even though the limitations period was subsequently amended. Parris v. APCO, 2 Va. App. 219, 343 S.E.2d 455, 1986 Va. App. LEXIS 262 (1986).

    Once the limitations period has run, any subsequent amendments to that period generally would have no effect on the parties’ procedural rights. It is noted, however, that an amendment to a period of limitation that enlarges the period is generally applicable to existing causes of action provided that an action already barred is not revived. Parris v. APCO, 2 Va. App. 219, 343 S.E.2d 455, 1986 Va. App. LEXIS 262 (1986).

    Communication to employee of a tentative diagnosis did not cause the period of limitation to commence. Blue Diamond Coal Company v. Pannell, 203 Va. 49 , 122 S.E.2d 666, 1961 Va. LEXIS 219 (1961).

    Where claimant with pneumoconiosis was informed by a physician that he “had some dust” but that his condition had not reached the first stage yet and that there was not enough to file for benefits, the statute of limitations ran from the date he was so informed notwithstanding that the disease was not yet compensable. Kiser v. Clinchfield Coal Co., 225 Va. 357 , 302 S.E.2d 44, 1983 Va. LEXIS 228 (1983).

    Statutory period runs when claimant receives diagnosis. —

    The two-year period set forth in the pertinent clause of this section begins to run only when a claimant has received a diagnosis of an occupational disease. Garrison v. Prince William County Bd. of Supvrs., 220 Va. 913 , 265 S.E.2d 687, 1980 Va. LEXIS 184 (1980).

    And a person has not received “a diagnosis of an occupational disease” until he receives a diagnosis that he suffers from an occupational disease; one arising out of and in the course of the employment. Garrison v. Prince William County Bd. of Supvrs., 220 Va. 913 , 265 S.E.2d 687, 1980 Va. LEXIS 184 (1980).

    Tentative diagnosis will not trigger running of limitation period. —

    The two year limitation period under this section begins to run when the claimant receives a positive diagnosis of occupational disease. A tentative diagnosis will not trigger the running of the limitation period. Via v. Citicorp Mtg., Inc., 10 Va. App. 572, 394 S.E.2d 505, 7 Va. Law Rep. 47, 1990 Va. App. LEXIS 128 (1990).

    Letter was communication of diagnosis. —

    Where doctor’s letter to plaintiff communicated in ordinary language existence of lung condition most likely caused by different metals plaintiff was exposed to on his welding job and plaintiff was unequivocally told in understandable language that he had lung condition (scarring) most likely caused by his working conditions as welder, this letter was sufficient notice to trigger plaintiff’s legal obligation to file claim. Hawks v. Henrico County School Bd., 7 Va. App. 398, 374 S.E.2d 695, 5 Va. Law Rep. 1131, 1988 Va. App. LEXIS 129 (1988).

    Physician is not required to utilize precise medical terminology to communicate existence of occupational disease in order to trigger obligation to file claim; a person receives diagnosis of occupational disease when he receives diagnosis that he suffers from disease that arises out of and in course of employment. Hawks v. Henrico County School Bd., 7 Va. App. 398, 374 S.E.2d 695, 5 Va. Law Rep. 1131, 1988 Va. App. LEXIS 129 (1988).

    The diagnosis required to trigger the running of the limitation period need not contain precise medical terminology, as long as the diagnosis is definite and informs the claimant in clear and understandable language that he or she is suffering from a disease that arises out of and in the course of employment. Via v. Citicorp Mtg., Inc., 10 Va. App. 572, 394 S.E.2d 505, 7 Va. Law Rep. 47, 1990 Va. App. LEXIS 128 (1990).

    A communication of any diagnosis of a mental disorder does not commence the running of the limitation period for all other types of mental illness. Via v. Citicorp Mtg., Inc., 10 Va. App. 572, 394 S.E.2d 505, 7 Va. Law Rep. 47, 1990 Va. App. LEXIS 128 (1990).

    Employee did not receive sufficient notice of nature of mental illness. —

    Employee ultimately diagnosed as suffering from bipolar disorder (also referred to as manic-depressive illness), who was told only that she was suffering from some form of depression, did not receive sufficient notice of the nature of her illness to file a claim based on her bipolar disorder, and she was not barred under this section from filing her claim based on ultimate communication of the correct diagnosis. Via v. Citicorp Mtg., Inc., 10 Va. App. 572, 394 S.E.2d 505, 7 Va. Law Rep. 47, 1990 Va. App. LEXIS 128 (1990).

    Award not adjusted to time of diagnosis. —

    While the Virginia Workers’ Compensation Commission awarded permanent partial benefits to the widow of a worker, it ruled the average weekly wages would be calculated at the wages the worker last earned prior to his retirement, 26 years before; the widow’s argument that she was entitled to an enhanced average weekly wage, based on the date the diagnosis was communicated to him, as provided in subsection C of § 65.2-406 was rejected. Robertson v. E.I. DuPont de Nemours & Co., 38 Va. App. 785, 568 S.E.2d 436, 2002 Va. App. LEXIS 520 (2002).

    Statutory presumption under former § 65.1-47.1 (now § 65.2-402 ) is irrelevant. —

    That a claimant might have successfully brought a claim at an earlier date due to the statutory presumption set forth in former § 65.1-47.1 is irrelevant to the resolution of whether the provisions of this section bar a claim. Garrison v. Prince William County Bd. of Supvrs., 220 Va. 913 , 265 S.E.2d 687, 1980 Va. LEXIS 184 (1980).

    Claim must be filed for limitations purposes even though subject to dismissal as not yet compensable. —

    Where worker was informed that lungs were scarred but functioned well and needed no treatment, worker was required to file, even if claim would have been dismissed as not yet compensable. Hawks v. Henrico County School Bd., 7 Va. App. 398, 374 S.E.2d 695, 5 Va. Law Rep. 1131, 1988 Va. App. LEXIS 129 (1988).

    Limitation of action regarding first diagnosis has no bearing on claim basis on later diagnosis. —

    Once an employee receives a communication of an occupational disease, it is incumbent upon that employee to file a claim. Once a claim is filed, it is the duty of the Commission to determine: (1) Whether the disease is in fact an “occupational disease” as defined in former § 65.1-46 (now § 65.2-400 ), and if so, (2) whether that occupational disease is compensable. If the Commission determines that the claimant does not have an occupational disease, or that his occupational disease is not compensable, then the statute of limitations in regard to the first communication of the diagnosis forming the basis of that claim has no bearing on a subsequent diagnosis and a claim filed as a result of the communication of that diagnosis. Parris v. APCO, 2 Va. App. 219, 343 S.E.2d 455, 1986 Va. App. LEXIS 262 (1986).

    Extension of period from five to seven years did not extend previously time-barred claim. —

    Where claimant’s last injurious exposure in employment was May 28, 1976, at which time the former version of this section allowed her to file her claim either five years from this date or two years from May 16, 1983 (the date of first communication of a diagnosis of byssinosis), whichever occurred first, and the five-year period expired first, on May 28, 1981, her claim was barred after that date. The amendment which extended the period to seven years from the date of the last injurious exposure did not take effect until July 1982. It could not operate to extend a claim that was barred. To hold otherwise would negate the vested right which employer acquired on May 28, 1981, when the limitation then in effect expired. Dan River, Inc. v. Adkins, 3 Va. App. 320, 349 S.E.2d 667, 3 Va. Law Rep. 1042, 1986 Va. App. LEXIS 367 (1986).

    Sufficient evidence of claim timely filed. —

    Since the doctor did write that employee’s hearing loss was induced by industrial noise, and since employee was exposed to the industrial noise within the five-year period prior to filing his claim, there was credible evidence to support the commission’s finding that the claim was timely filed. Ingersoll-Rand Co. v. Musick, 7 Va. App. 684, 376 S.E.2d 814, 5 Va. Law Rep. 1726, 1989 Va. App. LEXIS 16 (1989).

    Sufficient evidence of claim not timely filed. —

    Where claimant was aware that he suffered from an occupational disease over two years before his estate filed for death benefits, the statute of limitations barred his estate from receiving compensation. City of Alexandria v. Cronin, 20 Va. App. 503, 458 S.E.2d 314, 1995 Va. App. LEXIS 525 (1995), aff'd, 252 Va. 1 , 471 S.E.2d 184, 1996 Va. LEXIS 63 (1996).

    A claim for compensation for an occupational disease was not timely filed as credible evidence established that the claimant knew, several years earlier, that her contact dermatitis was a disease that might be caused by her wearing latex gloves at work and that, at that time, she took immediate precautions to avoid exposure to latex gloves at work. Smith v. Fairfax Hospital, 1998 Va. App. LEXIS 623 (Va. Ct. App. Dec. 8, 1998).

    Where evidence showed that employee who worked for a county fire department was diagnosed with high blood pressure as early as 1995, that he knew high blood pressure and hypertension were the same condition, and that even though his physician did not tell him his condition was work-related until January 1998, he knew about the statutory presumption that hypertension was an occupational disease, that the employee’s claim for benefits, filed more than two years after the employee’s obligation to file the claim arose, was untimely. Owens v. York Fire & Rescue, 38 Va. App. 354, 564 S.E.2d 150, 2002 Va. App. LEXIS 321 (2002).

    Employee’s claim for benefits was time barred because the employee filed the claim for benefits after the two-year statute of limitations expired, the statute of limitations was not tolled, a facsimile the employee sent the Virginia Workers’ Compensation Commission before the expiration of the two-year statute of limitations was not a notice for her claim for benefits, and the doctrine of imposition did not apply. Remington v. Global One Communs., LLC, 2003 Va. App. LEXIS 116 (Va. Ct. App. Mar. 4, 2003).

    Award of medical benefits to the claimant in a workers’ compensation action was inappropriate pursuant to subsection A of § 65.2-406 because he failed to comply with the statute of limitations. The claimant had begun experiencing problems with both wrists over five years prior to filing his claim. Gwaltney of Smithfield, Ltd. v. Peele, 2010 Va. App. LEXIS 257 (Va. Ct. App. June 29, 2010).

    Not an occupational disease. —

    Although a firefighter was diagnosed in 1995 with a mild form of asthma, the workers’ compensation claim the firefighter filed in June 2000 after his condition worsened was not barred by § 65.2-406 because the firefighter’s original condition was not a compensable occupational disease. Tomes v. James City Fire, 39 Va. App. 424, 573 S.E.2d 312, 2002 Va. App. LEXIS 755 (2002).

    Claim not barred. —

    See Pittston Co. v. Fulks, 201 Va. 128 , 109 S.E.2d 387, 1959 Va. LEXIS 202 (1959); Altizer v. City of Williamsburg, 220 Va. 9 , 255 S.E.2d 536, 1979 Va. LEXIS 225 (1979).

    Occupational disease portion of an employee’s workers’ compensation claim was not time-barred because the employee timely filed the claim within the five-year limitations period as the limitations period ended on a Sunday and the employee filed the claim on the following Monday. Iglesias v. QVC Suffolk, Inc., 2019 Va. App. LEXIS 86 (Va. Ct. App. Apr. 16, 2019).

    CIRCUIT COURT OPINIONS

    Relationship to other laws. —

    Circuit Court of Fairfax County, Virginia, finds that the five-year look-back period in § 65.2-406 was not incorporated in subsection B of § 9.1-401 as § 65.2-406 was not part of the list of expressly incorporated provisions. Gurdak v. Commonwealth, 96 Va. Cir. 236, 2017 Va. Cir. LEXIS 133 (Fairfax County Aug. 8, 2017).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Jurisdiction:

    Jurisdiction cannot be conferred by consent of the parties. Ryals v. Humble Oil & Refining Co., 52 O.I.C. 220 (1970).

    Once the period provided for enforcement of the right established by the Workers’ Compensation Act expired, the right expired with it and may not be revived by subsequent legislation. Nicholas v. Lynchburg Training School & Hospital, 44 O.I.C. 198 (1962).

    The law at the time of the accident fixed the rights of the parties as of that date. Therefore it was immaterial as to whether the 1983 amendment to § 65.1-52 (now § 65.2-406 ) was retroactive since the claim was barred by the previous limitation period before the amendment became effective. Gowen v. C. E. Thurston & Son, Inc., 63 O.I.C. 144 (1984) (see also Miller v. E. I. Dupont de Nemours & Company, 62 O.I.C. 322 (1983)).

    The law in effect on the date of accident (communication of diagnosis) controls and not law at time of exposure. Crenshaw v. Newport News Shipbuilding, 57 O.I.C. 83 (1977).

    Since the claimant’s deceased husband did not receive a diagnosis and communication of asbestosis prior to the July 1, 1983 amendment to § 65.1-52 (now § 65.2-406 ), injurious exposure to asbestos within five years of the date of the filing of a claim did not have to be established. An amendment deleting a statute of repose disturbs no employer’s substantive right prior to the occurrence of injury by accident, which in occupational disease cases is the date of communication. Roller v. Basic Construction Company, 238 Va. 321 , 384 S.E.2d 323, 6 Va. Law Rep. 447, 1989 Va. LEXIS 145 (1989).

    An employee’s claim for right and left carpal tunnel syndrome was not barred by either the statute of limitations or res judicata because her 1990 injury was not related to a 1987 injury. Chase Packaging Corporation v. Dorsey, 15 Va. App. 248, 421 S.E.2d 907, 9 Va. Law Rep. 413, 1992 Va. App. LEXIS 259 (1992).

    Compensation benefits may not be awarded to a claimant who is totally disabled from work as a result of asbestosis unless at least first stage has been diagnosed. Woody v. Charles Smith et al., 67 O.I.C. 120 (1988).

    A claimant cannot avoid application of statute of limitations by contending that the present claim is for coal worker’s pneumoconiosis rather than silicosis. Pneumoconiosis is generic term for the lung condition. Holmes v. Clinchfield Coal Co., 55 O.I.C. 176 (1973).

    Pneumoconiosis is a generic term for a group of pulmonary abnormalities from inhalation of dust particles including silicosis, siderosis, coal workers’ pneumoconiosis. The specific occupational disease (silicosis or coal worker’s pneumoconiosis) must be predicated on history of exposure. Shepherd v. Clinchfield Coal Co., 53 O.I.C. 329 (1971).

    An x-ray reading of 1/0, p, q is a positive reading sufficient to establish the presence of pneumoconiosis. Tiller v. Island Creek Coal Company, 67 O.I.C. 136 (1988).

    “Injurious Exposure”:

    Employee failed to prove that Hepatitis C was caused by her employment; evidence showed that employee, a nurse who worked for employer approximately fifteen years, exposed to patients’ blood and bodily fluids at work, but there was no evidence that any patients that were treated suffered from Hepatitis C; evidence showed no needle-sticks since 1995, and thus any possible exposure from needle-sticks more than five years from filing of claim in 2002. Holbrook v. Phoebe’s Physicians, VWC File No. 210-58-69 (Feb. 14, 2004).

    The October 1, 1991 recodification placed the definition of “injurious exposure” in § 65.2-404 . For additional cases consult § 65.2-404 .

    There must be exposure to hazards causing silicosis during five years immediately preceding date of claim. Rasnake v. Jewell Ridge Corp., 45 O.I.C. 207 (1963).

    Mesothelioma is treated as the happening of a new accident or occupational disease, even though the claimant had previously been awarded specific benefits for first stage asbestosis. Employer in whose employment claimant last injuriously exposed prior to diagnosis of mesothelioma held responsible. Brooks v. Caudle-Hyatt, 57 O.I.C. 56 (1976).

    Communication/Diagnosis:

    Claimant’s execution of required waiver and Commission’s subsequent approval same not sufficient to communicate a diagnosis of the disease of coal workers’ pneumoconiosis. Dodson v. Cedar Creek Coal LLC, JCN VA02000021119 (Aug. 15, 2017).

    See City of Alexandria v. Cronin, 20 Va. App. 503, 458 S.E.2d 314 (1995) affirmed per curiam June 7, 1996 concerning who may provide a communication of an occupational disease.

    Benefits for compensation or medical treatment cannot be received until there has been a diagnosis and communication of the occupational disease. Bray v. Dyatech Corporation, 60 O.I.C. 57 (1981).

    Until a diagnosis is made, the nature of the disease determined, and diagnosis communicated to employee, the statute of limitations does not begin to run. Scott v. Trego Stone Corp., 52 O.I.C. 225 (1970); Miller v. Lynchburg Foundry, 59 O.I.C. 211 (1980).

    The date of the injury by accident, i.e., the date the diagnosis is first communicated to the employee, establishes the rights of the parties. Until such date there is no cause of action and no vested rights. Dalton v. North Brothers, 64 O.I.C. 90 (1985).

    For there to be a communication of an occupational disease, the employee must be medically advised that his condition is causally related to his work. Miller v. Virginia State Police, 61 O.I.C. 297 (1982).

    An impression or tentative diagnosis will not trigger the running of the limitations period or commence the employer’s responsibility for medical treatment. Atkins v. Arlington County Public Schools, 71 O.W.C. 171 (1992).

    Diagnosis of occupational disease arising out of and in course of employment must be given claimant for effective notice. Garrison v. Pr. William County Supervisors, 59 O.I.C. 89 (1980).

    Where a claimant is not mentally competent to understand the rights and obligations imposed by the Workers’ Compensation Act, communication of an occupational disease by the treating physician to the claimant’s wife and next friend is sufficient to meet the notice requirement. Likewise, communication to the claimant’s counsel through medical reports is sufficient to meet the statutory requirement. Barnes v. Ivie Cleaners, Inc., 65 O.I.C. 176 (1986).

    The burden to prove incompetency so as to toll the statute of limitations is on the claimant. He must prove insufficient mind or reasoning powers to comprehend the ordinary affairs of life, or that loss of mental power deprived him of sane and normal action. Thomas v. Southwestern Virginia Mental Health Institute, 74 O.W.C. 219 (1995).

    The word “may” used in the report would indicate claimant might or might not have pneumoconiosis. No definite diagnosis was made until after chest surgery. Claim was filed within statutory period. Blue Diamond Coal Company v. Pannell, 203 Va. 49 , 122 S.E.2d 666, 1961 Va. LEXIS 219 (1961).

    Letter to employee from Department of Health, Education and Welfare (now Health and Human Services) did not constitute the communication of a diagnosis of an occupational pneumoconiosis. Meadows v. Kat Coal Corp., 57 O.I.C. 249 (1976).

    Letter from Social Security Administration denying claim for Federal Black Lung benefits was not sufficient to constitute communication of diagnosis. Berry v. Laningham, 55 O.I.C. 38 (1973).

    Job related retirement form reciting nature of disability is not “communication” of diagnosis. Reed v. City of Portsmouth, Fire Department, 60 O.I.C. 353 (1981).

    Advice to change jobs and that a malady may be related to the work is not a diagnosis. Sisler v. Safeway Stores, Inc., 44 O.I.C. 234 (1962).

    “Some type of pulmonary fibrosis perhaps silicosis” is indefinite and not a diagnosis. Worley v. Helen Coal Co., 48 O.I.C. 269 (1966).

    A diagnosis of atrial fibrillation is not a diagnosis of hypertension sufficient to commence the statute of limitations. Link v. Va. Dept. of State Police, 71 O.W.C. 143 (1992).

    While blood gas studies and pulmonary function tests may be useful in determining the extent of disability an employee suffers, x-ray readings delineating the specific type and profusion of opacities is the determining factor in a diagnosis of coal miners’ pneumoconiosis. White v. McClure River Coal Company, Inc., 67 O.I.C. 138 (1988).

    In order to be awarded workers’ compensation benefits for asbestosis in Virginia, the medical evidence must establish a minimum level of 1/0 in any profusion, size, type or opacity. Pendleton v. Newport News Shipbuilding and Dry Dock Company, 64 O.I.C. 258 (1985).

    See also notes to § 65.2-405 for other cases relating to a diagnosis and communication.

    When Must a Claim be Filed:

    There is no statute of limitations related to a claim for medical benefits for Category 1/0 or lower pneumoconiosis, as long as the condition does not progress to Category 1/0 or greater. The claimant has the option of filing a claim for medical benefits only, at any time before the pneumoconiosis reaches Category 1/0, or filing a claim within the three-year statutory period after the disease reaches Category 1/0 or greater. Three requirements must be satisfied before the statute of limitations of § 65.2-406 (A)(1) begins to run: (1) a communication from a physician that the claimant has coal workers’ pneumoconiosis; (2) a communication that the disease is work-related; and (3) a communication to the claimant that the disease has reached Category 1/0 or greater as classified under the International Labour Office Classification of Radiographs of the Pneumoconiosis (1980). Cook v. Virginia City Coal Co., VWC File No. 216-86-04 (Dec. 21, 2005).

    Time for filing cannot be enlarged by judicial inclination. Scott v. Trego Stone Corp., 52 O.I.C. 225 (1970); Ryals v. Humble Oil & Refining Co., 52 O.I.C. 220 (1970).

    An employee still must timely file a claim with the Commission even though notice was given to employer’s physician that the employee had an occupational disease. Markland v. Stonega Coke & Coal Co., 36 O.I.C. 28 (1954); Campbell v. Harman Coal Co., 36 O.I.C. 3 (1954); 35 O.I.C. 390 (1953) (appeal denied).

    Notice of diagnosis to attorney does not constitute constructive notice of occupational disease to employee; statute of limitations does not begin to run until diagnosis is communicated to employee personally. Honaker v. Harman Mining Corp., 54 O.I.C. 181 (1972).

    When claimant is incapacitated, notice to his wife or attorney may be sufficient to meet the statutory requirement. Barnes v. Ivie Cleaners, Inc., 65 O.I.C. 176 (1986).

    The claimant filed a claim for an occupational disease, which was found to be noncompensable based on the evidence presented. Another diagnosis based on x-rays taken after the first claim was filed, but before the evidentiary record in the claim was closed, was not filed as evidence in the proceedings and was not considered by the Deputy Commissioner when he issued his opinion. The Commission held that the interim diagnosis started the limitations period for a new claim, even if the opinion issued after the diagnosis found no compensable disease, because the new diagnosis was made after the medical evidence that was considered by the Deputy. Dye v. Sea “B” Mining Co., 75 O.W.C. 41 (1996).

    Claim must be filed within five years of last injurious exposure, as well as within two years after diagnosis of occupational disease is first communicated to employee. Morrison v. Stapleton, 46 O.I.C. 171 (1964).

    In upholding the Commission’s finding that the employee is barred by the statute of limitations for failure to file within five years from the date of last injurious exposure despite the fact that his date of communication was subsequent to this period, the Court held that § 65.1-52 (now § 65.2-406 ) does not contravene due process and equal protection rights. Miller v. Locher Silica Corp., 12 Va. App. 1213, 408 S.E.2d 566, 8 Va. Law Rep. 623, 1991 Va. App. LEXIS 223 (1991).

    In an occupational disease claim where there has been a “medical benefits only award”, the claimant cannot file a change in condition application more than two years after the date of communication of an occupational disease. Lacy v. Aerofin Corporation, 68 O.I.C. 120 (1989).

    Where there was a complete absence of earnings during the 52 weeks preceding death or communication of a diagnosis of an occupational heart disease, there are no earnings upon which an average weekly wage can be established to award weekly compensation benefits to statutory beneficiaries. The Commission distinguished Roller v. Basic Construction Company, 238 Va. 321 , 384 S.E.2d 323 (1989), as a case applying a statutory amendment to Code § 65.2-406 (C) pertinent only to asbestosis claims. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Employee’s motion to amend his application to show proper employer, was denied because it would nullify the (then) one year statute of limitations. Jones v. Virginia Pocahontas Coal Co., 57 O.I.C. 204 (1976).

    Second claim not barred by dismissal of first claim where the medical evidence failed to disclose any occupational disease at time of first claim. Cook v. Clinchfield Coal Co., 215 Va. 599 , 212 S.E.2d 263, 1975 Va. LEXIS 195 (1975).

    Limitation on time of filing under this section does not apply to mesothelioma due to asbestos exposure. Hunt v. E.I. DuPont, 57 O.I.C. 186 (1976).

    In mesothelioma cases, the rights of the parties attach as of the date of communication of the diagnosis. Crenshaw v. Newport News Shipbuilding & Dry Dock Co., 57 O.I.C. 83 (1977).

    What Constitutes “Filing a Claim”:

    While Commission encourages filing of claims on forms furnished by it, any letter or written statement setting forth basis of claim and requesting a hearing is sufficient. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297 (1947); Brown v. Jewell Ridge Coal Corp., 37 O.I.C. 94 (1955).

    The communication to the Commission must be more than an inquiry or request for information. Johns v. Casey Jones, Inc., 17 O.I.C. 336 (1935).

    Claimant’s letter to employer, advising he wanted to file claim for “rock dust,” which letter was forwarded to Commission by employer, constituted timely filing of application by claimant under this section. Hackney v. Hackney Coal Co., 57 O.I.C. 151 (1976).

    OPINIONS OF THE ATTORNEY GENERAL

    Covid-19. —

    A presumption could be created that would benefit first responders who contract COVID-19 because the nature of their duties place them at greater risk for contracting the disease. See opinion of Attorney General to The Honorable Ken Stolle, Sheriff, City of Virginia Beach, 20-024, 2020 Va. AG LEXIS 21 (5/22/20).

    § 65.2-406. (Effective July 1, 2022) Limitation upon claim; diseases covered by limitation.

    1. The right to compensation under this chapter shall be forever barred unless a claim is filed with the Commission within one of the following time periods:
      1. For coal miners’ pneumoconiosis, three years after a diagnosis of the disease, as category 1/0 or greater as classified under the current International Labour Office Classification of Radiographs of the Pneumoconiosis, is first communicated to the employee or the legal representative of his estate or within five years from the date of the last injurious exposure in employment, whichever first occurs;
      2. For byssinosis, two years after a diagnosis of the disease is first communicated to the employee or within seven years from the date of the last injurious exposure in employment, whichever first occurs;
      3. For asbestosis, two years after a diagnosis of the disease is first communicated to the employee;
      4. For symptomatic or asymptomatic infection with human immunodeficiency virus including acquired immunodeficiency syndrome, two years after a positive test for infection with human immunodeficiency virus;
      5. For diseases directly attributable to the rescue and relief efforts at the Pentagon following the terrorist attack of September 11, 2001, two years after a diagnosis of the disease is first communicated to the employee;
      6. For cancers listed in subsection C of § 65.2-402 , two years after a diagnosis of the disease is first communicated to the employee or within 10 years from the date of the last injurious exposure in employment, whichever first occurs; or
      7. For all other occupational diseases, two years after a diagnosis of the disease is first communicated to the employee or within five years from the date of the last injurious exposure in employment, whichever first occurs.
    2. If death results from an occupational disease within any of such periods, the right to compensation under this chapter shall be barred, unless a claim therefor is filed with the Commission within three years after such death. The limitations imposed by this section as amended shall be applicable to occupational diseases contracted before and after July 1, 1962, and § 65.2-601 shall not apply to pneumoconiosis. The limitation on time of filing will cover all occupational diseases except:
      1. Cataract of the eyes due to exposure to the heat and glare of molten glass or to radiant rays such as infrared;
      2. Epitheliomatous cancer or ulceration of the skin or of the corneal surface of the eye due to pitch, tar, soot, bitumen, anthracene, paraffin, mineral oil, or their compounds, products or residues;
      3. Radium disability or disability due to exposure to radioactive substances and X-rays;
      4. Ulceration due to chrome compound or to caustic chemical acids or alkalies and undulant fever caused by the industrial slaughtering and processing of livestock and handling of hides;
      5. Mesothelioma due to exposure to asbestos; and
      6. Angiosarcoma of the liver due to vinyl chloride exposure.
    3. A claim for benefits pursuant to subdivision A 6 made as a result of the diagnosis of a disease listed in subsection C of § 65.2-402 shall be barred if the employee is 65 years of age or older, regardless of the date of diagnosis, communication, or last injurious exposure in employment.
    4. When a claim is made for benefits for a change of condition in an occupational disease, such as advance from one stage or category to another, a claim for change in condition must be filed with the Commission within three years from the date for which compensation was last paid for an earlier stage of the disease, except that a claim for benefits for a change in condition in asbestosis must be filed within two years from the date when diagnosis of the advanced stage is first communicated to the employee and no claim for benefits for an advanced stage of asbestosis shall be denied on the ground that there has been no subsequent accident. For a first or an advanced stage of asbestosis or mesothelioma, if the employee is still employed in the employment in which he was injuriously exposed, the weekly compensation rate shall be based upon the employee’s weekly wage as of the date of communication of the first or advanced stage of the disease, as the case may be. If the employee is unemployed, or employed in another employment, the weekly compensation rate shall be based upon the average weekly wage of a person of the same or similar grade and character in the same class of employment in which the employee was injuriously exposed and preferably in the same locality or community on the date of communication to the employee of the advanced stage of the disease or mesothelioma. The weekly compensation rates herein provided shall be subject to the same maximums and minimums as provided in § 65.2-500 .

    History. Code 1950, § 65-49; 1952, c. 205; 1960, c. 297; 1962, c. 588; 1968, c. 660, § 65.1-52; 1970, c. 470; 1972, c. 612; 1974, c. 201; 1975, cc. 27, 471; 1979, cc. 80, 201; 1982, c. 82; 1983, c. 469; 1984, c. 411; 1985, c. 191; 1989, c. 502; 1990, c. 417; 1991, c. 355; 1992, c. 475; 1995, c. 324; 2005, c. 433; 2011, c. 513; 2022, cc. 497, 498.

    § 65.2-407. Waiver.

    1. When an employee or prospective employee, though not incapacitated for work, is found to be affected by, or susceptible to, a specific occupational disease he may, subject to the approval of the Commission, be permitted to waive in writing compensation for any aggravation of his condition that may result from his working or continuing to work in the same or similar occupation for the same employer.
    2. The Commission shall approve a waiver for coal worker’s pneumoconiosis and silicosis only when presented with X-ray evidence from a physician qualified in the opinion of the Commission to make the determination and which demonstrates a positive diagnosis of the pneumoconiosis or the existence of a lung condition which makes the employee or prospective employee significantly more susceptible to the pneumoconiosis.
    3. In considering approval of a waiver, the Commission may supply any medical evidence to a disinterested physician for his opinion as to whether the employee is affected by the disease or has the preexisting condition.

    History. Code 1950, § 65-50; 1968, c. 660, § 65.1-53; 1970, c. 517; 1979, c. 201; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1972-1973, see 59 Va. L. Rev. 1632 (1973).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 21, 41.

    CASE NOTES

    Editor’s note.

    The cases annotated below were decided under former § 65.1-53 or prior law.

    Vagueness of section does not have unconstitutional effect. —

    Any vagueness in the actual terms of this section relating to scope of waivers does not have an effect upon claimants so fundamentally unfair as to violate the due process clause of the Fourteenth Amendment. UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    Purpose. —

    The evident purpose of this section is to provide conditional employment for those found to be “affected by, or susceptible to” a specific occupational disease and at the same time provide protection for the employer who is willing upon the execution of a waiver to employ such persons. As an added safeguard such waiver is subject to the approval of the Compensation Commission. Jewell Ridge Coal Corp. v. Vance, 203 Va. 557 , 125 S.E.2d 879, 1962 Va. LEXIS 185 (1962); Williams v. Clinchfield Coal Co., 213 Va. 445 , 192 S.E.2d 751, 1972 Va. LEXIS 382 (1972), cert. denied, 412 U.S. 932, 93 S. Ct. 2761, 37 L. Ed. 2d 161, 1973 U.S. LEXIS 2240 (1973).

    The purpose of the waiver statute is to provide for conditional employment of workers found susceptible to occupational diseases while at the same time protecting the employer who is willing upon execution of a waiver to hire such a worker. UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    Waiver is of any aggravation of an existing condition and may or may not be a waiver of benefits for the specific occupational disease to which he is susceptible. Williams v. Clinchfield Coal Co., 213 Va. 445 , 192 S.E.2d 751, 1972 Va. LEXIS 382 (1972), cert. denied, 412 U.S. 932, 93 S. Ct. 2761, 37 L. Ed. 2d 161, 1973 U.S. LEXIS 2240 (1973); UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    Waivers not limited to diseases compensable at time of signing. —

    Although an employer might see no need to obtain a waiver of benefits for a disease for which no benefits were required, there is no hint of any statutory limitation of waivers to diseases compensable at the time of signing. UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    There is no corresponding federal constitutional right to workmen’s (now workers’) compensation benefits. UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    And no corresponding federal scrutiny of their waiver. UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    There is no heightened standard imposed by the Constitution of the United States by which waivers of workmen’s (now workers’) compensation benefits must be judged. UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    The standard for judging the validity of a statutory provision of the nature of this section is the “rational relation to a legitimate legislative objective” test. UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    Allowing employer to decide whether specific waiver is desirable is not arbitrary. —

    Absent a showing of resulting discrimination along suspect lines, it does not appear that allowing an employer to decide whether for his protection a waiver would be desirable in a specific case represents an arbitrary means of pursuing the objective of this section. Such a scheme is not without its potential for abuse, but neither is it without rational foundation. UMW v. Industrial Comm'n, 374 F. Supp. 1294, 1974 U.S. Dist. LEXIS 8799 (E.D. Va. 1974).

    Waiver held effective. —

    A waiver for “fibro-nodose infiltration of lungs consistent with early silicosis,” was held to be an effective bar to a claim for coal worker’s pneumoconiosis. Williams v. Clinchfield Coal Co., 213 Va. 445 , 192 S.E.2d 751, 1972 Va. LEXIS 382 (1972), cert. denied, 412 U.S. 932, 93 S. Ct. 2761, 37 L. Ed. 2d 161, 1973 U.S. LEXIS 2240 (1973).

    Section adequately complied with. —

    The requirement of this section that the prospective employee be “found to be affected by, or susceptible to, a specific occupational disease” was adequately complied with where a waiver regarding silicosis was sought and obtained by the employer, and approved by the Commission, following a finding by the company doctor of “diffuse fibrosis” and a recommendation by the doctor that the employee “must sign a waiver.” Jewell Ridge Coal Corp. v. Vance, 203 Va. 557 , 125 S.E.2d 879, 1962 Va. LEXIS 185 (1962).

    Statute of limitations. —

    Virginia Workers’ Compensation Commission did not err in concluding that a claim was not barred by the statute of limitations because there was evidence to support the Commission’s factual conclusion that no diagnosis of pneumoconiosis was communicated to the claimant when the claimant was presented by an employer with a waiver form pertaining to pneumoconiosis and nothing in the record compelled the opposite conclusion. Four \O\ Mining Corp. v. Deel, 2017 Va. App. LEXIS 158 (Va. Ct. App. June 27, 2017).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Purpose of Waiver:

    Claimant who had diffuse fibrosis was susceptible to the occupational disease of silicosis and would be unemployable were it not for this provision of the law allowing the employer to protect itself by obtaining a waiver of compensation right. Waiver valid and binding even though claimant could neither read nor write. Jewell Ridge Coal Corp. v. Vance, 203 Va. 557 , 125 S.E.2d 879, 1962 Va. LEXIS 185 (1962).

    Effect:

    Employee voluntarily signed waivers on two separate occasions as precondition to employment; rights under Workmen’s Compensation Act never came into being. Due Process Clause of U.S. Constitution not violated by Commission’s failure to provide a hearing before approving waivers. Williams v. Clinchfield Coal Co., 213 Va. 445 , 192 S.E.2d 751, 1972 Va. LEXIS 382 (1972), cert. denied, 412 U.S. 932, 93 S. Ct. 2761, 37 L. Ed. 2d 161, 1973 U.S. LEXIS 2240 (1973).

    Waiver was not a bar to claim against another employer. Owens v. Jewell Ridge Coal Corp., 55 O.I.C. 262 (1973); Honaker v. C & F Coal Co., 54 O.I.C. 180 (1972); Perkins v. Beatrice Pocahontas Co., 57 O.I.C. 291 (1976).

    A waiver effectively bars claim against a defendant that merged with the company for which waiver was executed. Stidham v Westmoreland Coal Co., 56 O.I.C. 300 (1973); Stiltner v. O & G Gas Co., 59 O.I.C. 287 (1980).

    Condition same now as that existing at time waiver executed and aggravation of pre-existing condition was not subject to an award. Shepherd v. Clinchfield Coal Co., 53 O.I.C. 329 (1971).

    Waiver for fibro-nodose infiltration of lungs is a bar to the present claim without regard to whether the condition is from coal dust or silica dust since both produce pneumoconiosis. Reece v. Westmoreland Coal Co., 54 O.I.C. 312 (1972), (appeal denied); Shepherd v. Clinchfield Coal Co., 53 O.I.C. 329 (1971).

    Chapter 5. Compensation and Payment Thereof.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 38, 42, 45.

    § 65.2-500. Compensation for total incapacity; computation of average wage; exclusion of AmeriCorps members, certain Food Stamp Employment and Training Program participants, and certain Temporary Assistance for Needy Families participants.

    1. Except as provided in subsections E, F and G, when the incapacity for work resulting from the injury is total, the employer shall pay, or cause to be paid, as hereinafter provided, to the injured employee during such total incapacity, a weekly compensation equal to 66 2/3 percent of his average weekly wages, with a minimum not less than 25 percent and a maximum of not more than 100 percent of the average weekly wage of the Commonwealth as defined herein. In any event, income benefits shall not exceed the average weekly wage of the injured employee. Any farm employer who continues to furnish benefits while the employee is incapacitated shall be given credit for the value of such benefits so furnished when computing the compensation due the employee.
    2. For the purpose of this section the average wage in the Commonwealth shall be determined by the Commission as follows: On or before January 1 of each year, the total wages, excluding wages of United States government employees, reported on contribution reports to the Virginia Employment Commission for the 12-month period ending the preceding June 30 shall be divided by the average monthly number of insured workers (determined by dividing the total insured workers reported for that 12-month period by 12). The average annual wage thus obtained shall be divided by 52 and the average weekly wage thus determined rounded to the nearest dollar. The average weekly wage as so determined shall be applicable for the full period during which income benefits are payable, when the date of occurrence of injury or of disablement in the case of disease falls within the year commencing with the July 1 following the date of determination.
    3. The minimum or the maximum weekly income benefits shall not be changed for any year unless the computation herein provided results in an increase or decrease of $2 or more, raised to the next even dollar in the level of the minimum or the maximum weekly income benefits.
    4. The weekly compensation on account of total and permanent incapacity as defined by subsection C of § 65.2-503 shall continue for the lifetime of the injured employee without limit as to total amount.
    5. AmeriCorps members as defined in subdivision r of § 65.2-101 shall not be eligible to receive weekly compensation for total incapacity, whether permanent or temporary, regardless of whether the injury results in death.
    6. Food Stamp recipients participating in the work experience component of the Food Stamp Employment and Training Program as defined in subdivision s of § 65.2-101 shall not be eligible to receive weekly compensation for total incapacity, whether permanent or temporary, regardless of whether the injury results in death.
    7. Temporary Assistance for Needy Families recipients participating in the work experience component of the Virginia Initiative for Education and Work as defined in subdivision t of § 65.2-101 shall not be eligible to receive weekly compensation for total incapacity, whether permanent or temporary, regardless of whether the injury results in death.

    History. Code 1950, § 65-51; 1952, c. 226; 1954, c. 654; 1956, c. 243; 1958, c. 568; 1960, c. 556; 1962, c. 503; 1964, c. 94; 1966, c. 64; 1968, cc. 8, 660, § 65.1-54; 1970, c. 470; 1972, c. 229; 1973, c. 542; 1974, c. 560; 1975, c. 447; 1991, c. 355; 1997, c. 511; 2004, c. 888; 2005, c. 472; 2019, c. 210.

    Cross references.

    As to prohibition against covenants not to compete as to low-wage employees, and civil penalty for such agreements, see § 40.1-28.7:7 .

    As to compensation for partial incapacity, and the eligibility for lawful employment requirement, see § 65.2-502 .

    As to the effect a voided award of compensation has on the statute of limitations applicable to any civil action upon the same claim, see § 8.01-229 .

    The 1997 amendment rewrote subsection D which formerly read: “In no case shall the period covered by such compensation be greater than 500 weeks, nor shall the total amount of all compensation exceed the result obtained by multiplying the average weekly wage of the Commonwealth as defined herein for the applicable year by 500, except that weekly compensation on account of total and permanent incapacity as defined by § 65.2-503 C shall continue for the lifetime of the injured employee without limit as to total amount.”

    The 2004 amendments.

    The 2004 amendment by c. 888, effective April 15, 2004, added “Except as provided in subsections E and F” to the beginning of subsection A; in subsection B, substituted “12” for “twelve” three times and “52” for “fifty two” once; in subsection D, substituted “$2” for “two dollars”; and added subsections E and F.

    The 2005 amendments.

    The 2005 amendment by c. 472 substituted “subsections E, F, and G” for “subsections E, and F” in subsection A; and added subsection G.

    The 2019 amendments.

    The 2019 amendment substituted “Virginia Initiative for Education and Work” for “Virginia Initiative for Employment Not Welfare Program” in subsection G.

    Law Review.

    For article on compensation for black lung at the federal level, see 57 Va. L. Rev. 97 (1971).

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    For comment, “Toward a Uniform State Product Liability Law — Virginia and the Uniform Product Liability Act,” see 36 Wash. & Lee L. Rev. 1145 (1979).

    For article, “Recovery for Accidental Injuries Under the Virginia Workmen’s Compensation Act,” see 14 U. Rich. L. Rev. 659 (1980).

    For article, “Workers’ Compensation for Disease in Virginia: The Exception Swallows the Rule,” see 20 U. Rich. L. Rev. 161 (1985).

    For an article relating to the most significant developments in the law of workers’ compensation since September, 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    CASE NOTES

  • Analysis
  • I.In General.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-54 or prior law.

    The Workmen’s (now Workers’) Compensation Act divides injuries into two general classes: (1) total incapacity, for which the maximum compensation is fixed by this section; (2) partial incapacity, for which compensation is fixed in former §§ 65.1-55 and 65.1-56 (now §§ 65.2-502 and 65.2-503 ). McCarrell v. Harrisonburg Mut. Tel. Co., 163 Va. 272 , 172 S.E. 241 , 1934 Va. LEXIS 184 (1934).

    This section measures the compensation for total disability. It is a weekly compensation measured by average weekly wages. Morris v. Pulaski Veneer Corp., 184 Va. 424 , 35 S.E.2d 342, 1945 Va. LEXIS 161 (1945).

    Total disabilities are dealt with by this section exclusively. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    Former § 65.1-56 (now § 65.2-503 ) and this section must be read together. Owen v. Chesapeake Corp. of Va., 198 Va. 440 , 94 S.E.2d 462, 1956 Va. LEXIS 227 (1956).

    This section and former §§ 65.1-55 and 65.1-56 (now §§ 65.2-502 and 65.2-503 ) compared. —

    This section exclusively provides for total incapacity, whether it be temporary or permanent, and it fixes the maximum and minimum amounts to be paid therefor. Former § 65.1-55 applies to partial incapacity, temporary or permanent, resulting from injury to every member of the body except those mentioned in former § 65.1-56. As former § 65.1-56 is an exception to former § 65.1-55, only as to members of the body mentioned in former § 65.1-56, and former § 65.1-55 deals only with partial incapacity, former § 65.1-56 must be held applicable to partial incapacity only. Former §§ 65.1-55 and 65.1-56 do not apply to the same state of facts. Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925).

    Benefits awarded under this section and former § 65.1-55 (now § 65.2-502 ) cover losses occasioned by the impairment of claimant’s earning capacity. This section applies where the loss is total, and former § 65.1-55 applies where it is partial. Pilot Freight Carriers, Inc. v. Reeves, 1 Va. App. 435, 339 S.E.2d 570, 1986 Va. App. LEXIS 220 (1986).

    Benefits awarded under both this section and former § 65.1-55 (now § 65.2-502 ) are for loss of earning capacity. One is applicable where the loss is total and the other where it is partial, but in both instances the extent of capacity is required to be evidentially ascertained. Nicely v. VEPCO, 195 Va. 819 , 80 S.E.2d 529, 1954 Va. LEXIS 161 (1954).

    Benefits under this section are for loss of earning power; and that is not necessarily proportional to bodily functional disability, nor is medical evidence the sole criterion. J.A. Foust Coal Co. v. Messer, 195 Va. 762 , 80 S.E.2d 533, 1954 Va. LEXIS 155 (1954).

    Benefits awarded under § 65.2-503 constitute indemnity for the loss of or loss of use of a scheduled body member; such benefits are not awarded for loss of earning capacity, as are benefits provided for under this section. Cross v. Newport News Shipbuilding & Dry Dock Co., 21 Va. App. 530, 465 S.E.2d 598, 1996 Va. App. LEXIS 17 (1996).

    Res judicata did not bar application. —

    Workers’ compensation claimant’s application to resume medical benefits for treatment by her physician was not barred by res judicata principles where her change-in-condition application for temporary total disability benefits was denied by the Virginia Workers’ Compensation Commission one month earlier as: (1) disability benefit claims were a distinct and separate remedy from medical benefits and there was no identity of remedies between the two claims; and (2) the two applications involved two separate time periods. Sprint Corp. v. Brooks, 2006 Va. App. LEXIS 129 (Va. Ct. App. Apr. 4, 2006).

    Loss of earning capacity test applicable. —

    Although both §§ 65.2-500 and 65.2-502 provide payments for injured workers, the corresponding tests differ significantly. Section 65.2-500 governs total incapacity and applies a loss of earning capacity test, while § 65.2-502 pertains to partial incapacity and applies an economic loss test. McKellar v. Northrop Grumman Shipbuilding, Inc., 290 Va. 349 , 777 S.E.2d 857, 2015 Va. LEXIS 140 (2015).

    Legislature intended non-technical meaning of term “imbecility” which is consistent with the functional approach of Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537 (1954) and the humane purposes of the act. In that context an irreversible brain injury which renders the employee permanently unemployable and so affects the non-vocational quality of his life by eliminating his ability to engage in a range of usual cognitive processes is the functional equivalent, and meets the intended statutory definition, of incurable imbecility contemplated by former § 65.1-56 (18) (now § 65.2-503 C 1) and is compensable pursuant to this section. Barnett v. D.L. Bromwell, Inc., 6 Va. App. 30, 366 S.E.2d 271, 4 Va. Law Rep. 2147, 1988 Va. App. LEXIS 16 (1988).

    Compensation where total disability is followed by partial disability. —

    Construing this and the two following sections together, upon an injury being received entailing total disability, the employee is entitled to receive compensation therefor under the provisions of this section. Where such total disability is succeeded by partial disability, he is entitled to recover additional compensation therefor, under either former § 65.1-55 (now § 65.2-502 ) or § 65.1-56 (now § 65.2-503 ), under former § 65.1-55 on account of all injuries except of the particular kind and character scheduled in former § 65.1-56, but exclusively under former § 65.1-56, if the partial disability is permanent and is occasioned by an injury of the character therein described. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    Insurance carrier is not entitled to credit for total disability payments. —

    Where a worker is entitled to compensation for a sixty percent loss of his foot under former § 65.1-56 (now § 65.2-503 ), the insurance carrier is not entitled to credit for payments made to the claimant during his temporary total disability under this section. Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925).

    Former § 65.1-60 (now § 65.2-507 ) supplements this section. —

    Former § 65.1-60, providing compensation for a second permanent injury, is not in conflict with this section, but is merely supplementary to it and must be read in connection therewith. Morris v. Pulaski Veneer Corp., 184 Va. 424 , 35 S.E.2d 342, 1945 Va. LEXIS 161 (1945).

    Where total incapacity payments are sought for partial physical disability, inability of the claimant to market his remaining capacity for work must be made to appear. Pocahontas Fuel Co. v. Agee, 201 Va. 678 , 112 S.E.2d 835, 1960 Va. LEXIS 146 (1960); Pocahontas Fuel Co. v. Barbour, 201 Va. 682 , 112 S.E.2d 904, 1960 Va. LEXIS 147 (1960).

    Though claimant’s physical disability is partial, yet the award of total incapacity payments under this section is warranted if the Commission can reasonably find from the evidence that his disability renders him unable to market his remaining capacity for work. Island Creek Coal Co. v. Fletcher, 201 Va. 645 , 112 S.E.2d 833, 1960 Va. LEXIS 140 (1960).

    Total disability benefits affirmed. —

    Decision of Virginia Workers’ Compensation Commission awarding the claimant total disability benefits was summarily affirmed under Va. Sup. Ct. R. 5A:27 where: (1) the treating doctor and treating neurosurgeon opined that the claimant’s injury was causally related to a work injury; (2) the treating doctor opined that the claimant was totally disabled; (3) the treating neurosurgeon opined that the claimant was temporarily disabled; and (4) the claimant testified that his neck pain had worsened, going down into his shoulders and hands, testified in depth as to why he was unable to work, and testified that the treating doctor told him not to work. Dynalectric Co. v. Downing, 2003 Va. App. LEXIS 65 (Va. Ct. App. Feb. 11, 2003).

    Where an employer/insurer chose not to contest the validity of a treating neurologist’s reports or present rebuttal evidence on remand, the workers’ compensation commission properly found that an employee was totally disabled. Coastal Mart, Inc. v. Wampler, 2003 Va. App. LEXIS 477 (Va. Ct. App. Sept. 16, 2003).

    Injury need not be medically rated. —

    A claimant’s injury is more or less rated in the various schedules in former § 65.1-56 (now § 65.2-503 ), but there is no statutory requirement either under this section or former § 65.1-55 (now § 65.2-502 ) that a claimant’s injury be medically rated. J.A. Foust Coal Co. v. Messer, 195 Va. 762 , 80 S.E.2d 533, 1954 Va. LEXIS 155 (1954).

    Claim supported by the evidence. —

    Credible evidence supported the Virginia Workers’ Compensation Commission’s decision to award a claimant continuing indemnity benefits because, after he sustained his new injury and his condition worsened, his doctor placed him on very light duty work and recommended fusion surgery. Dean Steel Erection Co. v. Arbaugh, 2006 Va. App. LEXIS 309 (Va. Ct. App. July 11, 2006).

    Employer’s attempt to terminate a workers’ compensation claimant’s award of temporary total disability benefits was properly rejected as the employer did not show that the claimant was able to perform the claimant’s pre-injury employment as: (1) the claimant’s pre-injury employment as a plumbing repair mechanic entailed strenuous manual labor; (2) a physical therapist who administered a functional capacities evaluation found that the claimant was not able to perform the claimant’s essential job tasks; (3) a treating physician stated that the claimant did not feel the claimant was ready or able to return to the claimant’s preinjury work without restrictions; (4) an independent medical examiner deferred to the treating physician’s opinion of the claimant’s work restrictions; and (5) a treating physician had not released the claimant to pre-injury employment. Herbert Clements & Sons, Inc. v. Harris, 52 Va. App. 447, 663 S.E.2d 564, 2008 Va. App. LEXIS 362 (2008).

    Award of temporary total disability benefits to the claimant was supported by credible evidence, including a disability slip stating that the claimant had a fractured ankle and could not return to work until further notice, the acknowledgement of responsibility by the claimant’s treating physician for the disability slip, and the claimant’s testimony that the treating physician told the claimant that the claimant would not be able to work due to the claimant’s foot injury. Chicks Constr. v. Torres, 2008 Va. App. LEXIS 511 (Va. Ct. App. Nov. 25, 2008).

    Virginia Workers’ Compensation Commission properly awarded a workers’ compensation claimant temporary total disability benefits because the Commission did not err in finding the claimant candid and credible; nor did the Commission err in giving deference to the expert opinion of the claimant’s treating physician that the claimant’s work-related injury was the cause of his back problems, despite the inconsistencies in the claimant’s medical records, and that the claimant was unable to work as a result. Starbucks Coffee Co. v. Merrill, 2011 Va. App. LEXIS 125 (Va. Ct. App. Apr. 12, 2011).

    Credible evidence supported the decision of the Virginia Workers’ Compensation Commission to award a workers’ compensation claimant medical benefits and temporary total disability benefits because the panel provided by the employer pursuant to § 65.2-603 was defective, and thus, claimant had the right to select the physician of his own choosing; because a neurologist and chiropractors were claimant’s treating physicians, the Commission was entitled to give their opinions great weight, and in the opinion of those physicians, claimant made progress over the course of the treatments, but he was unable to return to work until March 4, 2010, and then only for light-duty work. Gilbane v. Guzman, 59 Va. App. 128, 717 S.E.2d 433, 2011 Va. App. LEXIS 355 (2011).

    Workers’ Compensation Commission erred in denying an employee’s application for temporary total disability benefits after October 18, 2010, because the attending physician’s report relied upon an examination of the employee on that date, and indicated that the employee was unable to work as of that date, and that the employee’s disability continued beyond that date. Lyon v. Salvation Army, 2012 Va. App. LEXIS 153 (Va. Ct. App. May 8, 2012).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s determination that a workers’ compensation benefits claimant’s period of disability and knee surgery were causally related to his work accident because claimant’s treating physician opined that claimant’s right knee injury was caused by his work accident in his attending physician’s report; another doctor opined that claimant’s right knee arthroscopic partial lateral knee meniscectomy was causally related to his work injury. Salvation Army v. Lyon, 2012 Va. App. LEXIS 149 (Va. Ct. App. May 8, 2012).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s determination that a workers’ compensation benefits claimant was incapable of performing any type of work from August 1, 2010, to October 18, 2010, because claimant’s treating physician completed two work status updates requesting that claimant be excused from all work from August 13, 2010, when he underwent surgery, to October 18, 2010; medical evidence in the record showed that claimant was in pain and suffering from a lateral meniscus tear from the date of his work accident on April 20, 2010. Salvation Army v. Lyon, 2012 Va. App. LEXIS 149 (Va. Ct. App. May 8, 2012).

    Decision of the Virginia Workers’ Compensation Commission granting temporary total disability benefits for a claimant’s back injury was proper, as there was ample credible evidence supporting the Commission’s reliance on a doctor’s medical opinion, including that the doctor evaluated the patient himself, compared both of the claimant’s MRIs (pre-accident and post-accident), kept thorough notes, and reviewed the claimant’s previous medical records. Beam Bros. Trucking v. Bowers, 2012 Va. App. LEXIS 150 (Va. Ct. App. May 8, 2012).

    Workers’ Compensation Commission properly calculated a claimant’s average weekly wage for periods of temporary total disability by dividing her salary by 52 weeks instead of the 43 weeks that she actually worked each year because the claimant personally chose not to work summers even though summer work was available to her, she was not a seasonal employee, and her summer months were not “lost” time. Seminario v. Fairfax County Pub. Schs, 2014 Va. App. LEXIS 397 (Va. Ct. App. Dec. 9, 2014).

    Claim unsupported by the evidence. —

    Where an employer contested the compensability of a worker’s injury and the worker did not provide medical or pre-injury work evidence, there was no de facto award and the worker was not entitled to disability benefits. Smelcer v. Dickenson County Sch. Bd., 2003 Va. App. LEXIS 484 (Va. Ct. App. Sept. 23, 2003).

    Where the record on appeal contained credible evidence to support the Workers’ Compensation Commission’s determination that a hairstylist’s injury resulting from a slip and fall did not arise out of her employment, did not result from a condition of her employment, and was not a product of a design defect in the steps, her claim for benefits was properly denied. Smith v. J.C. Penny Co., 2004 Va. App. LEXIS 600 (Va. Ct. App. Dec. 7, 2004).

    Because an employee presented an unprofessional and uninterested demeanor to potential employers, the employee’s lack of cooperation amounted to a refusal of vocational rehabilitation; in addition, without medical documentation that the employee’s physical condition actually changed or deteriorated, the employee did not prove a continuing temporary total disability. Davis v. J.D. Littlejohn, Inc., 2005 Va. App. LEXIS 437 (Va. Ct. App. Nov. 1, 2005).

    Virginia Workers’ Compensation Commission did not err in awarding a workers’ compensation claimant compensation from the date of his accident through August 14, 2006, which was when his treating physician released him for light-duty work, and in finding that claimant’s evidence did not prove that he was entitled to temporary total disability benefits after August 10, 2007, because the physician did not explicitly state that, in his medical opinion, claimant was totally disabled; the physician did not explain how claimant’s condition had changed since August 14, 2006, when the physician released him to do light-duty work, and the physician also did not explain the limitations on claimant’s ability to work. Sherman & Sherman Props. v. Long, 2011 Va. App. LEXIS 128 (Va. Ct. App. Apr. 12, 2011).

    Virginia Workers’ Compensation Commission did not err in concluding that a claimant was not entitled to wage indemnity benefits because the claimant did not suffer an actual economic loss due to the claimant’s heart condition, as the claimant was voluntarily retired and not receiving wages during the time of the claimant’s hospitalization and total temporary disability. Shaver v. Dep't of State Police, 2014 Va. App. LEXIS 207 (Va. Ct. App. May 27, 2014).

    II.Compensation for Total Incapacity.

    The purpose of workers’ compensation is to provide compensation to the injured employee who suffers a work-related accident by continuing to pay her a wage comparable to that earned at the time of the injury. This purpose does not justify awarding an employee who suffers two unrelated injuries more money than she has ever earned in a week. Robinson v. Salvation Army/Georgia Corp., 20 Va. App. 570, 459 S.E.2d 103, 12 Va. Law Rep. 17, 1995 Va. App. LEXIS 578 (1995).

    This section limits claimant’s total disability benefits to 66 and two-thirds percent of the greater of her two average weekly wages. Robinson v. Salvation Army/Georgia Corp., 20 Va. App. 570, 459 S.E.2d 103, 12 Va. Law Rep. 17, 1995 Va. App. LEXIS 578 (1995).

    Commission awards should not be averaged over the period of disability, but rather, the injury benefits paid should be compared to the amount of monthly compensation due under the award. American Airlines, Inc. v. Webster, No. 1824-92-4 (Ct. of Appeals Jan. 26, 1993).

    Statute does not prohibit a claimant from being compensated for all actual losses sustained from an industrial accident, be they work incapacity under this section or permanent loss of use of a scheduled member under former § 65.1-56 (now § 65.2-503 ). The language “in lieu of all other compensation” in former § 65.1-56 means that the payments provided for by that section represent the only compensation for the loss of any member mentioned therein, such payments to be measured by the number of weeks listed after each scheduled loss in the statute. Commonwealth DMV v. Williams, 1 Va. App. 401, 339 S.E.2d 552, 1986 Va. App. LEXIS 214 (1986).

    There is no authority that requires a worker to show a loss to his employer, even when the worker is part owner of the employer corporation. Workers’ compensation benefits compensate the worker for his own loss of earnings or earning capacity, not losses suffered by his or her employer. In the instant case, claimant should be compensated as a worker for his loss of earning capacity caused by his work related injury. Twenty-First Century Concrete, Inc. v. Giacchina, 20 Va. App. 326, 457 S.E.2d 379, 1995 Va. App. LEXIS 438 (1995).

    Worker is allowed compensation for both partial and total disability. —

    A fair construction of this Act allows the worker compensation for both partial and total disability, subject to the qualification contained in this section. Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925).

    When total or partial incapacity to work continues for more than ten days after injury, and is followed by loss of any member mentioned in former § 65.1-56 (now § 65.2-503 ), this section and former § 65.1-55 (now § 65.2-502 ), as qualified by former §§ 65.1-62 and 65.1-88 (now §§ 65.2-509 and 65.2-604 ), provide for the compensation therein specified for total or partial disability to be paid up to the time of the loss of such member, at which time the right to such compensation ceases, and former § 65.1-56 provides for the compensation therein specified for the loss of the enumerated members in lieu of all other compensation. Crawford v. Virginia Iron, Coal & Coke Co., 136 Va. 266 , 118 S.E. 229 , 1923 Va. LEXIS 84 (1923); Nicely v. VEPCO, 195 Va. 819 , 80 S.E.2d 529, 1954 Va. LEXIS 161 (1954).

    The employer takes the employee as the employer finds the employee, even where the employee suffers some physical infirmity. Here, sufficient evidence proved that the claimant’s back injury accelerated and aggravated his avascular necrosis, and the employer was liable. Williams Indus., Inc. v. Wagoner, 24 Va. App. 181, 480 S.E.2d 788, 1997 Va. App. LEXIS 63 (1997).

    Authorization for simultaneous payments. —

    The only reasonable construction of the language which provides that payments for a rating “may be paid simultaneously with payments for temporary partial incapacity,” is that the Commission has discretion to order such payments. In cases where the Commission does not order such payments, employer would be free to make simultaneous payments voluntarily. Rusty's Welding Serv., Inc. v. Gibson, 29 Va. App. 119, 510 S.E.2d 255, 1999 Va. App. LEXIS 67 (1999).

    Permanant total benefits. —

    Evidence in the record supported the findings and decision of the Workers’ Compensation Commission that employee was entitled to permanent total disability benefits because he had a functional, permanent loss of use of both legs; the Commission explicitly stated that it had reviewed the entire record, and it was free to give great weight to the primary treating physician’s opinion that the employee was unable to use his lower extremities in any gainful employment. Kamco Bldg. Supply Corp. v. Heard, 2018 Va. App. LEXIS 246 (Va. Ct. App. Sept. 25, 2018).

    Benefits recoverable notwithstanding layoff. —

    A partially disabled employee was entitled to benefits following an economic layoff in that his injury placed the employee in a different position from the other, uninjured, employees; the employee’s opportunity to engage in work was limited by his permanent physical restrictions due to his compensable injury and, thus, he did not have the same opportunity or ability as other employees to find other employment. Metro Mach. Corp. v. Sowers, 33 Va. App. 197, 532 S.E.2d 341, 2000 Va. App. LEXIS 591 (2000), overruled in part, King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016) (applying an economic loss test as opposed to loss of earning capacity analysis).

    Retirement did not preclude award. —

    Injured worker’s retirement did not preclude the worker from receiving an award of temporary total disability compensation the worker was totally disabled and lacked all earning capacity. The loss of earning capacity test was the proper standard for the award of compensation because the worker was totally incapacitated, and the worker’s status in the labor market, therefore, was irrelevant. McKellar v. Northrop Grumman Shipbuilding, Inc., 290 Va. 349 , 777 S.E.2d 857, 2015 Va. LEXIS 140 (2015).

    Commission erred in finding that claimant did not experience any actual wage loss where claimant was totally incapacitated and earned no wages for the period February 25, 1993 to May 20, 1993. Thus, even though claimant had authority to draw wages from the corporations, he was not paid because he had to reassign other employees to perform his duties. Twenty-First Century Concrete, Inc. v. Giacchina, 20 Va. App. 326, 457 S.E.2d 379, 1995 Va. App. LEXIS 438 (1995).

    Cost-of-living payments paid under former § 65.1-99.1 (now § 65.2-707 ) are not compensation within the meaning of the Workers’ Compensation Act. Bishopric Prods. Co. v. Brock, No. 1481-86-1 (Ct. of Appeals June 22, 1987).

    Determination of amount of cost of living supplements. See Clinchfield Coal Co. v. Anderson, 222 Va. 62 , 278 S.E.2d 817, 1981 Va. LEXIS 275 (1981); Jewell Ridge Coal Corp. v. Wright, 222 Va. 68 , 278 S.E.2d 820, 1981 Va. LEXIS 276 (1981).

    A.Temporary Total Incapacity.

    Suspension of permanent partial award and substitution of temporary total benefits. —

    The Compensation Commission has the authority under former § 65.1-56 (now § 65.2-503 ) to suspend an award for permanent partial loss of the use of a leg and the authority under this section to award temporary total disability benefits where incapacity for work has been conceded by the employer. Commonwealth DMV v. Williams, 1 Va. App. 401, 339 S.E.2d 552, 1986 Va. App. LEXIS 214 (1986).

    Where claimant again becomes disabled for work as a result of injuries received in a prior accident, the question must be addressed whether there was sufficient evidence in the record to permit a finding that this disability was not embraced in the award for permanent partial loss of the leg. If the cause of the work incapacity, either in its nature or extent, was different from that upon which the permanent rating was grounded, then claimant would be entitled to return to temporary total benefits. Commonwealth DMV v. Williams, 1 Va. App. 401, 339 S.E.2d 552, 1986 Va. App. LEXIS 214 (1986).

    An employee’s return to dissimilar part-time employment represents a marketing of his residual work capacity justifying a change from compensation for total incapacity to compensation for partial incapacity. City of Fairfax v. Massey, 11 Va. App. 680, 401 S.E.2d 439, 7 Va. Law Rep. 1578, 1991 Va. App. LEXIS 24 (1991) (decided under former § 65.1-54).

    Termination of award was commission decision. —

    This section sets forth the amount of compensation a totally disabled employee is entitled to receive from an employer. Its provisions do not set forth the procedure for terminating such an award when an employee returns to light duty work. The determination whether benefits, in fact, should have been terminated could only have been made by the commission. Odin, Inc. v. Price, 23 Va. App. 66, 474 S.E.2d 162, 1996 Va. App. LEXIS 574 (1996).

    Inability to obtain employment. —

    The issue of whether a worker, who is partially physically incapacitated, is able to obtain employment requires proof that a reasonable effort to procure work has been made. Pocahontas Fuel Co. v. Barbour, 201 Va. 682 , 112 S.E.2d 904, 1960 Va. LEXIS 147 (1960).

    The extent of incapacity must be ascertained from the evidence, and such evidential ascertainment is not limited to or circumscribed by any special class of proof. All legal facts and circumstances surrounding the claim should properly be considered and due weight given them by the Commission. J.A. Foust Coal Co. v. Messer, 195 Va. 762 , 80 S.E.2d 533, 1954 Va. LEXIS 155 (1954); Pilot Freight Carriers, Inc. v. Reeves, 1 Va. App. 435, 339 S.E.2d 570, 1986 Va. App. LEXIS 220 (1986).

    Workers’ compensation commission properly found that a doctor’s opinion that a claimant had been totally disabled from the date of a work-related accident was not sufficient evidence of total disability where: (1) the doctor’s opinion was rendered months after the doctor had last examined the claimant; (2) was inconsistent with the doctor’s prior opinions, rendered at the time he saw the claimant, which only removed the claimant from work for a limited time and did not find total disability; and (3) the doctor admitted he could find no objective reason for the claimant’s complaints of continued knee pain. Thompson v. Branch Hwys., 2003 Va. App. LEXIS 89 (Va. Ct. App. Feb. 25, 2003).

    Sufficient evidence of permanent unemployability. —

    A ratable loss of use of both legs of less than 100 percent, coupled with evidence of incapacity for employment, is sufficient to establish that an employee is permanently unemployable. Eastern Airlines v. Janes, 1995 Va. App. LEXIS 574 (Va. Ct. App. July 18, 1995).

    Claimant proved compensable change in condition justifying award of temporary total disability benefits. —

    Although a workers’ compensation claimant signed two agreement forms indicating that the claimant was released to the claimant’s pre-injury job as of March 18, 2001, regardless of whether the forms and any final orders memorializing them were binding, substantial evidence, including the claimant’s testimony and a doctor’s medical report, supported the Virginia Workers’ Compensation Commission’s finding that the claimant was not released to perform the claimant’s pre-injury job as of June 20, 2001, the date that the claimant experienced a layoff, and that the claimant, thus, proved a compensable change in condition as of that date, because: (1) even if the forms and orders were binding and proved that the claimant was at full duty on March 18, 2000, the doctor’s June 20, 2001, report proved that the claimant’s condition changed, as the doctor found as of June 20, 2001, that the claimant was only able to perform light duty; and (2) if the forms and orders were not binding, then the claimant was on light duty from when the claimant returned to work on March 18, 2000, and was entitled to benefits since the layoff happened while the claimant was working in a light duty position. A.O. Smith Corp. v. Goad, 2003 Va. App. LEXIS 79 (Va. Ct. App. Feb. 19, 2003).

    Benefits denied for time spent undergoing tests. —

    Where a claimant’s benefits have been terminated for failure to market work capacity and the claimant’s subsequent hospitalization for diagnostic tests to determine if he is disabled fails to establish disability, the claimant is not entitled to disability benefits for the time spent undergoing diagnostic tests. Crystal Oil Co. v. Dotson, 12 Va. App. 1014, 408 S.E.2d 252, 8 Va. Law Rep. 410, 1991 Va. App. LEXIS 201 (1991) (decided under former § 65.1-54).

    Temporary total benefits denied. —

    Widow was properly denied her husband’s temporary total workers’ compensation benefits where her husband did not earn any wages the 52 weeks before the date of communication of his diagnosis to him. Robertson v. E.I. DuPont de Nemours & Co., 38 Va. App. 785, 568 S.E.2d 436, 2002 Va. App. LEXIS 520 (2002).

    Due to the lack of medical evidence showing total disability for a certain period, a claimant failed to prove entitlement to an award of temporary total disability benefits; due to conflicting evidence, the claimant also failed to prove benefit entitlement for another period of time. Sawyer v. Work Clothes Warehouse, Inc., 2003 Va. App. LEXIS 374 (Va. Ct. App. July 1, 2003).

    Where the claimant was injured in a fall from an eight-foot barbed-wire fence, which he climbed after he was unable to get into the employer’s main office after hours and during a rainstorm, the trial court did not err in denying his claim for temporary total disability benefits; the employer had no reason to expect that the claimant would be in that position, the claimant had never told the employer that he had previously climbed the security fence to access the office, and no evidence was presented suggesting that the employer knew that the claimant or anyone else had ever climbed the fence to access the lot where the office was located. Jones v. Va. Elevator Co., 2003 Va. App. LEXIS 469 (Va. Ct. App. Sept. 9, 2003).

    Where a worker failed to establish the requisite causal connection between a fall and her employment, the Virginia Workers’ Compensation Commission properly denied the worker’s request for temporary total disability and medical benefits. Miles v. City of Lynchburg Human Servs., 2004 Va. App. LEXIS 191 (Va. Ct. App. Apr. 27, 2004).

    Virginia Workers’ Compensation Commission was authorized to reject the claimant’s self-serving testimony that she was injured on the job and rule in favor of the employer where the claimant did not tell a physician until more than a month after she was terminated that she was injured on the job when she felt a “burning pop” in her neck that got progressively worse until she was laid off two weeks later, and, thus, no error occurred in denying her claim for temporary total disability benefits. Mitchell v. Miller Group, 2005 Va. App. LEXIS 53 (Va. Ct. App. Feb. 8, 2005).

    It was error to conclude that a workers’ compensation claimant suffered a continuing disability as the claimant’s clinic slip did not give any estimate as to how long the claimant’s condition was expected to continue, or indicate when the claimant would undergo the claimant’s next medical examination; the slip was purportedly issued almost nine months after the claimant’s last recorded examination. Hoffman v. Carter, 50 Va. App. 199, 648 S.E.2d 318, 2007 Va. App. LEXIS 298 (2007).

    Credible evidence supported the decision of the Virginia Workers’ Compensation Commission to award an employee temporary total disability benefits only through the date he was to return to his treating physician for reassessment because Commission found that the employee failed to prove that the temporary total disability continued after that date; although the physician instructed the employee to continue with out of work status with reassessment, there was no indication that a reassessment occurred. Windsor v. Loomis Fargo & Co., 2011 Va. App. LEXIS 407 (Va. Ct. App. Dec. 20, 2011).

    Evidence supported the Workers’ Compensation Commission’s finding that the employee failed to market his residual work capacity during the period at issue, and therefore the Commission’s decision denying the employee’s claim for wage loss benefits for an injury he sustained while on the employer’s professional football team’s practice squad was upheld, because the employee admitted that although he was disabled from playing football after his injury, no doctor ever opined that he was totally incapacitated from all work and he acknowledged that he did not actively look for work before obtaining a job as a sales representative for a company that distributed chemicals for automotive maintenance. Hamilton v. Pro-Football, Inc., 69 Va. App. 718, 823 S.E.2d 13, 2019 Va. App. LEXIS 33 (2019).

    Former claimant, having disability reappear after returning to work, again entitled to benefits. —

    If, after receiving benefits for a period of time, the claimant returns to work, but thereafter has a change in condition justifying further payments, he may recover them under the Act as long as he applies within 24 months from the date of the last payment and provided he has not already received 500 weeks of disability payments. Whitten v. Mead Paperboard Prods., 4 Va. App. 182, 355 S.E.2d 349, 3 Va. Law Rep. 2224, 1987 Va. App. LEXIS 178 (1987).

    Burden of proof. —

    Virginia Workers’ Compensation Commission did not err in finding that it was an employee’s burden to establish a new period of temporary total disability because the employee never sought full Commission review of the deputy commissioner’s decision to terminate the temporary total disability award effective on the date that the parties stipulated he had returned to light-duty work; therefore, the termination of the award was final. Windsor v. Loomis Fargo & Co., 2011 Va. App. LEXIS 407 (Va. Ct. App. Dec. 20, 2011).

    B.Incapacity Causally Related to Work Injury.

    Disability unrelated to compensible injury. —

    Based on testimony from the claimant’s surgeon, who gave the only medical opinion on the issue of causation, the Virginia Workers’ Compensation Commission did not err in finding that the claimant’s ongoing disability was not causally related to his compensable injury, and thus, also did not err by ordering that claimant’s temporary total disability benefits be terminated. Moreover, although some of the surgeon’s responses and statements regarding the causal connection between the claimant’s ongoing disability and his compensable injury could have arguably conflicted with each other, the Commission, as fact finder, was entitled to determine the weight, meaning, and credibility to give his respective responses and statements and to reconcile any possible conflicts therein. McDaniel v. Philip Morris United States, Inc., 2007 Va. App. LEXIS 310 (Va. Ct. App. Aug. 21, 2007).

    Lost wages claim dismissed. —

    Award of lost wages to the employee was improper because he failed to demonstrate that his lost wages were causally related to his injury. Accordingly, he was not permitted to look to the provisions of the Workers’ Compensation Act, § 65.2-500 et seq., for recompense. Util. Trailer Mfg. Co. v. Testerman, 58 Va. App. 474, 711 S.E.2d 232, 2011 Va. App. LEXIS 229 (2011).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Even though the claimant may testify that he is able to return to work, if the treating physician opines that the claimant is not able to return to work, greater weight will be given to that medical opinion, since it is based upon medical knowledge. This is simply the converse of the principle upon which the Commission relies in giving greater weight to a physician’s opinion that a claimant is able to return to work over the opinion of the claimant that he cannot. Moore v. Auto Truck Transport, VWC File No. 241-63-54 (February 18, 2011).

    Because the claimant is being compensated for a loss of earning capacity and not loss of actual wages, she was entitled to one day of compensation for time missed because of the accident even though her current wage was more than her pre-injury wage. Hitchcock v. Chesapeake Bagel Bakery, VWC File No. 192-32-27 (Jan. 24, 2007).

    Where the treating doctor determined that because of a change in the claimant’s physical condition he was totally disabled for two days, the injured worker was entitled to an award even if he was not scheduled to work on the dates included in the disability. Quesenberry v. Pilgrim’s Pride Corp., VWC File No. 206-01-68 (April 3, 2006).

    Where the claimant generally scheduled medical appointments at the end of the work day but requested the first available appointment because he “was hurting” which was corroborated by medical evidence, the claimant acted reasonably and there was sufficient reason for him to miss all day from work. Robbins v. Lee County School Bd., VWC File No. 209-20-79 (Sept. 26, 2005).

    Wage loss benefits may be received for required medical appointments during work time only if it is shown that the medical condition required the appointment during work hours, if the scheduling at a non-work time would interfere with obtaining favorable work assignments, or if scheduling at a non-work time would cause substantial hardship. Aubuchon v. Domino’s Pizza, VWC File No. 211-80-86 & 217-98-00 (Oct. 3, 2005).

    When seeking wage-loss benefits for work missed because of a medical appointment, the claimant has the burden to show why his appointment could not have been scheduled on a non-work day. Robbins v. County of Lee School Bd., VWC File No. 209-20-79 (Dec. 8, 2004).

    A disability claim for benefits is based on the law in effect on the date of injury. Prior to October 1, 1991, Code § 65.1-56 [now Code § 65.2-503 ] provided that a permanent partial disability award could not extend the limitations of Code § 65.1-54 [now Code § 65.2-500 ], or of Code § 65.1-55 [now Code § 65.2-502 ], each of which limited entitlement to compensation to a period not exceeding 500 weeks. A week of temporary partial compensation is equivalent to a week of temporary total compensation when computing the 500-week limitation. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    An employee who is entitled to compensation because of accident or occupational disease may be compensated under three sections of the Act. Under § 65.1-54 (now § 65.2-500 ) benefits for total incapacity for work are paid with certain stated limitations. Under § 65.1-55 (now § 65.2-502 ) benefits for partial incapacity for work are paid based on the difference between the pre-injury average weekly wage and the post-injury average weekly wage. If the injury resulted in the loss or loss of use of a member, under § 65.1-56 (§ 65.2-503 ) benefits are paid for a fixed period. Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954); Nicely v. VEPCO, 195 Va. 819 , 80 S.E.2d 529, 1954 Va. LEXIS 161 (1954).

    The employer does not have to anticipate continuing disability, so compensation is not due under an open Award until the last day of the next weekly period, i.e., on November 7 for a disability period beginning November 1. Robbins v. Greater Wise, Inc., 79 O.W.C. 67 (2000).

    The Workers’ Compensation Act does not provide for the job retention of an injured employee. Consequently the issue is whether the claimant is medically capable of returning to his regular work not whether such a position is still available. Adkins v. Knox Creek Coal Corporation, 63 O.I.C. 9 (1984).

    Where the evidence established that the employee’s pre-injury work as an appointments secretary and receptionist required only minimal overhead filing, and that work was actually performed by a records clerk, the claimant failed to prove that overhead filing was a necessary or material job duty and that she was disabled from her pre-injury work. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997).

    Once the evidence established that the claimant had recovered from fibromyalgia and that continuing work restrictions were imposed only to prevent a reoccurrence of the problem, the claimant no longer remained entitled to benefits. Cooper v. Ethan Allen, 73 O.W.C. 110 (1994).

    A medical release for a trial return to work in two weeks is anticipatory and too speculative to establish a release to light duty. Congleton v. Safeway Stores, Inc., 73 O.W.C. 203 (1994).

    Benefits received under the Work Force Transition Act are not “wages” for the purposes of the Workers’ Compensation Act, and workers’ compensation benefits are not prejudiced by participation in that voluntary separation program. Swiney v. Commonwealth of Virginia/Dept. of Transportation, 74 O.W.C. 214 (1995).

    If the employer continues to pay the injured employee his regular wage which are intended to constitute compliance with the Act no further compensation benefits are due. Brinkley v. Dept. of Agriculture, 49 O.I.C. 38 (1967); Hagar v. Appalachian Power Co., 2 O.I.C. 341 (1920).

    An employee able to perform sedentary work who has retired with the employer’s concurrence may continue to receive workers’ compensation benefits under an outstanding award. Bailey v. Arlington County Board of Supervisors, 69 O.I.C. 166 (1990).

    Code § 65.2-503 was amended effective October 1, 1991, and a claimant injured on or after that date was entitled to receive permanent partial incapacity benefits after receiving 500 weeks of temporary total or temporary partial benefits. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    At the conclusion of 500 weeks, the burden of proof shifts to the claimant to establish that an injury to a member specified in § 65.1-56 (18) (now § 65.2-503 C) precludes him from engaging in gainful employment. Fauls v. Willard Lilliard Company, 65 O.I.C. 201 (1986).

    If an award does not specify a precise disability but simply recites an industrial accident, a general injury, and consequent disability, the burden is on the employer seeking to terminate benefits to prove the employee is no longer disabled or that such disability does not result from the accident. It is not the burden of the employee to establish causally related disability. Rossello v. K-Mart Corporation, 15 Va. App. 333, 423 S.E.2d 214, 9 Va. Law Rep. 574, 1992 Va. App. LEXIS 274 (1992).

    In an original claim, the claimant must show that he was either totally disabled or that he unsuccessfully marketed his residual capacity. Compensation was denied where the evidence failed to show total disability and the claimant did not seek selective employment. Sawyer v. Mathews Masonry Co., 74 O.W.C. 124 (1995).

    A claim for initial wage loss benefits must be filed within two years of the work accident. The compensable disability must begin within that two years period. The limitation period is not tolled where only medical benefits were initially awarded because disability did not exceed seven days. The change in condition claim for disability had to be filed within two years of the accident. Ashby v. West Point School Board, 74 O.W.C. 90 (1995).

    Total Incapacity:

    Claimant was following his doctor’s unequivocal written instruction in a disability certificate and did not work from May 25, 2010 through October 25, 2010. Evidence sufficient to prove disability notwithstanding lack of corresponding office note. Malpartida v. Gabriels Framing, Inc., JCN VA02000003644 (Aug. 12, 2014).

    Where a claimant is employed at two dissimilar jobs, he is entitled to compensation benefits only for the period in which he is medically incapacitated for the duties required of the job in which the compensable injury occurred. Hinkle v. City of Covington, 65 O.I.C. 28 (1986).

    Compensation benefits may not be awarded to a claimant who is totally disabled from work as a result of asbestosis unless at least first stage has been diagnosed. Woody v. Charles E. Smith Company, 67 O.I.C. 120 (1988).

    An employee is entitled to compensation for days missed from work for the purpose of receiving medical treatment for the compensable injuries. Sluss v. Clinchfield Coal Company, 64 O.I.C. 281 (1985).

    Where there is no medical evidence that the employee was disabled on days he was absent from work, or that he was seen by his physician on those days, the employee has not proved he is entitled to compensation benefits. Thomas v. Eastern State Hospital, 75 O.W.C. 191 (1996).

    If an employee is incapacitated for a full day, she is entitled to temporary total benefits for that day. Section 65.2-500 does not require a minimum of one week of incapacity. Therefore, if the method in which wage loss for a period of disability of less than one week is calculated as an appropriate fraction of the weekly compensation rate, the requirement of the statute is met. Merillat v. Allegheny Airlines, U.S. Air, 14 Va. App. 341, 421 S.E.2d 867 (1992); 70 O.I.C. 213 (1991).

    A manual laborer, so disabled from the effects of the accident as to be unable to perform the only type of work which he might be expected to find, has suffered a total incapacity for work under this section. Morris v. Pulaski Veneer Corp., 183 Va. 748 , 33 S.E.2d 190 (1945); Green v. Leas & McVitty, Inc., 36 O.I.C. 170 (1954).

    Benefits awarded to claimant unable to perform pre-injury work as result of post-traumatic epileptic problem and sprain of knee aggravating pre-existing arthritis. Tatem v. Crest Constr. Corp., 51 O.I.C. 263 (1969).

    Complication of thrombophlebitis stemming from extensive burns precluded pre-injury work. Jenkins v. Walters, 54 O.I.C. 188 (1972).

    The combination of claimant’s blindness and arm and leg injuries renders her totally incapacitated for work. Nakpodia v. Marriott Corp., 59 O.I.C. 224 (1981).

    The claimant’s treating orthopedic surgeon released the employee to work, limited to no use of his injured right hand or right leg. The Commission agreed that such a work release was ambiguous, and that it set forth restrictions too severe to be characterized as a release to marketable duties. Total disability benefits were awarded through a date on which the physician reported that the claimant’s residual right wrist condition was “excellent” and that the claimant’s ankle showed minimal swelling. Swann v. SRS Communication, Inc. t/a Media One, 79 O.W.C. 206 (2000).

    Temporary Total and Specific Benefits:

    The statutory change effective July 1, 1987 which provides for the payment of temporary total benefits in an amputation case prior to the permanency award and allowing the payment of permanency concurrently with temporary partial compensation benefits is substantive in nature and has no applications to accidents occurring prior to the date of enactment. Williams v. Mead Paperboard Products, 67 O.I.C. 156 (1988) (see also Ridgeway v. Universal Electric Company, 67 O.I.C. 160 (1988)).

    The amount of compensation paid under this section, or that paid under § 65.1-55 (now § 65.2-502 ) for partial incapacity caused by injuries other than the loss for which compensation under § 65.1-56 (now § 65.2-503 ) is claimed, cannot be deducted from amount due for specific injury under § 65.1-56 (now § 65.2-503 ). Employee is entitled to both. Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954); Nicely v. VEPCO, 195 Va. 819 , 80 S.E.2d 529, 1954 Va. LEXIS 161 (1954); Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925).

    If total incapacity exists compensation will be allowed under this section, even though it results from a combination of specific injuries which if resulting only in partial incapacity, would have been compensable under § 65.1-56 (now § 65.2-503 ). Green v. Leas & McVitty, Inc., 36 O.I.C. 170 (1954); Scott v. Bldg. Supplies Corp., 6 O.I.C. 14 (1924).

    A 20% permanent disability of a general nature which prevents claimant from securing work elsewhere and causes a total loss of earning power entitles claimant to compensation under § 65.1-54 (now § 65.2-500 ). Life v. Rockingham Constr. Co., 36 O.I.C. 109 (1954).

    A partially disabled employee seeking an award of temporary total disability benefits has the burden of proving that he made reasonable efforts to procure suitable work, but was unable to successfully market his remaining capacity. Such evidence is properly addressed by the Deputy Commissioner, even if the employer does not raise it. Pullen v. Stackhouse, Inc., 78 O.W.C. 59 (1999).

    Claimant suffering 25% loss of use of right leg and 35% loss of use of left leg was totally disabled. Gregory v. George E. Bancroft & Co., 51 O.I.C. 118 (1969).

    Total loss of use of two members in same accident creates a conclusive presumption of total incapacity and compensation is provided in § 65.1-54 (§ 65.2-500 ) for total incapacity. Wilkerson v. Monarch Elevator & Machine Co., 41 O.I.C. 148 (1959); Homan v. Massanutten Development Co., 56 O.I.C. 175 (1974); Lewis v. Lewis Callis, et al., 58 O.I.C. 216 (1978).

    See Notes to § 65.2-503 .

    Effect of Second Accident:

    A new accident as a compensable consequence does not extend the maximum period of 500 weeks for total incapacity. Williams v. General Heating & Engineering Company, 67 O.I.C. 105 (1988).

    Where employee becomes totally and permanently incapacitated for work by reason of a second accident in the same employment his compensation will be fixed based on his average weekly wage at time of second accident payable for five hundred weeks less the number of weeks during which he drew compensation on account of first accident. Morris v. Pulaski Veneer Corp., 184 Va. 424 , 35 S.E.2d 342, 1945 Va. LEXIS 161 (1945).

    If, while still away from work recuperating from injuries suffered by industrial accident, employee accidentally rebreaks the member broken in original accident and such additional injures would not have occurred but for weakened condition of such member, he may draw compensation during the entire healing period until able to return to work. Wilkerson v. Weber, 20 O.I.C. 162 (1938); Powell v. Exchange Lumber Co., 8 O.I.C. 61 (1926).

    Compensation for partial disability due to first accident continued during period of total disability from subsequent non-industrial accident where partial work incapacity had not ceased. Brooks v. Olser Co., Inc., 46 O.I.C. 29 (1964).

    Total Disability After Termination of Selective Employment:

    An employee who is discharged for cause may be entitled to reinstatement of compensation benefits upon a finding of total disability. Remmell v. The Glidden Co., 71 O.W.C. 261 (1992).(see also).Arthur E. Parker v. Air Gate Service Corporation, VWC # 153-48-27 decided 11/20/92.

    An employee, who continued to work after a compensable injury, and was subsequently dismissed for reasons unconnected with the accident, is entitled to compensation benefits if total incapacity can be established at a later date. Hernandes v. Rocco Products, Inc., 70 O.I.C. 208 (1991).

    An employee who earlier resigned from work within her physical capacities provided by her employer is not precluded from subsequently receiving an award for temporary total disability. Browder v. Southside Regional Medical Center, 71 O.W.C. 289 (1992).

    Effect of Termination of Selective Employ- ment:

    Compensation benefits were reinstated to an employee who was able to perform light duty work but was unable to drive sixty-five miles each way to his pre-injury employment. Desmond v. Republic Claims, 70 O.I.C. 89 (1991).

    An employee’s loss of selective employment through no fault of his own is a change in condition entitling him to a resumption of compensation benefits if he is partially disabled and has made a reasonable effort to market his remaining work capacity. Huffman v. Toney Arey Trucking, 70 O.I.C 85 (1991).

    See notes to § 65.2-510 .

    Incarceration:

    See Notes to §§ 65.2-510.1 and 65.2-712 .

    § 65.2-501. Incapacity after permanent loss.

    After compensation has been paid as provided in § 65.2-503 , the employee may, within one year from the date compensation was last due under this section, file an application for compensation for incapacity to work, subject to the provisions of §§ 65.2-500 and 65.2-502 . Such application shall be considered and determined as of the date incapacity for work actually begins or as of the date ninety days prior to the date of filing, whichever is later.

    History. Code 1950, § 65-53; 1964, cc. 116, 190; 1968, cc. 347, 660, § 65.1-56; 1970, c. 470; 1972, c. 229; 1975, cc. 446, 450; 1976, c. 655; 1982, c. 326; 1983, c. 287; 1987, c. 560; 1988, cc. 564, 596.

    CASE NOTES

    Applicability. —

    Section 65.2-501 applies when the worker has not had a change in condition and is at the same disability level before and after an award. Va. Elec. & Power Co. v. Crawford, 2001 Va. App. LEXIS 680 (Va. Ct. App. Dec. 11, 2001).

    Because a policeman’s entitlement to sick leave for routine medical appointments was not a “change in condition,” and because the policeman’s claim was filed over five months past the one-year statute of limitations in § 65.2-501 , the Workers’ Compensation Commission properly denied the policeman’s applications for wage loss compensation as time-barred. Brightwell v. City of Richmond Police Dep't, 2007 Va. App. LEXIS 122 (Va. Ct. App. Mar. 27, 2007).

    Two year limitation period of former § 65.1-99 (now § 65.2-708 ) applies to filing an application for additional workers’ compensation benefits pursuant to a change in condition as defined by former § 65.1-8 (now § 65.2-101 ). Conversely, the one-year limitation period of this section applies to filing an application for additional workers’ compensation benefits in a situation when the disability is at the same level both when the award begins and ends. Thus, the limitation period of this section is triggered by a cessation of payments and a continued incapacity to work. Armstrong Furn. v. Elder, 4 Va. App. 238, 356 S.E.2d 614, 3 Va. Law Rep. 2583, 1987 Va. App. LEXIS 258 (1987) (decided under former § 65.1-56).

    The statute of limitations in this section does not begin to run until compensation for permanent loss was last due under § 65.2-503 . Virginia International Terminals, Inc. v. Moore, 22 Va. App. 396, 470 S.E.2d 574, 1996 Va. App. LEXIS 368 (1996), aff'd, 254 Va. 46 , 486 S.E.2d 528, 1997 Va. LEXIS 55 (1997).

    The one-year statute of limitations contained in § 65.2-501 applied to bar the Virginia Workers’ Compensation Commission from considering a claim for additional disability benefits where a doctor’s deposition testimony refuted claimant’s assertion that her plantar fascitis was caused by a change in her compensable knee condition. Clay v. Tultex Corp., 2002 Va. App. LEXIS 148 (Va. Ct. App. Mar. 12, 2002).

    An employee seeking to terminate compensation benefits based on refusal of selective employment must establish a bona fide job offer suitable to the employee’s capacity, procured for the employee by the employer, and an unjustified refusal by the employee to accept the job. Gallahan v. Free Lance Star Publ'g Co., 37 Va. App. 114, 554 S.E.2d 685, 2001 Va. App. LEXIS 628 (2001).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    One year statute of limitations of § 65.2-501 applies when disability is at same level before and after award of permanent partial disability. Section 65.2-708 ’s two-year limitation governed this claim because claimant proved her physical condition deteriorated since award for permanent partial disability was entered. Hernandez v. Mike’s American Grill, JCN VA00000222973 (Sept. 11, 2014).

    There are two statutes of limitation that could apply after payments of an award for permanent partial disability. If the claimant has undergone a change in condition, the two-year statute of limitation in Code § 65.2-708 applies. If there has not been a change in condition and the claimant is at the same disability level after the award for permanent loss as before, the one-year statute of limitations in Code § 65.2-501 applies. Phelps v. Safeway Stores, Inc., 77 O.W.C. 138 (1998).

    The 1991 amendment added to the language of Code § 65.2-101 “Change in condition” the reference to awards that had been “suspended,” and employees thereafter were required to prove continuing disability as well as a “cure” of an earlier refusal in order to have benefits reinstated. Perrigan v. Clinchfield Coal Co., 75 O.W.C. 324 (1996); Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    Employee did not exercise reasonable diligence in seeking employment and was not entitled to reinstatement of temporary total disability benefits pursuant to this section, where during a period of almost six months, he filed only four or five written job applications and no resumes, and the evidence indicated that there were numerous jobs available that were appropriate for him in view of his education, work history and physical restrictions, but he did not apply for any of these, seeking instead jobs for which he was not qualified by education and experience or which were not within the limitations placed upon him by his physician. Great Atlantic & Pacific Tea Co. v. Bateman, 4 Va. App. 459, 359 S.E.2d 98, 4 Va. Law Rep. 168, 1987 Va. App. LEXIS 199 (1987).

    A claimant who received compensation for a permanent loss of use and then files an application under § 65.1-56 (now in § 65.2-501 ) alleging continuing work incapacity, needs only to establish that he remains either totally or partially disabled from the industrial accident. It is not necessary that he establish any pathological change in condition. Ferguson v. Furman K. Barnes, Sr., 63 O.I.C. 111 (1984).

    After compensation for specific disability is paid, an employee is entitled to compensation for his continuing wage loss if such wage loss is attached to injuries suffered in the industrial accident. Holliday v. Bill Bull Electric, Inc., 62 O.I.C. 214 (1983).

    Where an employee is originally paid under the LHWCA without an award in Virginia and subsequently files for compensation benefits, it is an original claim and is not subject to the limitation period of § 65.2-501 or § 65.2-708 . Moore v. Virginia International Terminals, Inc., 73 O.W.C. 46 (1994).

    A claimant who is laid off from light duty work for economic reasons must show marketing of remaining capacity when seeking temporary total. After receiving permanent partial benefits, a claimant must show marketing of remaining capacity to receive additional temporary total benefits if released to light duty work. Smith v. Wells Fargo Guard Service, 73 O.W.C. 201 (1994).

    § 65.2-502. Compensation for partial incapacity; exclusion of AmeriCorps members, certain Food Stamp Employment and Training Program participants, and certain Temporary Assistance for Needy Families participants.

    1. Except as otherwise provided in § 65.2-503 or 65.2-510 , or as provided in subsections B, C and D, when the incapacity for work resulting from the injury is partial, the employer shall pay, or cause to be paid, as hereinafter provided, to the injured employee during such incapacity a weekly compensation equal to 66 2/3 percent of the difference between his average weekly wages before the injury and the average weekly wages which he is able to earn thereafter, but not more than 100 percent of the average weekly wage of the Commonwealth as defined in § 65.2-500 . For purposes of calculating an injured employee’s post-injury average weekly wage, the following rules shall apply to commissioned employees, self-employed income, and income derived from an employer in which the injured worker or their immediate family has an ownership interest: if the period of partial incapacity exists for 13 weeks or less, the injured employee’s post-injury average weekly wage shall be computed by dividing the employee’s total earnings during the first two weeks of partial incapacity by two, subject to retroactive adjustments as provided hereinafter. If the period of partial incapacity exists for more than 13 weeks, the injured employee’s post-injury average weekly wage for each 13-week interval shall be computed by dividing the employee’s total earnings during the period of partial incapacity by the number of weeks included in such period; however, if an injured employee’s period of partial incapacity ends after the close of a 13-week interval but before the close of the next 13-week interval, the injured employee’s post-injury average weekly wage for such portion of the subsequent 13-week interval shall be calculated by dividing the employee’s total earnings during the period of partial incapacity by the number of weeks included in such period. When an injured employee is under a continuing award of temporary partial benefits, the employer or the employee shall be entitled to seek a retroactive adjustment of the temporary partial rate for the 90 days preceding the application seeking such adjustment of the temporary partial rate computed in accordance with the above method of calculation. Any resulting amount due to the employee shall be paid to the employee. Any resulting credit due to the employer may be offset dollar for dollar against future compensation benefits due the injured employee, subject to the provisions of § 65.2-520 . The employee is required pursuant to § 65.2-712 to immediately disclose increases in his earnings. For all other employments, the employee’s post-injury average weekly wage may, in the Commission’s discretion, be calculated using the preceding formula or a week-to-week calculation. In case the partial incapacity begins after a period of total incapacity, the latter period shall be deducted from the maximum period herein allowed for partial incapacity. However, the employer shall not be required to pay, or cause to be paid, compensation under this section to any injured employee not eligible for lawful employment; nor shall any such injured employee not eligible for lawful employment who is partially incapacitated be entitled during partial incapacity to receive temporary total benefits under § 65.2-500 .
    2. AmeriCorps members as defined in subdivision r of § 65.2-101 shall not be eligible to receive weekly compensation for partial incapacity, whether permanent or temporary, regardless of whether the injury results in death.
    3. Food Stamp recipients participating in the work experience component of the Food Stamp Employment and Training Program as defined in subdivision s of § 65.2-101 shall not be eligible to receive weekly compensation for partial incapacity, whether permanent or temporary, regardless of whether the injury results in death.
    4. Temporary Assistance for Needy Families recipients participating in the work experience component of the Virginia Initiative for Education and Work as defined in subdivision t of § 65.2-101 shall not be eligible to receive weekly compensation for partial incapacity, whether permanent or temporary, regardless of whether the injury results in death.

    History. Code 1950, § 65-52; 1952, c. 226; 1954, c. 654; 1956, c. 243; 1958, c. 568; 1960, c. 556; 1962, c. 503; 1964, c. 94; 1966, c. 64; 1968, cc. 8, 660, § 65.1-55; 1970, c. 470; 1972, c. 229; 1973, c. 542; 1974, c. 560; 1975, c. 447; 1990, c. 559; 1991, c. 355; 1995, c. 319; 1997, c. 511; 2000, c. 1018; 2004, c. 888; 2005, c. 472; 2006, c. 660; 2019, c. 210.

    The 2000 amendments.

    The 2000 amendment by c. 1018, effective April 19, 2000, added the last sentence.

    The 2004 amendments.

    The 2004 amendment by c. 888, effective April 15, 2004, added subsection designation A; inserted “or as provided in subsections B and C” in subsection A; and added subsections B and C.

    The 2005 amendments.

    The 2005 amendment by c. 472 substituted “subsections B, C and D” for “subsections B and C” in subsection A; and added subsection D.

    The 2006 amendments.

    The 2006 amendment by c. 660 added the second through seventh sentences in subsection A.

    The 2019 amendments.

    The 2019 amendment by c. 210 substituted “Virginia Initiative for Education and Work” for “Virginia Initiative for Employment Not Welfare Program” in subsection D.

    Law Review.

    For survey of Virginia law on workers’ compensation in the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    CASE NOTES

  • Analysis
  • I.In General.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-55.

    Former § 65.1-54 (now § 65.2-500 ) compared. —

    Benefits awarded under former § 65.1-54 and this section cover losses occasioned by the impairment of claimant’s earning capacity. Former § 65.1-54 applies where the loss is total, and this section applies where it is partial. Pilot Freight Carriers, Inc. v. Reeves, 1 Va. App. 435, 339 S.E.2d 570, 1986 Va. App. LEXIS 220 (1986).

    This section and former § 65.1-56 (now § 65.2-503 ) are complementary. Morris v. Pulaski Veneer Corp., 183 Va. 748 , 33 S.E.2d 190, 1945 Va. LEXIS 222 (1945).

    Payments under this section not credited on payments under former § 65.1-56 (now § 65.2-503 ). —

    When an employee suffers injury to a member scheduled in former § 65.1-56 and is compensated for temporary partial disability under this section until such time as the injured employee attains maximum recovery, and the degree of permanent partial loss of use of the member can be determined, the employer is not entitled to a credit for the sums so paid against such award as must be made for such permanent partial loss of use as is then found to exist. Nicely v. VEPCO, 195 Va. 819 , 80 S.E.2d 529, 1954 Va. LEXIS 161 (1954).

    Act allows compensation for both total and partial disability. —

    A fair construction of the Workmen’s (now Workers’) Compensation Act allows compensation for both total incapacity and partial incapacity, subject to the qualifications contained in former § 65.1-54 (now § 65.2-500 ). Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925).

    Temporary interruptions do not extend five hundred weeks’ limit. —

    Under this section no compensation can be demanded after 500 weeks from the date of the injury. Temporary interruptions from time to time, during which no compensation was owing or paid, would not operate to extend the period for payment of compensation beyond the 500 weeks’ limit. Raven Red Ash Coal Corp. v. Absher, 153 Va. 332 , 149 S.E. 541 , 1929 Va. LEXIS 266 (1929); W.M. Ritter Lumber Co. v. Perry, 153 Va. 339 , 149 S.E. 543 , 1929 Va. LEXIS 267 (1929).

    Employee experienced repeated unplanned furloughs of undefined duration. —

    Partially incapacitated employee, who was provided selective employment in the construction industry, was entitled to workers’ compensation benefits because the employee experienced repeated unplanned furloughs of undefined duration due to the vagaries of the marketplace. Carr v. Atkinson/Clark/Shea, A Joint Venture, 63 Va. App. 281, 756 S.E.2d 191, 2014 Va. App. LEXIS 132 (2014).

    Illegal employment is not an acceptable marketing of remaining work capacity. Manis Construction Co. v. Arellano, 13 Va. App. 292, 411 S.E.2d 233, 8 Va. Law Rep. 1466, 1991 Va. App. LEXIS 301 (1991).

    Obligation to seek employment not dependent on physician’s advice. —

    It is not required that a workers’ compensation claimant who suffers partial disability be informed by his physician that he may undertake restricted work in order for him to be obligated to make reasonable efforts to market his residual skills. Ridenhour v. City of Newport News, 12 Va. App. 415, 404 S.E.2d 89, 7 Va. Law Rep. 2559, 1991 Va. App. LEXIS 88 (1991); Baum v. Sports Auth., 1993 Va. App. LEXIS 636 (Va. Ct. App. Dec. 14, 1993).

    An employee’s return to dissimilar part-time employment represents a marketing of his residual work capacity justifying a change from compensation for total incapacity to compensation for partial incapacity. City of Fairfax v. Massey, 11 Va. App. 680, 401 S.E.2d 439, 7 Va. Law Rep. 1578, 1991 Va. App. LEXIS 24 (1991).

    Claimant suffered a wage loss because, if he desired to do so, he was no longer physically able to perform his pre-injury work. Claimant’s ability to earn a higher average weekly wage was impaired due to the compensable consequence injury and not to his voluntary resignation. Therefore, the Commission did not err in awarding compensation benefits to claimant. Davey Tree Expert Serv. Co. v. Acuff, 20 Va. App. 320, 456 S.E.2d 544, 1995 Va. App. LEXIS 424 (1995).

    Claimant’s responses to discovery request. —

    Claimant for workers’ compensation benefits was properly permitted to testify as to the claimant’s efforts to market the claimant’s residual work capacity after the claimant obtained part-time work, even though the claimant failed to supplement the claimant’s response to the former employer’s discovery request seeking that information, because the claimant’s testimony did not materially affect the claimant’s prior response to discovery and the employer was able to effectively cross-examine the claimant regarding the claimant’s marketing efforts at a hearing. Tricon Constr., Inc. v. Rojas-Rojas, 2014 Va. App. LEXIS 49 (Va. Ct. App. Feb. 18, 2014).

    Stipulations. —

    Workers’ Compensation Commission properly decided that an employer was bound by the stipulations of an employee’s injuries and capacity because a valid stipulation constituted credible evidence, the employee had no duty to offer evidence to prove the conceded issues, and the stipulation that the employee was in a light-duty capacity was essentially a finding that she was partially disabled. King William County v. Jones, 65 Va. App. 536, 779 S.E.2d 213, 2015 Va. App. LEXIS 353 (2015), aff'd, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016).

    Failure to show causation. —

    Workers’ compensation claimant did not sustain his burden of proving that a right arm ulnar nerve condition discovered while he was being treated for a compensable injury was causally related to that injury, as one physician opined it was not, there was no medical evidence of an arm or elbow injury at the time of the accident, and the physician who treated the ulnar nerve condition did not give an opinion as to the condition’s cause. Barnes v. Marshalls, Inc., 2003 Va. App. LEXIS 90 (Va. Ct. App. Feb. 25, 2003).

    Because a firefighter did not testify that any defect or condition of a step caused the firefighter’s foot to slip on the step of a fire truck, the firefighter failed to prove that the firefighter’s injury arose out of the firefighter’s employment; consequently, substantial evidence supported the Workers’ Compensation Commission’s denial of benefits. Smith v. Rockingham & Va. Ass'n of Counties Group Self-Insurance, 2011 Va. App. LEXIS 58 (Va. Ct. App. Feb. 22, 2011).

    Claimant’s burden of proof. —

    Workers’ Compensation Commission erred in awarding disability benefits to a member of the employer’s custodial staff (the claimant)because, while she suffered work-related injuries, was partially disabledn a light-duty status when her employment ended, and did not knowingly violate a safety rule in the accident that led to her injuries, she did not establish an entitlement to benefits where, while there was evidence that the claimant unsuccessfully sought employment with numerous potential employers after being laid off, she was laid-off for reasons unrelated to her work-related injury and offered no evidence to establish that her inability to find other employment was in any way related to her injury. King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016).

    Claim supported by credible evidence. —

    Fact that there was evidence to the contrary of the finding by the Virginia Workers’ Compensation Commission that a claimant was injured in a work-related accident, after the claimant was denied benefits by a deputy commissioner, was of no consequence as there was credible evidence supporting the Commission’s decision, including medical testimony, which corroborated the claimant’s version of her accident; the contrary evidence included: (1) two co-workers’ testimony that they heard the claimant say that she was going to start her car and saw her leave with her car keys in her hand, but did not see her carrying any scraps, (2) one witness’s testimony that the claimant’s clothes were neither muddy nor dirty, while another witness saw the claimant “dust her clothes off,” but did not observe any dirt on her clothes, and (3) three witnesses testified the claimant regularly complained about shoulder pain, and one recalled a neck pain complaint. TRI Tube, Inc. v. Owens, 2004 Va. App. LEXIS 52 (Va. Ct. App. Feb. 3, 2004).

    Workers’ compensation claimant’s award for depression was supported by the evidence where: (1) the claimant’s doctors never revised their opinions that the claimant’s foot injury was the cause of his depression, (2) the record did not support the employer’s claim that the claimant’s doctors did not examine crucial medical records, (3) the claimant’s treating physicians were aware of at least some of the claimant’s previous psychiatric treatment, (4) the claimant never lied to his doctors, and (5) the employer’s doctor stated that the claimant’s injury might have contributed to his depression. Amelia Sand Co. v. Ellyson, 43 Va. App. 406, 598 S.E.2d 750, 2004 Va. App. LEXIS 305 (2004).

    Workers’ compensation claimant’s award for spinal cord stimulator (SCS) was affirmed as: (1) the employer failed to support its claim that all conventional therapies had to be tried before a claimant could receive compensation for a more innovative treatment, (2) the claimant tried the more conventional therapy, although he did not complete it, and (3) the employer did not rebut two doctors’ conclusions that SCS was needed. Amelia Sand Co. v. Ellyson, 43 Va. App. 406, 598 S.E.2d 750, 2004 Va. App. LEXIS 305 (2004).

    Because the Workers’ Compensation Commission was not bound to accept only a claimant’s testimony about the cause of an accident when the testimony of the claimant and a police officer was not contradictory, and because the accident was attributable to a hazard of the claimant’s employment as a truck driver, the employer’s appeal was without merit. Murphy-Brown, LLC v. Budnick, 2009 Va. App. LEXIS 171 (Va. Ct. App. Apr. 14, 2009).

    Claimant provided sufficient evidence to prove that his work-related injury caused his current temporary partial disability. Given all the physical limitations the claimant suffered subsequent to his fall that he did not experience prior to his fall, as evidenced by his and his wife’s testimony and some medical records, he sustained his burden of proving that his fall from the ladder caused his current disability. Uninsured Employer's Fund v. Carter, 2012 Va. App. LEXIS 119 (Va. Ct. App. Apr. 17, 2012).

    Panel provided by employer defective. —

    Credible evidence supported the decision of the Virginia Workers’ Compensation Commission to award a workers’ compensation claimant medical benefits and temporary total disability benefits because the panel provided by the employer pursuant to § 65.2-603 was defective, and thus, claimant had the right to select the physician of his own choosing; because a neurologist and chiropractors were claimant’s treating physicians, the Commission was entitled to give their opinions great weight, and in the opinion of those physicians, claimant made progress over the course of the treatments, but he was unable to return to work until March 4, 2010, and then only for light-duty work. Gilbane v. Guzman, 59 Va. App. 128, 717 S.E.2d 433, 2011 Va. App. LEXIS 355 (2011).

    Claim unsupported by the evidence. —

    Where an employer contested the compensability of a worker’s injury and the worker did not provide medical or pre-injury work evidence, there was no de facto award and the worker was not entitled to disability benefits. Smelcer v. Dickenson County Sch. Bd., 2003 Va. App. LEXIS 484 (Va. Ct. App. Sept. 23, 2003).

    Where the claimant failed to prove that he suffered an injury to his left knee as the result of a particular accident, the Workers’ Compensation Commission properly affirmed denial of his claim for benefits. Howington v. Image Works Landscape Mgmt., LLC, 2003 Va. App. LEXIS 454 (Va. Ct. App. Aug. 26, 2003).

    Workers’ compensation commission properly denied the claimant’s request for temporary partial disability benefits; substantial, credible evidence in the record showed that the claimant forfeited any right to post-termination partial disability benefits due to his voluntary criminal conduct, for which he was terminated, and that his termination was not due to the disability he sustained while working for the employer. Artis v. Ottenberg's Bakers, Inc., 45 Va. App. 72, 608 S.E.2d 512, 2005 Va. App. LEXIS 108 (2005).

    Benefits after termination of employment. —

    Although an employee’s poor work performance was sufficient to show conduct unrelated to the employee’s disability that warranted a permanent suspension of benefits, the Workers’ Compensation Commission made no findings and conducted no analysis with respect to whether the employee’s misconduct was voluntary or involuntary. Chem. Producers & Distribs. Ass'n v. Perry, 2009 Va. App. LEXIS 259 (Va. Ct. App. June 9, 2009).

    Claim for hot tub properly denied. —

    Workers’ compensation claimant failed to meet his burden of proving that a hot tub he purchased and installed at his home constituted reasonable and necessary medical treatment causally related to his compensable injury by accident in the absence of a contemporaneous prescription for the hot tub in 1998 in his doctor’s medical records, no mention from the doctor in his deposition about a hot tub or whirlpool prescription, the lack of any evidence that whirlpool treatment was not available close to the claimant’s home, and the lack of any medical evidence explaining why the hot tub was reasonable and necessary. Suggs v. Suggs Carpet Installation, 2006 Va. App. LEXIS 115 (Va. Ct. App. Mar. 28, 2006).

    II.Calculation of Average Weekly Wage.

    Earnings computation on week-by-week basis not contrary to this section. —

    Where the commission found that it would be unfair to compute claimant’s earnings on a quarterly basis as it normally did, and that the best indication of his partial wage loss would be on a week-by-week basis, credible evidence supported this finding, and it was not contrary to provisions of this section. Branscome Paving Co. v. Sullivan, 1993 Va. App. LEXIS 615 (Va. Ct. App. Dec. 21, 1993).

    Economic loss test applicable. —

    Although both §§ 65.2-500 and 65.2-502 provide payments for injured workers, the corresponding tests differ significantly. Section 65.2-500 governs total incapacity and applies a loss of earning capacity test, while § 65.2-502 pertains to partial incapacity and applies an economic loss test. McKellar v. Northrop Grumman Shipbuilding, Inc., 290 Va. 349 , 777 S.E.2d 857, 2015 Va. LEXIS 140 (2015).

    Earning capacity after transfer. —

    Where an employee’s post-injury earnings were substantially below an agreed upon weekly wage after a job transfer, the workers’ compensation commission did not have to use a 52-week average to compute temporary partial disability benefits under § 65.2-502 . Fed. Mogul Friction Corp. v. Butcher, 2003 Va. App. LEXIS 478 (Va. Ct. App. Sept. 16, 2003).

    Overtime compensation allowed. —

    Where claimant, who made at least some overtime in his previous position and then made none, offered evidence which demonstrated that other linemen continued to receive overtime and claimant’s range of duties in his light duty work did not include overtime, and he had yet to be released to his pre-injury capacity as a lineman, claimant was entitled to compensation for a measure of overtime, despite employer’s inability to precisely predict how much overtime was available to other linemen. Carr v. Va. Electric & Power, 25 Va. App. 306, 487 S.E.2d 878, 1997 Va. App. LEXIS 500 (1997).

    Overtime compensation not allowed. —

    Fact that an injured employee accepts a light duty job and is willing to work overtime when the employer offers it does not negate the requirement that he make a reasonable effort to market his residual work capacity, i.e. , the additional overtime he had received before his injury. In the absence of a reasonable effort to market his residual work capacity, the employee is not entitled to temporary partial disability benefits for his alleged loss of overtime earnings. Ford Motor Co. v. Favinger, 275 Va. 83 , 654 S.E.2d 575, 2008 Va. LEXIS 4 (2008).

    Calculation of injured worker’s average weekly wage affirmed. —

    Where credible evidence supported the Virginia Workers’ Compensation Commission’s findings, and the Commission’s calculation best indicated an injured worker’s partial wage loss, an award of temporary partial disability benefits was affirmed. Rich Prods. Corp. v. Steere, 2003 Va. App. LEXIS 321 (Va. Ct. App. June 3, 2003).

    Virginia Workers’ Compensation Commission did not err in imputing earnings to a claimant, as the average weekly wage the Commission imputed to the claimant was based solely on the Commission’s determination of the value of the work the claimant performed. The evidence identified several work activities engaged in by the claimant that significantly contributed to the employer’s business, such as teaching a class, ringing up sales, attending a gun show, assisting customers, and answering phones. NiSource, Inc. v. Thomas, 53 Va. App. 692, 674 S.E.2d 581, 2009 Va. App. LEXIS 161 (2009).

    III.Residual Work Capacity.

    Claimant made good faith effort to market remaining capacity. —

    Claimant’s efforts to market his remaining capacity, although inconsistent, were made in good faith, where his efforts included obtaining painting jobs and deck-building projects, and the evidence showed that he had submitted an application to a convenience store and had obtained employment for 20 hours per week as a tractor operator on a farm. Giant Food, Inc. v. Stevens, No. 0681-91-4 (Ct. of Appeals Oct. 29, 1991).

    Where a claimant’s benefits have been terminated for failure to market work capacity and the claimant’s subsequent hospitalization for diagnostic tests to determine if he is disabled fails to establish disability, the claimant is not entitled to disability benefits for the time spent undergoing diagnostic tests. Crystal Oil Co. v. Dotson, 12 Va. App. 1014, 408 S.E.2d 252, 8 Va. Law Rep. 410, 1991 Va. App. LEXIS 201 (1991).

    Reasonable effort to market remaining work capacity. —

    As a condition to benefits under the Act, a partially disabled employee must make a reasonable effort to market his remaining work capacity. Manis Construction Co. v. Arellano, 13 Va. App. 292, 411 S.E.2d 233, 8 Va. Law Rep. 1466, 1991 Va. App. LEXIS 301 (1991).

    Burden was on claimant to prove that “[h]e made a reasonable effort to procure suitable work but [was] unable to market [his] remaining work capacity.” Manis Construction Co. v. Arellano, 13 Va. App. 292, 411 S.E.2d 233, 8 Va. Law Rep. 1466, 1991 Va. App. LEXIS 301 (1991); Hunter v. Newport News Shipbuilding & Dry Dock Co., 2001 Va. App. LEXIS 312 (Va. Ct. App. June 5, 2001).

    When determining whether an employee has made a reasonable effort to market his remaining work capacity the trier of fact should compare the efforts of the employee to those of a reasonable employee in the same or similar circumstances seeking suitable employment in good faith. National Linen Serv. v. McGuinn, 8 Va. App. 267, 380 S.E.2d 31, 5 Va. Law Rep. 2607, 1989 Va. App. LEXIS 60 (1989).

    In deciding whether a partially disabled employee has made reasonable effort to find suitable employment commensurate with his abilities, the commission should consider such factors as: (1) the nature of and extent of employee’s disability; (2) the employee’s training, age, experience, and education; (3) the nature and extent of employee’s job search; (4) the employee’s intent in conducting his job search; (5) the availability of jobs in the area suitable for the employee, considering his disability; and (6) any other matter affecting employee’s capacity to find suitable employment. The commission, of course, determines which of these or other factors are more or less significant with regard to the particular case. Where the commission takes notice of employment conditions in a particular area, such should be stated in the findings of fact along with the findings regarding the other factors considered. National Linen Serv. v. McGuinn, 8 Va. App. 267, 380 S.E.2d 31, 5 Va. Law Rep. 2607, 1989 Va. App. LEXIS 60 (1989); Newport News Shipbuilding & Dry Dock Co. v. Walton, 2001 Va. App. LEXIS 209 (Va. Ct. App. Apr. 17, 2001).

    To prove her entitlement to benefits, claimant was required to demonstrate that she made a reasonable effort to procure suitable work but was unable to market her remaining work capacity. Baum v. Sports Auth., 1993 Va. App. LEXIS 636 (Va. Ct. App. Dec. 14, 1993).

    An employee working under restrictions attendant to a compensable injury may have benefits restored upon termination of such employment, provided the employee thereafter reasonably markets his or her residual earning capacity. Westmoreland Coal Co. v. Kilgore, 1997 Va. App. LEXIS 289 (Va. Ct. App. May 6, 1997).

    What constitutes a reasonable marketing effort depends upon the facts and circumstances of each case. Newport News Shipbuilding & Dry Dock Co. v. Walton, 2001 Va. App. LEXIS 209 (Va. Ct. App. Apr. 17, 2001).

    Employer’s appeal of a decision of the Virginia Worker’s Compensation Commission was summarily affirmed as the claimant’s testimony, coupled with documentary evidence and medical records, supported the Commission’s decision that claimant had made reasonable efforts to market her residual work capacity; the claimant had taken courses and applied for grants to create an employment opportunity, and had limited her job search to potential employers within an hour’s distance of her home. Fairfax County Sch. Bd. v. Nolden-Thompson, 2003 Va. App. LEXIS 408 (Va. Ct. App. July 22, 2003).

    Workers’ Compensation Commission wrongly awarded temporary partial disability benefits under subsection A of § 65.2-502 to a claimant as the claimant did not market her residual work capacity. She accepted the only position offered by the employer, a position consistent with her post-injury work restrictions and her self-limited hours of availability due to family responsibilities and reluctance to drive at night. CVS # 1549/CVS of Va., Inc. v. Plunkett, 57 Va. App. 373, 702 S.E.2d 578, 2010 Va. App. LEXIS 493 (2010).

    Because a workers’ compensation claimant did not make a reasonable effort to market the claimant’s residual work capacity beyond obtaining a new job for a portion of the hours the claimant worked before being injured, the Virginia Workers’ Compensation Commission erred in awarding temporary partial disability benefits to the claimant. Ross & Sons Util. Contr., Inc. v. Hively, 2011 Va. App. LEXIS 92 (Va. Ct. App. Mar. 15, 2011).

    Credible evidence supported a determination that a claimant had made a reasonable effort to market his remaining work capacity under subsection A of § 65.2-502 . He worked the maximum number of hours as restricted by his treating physicians and did not refuse any offer of light-duty work. G. C. Constr., L.L.C. v. Cruz, 2012 Va. App. LEXIS 62 (Va. Ct. App. Mar. 6, 2012).

    Evidence supported the finding that a temporary partial disability claimant engaged in a good faith effort to obtain work that was within the tolerance of his physical condition and that the jobs he held since the accident were the best jobs for him as the evidence showed that the claimant was 61 years old at the time of the accident, he had been in the industry for 24 years, and he had a good customer base. Thus, the claimant marketed the full extent of his residual work capacity. Uninsured Employer's Fund v. Carter, 2012 Va. App. LEXIS 119 (Va. Ct. App. Apr. 17, 2012).

    Remand was necessary because the Virginia Workers’ Compensation Commission erred by finding that a claimant met the claimant’s burden to prove that the claimant reasonably marketed the claimant’s residual work capacity after obtaining part-time work. The claimant should have present evidence of: (1) the names of businesses the claimant contacted; (2) the types of positions sought; (3) the number of contacts made; and (4) the time frame within which work was sought. Tricon Constr., Inc. v. Rojas-Rojas, 2014 Va. App. LEXIS 49 (Va. Ct. App. Feb. 18, 2014).

    Workers’ Compensation Commission properly denied an injured employee’s claim for temporary partial disability benefits because, while he did not unjustifiably refuse selective employment, he presented no evidence that he marketed his residual capacity, and the employee’s affirmative duty to market his residual capacity and present evidence of such marketing was not relieved by the existence of a separate and unrelated claim for vocational training benefits. BWX Techs. v. Ashby, 2020 Va. App. LEXIS 133 (Va. Ct. App. May 5, 2020).

    Failure to market residual work capacity. —

    The Commission’s decision that an employee had failed to make a reasonable effort to market his residual work capacity was supported by credible evidence where the evidence established that during a 4-month period which included hunting season, the employee had made no efforts to find work other than checking on applications submitted the previous summer, and that in the week prior to the hearing before the Commission, the employee had submitted six applications to businesses in a very limited area but that the employee didn’t know whether these businesses were hiring or whether they had jobs within his physical limitations. Hunter v. Newport News Shipbuilding & Dry Dock Co., 2001 Va. App. LEXIS 312 (Va. Ct. App. June 5, 2001).

    Workers’ Compensation Commission determination that a claimant failed to market his residual wage earning capacity was supported where he left jobs after short periods and his choice of self-employment was not his only remaining job option. Allen v. S. Commer. Repair, Inc., 40 Va. App. 116, 578 S.E.2d 64, 2003 Va. App. LEXIS 152 (2003).

    Where a partially disabled employee only made 1.07 job contacts per week during a 28-week period and was unable to document the contacts that were made, the workers’ compensation commission properly found that the employee did not adequately market the employee’s residual work capacity. Wilson v. Perdue Farms, Inc., 2004 Va. App. LEXIS 75 (Va. Ct. App. Feb. 17, 2004).

    As there was no evidence that an injured employee made a reasonable effort to market his residual work capacity, under subsection A of § 65.2-502 , he was not entitled to temporary partial disability benefits for the weeks during which he was placed on light duty work and did not receive overtime, which he had regularly received before his injury. Ford Motor Co. v. Favinger, 275 Va. 83 , 654 S.E.2d 575, 2008 Va. LEXIS 4 (2008).

    Employee who waited over 10 months after his retirement due to an occupational disease to seek employment, did not offer evidence as to what jobs were available based on his education, training, and limitations, and sought no further employment for higher pay after accepting a low-paying part-time position did not reasonably market his residual work capacity, such that an award of total partial disability benefits by the Virginia Workers’ Compensation Commission was not supported by the evidence pursuant to the applicable standard of review under § 65.2-706 . County of James City Fire Dep't v. Smith, 54 Va. App. 448, 680 S.E.2d 307, 2009 Va. App. LEXIS 348 (2009).

    In a case in which an employer and an insurance company appealed a decision by the Virginia Workers’ Compensation Commission (Commission) awarding ongoing temporary partial disability benefits to a claimant, the Commission’s conclusion that, given the claimant’s restrictions, she sufficiently marketed her residual capacity in finding a job was erroneous as a matter of law, as the claimant failed to present evidence, as required by the Favinger decision, that she attempted to market her residual work capacity of twenty hours per week after March 31, 2008. Further, she presented no evidence that available jobs within her capacity would have interfered with the duties of her part-time employment. Plant Ptnrs. & Nationwide Agribusiness Ins. Co. v. Pittman, 2009 Va. App. LEXIS 448 (Va. Ct. App. Oct. 6, 2009).

    Claimant was not entitled to temporary partial disability benefits because he failed to apply for any jobs or even make contact with any potential employers, and his argument that obtaining part-time position with another employer would have interfered with his full-time or overtime opportunities with the employer was premature and unpersuasive. Chaney v. Honeywell Int'l, Inc., 2011 Va. App. LEXIS 69 (Va. Ct. App. Mar. 1, 2011).

    Employee was not entitled to temporary partial disability benefits because the employee’s forty-two-hour work restriction did not apply to work other than the employee’s full duty job as a tire builder at the employer and the employee failed to make a good faith effort to market his residual work capacity; the employee routinely worked sixty to seventy hours per week before his injury. Wells v. Goodyear Tire & Rubber Co., 2013 Va. App. LEXIS 376 (Va. Ct. App. Dec. 17, 2013).

    Medical evidence supported the Workers’ Compensation Commission’s finding that an employee was not totally disabled because the employee admitted that he had not sought other employment after the employer told him no light-duty work was available; thus, the evidence established that the employee failed to market his residual capacity, as he was required to do to receive partial disability benefits. Case v. UPS, 2017 Va. App. LEXIS 107 (Va. Ct. App. Apr. 18, 2017).

    Selective employment where worker not temporarily totally disabled. —

    Workers’ Compensation Commission properly found the worker was not justified in refusing to perform a cashier job that she was able to perform as her employer offered selective employment that complied with her restrictions as the worker was not temporarily totally disabled. Vance v. Lowes of Staunton, 2003 Va. App. LEXIS 455 (Va. Ct. App. Aug. 26, 2003).

    The extent of earning capacity must be ascertained from the evidence, and such is not limited to any special class of proof. All legal facts and circumstances surrounding the claim should properly be considered and due weight given them by the Commission. Pilot Freight Carriers, Inc. v. Reeves, 1 Va. App. 435, 339 S.E.2d 570, 1986 Va. App. LEXIS 220 (1986).

    “Able to earn” should not be construed to be synonymous with “earns” or “is paid” and a claimant who has the burden of proof, and who seeks compensation of the wage differential between his new and his old jobs, has the burden of proving that he has made a reasonable effort to market his full remaining work capacity. National Linen Serv. v. McGuinn, 8 Va. App. 267, 380 S.E.2d 31, 5 Va. Law Rep. 2607, 1989 Va. App. LEXIS 60 (1989).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Compensation awarded for time missed from work following diagnostic tests where the claimant undergoes multiple diagnostic studies during non-work hours, as ordered and scheduled by a treating physician, and the physician excused the claimant from work as a result of those tests. The Commission will not second guess a professional rationale which appears to be a reasonable and necessary medical practice. Brown v. Johnson Memorial Hospital, VWC File No. 233-60-73 (March 8, 2010).

    The claimant did not show a good faith effort to market his residual work capacity where his marketing list contained few dates of contact, did not indicate whether he inquired about work, whether the businesses were hiring, and did not identify the positions about which he was inquiring. Cogdell v. Gwaltney of Smithfield, Ltd/Smithfield Foods, Inc., VWC File No. 232-95-22 (April 28, 2008).

    Where the treating doctor determined that because of a change in the claimant’s physical condition he was totally disabled for two days, the injured worker was entitled to an award even if he was not scheduled to work on the dates included in the disability. Quesenberry v. Pilgrim’s Pride Corp., VWC File No. 206-01-68 (April 3, 2006).

    Wage loss benefits may be received for required medical appointments during work time only if it is shown that the medical condition required the appointment during work hours, if the scheduling at a non-work time would interfere with obtaining favorable work assignments, or if scheduling at a non-work time would cause substantial hardship. Aubuchon v. Domino’s Pizza, VWC File No. 211-80-86 & 217-98-00 (Oct. 3, 2005).

    In determining whether an award should be terminated because the claimant earned greater than her pre-injury wage it was appropriate to use a bi-weekly method of calculation, as the pay records were generated on this basis, rather than either a quarterly or a single weekly average covering the entire period. Deel v. Buchanan General Hospital, VWC File No. 215-84-18 (Aug. 8, 2005).

    The Guidelines for Vocational Rehabilitation require professional rehabilitation counselors to pre-screen jobs for suitability. A claimant is not required to pre-screen jobs in order to satisfy his obligation to adequately market his residual physical capacity. Smith v. Dickenson (County of) School Bd., VWC File No. 208-74-32 (May 11, 2005), aff’d, No. 1379-05-3 (Ct. App. Va., Oct. 11. 2005) (Unpublished Opinion).

    Because a list of job contacts and the claimant’s deposition are not medical records, they are not part of the record unless they were moved into evidence. Even in on-the-record hearings the entirety of the file does not become part of the record. Owens v. Miners and Merchants Bank and Trust, VWC File No. 219-47-41 (Jan. 10, 2006).

    During brief period of temporary partial disability, claimant must contact employer to inquire if light duty work is available. Couch v. Dominion Virginia Power, VWC File No. 203-89-55 (Nov. 22, 2004).

    No duty to market during ten week period where claimant was eager to return to work, employer was pleased with claimant’s work and eager for his return, and claimant returned to work shortly after anticipated return date. Temple v. Halls Auto Body, Inc., VWC File No. 215-37-34 (Aug. 2, 2004).

    The employer does not have to anticipate continuing disability, so compensation is not due under an open Award until the last day of the next weekly period, i.e., on November 7 for a disability period beginning November 1. Robbins v. Greater Wise, Inc., 79 O.W.C. 67 (2000).

    The amendment to § 65.1-55 (now § 65.2-502 ) requiring payment of temporary partial benefits for a total of 500 weeks rather than limiting such benefits to 500 weeks from the date of the accident is a substantive change and, therefore, not retroactive. Adams v. State Farm Insurance Co., 69 O.I.C. 134 (1990) (see also Sines v. Fairfax County, 75 O.W.C. 321 (1996)).

    Cost-of-living benefits do not accrue during the payment of temporary partial compensation. Dehart v. Safeway Stores, Inc., 67 O.I.C. 202 (1988).

    An employee not under an open Award has an affirmative duty to market his residual capacity, and this includes a duty to make a reasonable inquiry of his physician to ascertain his capacity for work. Where the employee testified that he sought work at “many” restaurants, there was insufficient proof of marketing efforts. Ruiz v. Abbotts Upholstery, 75 O.W.C. 213 (1996).

    While a claimant ordinarily has the burden to prove he made a reasonable effort to market his residual work capacity, he is not required to prove marketing efforts where the evidentiary hearing was held only three days after his release to light duty. A statement by the treating physician two months earlier that the claimant might possibly be able to work in three weeks was found by the Commission to be too indefinite to be a release, where the subsequent medical reports show the claimant was still symptomatic and the physician completed a disability slip reporting the claimant was totally disabled until three days before the hearing. Pineda v. Brothers, 78 O.W.C. 1 (1999).

    A partially disabled employee seeking an award of temporary total disability benefits has the burden of proving that he made reasonable efforts to procure suitable work, but was unable to successfully market his remaining capacity. Such evidence is properly addressed by the Deputy Commissioner, even if the employer does not raise it. Pullen v. Stackhouse, Inc., 78 O.W.C. 59 (1999).

    Payments made to an employee performing light duty work under a wage continuation program that exceeded the hourly wage for the job to which the employee was assigned and which greatly surpassed the maximum compensation rate under the Act, constitute payments in lieu of compensation. Therefore, the employee is not entitled to temporary partial benefits. Michael v. Appalachian Power Company, 70 O.I.C. 218 (1991).

    Compensation for partial disability due to first accident continued during period of total disability from subsequent non-industrial accident where partial work incapacity had not ceased. Brooks v. Olsen Co., Inc., 46 O.I.C. 29 (1964).

    Benefits received under the Work Force Transition Act are not “wages” for the purposes of the Workers’ Compensation Act, and workers’ compensation benefits are not prejudiced by participation in that voluntary separation program. Swiney v. Commonwealth of Virginia/Dept. of Transportation, 74 O.W.C. 214 (1995).

    Not Eligible for Employment:

    Employer’s Application for Hearing rejected because when application was filed there was no documentary evidence to show claimant could not be lawfully employed in the United States. Employer later filed additional evidence after its application was filed to support its application. Rejection of application affirmed. Martinez v. Crews for You, JCN VA00000850632 (Aug. 25, 2014).

    Partial Incapacity Benefits:

    A disability claim for benefits is based on the law in effect on the date of injury. Prior to October 1, 1991, Code § 65.1-56 [now Code § 65.2-503 ] provided that a permanent partial disability award could not extend the limitations of Code § 65.1-54 [now Code § 65.2-500 ], or of Code § 65.1-55 [now Code § 65.2-502 ], each of which limited entitlement to compensation to a period not exceeding 500 weeks. A week of temporary partial compensation is equivalent to a week of temporary total compensation when computing the 500-week limitation. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    Code § 65.2-503 was amended effective October 1, 1991, and a claimant injured on or after that date was entitled to receive permanent partial incapacity benefits after receiving 500 weeks of temporary total or temporary partial benefits. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    The claimant was under an open award for temporary partial disability resulting from an October 1990 accident when he filed a claim for permanent partial disability compensation. The Deputy Commissioner limited the award to the difference between the claimant’s statutory entitlement to 500-weeks benefits and the number of weeks’ benefits that the claimant had already received. The Commission modified that award, holding that the claimant’s entitlement to permanent partial disability benefits accrued on the date his application was filed, although the employer was entitled to a credit for temporary partial disability benefits it had continued to pay. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    Actual wage loss by a claimant attributable to incapacity to perform his pre-injury employment as a result of a compensable injury is the standard upon which compensation entitlement is based. Entitlement to temporary total disability benefits requires that the claimant be totally incapacitated from earning wages. Entitlement to temporary partial disability benefits is based on the difference between the average weekly wage before the injury and the average weekly wage that the employee is able to earn thereafter. Moreland v. Cellofoam North America, Inc., 78 O.W.C. 259 (1999).

    Although entitlement to temporary partial benefits is generally computed on a quarterly basis, the rate of temporary partial benefits will be computed on a weekly basis when a quarterly determination would be unfair to the employee. Adams v. State Farm Insurance Co., 69 O.I.C. 134 (1990).

    Virginia Code § 65.2-502 provides that an employee’s partial incapacity compensation will be based on an amount “equal to 66 2/3 percent of the difference between his average weekly wages before the injury and the average weekly wages which he is able to earn thereafter, . . .” Generally, the Commission computes this compensation on a quarterly basis, unless it would cause undue hardship or be unfair to the employee. A weekly calculation of partial wage loss is appropriate where the quarterly average calculation would deprive the employee of receiving compensation for the weeks that he earned less than his pre-injury average weekly wage. Harold v. Design and Production, Inc., 79 O.W.C. 167 (2000).

    In this case, the claimant’s wage records showed that his post-injury weekly wage exceeded his pre-injury average weekly wage on only five occasions in a 25-week period. The Commission agreed that a week-by-week compensation rate more properly compensated the claimant for his wage loss during the 25-week period, while denying compensation for the other five weeks that his post-injury weekly wage exceeded his pre-injury average weekly wage. Thus, the Commission held that a quarterly computation of the claimant’s post-injury weekly wages unfairly deprived him of compensation benefits, and the week-by-week determination better indicated his partial wage loss. Harold v. Design and Production, Inc., 79 O.W.C. 167 (2000).

    Entitlement to temporary partial benefits should be determined on a weekly basis. Such method is consistent with Code § 65.2-502 , which compares weekly earnings before and after the accident. Hall v. Wampler-Longacre, Inc., 77 O.W.C. 48 (1998).

    When computing temporary partial benefits the statutory formula is applied without regard to economic conditions unrelated to the injury or labor agreements. Beasley v. Kroger Company, 67 O.I.C. 226 (1988).

    Employment and earnings obtained as a result of marketing efforts after a compensable industrial injury offsets disability compensation benefits, whether or not the subsequent employment is similar to or has similar work hours as the pre-injury employment. Edwards v. Ramada Hotel Tyson/Richfield Hotel, 74 O.W.C. 216 (1995).

    If the employee restricts his job search to jobs which he cannot reasonably expect to perform, he may not have made a reasonable effort to market his residual capacity. Harvey v. Dean Steel Erectors Co., 76 O.W.C. 24 (1997).

    Where the evidence shows that light duty work was difficult to find, and the employee could reasonably expect his disability to be short lived and that his doctors might consider adjustment of restrictions, at least on a trial basis, the fact that the employee actually found work without assistance from the employer is compelling evidence that he made his job search with the intent of locating employment, and the employee therefore proved he had made reasonable efforts to market his residual work capacity. Harvey v. Dean Steel Erectors Co., 76 O.W.C. 24 (1997).

    The average weekly wage of a claimant, who after his injury started a sole proprietorship, is based on the net taxable income reported by the business for Federal Income Tax purposes. This includes allowable expenses such as depreciation and interest without regard to whether a special fund was established as well as any draw or salary paid to or on behalf of the claimant. The concurring opinion noted several methods for calculating depreciation under federal law and limited the exclusion for depreciation to the straight line procedure. Accelerated depreciation would not be permitted. Holcombe v. Meredith Construction Company, Inc., 73 O.W.C. 31 (1994).

    After the claimant was released to light-duty employment in October 1997, he purchased a truck and drove it as an owner/operator, leasing both the truck and his services to Roberts Express. The claimant stopped working as a truck driver on December 26, 1997, although the lease arrangement continued. Roberts Express thereafter controlled the operation of the truck, scheduled delivery and pick-up assignments, assumed truck maintenance responsibilities, and paid the driver. The Commission found that the claimant stopped earning wages once he stopped working as an owner/operator, and his truck became solely a capital investment. It held that these investment earnings were not wage income to be used to determine the claimant’s disability compensation benefits. Moreland v. Cellofoam North America, Inc., 78 O.W.C. 259 (1999).

    In determining the temporary partial benefits to a self-employed claimant, it is appropriate to allow a credit for capital expenditures, repayment of loans and other expenses of the business including the cost of operations and labor. Simms v. Giant Food, Inc., 71 O.W.C. 189 (1992).

    An employee who is in engaged in on the job training with his wages supplemented by benefits from the Veterans Administration must include these benefits in determining the actual hourly rate received. Johnson v. Railway Handle Corp., 71 O.W.C. 191 (1992).

    While wages actually earned are the best evidence of earning ability after an injury, if, for reasons not injury-connected, the injured workman elects to earn no wages, the ability to earn must be determined from other facts and circumstances. Sorrell v. Westinghouse Elec. Corp., 48 O.I.C. 225 (1966).

    Compensation cannot be based on wage employee would earn if he were able to return to pre-injury employment; must be based on difference in actual wages earned. Parr v. B & W Associates, 51 O.I.C. 207 (1969).

    Where claimant secured a job where he could work or not work as he liked, compensation for loss of wages was based on wage working regularly would have produced. McClanahan v. Panther Coal Co., Inc., 43 O.I.C. 75 (1961).

    The employee, a flight attendant, was entitled to payment of compensation benefits for those intermittent days in which she was unable to fly because of her industrial injury even though her monthly earnings resulted in an average weekly wage in excess of her pre-injury wage. Merillat v. Allegheny Airlines, U.S. Air, 70 O.I.C. 213 (1991), affirmed, 14 Va. App. 341, 416 S.E.2d 467 (1992).

    The fact that an employee must work longer hours to earn the same or greater wages subsequent to his compensable injury is not a basis for awarding compensation benefits. Banks v. Spotsylvania County School Board, 70 O.I.C. 216 (1991).

    This section does not limit earnings to a forty-hour week. The fact that it was due to additional hours of employment that wage after return to work was in excess of that earned at time of accident is not basis for payment of compensation for loss of wages. Floyd v. Foote Mineral Co., 43 O.I.C. 44 (1961).

    If the employer provides selective work only part time the compensation rate is governed by workmen’s average weekly wages, not what he would have earned at new rate if he were working every day. Golley v. Stonega Co., 3 O.I.C. 659 (1921).

    The treating psychiatrist reported that the claimant was disabled from post traumatic stress disorder and depression related to the work accident, and “may not be able to work for the next six to twelve months,” and that the claimant was unable to return to his regular job. Another psychiatrist concluded after an independent evaluation that the claimant remained symptomatic, but could perform light duty work. The Commission held that the claimant had failed to prove a total inability to perform work, and he had to market his residual capacity. Meadows v. Condon Reed, Inc., 76 O.W.C. 241 (1997).

    An employee marketed her remaining capacity when she began a babysitting business which produced income that generally exceeded her pre-injury wage but occasionally fluctuated. The earnings for each thirteen-week quarter should be added and divided by the number of weeks to determine if the employee is entitled to disability benefits or the employer to a credit for overpayment. Zimmer v. Capital Milk Producers Cooperative, Inc., 69 O.I.C. 184 (1990).

    A claimant seeking an increase in benefits has an obligation to fully market her residual capacity. Merely obtaining employment, by itself, does not necessarily prove adequate marketing. Mannix v. St. Mary’s Hospital, 76 O.W.C. 515 (1997).

    Wage Loss from Work Related Injury:

    Deputy Commissioner correctly awarded wage-loss benefits to employee who earned less in selective employment than in pre-injury employment, despite employer’s argument that wage loss was attributable to worsening economic conditions and not to the injury; evidence showed employee was restricted from performing overtime work because of physical incapacity, and thus non-availability of overtime work not relevant to determination of amount of wage-loss benefits. Elkon v. Metropolitan Washington Airport Auth., VWC File No. 202-62-61 (Sept. 26, 2003).

    Where employee is discharged after becoming incapacitated and is unable to secure a wage equal to that earned by him before accident he is entitled to compensation under this section. Caudell v. Va. Ry. & Power Co., 3 O.I.C. 154 (1921).

    Compensation continued where change in working condition recommended by doctor resulted in reduction wage. Brill v. O’Boyle Tank Lines, 48 O.I.C. 13 (1966).

    Medical restrictions from returning to the workplace that are shown to be causing the employee’s compensable allergic reaction are analogous to a release with restrictions that prevent a return to pre-injury work, and establishes continuing partial impairment. Simpson v. Department of Social Services, 75 O.W.C. 105 (1996).

    Claimant who terminated employment as asbestos worker on physician’s advice entitled to temporary partial benefits. Gowen v. Thurston & Sons, Inc., 52 O.I.C 117 (1970).

    For cases discussing loss of overtime see Carr v. Va. Electric & Power, 25 Va. App. 306, 487 S.E.2d 878, 1997 Va. App. LEXIS 500 (1997); Consolidated Stores Corp. v. Graham, 25 Va. App. 133, 486 S.E.2d 576, 1997 Va. App. LEXIS 409 (1997), overruled in part, King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016).

    Wage Loss Not from Work Related Injury:

    Employer’s managerial decision to limit the overall amount of overtime worked by its employees does not constitute a change in condition warranting suspension of temporary partial disability benefits where the partially disabled employee’s work-related incapacity also prevents him from being able to market his pre-injury work capacity. Cox v. Korman Signs, Inc., VWC File No. 211-25-39 (Dec. 21, 2004).

    Employer responsible for claimant’s wage loss attributable to union concessions resulting in change in claimant’s post-injury wage. Smith v. U.S. Airways, Inc., VWC File No. 209-36-81 (Dec. 10, 2004).

    Where an employee is seeking reinstatement of compensation benefits following an economic layoff from a light duty position, anticipation of being recalled by the employer is not justification for failure to market remaining capacity. Hall v. C.R. Hudgins Plating, Inc., 70 O.I.C. 237 (1991).

    While recognizing that employees who work on commission face a more difficult burden of proof in establishing wage loss from an injury than those employees who are paid on an hourly basis, the Commission found that the claimant failed to establish that medication or medical treatment from the injury resulted in his demotion from manager to salesman and a reduction in earnings. Scotece v. Prudential Insurance Co., 68 O.I.C. 69 (1989).

    Where claimant’s request for part-time work at a wage of $100 per month was motivated by the provisions of the Social Security Act rather than physical inability to continue full-time employment, compensation will not be allowed for the diminution in wage. Robinson v. Sayers Florists, 39 O.I.C. 94 (1957).

    An employee who accepted employment without regard to the salary but because of interest in the type of work and made no other effort to explore the employment market is not entitled to temporary partial disability benefits because he failed to reasonably market his residual skills. Cooper v. Loudoun County Sheriff ’s Dept., 69 O.I.C. 180 (1990).

    Benefits will not be allowed where a six-day week employment was voluntarily terminated and five-day week obtained. Miller v. Black Diamond Coal Co., 42 O.I.C. 98 (1960).

    Loss of wages attributable to preference for farm work six months of each year is not compensable. Moore v. Seaside Sand & Gravel Co., 45 O.I.C. 179 (1963).

    An employee who procures full-time selective employment after being injured performing seasonal work was not entitled to temporary partial benefits if he refused seasonal work within his physical capacity in order to remain in the year-around position. Yager v. Noah P. Turner Landscaping, Inc., 68 O.I.C. 7 (1989).

    When an employee is medically able to carry out all the duties of his pre-injury employment, he is not entitled to compensation benefits for any wage loss that might occur. Prescott v. Contractors Group, Inc., 65 O.I.C. 205 (1986).

    Where claimant is actually earning more than at time of injury, it is irrelevant that he is on selective work. Cooper v. Dowling Neon Sign Co., 49 O.I.C. 77 (1967).

    In the case of temporary partial incapacity, when a claimant’s incarceration for a criminal act rather than his physical incapacity causes the claimant’s loss of earning power, the employer is relieved from paying benefits during the period of incarceration. Baskerville v. Saunders Oil Co., 1 Va. App. 188, 336 S.E.2d 512, 1985 Va. App. LEXIS 83 (1985).

    Effect of Two Jobs at Time of Injury:

    Where a claimant is employed at two dissimilar jobs, he is entitled to compensation benefits only for the period in which he is medically incapacitated for the duties required of the job in which the compensable injury occurred. Hinkle v. City of Covington, 65 O.I.C. 28 (1986).

    After claimant’s work injury in evening hours employment, she also lost her dissimilar daytime job. The Commission did not agree that work she later found was a replacement for her second employment, rather than the results of successful marketing efforts following the work accident, and the wages earned were considered to determine the amount of any wage loss attributable to the work injury. Edwards v. Ramada Hotel Tyson/Richfield Hotel, 74 O.W.C. 216 (1995).

    When a claimant is employed at two similar jobs for which the wages were combined, he is entitled to compensation on a partial basis when he is unable because of his compensable injury to return to work at either employment position. Beisler v. Commonwealth of Virginia/Brunswick County Correctional Center, 65 O.I.C. 32 (1986).

    Compensation awarded for loss of time from second job though continuing regular job. Taylor v. Richard Foundry Corp., 54 O.I.C. 366 (1972).

    An employee who returns to his pre-injury dissimilar part-time employment has marketed his remaining capacity and is entitled to an award for temporary partial incapacity. The employer was entitled to a credit for increased earnings when the claimant, because of additional available time, worked extra hours at the dissimilar job. City of Fairfax v. Massey, 11 Va. App. 680, 401 S.E.2d 439 (1991) also 68 O.I.C. 11 (1989).

    The employer is entitled to a credit for the claimant’s earnings in other pre-injury employment which continued after the industrial accident. Compensation benefits are based on two-thirds of this partial wage loss even though this rate would entitle the claimant to greater compensation benefits than his actual earnings with the Guard. Wade v. Virginia Military Affairs, 70 O.I.C. 1 (1991).

    Effect of Refusing Selective Employment or Rehabilitation:

    A claimant who cured an earlier refusal of selective employment by finding another job was not entitled to temporary partial benefits until his wages reached that of the previously refused position. The wage loss was not a result of the accident but of his earlier refusal. Lawhorne v. H. F. Interiors, Inc., 68 O.I.C. 176 (1989).

    A claimant may cure an unjustified refusal of vocational rehabilitation and be entitled to temporary partial disability benefits by obtaining selective employment on his own initiative. However, the employer is not precluded from seeking a better-paying position for the claimant who has a continuing obligation to cooperate with those efforts. Vernon v. Hampton Roads Sanitation District, 68 O.I.C. 190 (1989).

    The employee’s relocation to South Carolina for financial reasons did not justify refusing selective employment. Having refused a good faith offer of selective employment at his pre-injury wage, the employee was not entitled to temporary partial benefits upon curing his refusal by finding selective work in South Carolina. Port v. Suburban Grading & Utilities, Inc., 69 O.I.C. 169 (1990).

    The claimant returned to light duty with the employer after sustaining a back injury that left her permanently disabled from her pre-injury work. The employer had created the job for her, but it was not a permanent position and the claimant was encouraged to look for other work. The employer, through a vocational rehabilitation provider, was unable to locate appropriate alternative work. On her own, the claimant located and accepted a position with earnings approximately 10% below her pre-injury average weekly wage. The employer defended the claim for temporary partial disability on the ground that the claimant voluntarily resigned and did not have a compensable change in condition. The Commission held that these facts demonstrated the claimant’s good faith efforts to market her residual capacity and supported the Deputy Commissioner’s award of temporary partial disability. Mannix v. St. Mary’s Hospital, 76 O.W.C. 515 (1997).

    Except in unusual circumstances selective employment must be offered within a reasonable distance of the employee’s residence or place of injury. It is unreasonable to expect an employee, whether at his expense or the employer’s, to move from North Carolina to Florida to accept a light duty position. Mullins v. Misener Marine Construction Inc., 69 O.I.C 167 (1990).

    § 65.2-503. (Effective until July 1, 2022) Permanent loss.

    1. Compensation for permanent partial and permanent total loss and disfigurement shall be awarded as provided in this section.
    2. The following losses shall be compensated for the period specified at the rate of 66 2/3 percent of the average weekly wage as defined in § 65.2-101 : Click to viewThe loss of more than one phalanx of a thumb or finger is deemed the loss of the entire thumb or finger. Amounts received for loss of more than one finger shall not exceed compensation provided for the loss of a hand. Click to viewThe loss of more than one phalanx of a toe is deemed the loss of the entire toe. Click to view
    3. Compensation shall be awarded pursuant to § 65.2-500 for permanent and total incapacity when there is:
      1. Loss of both hands, both arms, both feet, both legs, both eyes, or any two thereof in the same accident;
      2. Injury for all practical purposes resulting in total paralysis, as determined by the Commission based on medical evidence; or
      3. Injury to the brain which is so severe as to render the employee permanently unemployable in gainful employment.
    4. In construing this section, the permanent loss of the use of a member shall be equivalent to the loss of such member, and for the permanent partial loss or loss of use of a member, compensation may be proportionately awarded. Compensation shall also be awarded proportionately for partial loss of vision or hearing.
    5. Except as provided in subsection C, the weekly compensation payments referred to in this section shall be subject to the same limitations as to maximum and minimum as set out in § 65.2-500 .
      1. Compensation awarded pursuant to this section shall be payable after payments for temporary total incapacity pursuant to § 65.2-500 .
      2. Compensation pursuant to this section may be paid simultaneously with payments for partial incapacity pursuant to § 65.2-502 . Where compensation pursuant to this section is paid simultaneously with payments for partial incapacity pursuant to § 65.2-502 , each combined payment shall count as two weeks against the total maximum allowable period of 500 weeks.

    Loss Compensation Period 1. Thumb 60 weeks. 2. First finger (index finger) 35 weeks. 3. Second finger 30 weeks. 4. Third finger 20 weeks. 5. Fourth finger (little finger) 15 weeks. 6. First phalanx of the thumb or any finger one-half compensation for loss of entire thumb or finger.

    7. Great toe 30 weeks. 8. A toe other than a great toe 10 weeks. 9. First phalanx of any toe one-half compensation for loss of entire toe.

    10. Hand 150 weeks. 11. Arm 200 weeks. 12. Foot 125 weeks. 13. Leg 175 weeks. 14. Permanent total loss of the vision of an eye 100 weeks. 15. Permanent total loss of hearing of an ear 50 weeks. 16. Severely marked disfigurement of the body resulting from an injury not otherwise compensated by this section not exceeding 60 weeks. 17. Pneumoconiosis, including but not limited to silicosis and asbestosis, medically determined to be in the a. First stage 50 weeks. b. Second stage 100 weeks. c. Third stage 300 weeks. 18. Byssinosis 50 weeks.

    History. Code 1950, § 65-53; 1964, cc. 116, 190; 1968, cc. 347, 660, § 65.1-56; 1970, c. 470; 1972, c. 229; 1975, cc. 446, 450; 1976, c. 655; 1982, c. 326; 1983, c. 287; 1987, c. 560; 1988, cc. 564, 596; 1991, c. 355; 1997, c. 511; 2000, c. 520.

    The 2000 amendments.

    The 2000 amendment by c. 520 inserted “as defined in § 65.2-101 ” at the end of the introductory language of subsection B.

    The 2022 amendments.

    The 2022 amendment by c. 530, substituted “thereof either from the same accident or a compensable consequence of an injury sustained in the original accident” for “thereof in the same accident” in subdivision C 1.

    Law Review.

    For article on compensation for black lung at the federal level, see 57 Va. L. Rev. 97 (1971).

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    for the year 1975-1976, see 62 Va. L. Rev. 1506 (1976).

    For survey of Virginia law on governmental services and social welfare for the year 1977-1978, see 64 Va. L. Rev. 1461 (1978).

    For 1995 survey of workers’ compensation, see 29 U. Rich. L. Rev. 1199 (1995).

    For an article relating to the most significant developments in the law of workers’ compensation since September, 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 21, 23, 42, 44, 58, 72, 74.

    CASE NOTES

  • Analysis
  • I.General Consideration.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-56 or prior law.

    This section and former § 65.1-55 (now § 65.2-502 ) are complementary. Morris v. Pulaski Veneer Corp., 183 Va. 748 , 33 S.E.2d 190, 1945 Va. LEXIS 222 (1945).

    Section deals exclusively with partial disabilities; its scope is limited to partial disabilities resulting from injuries of a certain, definite, and particularly described character, to-wit, injuries to particular members or organs of the body. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    Benefits awarded under this section constitute indemnity for the loss of or loss of use of a scheduled body member; such benefits are not awarded for loss of earning capacity, as are benefits provided for under § 65.2-500 . Cross v. Newport News Shipbuilding & Dry Dock Co., 21 Va. App. 530, 465 S.E.2d 598, 1996 Va. App. LEXIS 17 (1996).

    Benefits for loss of “human capital.” —

    Benefits paid pursuant to this section for the loss of use of a body member are not payments for loss of wages but for loss of what might be termed “human capital”; they are in no way contingent upon or related to a worker’s capacity to work or income earned after return to work. Morris v. Virginia Retirement Sys., 28 Va. App. 799, 508 S.E.2d 799 (1999).

    Occasioned by permanent injuries of a particular character. —

    This section is the only one which provides for partial disabilities occasioned by permanent injuries of the particular character therein set forth; neither this nor the preceding section in any wise purports to deal with the subject of total disabilities. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    Conflicting medical evidence will be resolved by commission. —

    Generally, “great weight should be given to the evidence of an attending physician;” “an attending physician’s opinion is not binding on the commission. The probative weight to be accorded such evidence is for the commission to decide; and if it is in conflict with other medical evidence, the commission is free to adopt that view which is most consistent with reason and justice.” Hayes v. 4 E Corp., 1997 Va. App. LEXIS 194 (Va. Ct. App. Apr. 1, 1997).

    It is an exception to former §§ 65.1-54 and 65.1-55 (now §§ 65.2-500 and 65.2-502 ). —

    This section is clearly an exception to former §§ 65.1-54 and 65.1-55, which cover total and partial incapacity. The benefits under such sections are predicated upon the incapacity to work produced by the accident. The benefits provided by this section are based upon the loss, or loss of use of the members scheduled therein, irrespective of the future incapacity to work which may have resulted from the loss, or loss of use, of such member or members as are covered in the various schedules. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942); J.A. Foust Coal Co. v. Messer, 195 Va. 762 , 80 S.E.2d 533, 1954 Va. LEXIS 155 (1954).

    And must be read with former § 65.1-54 (now § 65.2-500 ). —

    This section and former § 65.1-54 must be read together. Owen v. Chesapeake Corp. of Va., 198 Va. 440 , 94 S.E.2d 462, 1956 Va. LEXIS 227 (1956).

    Construction with § 65.2-504.1. —

    Section 65.2-504 must be construed according to its own language and is independent of this section. Chitwood v. E.I. Du Pont de Nemours & Co., 29 Va. App. 611, 513 S.E.2d 890, 1999 Va. App. LEXIS 235 (1999).

    Remedy prescribed is exclusive. —

    If additional compensation for permanent partial disability is recovered under this section for the “loss” or “partial loss” of a member therein designated, no additional compensation can be had for partial disability under former § 65.1-55 (now § 65.2-502 ), but the remedy prescribed therefor by this section is exclusive. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    But compensation may exceed sums mentioned. —

    That this section fixes the amounts to be paid for the permanent total disability of the members mentioned, and that the amounts recoverable by the worker can never exceed the sums mentioned in this section, is a misconception of the Workmen’s (now Workers’) Compensation Act. Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925).

    Authorization for simultaneous payments. —

    The only reasonable construction of the language which provides that payments for a rating “may be paid simultaneously with payments for temporary partial incapacity,” is that the Commission has discretion to order such payments. In cases where the Commission does not order such payments, employer would be free to make simultaneous payments voluntarily. Rusty's Welding Serv., Inc. v. Gibson, 29 Va. App. 119, 510 S.E.2d 255, 1999 Va. App. LEXIS 67 (1999).

    The statute permits, but does not mandate, simultaneous payments of temporary and permanent partial disability payments. King, Jr. v. Pepsi Cola Co., 1999 Va. App. LEXIS 83 (Va. Ct. App. Feb. 9, 1999).

    The words “in the same accident” in former subdivision (18) (now subdivision C 1) were intended to prevent the injustice of saddling the onus of a prior accident, with which the employer had no connection, upon the employer. Morris v. Pulaski Veneer Corp., 183 Va. 748 , 33 S.E.2d 190, 1945 Va. LEXIS 222 (1945).

    Former subdivision (18) (now subdivision C 1) is a conditional enunciation and is not intended to be exclusive. It must be read with the other applicable sections of this chapter and all must be given their composite related meaning. Morris v. Pulaski Veneer Corp., 183 Va. 748 , 33 S.E.2d 190, 1945 Va. LEXIS 222 (1945).

    The statutory language “injury to the brain” refers to direct injury to the brain rather than psychological or emotional disability resulting from a compensable injury to another body member. Midulla v. General Elec. Co., No. 1607-88-2 (Ct. of Appeals Nov. 28, 1989).

    Former subdivision (18) (now subsection C) does not include a permanent partial loss. —

    The former next-to-last paragraph of this section (now subsection D), does not so enlarge the meaning of former subdivision (18) as to include a permanent partial loss, or loss of use, of two members. McCarrell v. Harrisonburg Mut. Tel. Co., 163 Va. 272 , 172 S.E. 241 , 1934 Va. LEXIS 184 (1934).

    Compensation allowed for both total and partial incapacity. —

    A fair construction of the Workmen’s (now Workers’) Compensation Act allows compensation for both total incapacity and partial incapacity, subject to the qualifications contained in former § 65.1-54 (now § 65.2-500 ). Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925).

    In construing this section, the permanent loss of the use of a member shall be equivalent to the loss of such member, and for the permanent partial loss or loss of use of a member, compensation may be proportionately awarded. Pantry Pride-Food Fair Stores, Inc. v. Backus, 18 Va. App. 176, 442 S.E.2d 699, 10 Va. Law Rep. 1123, 1994 Va. App. LEXIS 195 (1994).

    Employer liable only for amount of injury sustained in his business. —

    That the employer is liable only for the amount of injury sustained in the conduct of his particular business, is clearly revealed by the provisions of this section and former § 65.1-58 (now § 65.2-505 ). Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    Work-related injury required for compensation. —

    Although nowhere does this section specify that any loss of use must result from injury directly to the member itself the statute will be read to allow compensation for any work-related injury which manifests itself in a scheduled member. Washington Metro. Area Transit Auth. v. Rogers, 17 Va. App. 657, 440 S.E.2d 142, 10 Va. Law Rep. 854, 1994 Va. App. LEXIS 40 (1994).

    Incapacity must be permanent. —

    Before benefits under this section are awardable, it must appear both that the partial incapacity is permanent and that the injury has reached maximum medical improvement. County of Spotsylvania v. Hart, 218 Va. 565 , 238 S.E.2d 813, 1977 Va. LEXIS 292 (1977).

    Where an employee suffers the loss of use of a scheduled body member, the compensation provided by this section is not awardable until the injury has reached a state of permanency, i.e., maximum improvement, when the degree of loss may be medically ascertained. County of Spotsylvania v. Hart, 218 Va. 565 , 238 S.E.2d 813, 1977 Va. LEXIS 292 (1977).

    The benefits under this section are not based upon the loss of earning ability, but are regarded as an indemnity for the loss or loss of use of a member of the body. Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954).

    An award under this section is not dependent upon a claimant’s incapacity for work. This section is intended to provide benefits in the nature of indemnity for the loss of a scheduled body member. Commonwealth DMV v. Williams, 1 Va. App. 401, 339 S.E.2d 552, 1986 Va. App. LEXIS 214 (1986).

    The right to compensation under this section does not depend on incapacity for work or loss of earnings, but is indemnity for permanent loss of use, total or partial, of the injured member. Great Atlantic & Pacific Tea Co. v. Bateman, 4 Va. App. 459, 359 S.E.2d 98, 4 Va. Law Rep. 168, 1987 Va. App. LEXIS 199 (1987).

    And are payable regardless of actual degree of disability. —

    The benefits payable under this section are for “loss or loss of use” of a member and are fixed and payable regardless of the actual degree of disability, and irrespective of continued employment, loss of wages, or like considerations. Nicely v. VEPCO, 195 Va. 819 , 80 S.E.2d 529, 1954 Va. LEXIS 161 (1954).

    The benefits provided by this section for the loss or the loss of use of a body member are payable irrespective of continued employment, loss of wages, or like considerations. County of Spotsylvania v. Hart, 218 Va. 565 , 238 S.E.2d 813, 1977 Va. LEXIS 292 (1977).

    But ability to engage in gainful employment may be considered in determining extent of loss of use of member. —

    In determining the extent of the loss of use of a member the capacity or incapacity of claimant to engage in gainful employment is a proper element for consideration. Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954).

    Although an award of benefits under this section does not depend upon the capacity or incapacity of claimant to engage in gainful employment, this capacity is a proper element for consideration in determining the extent of loss of use of a member. Pantry Pride-Food Fair Stores, Inc. v. Backus, 18 Va. App. 176, 442 S.E.2d 699, 10 Va. Law Rep. 1123, 1994 Va. App. LEXIS 195 (1994).

    No requirement that loss be measured in terms of anatomical loss. —

    This section provides specific periods of payment for the permanent loss, or loss of use, of various members of the body. Compensation is proportionately awarded for the permanent partial loss, or loss of use, of a member. The compensation provided is indemnity for loss of the member and is fixed and payable irrespective of continued employment, loss of wages, or like considerations. Nowhere in the statute is there expressed a requirement that the loss or loss of use of the member must be measured in terms of an anatomical loss. Commonwealth Dep't of Cors. v. Powell, 2 Va. App. 712, 347 S.E.2d 532, 3 Va. Law Rep. 292, 1986 Va. App. LEXIS 323 (1986).

    Functional loss of capacity must be quantified or rated. —

    Even though claimant had already received an award of temporary total disability benefits as a result of his back injury, he was still required to present evidence rating the functional loss of use of his legs suffered as a result of the back injury in order to receive an award of permanent total disability; thus, the Commission erred in relying on the claimant’s prior “total” disability from his back injury as a rating to satisfy the requirements of this section. Cafaro Constr. Co. v. Strother, 15 Va. App. 656, 426 S.E.2d 489, 9 Va. Law Rep. 846, 1993 Va. App. LEXIS 25 (1993).

    In order to receive compensation under this section, a claimant is required to present evidence of the specific percentage of permanent loss of the alleged disabled member. Norris v. Fairfax County Sch. Bd., 2000 Va. App. LEXIS 491 (Va. Ct. App. July 5, 2000).

    Workers’ compensation claimant’s functional loss of use under § 65.2-503 was properly measured by the extent of his impairment before undergoing hip replacement surgery where that interpretation acknowledged the irreplaceable loss of the natural joint, the nonmonetary costs associated with the corrective surgery, and the permanent restrictions on the claimant’s activities resulting from the work-related injury. This construction did not create a windfall for claimants as §/ 65.2-708 reflected the General Assembly’s recognition that an artificial joint replacement was an imperfect treatment for a compensable injury that often required subsequent revision surgeries. Loudoun Cty. v. Richardson, 298 Va. 528 , 841 S.E.2d 629, 2020 Va. LEXIS 40 (2020).

    Burden of proof. —

    To meet her burden of proof under this section, claimant was required to prove that she was unable to use her permanently impaired members in gainful employment, and to establish that she had reached maximum medical improvement; in addition, her functional loss of capacity was required to be quantified or rated. Anderson v. Union Camp Corp., 2000 Va. App. LEXIS 91 (Va. Ct. App. Feb. 15, 2000).

    A claimant is required to establish that he has reached maximum medical improvement and his functional loss of capacity must be quantified or rated. Chap Van Ngo v. N&L Carpentry, 2001 Va. App. LEXIS 206 (Va. Ct. App. Apr. 17, 2001).

    To meet his burden of proof under this section, a claimant is required to prove that he is unable to use his permanently impaired members in gainful employment. Chap Van Ngo v. N&L Carpentry, 2001 Va. App. LEXIS 206 (Va. Ct. App. Apr. 17, 2001).

    Virginia Workers’ Compensation Commission properly concluded that a workers’ compensation claimant did not prove that he had achieved maximum medical improvement as, while he presented the medical opinion of a doctor who opined that the claimant had reached maximum medical improvement, the claimant failed to convince the Commission that his medical evidence should be afforded greater weight than the conflicting medical testimony presented by the employer. Montalbano v. Richmond Ford, LLC, 57 Va. App. 235, 701 S.E.2d 72, 2010 Va. App. LEXIS 448 (2010).

    Virginia Workers’ Compensation Commission did not err in awarding benefits to a workers’ compensation claimant because the evidence, including the testimony from an orthopedic surgeon and the functional capacity evaluation, established an ongoing injury that prevented the claimant from lifting 25 to 30 pounds; the burden rested with the employer, and the Commission was not required to accept the testimony of the employer’s doctor, who did not personally examine the claimant and whose expertise and opinion was obtained by the employer. Philip Morris USA, Inc. v. Blankenship, 2011 Va. App. LEXIS 357 (Va. Ct. App. Nov. 22, 2011).

    Claimant failed to provide evidence of permanent partial disability to her left leg within the 36-month limitation period because the claimant did not claim a left leg injury on her November 2013 application requesting medical benefits, compensation, temporary total disability, and permanent disability; she did not provide evidence that the disability to her left leg existed at the time she filed the claim; the doctor’s evaluation submitted by the claimant in support of her claim — dated December 20, 2016, and amended on January 31, 2017 — did not state when the left leg disability began, what caused it, or its connection to the original injury; and she did not show that the leg disability was related to her compensable back injury. Rivera v. Kohl's Dep't Stores, Inc., 2018 Va. App. LEXIS 188 (Va. Ct. App. July 10, 2018).

    A close reading of Cafaro Constr. Co. v. Strother, 15 Va. App. 656, 426 S.E.2d 489 (1993) suggests that, although correct with respect to permanent partial loss of use of a member under subsection D of this section, the rule in Cafaro may not be applicable to permanent total loss of use under subsection C of this section. Hill v. Woodford B. Davis Gen. Contractor, 18 Va. App. 652, 447 S.E.2d 237, 11 Va. Law Rep. 33, 1994 Va. App. LEXIS 468 (1994).

    Notice. —

    An employer was not notified of a claim of permanent and total injury to the brain where the injury was described as an injury to the head. Johnson v. Paul Johnson Plastering, 37 Va. App. 716, 561 S.E.2d 40, 2002 Va. App. LEXIS 183 (2002), aff'd in part and rev'd in part, 265 Va. 237 , 576 S.E.2d 447, 2003 Va. LEXIS 28 (2003).

    Simply because the claimant’s asbestosis contamination failed to rise to the level of a permanent loss on the schedule set out in this section, this did not automatically preclude an award of medical benefits. Jones v. E.I. DuPont De Nemours & Co., 24 Va. App. 36, 480 S.E.2d 129, 1997 Va. App. LEXIS 6 (1997).

    Functional impairment of arm due to shoulder injury. —

    Virginia Workers’ Compensation Commission did not err in crediting the examining doctor’s opinion that the claimant suffered functional impairment to her right arm as a result of the injury to her shoulder and in awarding the claimant permanent partial disability benefits for loss of the use of the claimant’s right arm because the only medical opinion concerning the claimant’s functional impairment was provided by the examining doctor, who stated that the claimant suffered functional impairment to her right arm; and the examining doctor’s opinion that the claimant experienced impairment to the use of her right arm was consistent with the restriction that the claimant’s treating physician placed on her use of her right arm. N. Va. Training Center v. Adomako, 2014 Va. App. LEXIS 394 (Va. Ct. App. Dec. 2, 2014).

    II.Compensable Injuries.

    Pain that is inhibiting factor causing loss of use is compensable. —

    Pain alone is not compensable; however, common sense, logic, and medical opinion dictate that pain can, at times, impair function and result in disability. Accordingly, pain which is an inhibiting factor causing loss of use is compensable. Lynchburg Foundry Co. v. Tucker, No. 2251-91-3 (Ct. of Appeals Sept. 29, 1992) (decided under former § 65.1-56).

    Loss of leg includes loss of foot. —

    The section deals on its face with actual loss, and the actual loss of a leg necessarily includes the actual loss of the attached foot. Lester v. Tri-Della Coal Mining Corp., 18 Va. App. 551, 445 S.E.2d 691, 10 Va. Law Rep. 1604, 1994 Va. App. LEXIS 409 (1994).

    Leg, attached foot, not separately ratable. —

    A logical reading of the phrase, “any two thereof,” requires that the leg and attached foot are not two separately ratable members. Lester v. Tri-Della Coal Mining Corp., 18 Va. App. 551, 445 S.E.2d 691, 10 Va. Law Rep. 1604, 1994 Va. App. LEXIS 409 (1994).

    The phrases “total and permanent loss” or “loss of use” of a leg do not mean that the leg is immovable or that it cannot be used in walking around the house, or even around the block. They do mean that the injured employee is unable to use it in any substantial degree in any gainful employment. Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954).

    Total loss of use of both legs. —

    For the total loss of use of both legs claimant is entitled to the same compensation as if they had been severed. Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954).

    A 10% to 15% impairment of one leg and a 30% to 50% impairment of the other did not constitute a total loss of the use of both legs. Borden, Inc. v. Norman, 218 Va. 581 , 239 S.E.2d 89, 1977 Va. LEXIS 294 (1977).

    One hundred percent disability to left leg and 15% disability to right let, plus inability to work, amounts to permanent and total disability. —

    To recover under section providing that compensation shall be awarded for permanent and total loss of both legs, claimant did not have to establish that each leg is unusable in employment; therefore Workers’ Compensation Commission did not err when it found that the combination of 100% disability to claimant’s left leg and 15% disability to his right leg, coupled with his inability to work, rendered him permanently and totally disabled. Georgia-Pacific Corp. v. Dancy, 255 Va. 248 , 497 S.E.2d 133, 1998 Va. LEXIS 40 (1998).

    Basis for determining extent of eye injuries. —

    Since this section is silent as to whether corrected or uncorrected vision should be the basis for determining the extent of eye injuries, it should be interpreted and applied in a practical and common-sense manner so as to accomplish the purposes of the Act. Walsh Constr. Co. v. London, 195 Va. 810 , 80 S.E.2d 524, 1954 Va. LEXIS 160 (1954).

    Workers’ compensation commission did not err in relying on established precedent to find that an employee suffered a permanent partial disability for total loss of vision in one eye where an intraocular lens transplant did not eliminate the vision loss and the implant should not have been considered in determining the extent of the employee’s loss. Venezia Transp. Serv. v. Liming, 2010 Va. App. LEXIS 191 (Va. Ct. App. May 11, 2010).

    Loss of both eyes in different accidents. —

    The legislature did not intend that the loss of sight should be construed to mean a total and permanent incapacity unless the sight of both eyes was lost in the same accident. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    Where the videotape in question depicted defendant using his right arm and walking, it was relevant to whether or not the claimant had lost the use of these extremities. Hayes v. 4 E Corp., 1997 Va. App. LEXIS 194 (Va. Ct. App. Apr. 1, 1997).

    Total and permanent disability resulting from brain injury is established only when an employee proves a sudden shock or injury specifically to the brain, not to some other body part such as the spinal cord. Elgnawey v. Commonwealth, 2000 Va. App. LEXIS 213 (Va. Ct. App. Mar. 21, 2000).

    Disfigurement alone is not made compensable by former subdivision (19) (now subdivision B 16) of this section. Before it is compensable it must be not only (1) a marked disfigurement, but also one which (2) impairs the future usefulness or occupational opportunities of the injured employee. These are questions of fact, and the burden rests upon the claimant to establish the existence of both factors. Stephens v. A.L. Wright & Co., 194 Va. 404 , 73 S.E.2d 399, 1952 Va. LEXIS 245 (1952).

    The legislative history of former subdivision (19) (now subdivision B 16) of this section indicates some hesitation about making disfigurement compensable. When it was finally brought within the coverage of the compensation law, and by amendments subsequently made, the solution of the basic questions, as well as the amount of compensation to be allowed, was confided to the Commission with broader latitude of decision than had been given with respect to the specific injuries made compensable by the preceding subdivisions of this section. Stephens v. A.L. Wright & Co., 194 Va. 404 , 73 S.E.2d 399, 1952 Va. LEXIS 245 (1952).

    Compensable consequence. —

    Workers’ Compensation Commission properly affirmed a deputy commissioner’s award of permanent total disability benefits to a claimant who lost the use of his left arm while working for employer and subsequently lost the use of his leg as a consequence of the effects of medication taken for the arm injury, because compensable consequences of the leg injury arose “in the same accident” as the arm injury. Merck & Co. v. Vincent, 71 Va. App. 439, 837 S.E.2d 80, 2020 Va. App. LEXIS 18 (2020), rev'd, 299 Va. 705 , 858 S.E.2d 190, 2021 Va. LEXIS 56 (2021).

    The statute of limitations in § 65.2-501 does not begin to run until compensation for permanent loss was last due under this section. Virginia International Terminals, Inc. v. Moore, 22 Va. App. 396, 470 S.E.2d 574, 1996 Va. App. LEXIS 368 (1996), aff'd, 254 Va. 46 , 486 S.E.2d 528, 1997 Va. LEXIS 55 (1997).

    III.Determination of Benefits.

    Suspension of permanent partial award and substitution of temporary total benefits. —

    The Compensation Commission has the authority under this section to suspend an award for permanent partial loss of the use of a leg and the authority under former § 65.1-54 (now § 65.2-500 ) to award temporary total disability benefits where incapacity for work has been conceded by the employer. Commonwealth DMV v. Williams, 1 Va. App. 401, 339 S.E.2d 552, 1986 Va. App. LEXIS 214 (1986).

    Where claimant again becomes disabled for work as a result of the injuries received in a prior accident, the question must be addressed whether there was sufficient evidence in the record to permit a finding that this disability was not embraced in the award for permanent partial loss of the leg. If the cause of the work incapacity, either in its nature or extent, was different from that upon which the permanent rating was grounded, then claimant would be entitled to return to temporary total benefits. Commonwealth DMV v. Williams, 1 Va. App. 401, 339 S.E.2d 552, 1986 Va. App. LEXIS 214 (1986).

    Incapacity due to scheduled loss and to other injuries or effects. —

    If the scheduled loss is the sole cause for work incapacity, once a permanent rating is established, a claimant’s compensation payments are made under this section. However, a claimant may sustain a permanent loss of a member and also work incapacity from other injuries or effects of the accident not embraced in the rated loss. Commonwealth DMV v. Williams, 1 Va. App. 401, 339 S.E.2d 552, 1986 Va. App. LEXIS 214 (1986).

    If only one member is involved compensation is computed under this section. If two members are injured in the same accident and it is proven that there is total and permanent loss or loss of use of both members resulting therefrom, compensation is computed under former § 65.1-54 (now § 65.2-500 ). Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954).

    And all such injuries are treated as causing only partial disability. —

    All of the scheduled injuries are treated as causing only partial disability to work and compensated for as such except the injuries listed in subdivision (18), which are declared total disabilities and are expressly directed to be compensated as such under former § 65.1-54 (now § 65.2-500 ). Nicely v. VEPCO, 195 Va. 819 , 80 S.E.2d 529, 1954 Va. LEXIS 161 (1954).

    Effect of pre-existing defect in member. —

    Because there was no evidence that a claimant suffered a permanent pre-existing functional loss of use of the claimant’s right leg, an employer was not entitled to a credit for a pre-existing arthritic condition. Awarding permanent partial disability benefits under subsections B and D of § 65.2-503 based on an entire 37% impairment rating was proper. Va. Natural Gas, Inc. v. Clinton Tenn., 50 Va. App. 270, 649 S.E.2d 206, 2007 Va. App. LEXIS 312 (2007).

    Workers’ Compensation Commission did not err in awarding the claimant permanent partial disability benefits based on a finding that she had a 7% impairment of her right lower extremity because she had a history of right knee problems before the 2009 work injury to her left knee; the first doctor considered the claimant’s prior medical history as well as his examination of her when he rated her impairment at 37% and opined that 30% was related to her pre-existing osteoarthritis; the second doctor’s 50% impairment rating did not account for the claimant’s pre-existing knee condition; and the remaining evidence before the Commission consisted of the first doctor’s report and rating of 7% loss of use. Hicks v. Giant Landover, 2019 Va. App. LEXIS 130 (Va. Ct. App. June 4, 2019).

    A medical rating of the employee’s disability is evidence which an employee offers in order to meet the burden of proof. The Code does not require that this evidence be established before the statute of limitations expires. The timely filing of evidence in accordance with the Commission’s rules and the facts established by that evidence are the operative considerations in determining whether a claimant is entitled to compensation benefits. Hungerford Mechanical Corp. v. Hobson, 11 Va. App. 675, 401 S.E.2d 213, 7 Va. Law Rep. 1582, 1991 Va. App. LEXIS 23 (1991) (decided under former § 65.1-56).

    Benefits awardable on rating by Commission. —

    The benefits provided by this section for partial loss are awardable upon a rating by the Commission of the percentage of incapacity suffered by the employee. The rating determines the ultimate amount of compensation the employee is entitled to receive. County of Spotsylvania v. Hart, 218 Va. 565 , 238 S.E.2d 813, 1977 Va. LEXIS 292 (1977).

    An unjustified refusal of selective employment based upon a termination for cause from that employment is not a bar under former § 65.1-63 (now § 65.2-510 ) to eligibility for permanent partial disability benefits provided by former § 65.1-56 (now this section). Tumlin v. Goodyear Tire & Rubber Co., 18 Va. App. 375, 444 S.E.2d 22, 10 Va. Law Rep. 1378, 1994 Va. App. LEXIS 305 (1994).

    Use of former § 65.1-63 (now § 65.2-510 ) by employer as affirmative defense. —

    Nothing in former § 65.1-63 (now § 65.2-510 ), which defines the consequences of an employee’s refusal of selective employment, prohibits its use by the employer as an affirmative defense rather than as a basis for an employer’s change-in-condition petition. Thus, the Commission is entitled to consider the tender and refusal of selective employment during a hearing on an application under this section, claiming incapacity to work. Talley v. Goodwin Bros. Lumber Co., 224 Va. 48 , 294 S.E.2d 818, 1982 Va. LEXIS 270 (1982).

    The hearing determination chart is not a substantive rule of the commission subject to the Virginia Administrative Process Act (VAPA) or the Virginia Register Act. Bader v. Norfolk Redevelopment & Hous. Auth., 10 Va. App. 697, 396 S.E.2d 141, 7 Va. Law Rep. 204, 1990 Va. App. LEXIS 152 (1990).

    The hearing determination chart is merely a guideline which the commission may use in determining the percentage of compensable hearing loss according to the American National Standards Institute (ANSI) standard. There is no binding rule of the commission requiring the use of the ANSI standard for measuring hearing loss. Bader v. Norfolk Redevelopment & Hous. Auth., 10 Va. App. 697, 396 S.E.2d 141, 7 Va. Law Rep. 204, 1990 Va. App. LEXIS 152 (1990).

    The hearing determination chart was not adopted pursuant to the commission’s rule making authority under former § 65.1-18 (now § 65.2-201 ) and therefore is not binding in law as are rules. Bader v. Norfolk Redevelopment & Hous. Auth., 10 Va. App. 697, 396 S.E.2d 141, 7 Va. Law Rep. 204, 1990 Va. App. LEXIS 152 (1990).

    The commission’s utilization of the hearing determination chart as a guideline is subject to less deference and weight on review than a “legislative rule.” Bader v. Norfolk Redevelopment & Hous. Auth., 10 Va. App. 697, 396 S.E.2d 141, 7 Va. Law Rep. 204, 1990 Va. App. LEXIS 152 (1990).

    Use of Schilling Index to determine stage of byssinosis. —

    Although the Schilling Index does not conform to Commission guidelines requiring radiographic findings in lung disease cases, because it is impossible to determine the presence of byssinosis by radiographic findings, Commission-set guidelines cannot take precedence over this section which contains no guidelines. It is proper for a claimant to attempt to stage byssinosis with reference to the Schilling Index. Although the Index is a crude classification, it is the only scientific scale specifically related to byssinosis. Smith v. Fieldcrest Mills, Inc., 224 Va. 24 , 294 S.E.2d 805, 1982 Va. LEXIS 267 (1982).

    Pneumoconiosis. —

    This section contemplates that claimant with pneumoconiosis be awarded compensation only in proportion to any increase in the severity of his or her disease. Chitwood v. E.I. Du Pont de Nemours & Co., 29 Va. App. 611, 513 S.E.2d 890, 1999 Va. App. LEXIS 235 (1999).

    Coal workers’ pneumoconiosis. —

    Fact that an occupational disease did not rise to the level of permanent loss on the schedule of § 65.2-503 did not automatically preclude an award of medical benefits, and thus, the workers’ compensation commission did not err in awarding benefits to the claimant on claim for benefits for coal workers’ pneumoconiosis. Clinchfield Coal Co. v. Reed, 40 Va. App. 69, 577 S.E.2d 538, 2003 Va. App. LEXIS 123 (2003).

    The amounts paid by employer under the federal Longshore and Harbor Workers’ Compensation Act should have been set off against any future liability it may have to claimant for the injury received, regardless of the classification of the disability. Ceres Marine Terms., Inc. v. Artis, 1997 Va. App. LEXIS 106 (Va. Ct. App. Feb. 18, 1997).

    As fact finder, commission may accept certain and reject other medical evidence. —

    In its role as fact finder, the commission was entitled to weigh the medical evidence and to accept the opinions of claimant’s treating physicians. The commission was also entitled to reject the opinion of independent medical examiner who examined claimant on two occasions at employer’s request. Peoples Drug Stores, Inc. v. Cousar, 1997 Va. App. LEXIS 110 (Va. Ct. App. Feb. 18, 1997).

    Commission may choose not to adopt findings of deputy commissioner. —

    If the deputy commissioner does not include a specific, recorded observation regarding the behavior, demeanor or appearance of a witness in his or her opinion, the commission has no duty to explain its reasons for making credibility determinations that differ from those made by the deputy commissioner. Hayes v. 4 E Corp., 1997 Va. App. LEXIS 194 (Va. Ct. App. Apr. 1, 1997).

    IV.Illustrative Cases.

    The commission did not deny employer due process by affirming employee’s award of disability benefits based upon a theory different from that adopted by the deputy commissioner. Employer contended that because the deputy commissioner awarded benefits based on the theory of a change in the condition under § 65.1-99, it did not have adequate notice and a fair opportunity, upon review, to present evidence or argument in defense of a claim based on the theory that employee’s partial disability was totally disabling because he would be required to complete a work hardening program in order to return to work. However, employer received fair notice and an opportunity to litigate the issues that the commission considered in making its ruling. Georgia Pac. Corp. v. Dancy, 17 Va. App. 128, 435 S.E.2d 898, 1993 Va. App. LEXIS 460 (1993).

    Loss of teeth. —

    Claimant’s loss of four front teeth and one back tooth as result of accident did not constitute a compensable disfigurement under former subdivision (19) (now subdivision B 16) of this section as a matter of law. Neither of these conditions is per se a question of law. Stephens v. A.L. Wright & Co., 194 Va. 404 , 73 S.E.2d 399, 1952 Va. LEXIS 245 (1952).

    Commission’s finding that claim for loss of four teeth was covered by subdivision B 16 of this section, resulting in severely marked disfigurement, and that this claim was not yet ripe for decision, as until dental implant surgery was complete claimant would not have reached maximum medical improvement, would be affirmed. Stanfield v. City of Hampton Fire & Rescue, 31 Va. App. 240, 522 S.E.2d 404, 1999 Va. App. LEXIS 692 (1999).

    Irreversible brain injury which renders the employee permanently unemployable and so affects the non-vocational quality of his life by eliminating his ability to engage in a range of usual cognitive processes was the functional equivalent, and met the intended statutory definition, of “incurable imbecility” contemplated by former subdivision (18) as it read prior to amendment in 1988 and was compensable pursuant to former § 65.1-54 (now § 65.2-500 ). Barnett v. D.L. Bromwell, Inc., 6 Va. App. 30, 366 S.E.2d 271, 4 Va. Law Rep. 2147, 1988 Va. App. LEXIS 16 (1988).

    Employee who sustained brain injury from a fall in an on-the-job accident was totally incapacitated for workers’ compensation purposes, as the evidence showed he was “unemployable in gainful employment,” especially in his job as a work order processer for his employer, as the job was essentially created for him, was the only thing his employer could find that he was capable of doing, and was not mutually beneficial to both him and the employer. Great N. Nekoosa Corp. v. Wood, 37 Va. App. 54, 553 S.E.2d 555, 2001 Va. App. LEXIS 578 (2001).

    Brain injury claim untimely. —

    Where an employee’s claim for permanent total workers’ compensation disability under subdivision C 3 of § 65.2-503 was untimely pursuant to § 65.2-601 and the workers’ compensation commission’s factual finding that the employee’s brain injury did not arise from a work injury was never set aside, the appellate court erred by remanding the matter for further factual findings. Paul Johnson Plastering v. Johnson, 265 Va. 237 , 576 S.E.2d 447, 2003 Va. LEXIS 28 (2003).

    Award of permanent disability benefits to claimant for an eye injury was unsupported, where none of the evidence showed that the injury had reached maximum medical improvement. Kirk Plastering Co. v. Netherwood, 7 Va. App. 177, 372 S.E.2d 192, 5 Va. Law Rep. 379, 1988 Va. App. LEXIS 107 (1988).

    Prosthetic device implanted in claimant’s eye did not eliminate claimant’s loss of vision. —

    Where claimant had suffered a “total loss of vision” in his right eye, and the compensable injury suffered by the claimant required the removal of his natural lens, this procedure rendered him industrially blind, and the fact that claimant presently received some benefit from a prosthetic device implanted within his eye did not establish that claimant’s loss had been eliminated; therefore the Commission’s holding that the intraocular lens implanted had not eliminated the loss that the claimant sustained, and, as a mere corrective device, the implant should not be considered in determining the extent of claimant’s loss was proper. Creative Dimensions Group, Inc. v. Hill, 16 Va. App. 439, 430 S.E.2d 718, 9 Va. Law Rep. 1405, 1993 Va. App. LEXIS 176 (1993).

    Degree of loss of vision determined on basis of uncorrected vision. —

    Where prior to the accident claimant did not use glasses in the performance of his work as a pipe fitter but did use them for reading when off duty, and after the accident, without the aid of glasses, the vision in each eye had been reduced to a fraction which by Snellen’s Chart is equivalent to industrial blindness, it was proper to determine claimant’s degree of loss without recourse to the artificial aid which proper glasses would render. Owen v. Chesapeake Corp. of Va., 198 Va. 440 , 94 S.E.2d 462, 1956 Va. LEXIS 227 (1956).

    Where claimant had previously from natural causes suffered a reduction in the vision of the injured eye amounting to total loss of vision, but this had been corrected to normal by use of glasses, the basis for determining whether compensation should be paid was the corrected vision, and claimant was not limited to an award under former subdivision (19) (now subdivision B 16) of this section for a percentage of facial disfigurement. Walsh Constr. Co. v. London, 195 Va. 810 , 80 S.E.2d 524, 1954 Va. LEXIS 160 (1954).

    Direct injury not required for benefits. —

    Although employee sustained no direct injury to his leg, rather, an injury to his back caused permanent partial disability to his leg, and in addition, he experienced no reduction in earning capacity as a result of the injury, he was still entitled to benefits for permanent partial disability. Washington Metro. Area Transit Auth. v. Rogers, 17 Va. App. 657, 440 S.E.2d 142, 10 Va. Law Rep. 854, 1994 Va. App. LEXIS 40 (1994).

    Partial loss of use of each foot. —

    Where the Commission found that an employee had suffered a permanent partial loss of 50% of the use of each foot and computed compensation for a period of 125 weeks upon the basis of the scheduled injury to each foot, the equivalent of the total loss of one foot, it was held that there was no error in the award. McCarrell v. Harrisonburg Mut. Tel. Co., 163 Va. 272 , 172 S.E. 241 , 1934 Va. LEXIS 184 (1934).

    Loss of both hands in successive injuries in the same employment. —

    Where a second accident resulted in the loss of the first, second, third and fourth fingers and a portion of the palm of claimant’s right hand, and, approximately nine years before, while working for the same employer in the same capacity, the employee was involved in another accident from which he sustained an injury which resulted in the loss of his left hand just above his wrist, the employee was entitled to permanent and total disability compensation. Morris v. Pulaski Veneer Corp., 183 Va. 748 , 33 S.E.2d 190, 1945 Va. LEXIS 222 (1945).

    Industrial blindness. —

    Where injury sustained by claimant is equivalent to industrial blindness, making the loss medically total, but it is conceded that his “loss of use” is less than “total,” under the wording of former § 65.1-54 (now § 65.2-500 ) and this section, his ability to engage in gainful employment should be considered. Owen v. Chesapeake Corp. of Va., 198 Va. 440 , 94 S.E.2d 462, 1956 Va. LEXIS 227 (1956).

    Scarring disfigurement. —

    The Workers’ Compensation Commission properly reduced a claimant’s award for disability compensation for a permanent partial loss of use of his right arm by the amount of disability compensation previously awarded for scarring disfigurement involving the same anatomical area. Pruden v. Plasser Am. Corp., 45 Va. App. 566, 612 S.E.2d 738, 2005 Va. App. LEXIS 182 (2005).

    Where the employee’s arm injury had not reached maximum medical improvement at the time of his death, the employee could not have been rated for benefits under this section, and he was not “entitled to compensation” for the injury within the meaning of former § 65.1-64 (now § 65.2-500 ). County of Spotsylvania v. Hart, 218 Va. 565 , 238 S.E.2d 813, 1977 Va. LEXIS 292 (1977).

    A ratable loss of use of both legs of less than 100 percent, coupled with evidence of incapacity for employment, is sufficient to establish that an employee is permanently unemployable. Eastern Airlines v. Janes, 1995 Va. App. LEXIS 574 (Va. Ct. App. July 18, 1995).

    Employee did not exercise reasonable diligence in seeking employment and was not entitled to reinstatement of temporary total disability benefits pursuant to this section, where during a period of almost six months, he filed only four or five written job applications and no resumes, and the evidence indicated that there were numerous jobs available that were appropriate for him in view of his education, work history and physical restrictions, but he did not apply for any of these, seeking instead jobs for which he was not qualified by education and experience or which were not within the limitations placed upon him by his physician. Great Atlantic & Pacific Tea Co. v. Bateman, 4 Va. App. 459, 359 S.E.2d 98, 4 Va. Law Rep. 168, 1987 Va. App. LEXIS 199 (1987).

    It was not error to find an employee did not reasonably market the employee’s residual work capacity because the employee visited businesses randomly and applied for jobs, so the employee’s marketing efforts were not made in a good faith attempt to find employment within the employee’s restrictions, as the employee’s job hunt was purely random and uncalculated. Creasey v. GP Big Island, LLC, 2014 Va. App. LEXIS 381 (Va. Ct. App. Nov. 18, 2014).

    Loss of use of two members in same accident. —

    Where Commission found that the injury to claimant’s eyes amounted to industrial blindness, but also that as a result of the accident he was only reduced to a lower grade of work, remaining employable, claimant was not entitled to an award for total disability under former subdivision (18) (now subdivision C 1) of this section. In determining the extent of loss of use of two members injured in the same accident, the ability of the injured employee to engage in gainful employment is a proper element for consideration, and here showed the loss to be in fact less than total, though medically it might be considered total. Owen v. Chesapeake Corp. of Va., 198 Va. 440 , 94 S.E.2d 462, 1956 Va. LEXIS 227 (1956).

    Loss of use of two members. —

    Claimant’s loss of use in two members, both arms, and his inability to sustain gainful employment were proper considerations in determining extent of claimant’s incapacity, including total permanent disability. All States Steel Erectors Corp. v. Steele, 2004 Va. App. LEXIS 634 (Va. Ct. App. Dec. 28, 2004).

    Permanent partial disability rating accepted. —

    Workers’ Compensation Commission did not err in accepting the 2% permanent partial disability (PPD) rating for the claimant’s left arm as the award was based on credible evidence because the claimant’s treating physician agreed that she had reached maximum medical improvement and that the functional capacity evaluation conclusion was correct; the treating physician was aware the claimant had suffered a frozen shoulder that was being treated in the same office by the second doctor; the second doctor had released her from treatment; and there was no evidence in the record that the second doctor diagnosed the frozen shoulder as contributing to a permanent disability or disagreed with the treating physician’s opinion regarding the PPD rating. Allen v. County of Henrico Pub. Schs., 2019 Va. App. LEXIS 303 (Va. Ct. App. Dec. 10, 2019).

    The fact that the claimant could not return to his former employment did not alone establish a basis for awarding compensation pursuant to this section; the claimant had the burden to prove that he made a reasonable effort to secure suitable work but was unable to market his remaining work capacity. Great Atlantic & Pacific Tea Co. v. Bateman, 4 Va. App. 459, 359 S.E.2d 98, 4 Va. Law Rep. 168, 1987 Va. App. LEXIS 199 (1987).

    Earlier report of surgeon not controlling. —

    Award of total permanent disability was supported by the evidence, where claimant’s physician rated his left leg disability at 100%, a 15% disability in the right leg, and another physician reported that claimant was unable to sustain gainful employment due to his on-the-job injuries, despite surgeons’ earlier report that claimant could return to work with numerous restrictions. Georgia-Pacific Corp. v. Dancy, 24 Va. App. 430, 482 S.E.2d 867, 1997 Va. App. LEXIS 171 (1997), aff'd, 255 Va. 248 , 497 S.E.2d 133, 1998 Va. LEXIS 40 (1998).

    Quantification of functional loss of legs required. —

    Although claimant produced evidence that he was industrially disabled and that the disability in his legs was a substantial contributing factor to that disability, he failed to quantify a functional loss of the legs that could be translated into loss of these members pursuant to this section. LesCallett v. Rozansky & Kay Constr. Co., 23 Va. App. 404, 477 S.E.2d 746, 1996 Va. App. LEXIS 705 (1996).

    Failure to present quantification of functional loss. —

    Claimant was not entitled to permanent total disability benefits, where she failed to present evidence of a specific rating of functional loss of use of two scheduled members, as required for an award under subsection C of this section. Wise v. Bonfeld, Inc., 1999 Va. App. LEXIS 590 (Va. Ct. App. Oct. 19, 1999).

    Virginia Workers’ Compensation Commission did not err in accepting a doctor’s rating of a claimant’s injury from a functional capacity evaluation when awarding PPD benefits because (1) the claimant offered no medical evidence to meet the burden to prove the claimant was entitled to more than the doctor’s rating, and (2) the award was based on credible evidence. Allen v. Cty. of Henrico Pub. Sch., 2019 Va. App. LEXIS 220 (Va. Ct. App. Oct. 8, 2019), op. withdrawn, No. 0275-19-2, 2019 Va. App. LEXIS 303 (Va. Ct. App. Dec. 10, 2019).

    Hip replacement. —

    Award of permanent partial disability benefits was appropriate, based on the degree of the impairment rating for the claimant’s loss of use of the claimant’s left leg prior to a hip replacement, because the treating physician testified that the claimant’s hip injury manifested in a functional loss of use to the leg, the claimant’s leg impairment rating was based on the condition before the hip replacement, and the claimant was at maximum medical improvement immediately prior to the hip replacement. Loudoun Cty. v. Richardson, 70 Va. App. 169, 826 S.E.2d 326, 2019 Va. App. LEXIS 87 (2019), aff'd, 298 Va. 528 , 841 S.E.2d 629, 2020 Va. LEXIS 40 (2020).

    Award of permanent partial disability benefits was appropriate, based on the degree of the impairment rating for the claimant’s loss of use of the claimant’s left leg prior to a hip replacement, because the treating physician testified that the claimant’s hip injury manifested in a functional loss of use to the leg, the claimant’s leg impairment rating was based on the condition before the hip replacement, and the claimant was at maximum medical improvement immediately prior to the hip replacement. Loudoun Cty. v. Richardson, 70 Va. App. 169, 826 S.E.2d 326, 2019 Va. App. LEXIS 87 (2019), aff'd, 298 Va. 528 , 841 S.E.2d 629, 2020 Va. LEXIS 40 (2020).

    Claimant’s loss of use in two members, both legs, and his inability to sustain gainful employment were proper considerations in determining extent of claimant’s incapacity, including total permanent disability. Georgia-Pacific Corp. v. Dancy, 24 Va. App. 430, 482 S.E.2d 867, 1997 Va. App. LEXIS 171 (1997), aff'd, 255 Va. 248 , 497 S.E.2d 133, 1998 Va. LEXIS 40 (1998).

    Loss of use of legs in employment. —

    Decision of the Virginia Workers’ Compensation Commission to award a claimant permanent total disability benefits was affirmed because there was credible evidence that the claimant’s disability was caused by a compensable injury when the claimant injured the claimant’s back at work and that the claimant was unable to use the claimant’s legs in any employment. Va. Dep't of Transportation v. Shaffer, 2011 Va. App. LEXIS 86 (Va. Ct. App. Mar. 8, 2011).

    Evidence in the record supported the findings and decision of the Workers’ Compensation Commission that employee was entitled to permanent total disability benefits because he had a functional, permanent loss of use of both legs; the Commission explicitly stated that it had reviewed the entire record, and it was free to give great weight to the primary treating physician’s opinion that the employee was unable to use his lower extremities in any gainful employment. Kamco Bldg. Supply Corp. v. Heard, 2018 Va. App. LEXIS 246 (Va. Ct. App. Sept. 25, 2018).

    Insurer is not entitled to credit for payments on temporary total disability. —

    Where a worker is entitled to compensation for a sixty percent loss of his foot under this section, the insurance carrier is not entitled to credit for payments made to the claimant during his temporary total disability under former § 65.1-54 (now § 65.2-500 ). Gobble v. Clinch Valley Lumber Co., 141 Va. 303 , 127 S.E. 175 , 1925 Va. LEXIS 409 (1925).

    Benefits not adjusted to time of diagnosis. —

    While the Virginia Workers’ Compensation Commission awarded permanent partial benefits to the widow of a worker, it ruled the average weekly wages would be calculated at the wages the worker last earned prior to his retirement, 26 years before; the widow’s argument that she was entitled to an enhanced average weekly wage, based on the date the diagnosis was communicated to him, as provided in § 65.2-406 C was rejected. Robertson v. E.I. DuPont de Nemours & Co., 38 Va. App. 785, 568 S.E.2d 436, 2002 Va. App. LEXIS 520 (2002).

    Calculation of limitation period. —

    Section 65.2-601 provides that compensation shall be forever barred, unless a claim is filed with the Commission within two years after an accident; during this period an employee must assert against his employer “any claim” that he might have for an injury growing out of the accident. However here, claimant made an original claim for medical mileage and prescriptions which was satisfied voluntarily by the employer without an award, and then made a formal claim under this section in which a 36 month filing period is allowed pursuant to § 65.2-708 ; thus claimant properly received permanent partial disability award. Lynchburg Foundry Co. v. McDaniel, 22 Va. App. 307, 469 S.E.2d 85, 1996 Va. App. LEXIS 266 (1996).

    Permanent disability not found. —

    Workers’ Compensation Commission properly denied a nurse’s change in condition application pursuant to § 65.2-708 , because the commission properly determined that the nurse’s legs were not permanently and totally disabled pursuant to § 65.2-503 based on pain allegedly caused by a prior work-related back injury. Mawson v. Rappahannock Gen. Hosp., 2003 Va. App. LEXIS 236 (Va. Ct. App. Apr. 22, 2003).

    There was credible evidence to support the Virginia Workers’ Compensation Commission’s findings that a workers’ compensation benefits claimant was not entitled to permanent and total disability benefits under § 65.2-503 because three doctors opined that claimant did not suffer from a permanent and total disability, and two of those doctors concluded that claimant had the capacity for light-duty or sedentary work. Hopkins v. RDA, Inc., 2012 Va. App. LEXIS 3 (Va. Ct. App. Jan. 10, 2012).

    Workers’ Compensation Commission did not err in denying a teacher’s request for permanent partial disability benefits for loss of use of his left leg because there was no way to separate out what portion of the 25% impairment rating was for the teacher’s leg as opposed to his hip. Trevathan v. Loudoun County Sch. Bd., 2013 Va. App. LEXIS 205 (Va. Ct. App. July 16, 2013).

    Permanent and total incapacity not proven. —

    Virginia Workers’ Compensation Commission did not err in denying the claimant permanent total disability benefits beyond the maximum 500 weeks she had already received and that were the most allowed as she did not meet her burden of proving permanent and total incapacity in both legs because the deputy commissioner never made a specific finding of fact at a hearing regarding whether the work-related accident caused any right leg disability; no treating physicians testified at the hearing before the deputy commissioner; and the deputy commissioner’s opinion stated that the claimant met with a doctor on July 25, 2013, who felt she had morbid obesity and that she had multiple MRIs of the lumbar spine which revealed degenerative disease. Roane v. Wash. Metro. Area Transit Auth., 2020 Va. App. LEXIS 263 (Va. Ct. App. Oct. 27, 2020).

    Post-traumatic stress disorder. —

    Court of Appeals of Virginia declined to hold as a matter of law that post-traumatic stress disorder is conclusive evidence of a brain injury in workers’ compensation cases. Don Pablos Mexican Kitchen v. Nice, 2004 Va. App. LEXIS 411 (Va. Ct. App. Sept. 7, 2004).

    Claim timely filed. —

    Virginia Workers’ Compensation Commission erred in denying a workers’ compensation claimant permanent disability benefits because claimant timely filed her claim within two years of the accident pursuant to § 65.2-601 ; the joint stipulation claimant and her employer entered into did not operate as an abandonment or waiver of claimant’s permanency claim because it did not contain a clear showing that the claim had been withdrawn, and thus, the permanency claim remained ongoing and uninterrupted since claimant first filed the claim. Howard v. Cost Plus World Mkt., 2011 Va. App. LEXIS 182 (Va. Ct. App. May 24, 2011).

    Claim ripe for review. —

    Claimant’s permanent partial disability claim was ripe for adjudication at the time of a hearing where he had obtained a medical evaluation pror to the hearing stating that he had reached maximum medical improvement, he had filed a claim for permanent partial disability benefits based in part on the doctor’s conclusion that he had reached maximum medical improvement and suffered from an 11 percent impairment to his left lower extremity, and at the hearing, the parties stipulated that claimant had reached maximum medical improvement. Boukhira v. George Mason Univ., 2015 Va. App. LEXIS 363 (Va. Ct. App. Dec. 8, 2015).

    Denial of compensation claim. —

    Denial of § 65.2-503 compensation claim was affirmed because the commissioner ruled that the evidence was insufficient to prove the claimant’s functional loss of capacity and explained this decision; the commission’s rejection of the disability rating given by the claimant’s treating physicians was not plainly wrong. One doctor’s rating was based solely on the claimant’s subjective pain complaints rather than objective facts, and another admitted he did not recall how he calculated his rating. Hedrick v. Mary's Diner, Inc., 2012 Va. App. LEXIS 139 (Va. Ct. App. May 1, 2012).

    Employee’s permanent partial disability claim was properly dismissed, instead of waiting for more supporting evidence, because the employee showed no permanent impairment or that the employee’s impairment rating related to the employee’s compensable injury, so there was no need to wait for a non-compensable impairment to reach maximum medical improvement. Creasey v. GP Big Island, LLC, 2014 Va. App. LEXIS 381 (Va. Ct. App. Nov. 18, 2014).

    Separate accidents. —

    Court of Appeals erred by affirming the Workers’ Compensation Commission’s ruling because this section permitted an award of permanent total disability only if two disabling injuries occurred in the same accident and the claimant suffered his original injuries and his knee injury in different accidents. Merck & Co. v. Vincent, 299 Va. 705 , 858 S.E.2d 190, 2021 Va. LEXIS 56 (2021).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    The Commission affords significant probative value to the treating physician’s assessment of the claimant’s impairment rating and an impairment rating does not have to be determined by any set of guidelines, tables or otherwise. Use of an earlier edition of the AMA Guidelines to Permanent Impairment by the treating physicians in determining the impairment rating is not fatal. Choudhary v. Fairfax Co. Pub. Sch., JCN VA00000199617 (July 6, 2016).

    A chiropractor’s opinion concerning a thumb and hand condition is beyond the scope of the “practice of chiropractic” as defined by § 54.1-2900 and therefore will not be considered. Fedorko v. Prince William Hospital, VWC File No. 208-77-08 (Feb. 7, 2006) see also Torres v. Maid Brigade, #153, VWC File No. 203-57-08 (April 1, 2004) (chiropractor’s rating to an arm not considered).

    Where a claimant’s condition improves after replacement surgery, the permanent partial disability benefit is based on the pre-surgery impairment because the surgery provided an opportunity beyond the body’s natural ability to heal itself, and the implant could have possible complications in the future. But where a claimant’s condition declines after replacement surgery it is appropriate that the rating reflect the true degree of disability that resulted from the accident even if some portion of the disability is a result of the corrective surgery. Perkins v. Paramount Coal Corporation, VWC File No. 187-95-91 (Nov. 1, 2005).

    Opinions contained in physical therapy reports are not admissible hearsay except to the extent such opinions may be ratified and incorporated in the medical reports of licensed physicians as their own opinions. Physical therapists are not competent to offer expert medical opinions regarding diagnosis and causal relationships. Here the report was not “ratified or incorporated” in the doctor’s medical reports because he had not examined the claimant since August 1999 and did not refer the claimant to the physical therapist. Sutherland v. Craft Machine Works, Inc., VWC File No. 194-35-92 (Nov. 1, 2005).

    An award of permanent impairment should reflect the true measure of the claimant’s disability resulting from the industrial accident, even if a portion of such disability is attributable to corrective surgery. Groover v. Bell Atlantic Va., Inc., VWC File No. 173-16-00 (Oct. 6, 2004).

    Deputy Commissioner correctly determined degree of permanent disability established by the evidence, deferring to rating provided by treating physician, despite reliance by the treating physician on the Fourth Edition of the AMA Guidelines to Permanent Impairment; although Fifth Edition of Guidelines had been published and was available, Commission found that rating was reasonable and supported by the evidence and found no evidence that reliance of Fourth Edition was flawed. Mullins v. Edwards Enterprises, Inc., VWC File No. 208-36-67 (Sept. 25, 2003).

    In determining extent of permanent loss, Commission not bound by rating of treating physician but may average such rating with those of other examiners; treating physician rated loss to arm at 25% and two examiners rated loss to arm at 75% and 61%, respectively; Commission found claimant showed 47% loss to arm, averaging treating physician’s rating with combined rating of examiners. Peacemaker v. Geon Co., VWC File No. 202-52-25 (June 19, 2003), aff’d, Ct. App. Record No. 1853-03-4 (Nov. 12, 2003) unpublished.

    Treating physician’s opinion of 60% loss of use of leg, although other treating physician concurred, not supported by evidence, and tended to include loss of function caused by back problems, which were not causally related to accident; employer’s physician’s rating of 15% loss of use based on knee; Commission found loss of use to leg of 38% upon consideration of entire record. Frameli v. Amerprint, Inc., VWC File No. 202-71-40 (Mar. 17, 2003).

    Deputy Commissioner’s decision, in arriving at permanent partial rating, to average treating physicians’ ratings with one employer’s physician’s rating, and not second employer’s physician’s rating, upheld; appropriate to discard rating that was wholly inconsistent with ratings of other physicians. Simms v. Macy’s, VWC File No. 190-57-78 (Jan. 28, 2003).

    The right to compensation under this section does not depend upon incapacity for work or loss of earnings, it being in the nature of indemnity for loss or permanent loss of use, total or partial, of the injured member. Va. Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537 (1954); Nicely v. Va. Elec. & Power Co., 195 Va. 819 , 80 S.E.2d 529 (1954); Whitlock v. Zirkle, 50 O.I.C. 337 (1968); Lawson v. Woodrow Wilson Rehab. Center, 49 O.I.C. 179 (1967).

    Benefits under § 65.2-503 are fixed and payable, regardless of actual disability, and they are paid irrespective of continued employment, loss of wages, or other considerations. The benefits are payable for the loss of use of a body part based upon the statutory presumption that the employee will sustain a lifetime loss of economic benefit that would have derived from the injured body part. Boone v. Newport News Shipbuilding, 79 O.W.C. 133 (2000).

    The 1991 amendment to Code § 65.2-503 regarding simultaneous payment of temporary total and permanent partial disability benefits was a substantive change and is not applied retroactively to accidents occurring before October 1, 1991. Potter v. Crossroads Moving & Storage, Inc., 75 O.W.C. 337 (1996).

    Because the pre-1991 Code § 65.2-503 did not authorize or require simultaneous payment of temporary total and permanent partial benefits, simultaneous weekly payments made for an accident occurring before October 1, 1991 count as payments for two weeks against the 500-week compensation limit. Potter v. Crossroads Moving & Storage, Inc., 75 O.W.C. 337 (1996).

    A disability claim for benefits is based on the law in effect on the date of injury. Prior to October 1, 1991, Code § 65.1-56 [now Code § 65.2-503 ] provided that a permanent partial disability award could not extend the limitations of Code § 65.1-54 [now Code § 65.2-500 ], or of Code § 65.1-55 [now Code § 65.2-502 ], each of which limited entitlement to compensation to a period not exceeding 500 weeks. A week of temporary partial compensation is equivalent to a week of temporary total compensation when computing the 500-week limitation. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    The claimant was under an open award for temporary partial disability resulting from an October 1990 accident when he filed a claim for permanent partial disability compensation. The Deputy Commissioner limited the award to the difference between the claimant’s statutory entitlement to 500-weeks benefits and the number of weeks’ benefits that the claimant had already received. The Commission modified that award, holding that the claimant’s entitlement to permanent partial disability benefits accrued on the date his application was filed, although the employer was entitled to a credit for temporary partial disability benefits it had continued to pay. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    Code § 65.2-503 was amended effective October 1, 1991, and a claimant injured on or after that date was entitled to receive permanent partial incapacity benefits after receiving 500 weeks of temporary total or temporary partial benefits. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    An employee seeking benefits for a permanent partial disability must establish a work-related permanent loss or loss of use to an anatomical member specified in Va. Code Ann. § 65.2-503 . Gatling v. Siemen’s Corporation, 77 O.W.C. 95 (1998).

    In order to obtain benefits for permanent disability, the claimant must establish that he has achieved maximum medical improvement, and that his functional loss of capacity can be quantified or rated. The claimant must also establish that his partial incapacity is permanent. Jackson v. Haynes Furniture Co., Inc., 77 O.W.C. 92 (1998).

    Where the parties enter a Memorandum of Agreement requiring payment of permanent disability for a specific period of time, the Commission will not disturb the agreement even though medical reports suggest an entitlement to compensation for a lesser period. Smith v. Stackhouse, Inc., 66 O.I.C. 138 (1987).

    Where an injury is confined to a specific member, there is no provision for payment of compensation other than that provided for such member. Raines v. Celanese Corporation, 61 O.I.C. 331 (1982).

    A permanency rating is limited to the larger member or, conversely, to the member which would result in the maximum amount of compensation for the injury. Thus, a disability award based on the rating for a hand must yield to an award for the thumb and fingers on that hand, if an award for the thumb and fingers would result in greater compensation than for the hand. Fetzer v. Arban Associates, Inc., 78 O.W.C. 139 (1999).

    A claimant seeking compensation for increased permanent partial disability must prove that his condition has deteriorated since his disability rating was last determined by the Commission and that his current permanent disability is greater than that previously awarded. Swearingen v. Westvaco Corporation, 74 O.W.C. 36 (1995) (see also Peak v. Mullican Flooring, VWC File No. 209-87-68 (May 12, 2005)).

    Award Apportioned:

    Medical opinions of partial disability are estimates at best, and the Commission frequently averages medical opinions when they are closely grouped. Washington v. City of Richmond Fire Dept., 75 O.W.C. 347 (1996).

    Where there is a large, unexplained discrepancy in the ratings given by physicians of comparable experience and training, the Commission normally gives greater weight to the treating physician on the basis that he is more familiar with the employee’s injury, long-term treatment, and current condition, although some weight may be given to the opinion of the other physician. When estimates of permanent partial disability are in close proximity, the Commission frequently awards the average. Trekas v. Continental Baking Co., 75 O.W.C. 203 (1996).

    The Commission gave greater weight to the permanency rating of the physician who examined the claimant for the employer than to the treating physician, where the employer’s physician documented his objective findings and based his rating on the AMA Guide to the Evaluation of Permanent Impairment, while the treating physician did not explain the basis or reason for his rating. Rodda v. Fredericksburg Glass and Mirror, 76 O.W.C. 196 (1997).

    Absent persuasive evidence that the claimant suffered from a preexisting condition at the time of her accident, for which a specific ratable permanent impairment rating had been assigned, it would be improper to apportion her award of permanent partial disability benefits between the preexisting condition and permanent disability resulting from the later accident. The Commission found that the compensable injury materially aggravated the claimant’s preexisting arthritis. While the claimant experienced symptoms in her knee prior to the compensable knee injury, there was no persuasive medical evidence in the record suggesting that she had a specific percentage of permanent functional loss prior to the injury. Accordingly, there was no basis upon which to assess the increased permanent impairment, if any, resulting from the accident. Salimi v. James Madison University, VWC File No. 192-70-54 (August 28, 2002).

    Effect of Pre-existing Defect In Member:

    Absent persuasive evidence that the claimant suffered from a preexisting condition at the time of her accident, for which a specific ratable permanent impairment rating had been assigned, it would be improper to apportion her award of permanent partial disability benefits between the preexisting condition and permanent disability resulting from the later accident. The Commission found that the compensable injury materially aggravated the claimant’s preexisting arthritis. While the claimant experienced symptoms in her knee prior to the compensable knee injury, there was no persuasive medical evidence in the record suggesting that she had a specific percentage of permanent functional loss prior to the injury. Accordingly, there was no basis upon which to assess the increased permanent impairment, if any, resulting from the accident. Salimi v. James Madison University, VWC File No. 192-70-54 (August 28, 2002).

    Statute of Limitations:

    Also see § 65.2-708 B.

    The Commission may retain jurisdiction over a premature claim for permanent partial disability benefits and where claimant asked that his claim for such benefits be held in abeyance he was not required at that time to establish that he suffered a permanent disability within the statute of limitations. Addison v. Kimballton Hical, JCN VA00000970117 (Aug. 15, 2019).

    The Commission found that a claim for permanent total benefits for a brain injury was a change in condition rather than a new claim because the spreading from the lungs to the brain of the histoplamosis for which benefits were initially awarded was a progression of the original condition. Heller v. Powhatan Correctional Center/Commonwealth of Va., VWC File No. 174-73-32 (July 19, 2006).

    Where the claimant alleged a change in condition and permanent total disability, the Commission held that the three year limitation period of § 65.2-708 applied. Hayes v. 4 E Corporation, 78 O.W.C. 147 (1999).

    A claimant cannot file a speculative application and extend the time for which permanent partial disability compensation may be awarded. Therefore, if the employee files a timely application, but does not have evidence of a permanent functional disability within three years from the date compensation was last paid pursuant to an Award, she cannot be awarded compensation for the permanent injury. Choi v. Shoppers Food Warehouse, 76 O.W.C. 183 (1997).

    The claim for permanent partial disability cannot be considered unless it is both filed and shows some permanent functional impairment within three years from the date for which compensation was last paid pursuant to an award. An employee cannot file a speculative application and extend the time for which permanent partial disability compensation may be awarded. Gatling v. Siemen’s Corporation, 77 O.W.C. 95 (1998).

    Where there has been no prior award of compensation for any type of disability, an employee seeking permanent partial disability benefits must file a claim and establish some degree of permanent partial disability within two years from the date of the accident. It is unnecessary that the employee demonstrate the degree of permanency or that he has reached maximum medical improvement within the two year period. Hood v. CPP Security Service, 69 O.I.C. 30 (1990).

    Proof of the employer’s “knowledge” or “notice” of a brain injury is insufficient to toll the two-year statute of limitations found in Virginia Code § 65.2-601 . The parties’ memorandum of agreement (MOA) and supplemental MOA noted injuries of the right wrist and back, suffered in 1991. The medical records generated within two years of the accident suggested the possibility of head trauma from the accident, but no specific claim was made for injury to the head or brain within those two years. The Commission, relying on Shawley v. Shea-Ball Construction Company, denied the employee’s March 2001 claim for permanent total disability, finding that he failed to make a claim for brain injury within two years of the accident. Jenkins v. Dynatran, Inc., VWC file No. 154-37-59 (October 12, 2001)aff’d Record No. 3065-01-2 (Va. Ct. App. June 11, 2002).

    Where x-rays revealed no change over several months and there was no significant improvement with physical therapy in the two months prior to death from causes unrelated to the claimant’s injuries, such medical evidence supports the inference that the claimant had reached maximum medical improvement. Arey v. Independent Stamping, Inc., 76 O.W.C. 206 (1997).

    A physician need not expressly state that a claimant has reached maximum medical improvement. The physician’s numerical rating of permanent impairment can justify an inference that maximum medical improvement has been reached. Arey v. Independent Stamping, Inc., 76 O.W.C. 206 (1997).

    Where there was unexplained residual swelling and persistent pain during a rating examination for her knee injury, which might or might not be permanent and could affect her final disability rating, the Commission found that the employee had not proved maximum medical improvement. Andrews v. St. Mary’s Hospital, 76 O.W.C. 43 (1997).

    When an application establishing some degree of permanent loss of use is filed by an employee within three years from the date of the last payment of compensation, the statute of limitations is tolled even though maximum medical improvement has not been reached. The Commission may retain jurisdiction to determine the percentage of loss at a later date. Griffin v. Breeden Company, 63 O.I.C. 151 (1984).

    While an employee must file a claim within two years from the date of the accident, it does not require that an application for permanent partial disability benefits establish the rating of a degree of impairment within the two year limitations period. Hungerford Mechanical Corporation v. Hobson, 11 Va. App. 675, 401 S.E.2d 423 (1991).

    A claimant seeking permanent partial disability benefits must establish a work-related permanent loss or loss of use to an anatomical member specified in Va. Code Ann. § 65.2-503 . The claim cannot be considered unless it is filed within three years from the date for which compensation was last paid pursuant to an award. The commission can retain jurisdiction of a premature claim if the rated degree of permanency and maximum medical improvement are not manifest and established within that time frame. However, the evidence of the claimant must show some permanent functional disability within the statutory period. Pollard v. First General Services, 77 O.W.C. 259 (1998).

    When a claimant, who has last been paid compensation for permanent partial loss of use, files an application alleging a change in condition, as defined by § 65.1-8 (now § 65.2-101 ), the two year limitation of § 65.1-99 (now § 65.2-708 ) applies. If the application specifies a change in condition, supporting medical evidence does not have to be filed to toll the statute of limitations. Whitehair v. American Industrial Contracting, Inc., 63 O.I.C. 367 (1984).

    A statute of limitations may not be extended by a claimant through his own actions. Ratliff v. Dominion Coal Corporation, 64 O.I.C. 268 (1985), aff’d, 3 Va. App. 175, 349 S.E.2d 147 (1986).

    There are two statutes of limitation that could apply after payments of an award for permanent partial disability. If the claimant has undergone a change in condition, the two-year statute of limitation in Code § 65.2-708 applies. If there has not been a change in condition and the claimant is at the same disability level after the award for permanent loss as before, the one-year statute of limitations in Code § 65.2-501 applies. Phelps v. Safeway Stores, Inc., 77 O.W.C. 138 (1998).

    Rule 1.2 B (previously Rule 13 B):

    Rule 13 (B) (now Rule 1.2 B) applies only to applications filed on change in condition making claim for further work incapacity rather than for permanent disability. Hollins v. Scott Long Construction, Inc., 62 O.I.C. 218 (1983).

    Rule 13 (B) (now Rule 1.2 B) which limits the award of benefits to ninety days prior to the date of the change in condition application, does not apply to claims for permanent partial loss of use of a member. The date for commencement of compensation benefits under § 65.1-56 (now § 65.2-503 ) is the date on which medical maximum improvement was reached. Wolf v. Baskin & Robbins, Inc., 70 O.I.C. 227 (1991).

    When Specific Benefits Begin:

    Because benefits paid under § 65.2-503 are not wage loss indemnity benefits paid to compensate a worker for his incapacity from work, benefits paid under this section should not be counted as payments for an incapacity that extends the claimant’s period of disability as contemplated in § 65.2-509 . Thus, the Commission held that such benefits under § 65.2-503 cannot be counted to determine whether the employee is entitled to payment for the first seven days of disability under § 65.2-509 . Boone v. Newport News Shipbuilding, 79 O.W.C. 133 (2000).

    Before permanent partial benefits may be awarded, the evidence must establish the claimant has reached maximum medical improvement. Rodda v. Fredericksburg Glass and Mirror, 76 O.W.C. 196 (1997).

    The statutory change effective July 1, 1987 which provides for the payment of temporary total benefits in an amputation case prior to the permanency award and allowing the payment of permanency concurrently with temporary partial compensation benefits is substantive in nature and has no application to accidents occurring prior to the date of enactment. Williams v. Mead Paperboard Products, 67 O.I.C. 156 (1988) (see also Hudson v. American Balance Corporation, 67 O.I.C. 165 (1988); Ridgeway v. Universal Electric Company, 67 O.I.C. 160 (1988)).

    The Commission has the authority to order simultaneous compensation payments of temporary partial and permanent partial disability if, in its discretion, it deems such simultaneous payments to be appropriate, but there should be some basis for exercising that discretion absent agreement of the parties. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    Where the claimant’s temporary partial disability rate is approximately 80% of the temporary total disability rate; the average weekly wage is relatively high; the temporary partial disability rate is about 60 percent of the average weekly wage; and the combination of the temporary partial disability rate and the permanent partial disability rate exceeds the average weekly wage, the record on its face does not support either an award for simultaneous payments or the denial of simultaneous payments, and the case was remanded to give the parties an opportunity to present their respective positions on whether the Commission should exercise its discretion and order simultaneous payments in this case. The time remaining that the claimant can potentially receive compensation for disability is also a factor for consideration. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    If an employee remains incapacitated for work as a result of other injuries received in the same industrial accident, a scheduled loss should not be paid even if maximum medical improvement has been reached and the permanent loss of use to that member rated. O’Quinn v. Clinchfield Coal Company, 63 O.I.C. 251 (1984).

    Where claimant has loss of vision and loss of hearing, if he is totally incapacitated from other injuries, compensation continues for total work incapacity. Cook v. Thompson & Litton Civil & Mining Engrs., 52 O.I.C. 66 (1970).

    Permanent Loss of Use:

    Where an injury is confined to a specific member, the claimant is entitled to compensation only for the percentage of loss of use to that member. Pfaff v. Mactavish Machine Mfg. Co., Inc., 76 O.W.C. 324 (1997).

    Benefits may not be awarded unless there is direct injury or pathological impairment to a scheduled member. The Act does not compensate pain alone, without evidence that pain interferes with the functional use of the member. Pfaff v. Mactavish Machine Mfg. Co., Inc., 76 O.W.C. 324 (1997).

    It is not necessary that a permanent rating be based upon published guides. A physician’s empirical rating of permanent impairment is sufficient evidence for a compensation award. Smith v. North Branch Coal Co., Inc., 75 O.W.C. 68 (1996).

    The maximum disability rating need not be limited to that provided by the American Medical Association Guidelines for loss in range of motion only, where the evidence demonstrates that the claimant suffered loss of strength and physical limitations not considered by the employer’s medical examiners. Jackson v. Haynes Furniture Co., Inc., 77 O.W.C. 92 (1998).

    Virginia Code § 54.1-2900 defines the “practice of chiropractic” to be “the adjustment of the twenty-four movable vertebrae of the spinal column, and assisting nature for the purpose of normalizing the transmission of nerve energy. . . .” The treating physician, a chiropractor, assigned impairment ratings to the claimant’s arms and legs, based on an alleged torn rotator cuff and bilateral hip conditions, parts of the body clearly not included within the statutory definition of the “practice of chiropractic”. The Commission held that the chiropractor’s opinions on the impairments exceeded the statutory definition of chiropractic practice and were not probative. Marshall v. Old Dominion University, 78 O.W.C. 238 (1999).

    An employer’s acceptance of prior disability ratings of a chiropractor does not estop it from denying liability in a subsequent claim. An employer may voluntarily pay compensation benefits or medical expenses. However, such voluntary payment does not waive the employer’s right to assert defenses it may have, absent fraud or concealment on the part of the employer or insurer. Marshall v. Old Dominion University, 78 O.W.C. 238 (1999).

    A medical report which fails to identify the extremity for which a rating is made does not satisfy the employee’s burden to prove a compensable permanent injury, since the Commission could not enter a compensation award in reliance upon such medical opinion. Gatling v. Siemen’s Corporation, 77 O.W.C. 95 (1998).

    Pain per se is not compensable except as it causes functional impairment, and then it is the dysfunction that is rated. Washington v. City of Richmond Fire Dept., 75 O.W.C. 347 (1996).

    As the section applies only to permanent loss, there can be no compensation under this section until such time as injury to member becomes permanent so the percentage of loss can be medically ascertained. Freeman v. Falls Church, 45 O.I.C. 84 (1963).

    Permanent means “fixed” or “static”. Weightman v. H. W. Contractors, Inc., 46 O.I.C. 250 (1964).

    Loss of use cannot be rated until injury is static. Freeman v. Falls Church Bank, 45 O.I.C. 84 (1963); Moore v. Mill-to-You-Fences, Inc., 59 O.I.C. 214 (1980).

    Possibility of future development of traumatic arthritis is not sufficient for award now. Awards cannot be predicated on surmise or conjecture. Jones v. Nash Timber Corp., 47 O.I.C. 182 (1965).

    Benefits under § 65.1-56 (now § 65.2-503 ) were not awardable where physician’s report described claimant’s partial disability “temporary”; disability rating must be permanent. McClure v. Ingalls Steel Company, 60 O.I.C. 307 (1981).

    The measure of permanent loss of use envisioned by the General Assembly is the severely injured employee’s impairment status prior to the implantation of any mechanical device. A claimant who has reached maximum medical improvement (unaided by prosthetics) is entitled to permanent partial disability benefits based on the pre-implantation permanent impairment rating. The claimant was awarded benefits based on the impairment rating assigned to him prior to knee replacement surgery, and the Commission affirmed. Citing Creative Dimensions Group, Inc. v. Hill , 16 Va. App. 439, 430 S.E.2d 718 (1993), the Commission noted no legislative intent suggesting that permanency is to be evaluated only after the ameliorative effect of a mechanical implant is considered. Rowe v. Dycom Industries, Inc., VWC File No. 179-38-18 (April 24, 2002).

    Maximum Medical Improvement:

    Finding of maximum medical improvement may be inferred where doctor did not recommend any further treatment or surgery, nothing in the record suggested claimant’s condition would change substantially, and doctor offered a permanency rating. Frazier v. J.W. Sieg & Co., VWC File No. 218-06-44 (Feb. 18, 2005).

    Employee established maximum medical improvement although treating physician opined that further surgery might reduce pain; evidence showed that treating physician proposed that employee, who injured ankle in workplace accident, undergo surgery within five years to alleviate pain; no evidence that proposed surgery would improve function. Chorley v. Belleville Supply Co., VWC File No. 207-69-36 (Mar. 8, 2004).

    Where the claimant’s injury occurred four years earlier, and the examining physicians determined that the injury was permanent and required no further treatment except for pain control, the Commission found that these facts established maximum medical improvement. Deel v. Goodyear Tire & Rubber Co., 77 O.W.C. 167 (1998).

    There was no evidence that any of the claimant’s physicians recommended additional treatment. One physician’s advice that the claimant avoid certain sports, wear soft-soled shoes, perform certain exercises, and keep his weight down, were only precautionary remarks concerning re-injury, and were not recommendations for treatment. Moreover, the claimant was under no work restrictions, but was released to full duty. The Commission concluded that a physician’s comment that the claimant’s “prognosis long term should be good” was not predicting future improvement, in light of the absence of any further treatment recommendations or follow-up visits, and found that the claimant had proved maximum medical improvement. Terry v. A.B.C. Staffing, 79 O.W.C. 152 (2000).

    Effect of Death:

    Award may be entered after employee’s death for specific disability rated prior to death. Hart v. Co. of Spotsylvania, 57 O.I.C. 162 (1977); Carter v. Chewning, 57 O.I.C. 69 (1977).

    Entitlement to permanent partial disability benefits survives the claimant’s death. That is, the employee’s dependents may receive the permanent partial benefits to which the employee would have been entitled, had he not died. Flood v. Thomas Refuse Service, 77 O.W.C. 170 (1998).

    If an employee is entitled to compensation and dies from a cause other than the compensable injury, payment of the unpaid balance of compensation is made to his statutory dependents under the Workers’ Compensation Act. The right of a dependent to obtain unpaid compensation is determined by the facts as of the date of the work accident, not as of the date of death. Roberson v. Ice Follies, 75 O.W.C. 143 (1996).

    Where an employee who has undergone surgery fails to reach maximum medical improvement prior to death, an award for permanent partial disability benefits may not be entered. Steen v. Norfolk Sheet Metal Works, Inc., 71 O.W.C. 194 (1992).

    The employee was a total quadriplegic when he died, and therefore met the requirements for permanent and total disability under Code § 65.2-503 (C). However, although the employee was eligible for benefits under Code § 65.2-503 (C)(2), he never was awarded those benefits, and the provision of Code § 65.2-511 limiting such benefits for the employee’s lifetime did not apply. Because the claimant’s award had not been converted to an award for permanent and total benefits before his death, his dependents are in the same legal posture as dependents of other employees who were receiving benefits for temporary total disability. If the employee was receiving compensation for temporary total disability at the time of his death from another cause, and for any reason his rights under Code § 65.2-503 were never determined, the dependent distributees could enforce their rights under § 65.2-511 . Flood v. Thomas Refuse Service, 77 O.W.C. 170 (1998).

    Conditions For Which Specific Benefits are not Provided:

    Back injury not covered by this section; wage loss only basis for compensation despite medical assessment of 20% permanent disability of spine. Cumberland v. Prince William School Board, 50 O.I.C. 106 (1968); Hartley v. Holiday Apts., Inc., 49 O.I.C. 141 (1967). (See back section below).

    There is no provision in Workmen’s Compensation Act for payment for loss of a kidney. Lee v. Tidewater Constr. Corp., 52 O.I.C. 164 (1970).

    The act does not provide for payment for loss of senses of smell and taste, absent wage loss. Hodge v. Caruthers, 55 O.I.C. 174 (1973); Smith v. Westfield Realty, Inc., 53 O.I.C. 342 (1971); Lineweaver v. Thorington Constr. Co., 52 O.I.C. 168 (1970).

    Act does not provide for specific disability to clavicle; general disability based on loss of wage. Biltner v. Belanger & Sons, Inc., 51 O.I.C. 15 (1969).

    Section 65.2-503 does not provide compensation to injured workers for permanent loss of, or loss of function of their teeth. Therefore, any recovery for permanent impairment related to the loss of a tooth, or multiple teeth, is limited to the remedy provided by § 65.2-503 B 16. To succeed, the claimant must establish that his condition, after considering the ameliorative effect of dental implants, constitutes a severely marked disfigurement. Stanfield v. City of Hampton Fire and Rescue, VWC File No. 189-67-29 (January 23, 2002).

    Effect of Back, Cervical or Head Injury on Specific Member:

    While the Commission has consistently held that injury to the neck or back that manifests itself in the loss of use of the extremities specified in § 65.1-56 (now § 65.2-503 ) is compensable, it is not appropriate to accept a general disability rating to the body as a whole for the purpose of rating a specific member when there has been no manifestation of any disability in that particular member. Anderson v. Richardson Wayland Electrical, 68 O.I.C. 148 (1989).

    Permanent disability benefits were denied to an employee who suffered an injury to his back because the medical evidence failed to substantiate any actual loss of use or function in the legs. Pain, unless it is shown to be a specific inhibiting factor causing loss of use, is not a basis for an award of compensation under Section 65.1-56. Young v. Westmoreland Coal Company, 69 O.I.C. 127 (1990).

    Back injury not covered by this section; wage loss only basis for compensation despite medical assessment of 20% permanent disability of spine. Cumberland v. Prince William School Board, 50 O.I.C. 106 (1968); Hartley v. Holiday Apts., Inc., 49 O.I.C. 141 (1967).

    If a back injury results in permanent disability to a rateable member, compensation may be awarded. Scott v. Diener, 57 O.I.C. 313 (1976) (see also Cooper v. Westmoreland Coal Co., 59 O.I.C. 61 (1980)).

    Compensation awarded under this section for loss of use of leg emanating from compensable injury to back. Scott v. Diener’s Linoleum & Tile Co., 57 O.I.C. 313 (1976).

    Compensation awarded for loss of use of arm emanating from a compensable injury to the cervical spine. Merillat v. Allegheny Airlines, 62 O.I.C. 314 (1983).

    Where the claimant suffered disability to the arm as a result of an injury to the shoulder and the doctor recommended a 15% disability with an additional 5% impairment for pain, it was appropriate to award a combination of 20% because the evidence established that the claimant’s pain at times resulted in a loss of function. Williams v. Stone Container Corporation, 73 O.W.C. 143 (1994).

    Accident to head and cervical spine resulting in loss of use of arm. Hunter v. Kelly, Inc., 46 O.I.C. 115 (1964).

    Loss of use of leg emanating from head injury was compensable. Palmer v. Bru Mar Equip. Corp., 54 O.I.C. 302 (1972).

    Loss to Upper Extremity (Fingers, Hand, Arm):

    Section 65.2-503 B guidelines for finger amputations found to override suggested impairment ratings for similar amputations contained in AMA Guidelines; employee’s finger was amputated below the nail bed but above the joint line; treating physician opined that AMA afforded 39% rating based on amputation level, although Act allowed 50% for amputation of the first phalanx of a finger; Commission found that Act does not require amputation exactly at joint line and awarded 50% loss of use of finger. Buck v. Kingsdown, Inc., VWC File No. 213-22-18 (Jan. 8, 2004).

    Where the employee suffers permanent compensable injuries to the fingers, hand, wrist, and arm, any permanency rating is limited to the larger member or to the member that results in the maximum amount of compensation for the injury. Trekas v. Continental Baking Co., 75 O.W.C. 203 (1996).

    The claimant suffered a permanent injury to his right little finger. His physician gave a 12% rating to the right arm and declined the carrier’s request to rate the affected member, explaining that the finger injury “facilitate[s] use of the hand as an integral part of the upper extremity.” The Commission held that the evidence failed to show any injury or loss of function to the arm, except as a possible incidental functional effect, and it denied the claim for permanent disability until the claimant submitted a medical report rating his finger. Pfaff v. Mactavish Machine Mfg. Co., Inc., 76 O.W.C. 324 (1997).

    Where failure to accept medical treatment increased loss of use of the hand by 20% to 90% compensated for 70%. Gayle v. Coleman Excelsior Co., 47 O.I.C. 141 (1965).

    Amputation of head of metacarpal not compensable per se; compensated for fingers. Hale v. Kilgore Creek Coal Corp., 50 O.I.C. 171 (1968).

    Compensation payable only for loss of finger where sole cause of loss of use of hand is amputation of finger. Lewis v. Timberlake, Inc., 46 O.I.C. 138 (1964).

    Where injury was to finger but ratings given for both hand and finger award given for finger. Pritchard v. Izzo Co., Inc., 48 O.I.C. 189 (1966).

    Where injury was to the distal phalange of thumb, but amputation of the injured portion required removal of a few millimeters of proximal phalange to produce a better stump, there is loss of more than one phalange and compensation is payable for loss of entire thumb. Smith v. Hiden Storage & Forwarding Co., 38 O.I.C. 93, 160 (1956) (appeal denied).

    Loss of all fingers, rendering hand unusable, amounts to loss of hand. Morris v. Pulaski Veneer Corp., 183 Va. 748 , 33 S.E.2d 190 (1945); Eavey v. Hummel-Ross Fibre Co., 8 O.I.C. 446, 838 (1926).

    Loss of use of hand; traumatic amputation of most of all fingers. Kastrenopoulos v. Arlington Woodworking & Lumber Co., Inc., 44 O.I.C. 155 (1962).

    Portion of hand (three-fourths of first metacarpal) amputated with thumb is not 100% loss of use of hand. Lee v. Brunswick Corp., 52 O.I.C. 166 (1970).

    Loss of use of arm includes the hand, but loss of use of hand does not include the arm. Johnson v. Lynchburg Foundry Co., 51 O.I.C. 135 (1969).

    Section 65.1-56 (now § 65.2-503 ) makes no distinction between the loss of, or loss of use of, a dominant member and the non-dominant member. Cason v. Brown Mechanical Corp., 70 O.I.C. 223 (1991).

    Where a new condition was not present when an earlier disability rating to an inferior member [hand] was approved, the employee is entitled to a new rating for the superior member [arm], but the employer is entitled to a credit for permanent partial disability payments made pursuant to the earlier award. Watson v. Kentucky Fried Chicken, 75 O.W.C. 113 (1996).

    The Act makes no distinction between right or left hand or arm regarding loss of use. Kackley v. Abex Corp., 55 O.I.C. 204 (1973).

    A loss or loss of use of the wrist and lower forearm can support finding of a permanent partial loss of use of the arm rather than the hand. Washick v. Bender Co., Inc., 37 O.I.C. 138 (1955); Bane v. Stone & Webster Eng. Corp., 37 O.I.C. 89 (1955).

    Apportionment of loss where arm is amputated 41/2 inches below elbow, compensated for 871/2% loss of arm. Bolling v. Whitaker Coal Co., 41 O.I.C. 6 (1959) (appeal denied).

    Arm amputated 4 inches below elbow; additional 20% loss of use of remainder of arm. Pendleton v. Doyle Lumber, Inc., 53 O.I.C. 254 (1971).

    Ulnar nerve palsy either caused or aggravated by treatment for original industrial injury; 38% loss of use of arm due to ulnar neuropathy. Haynes v. Arban & Carosi, Inc., 55 O.I.C. 170 (1973).

    Rupture of biceps tendon caused 15% loss of use of arm; specific disability benefits payable as of date of injury; recovery limited to loss of use. Mabry v. Newcomer Ford, Inc., 54 O.I.C. 245 (1972).

    Loss to Lower Extremity (Toes, Foot, Leg):

    Foot compensable not toe where injury involved metatarsal phalangeal joint. Antonopolos v. Price Candy Co., 50 O.I.C. 7 (1968).

    Translating percentage of disability from foot to leg should not result in lesser compensation. Evans v. Shaw Paint & Wallpaper Co., 51 O.I.C. 90 (1969).

    The term “leg” as used in this section must be given its ordinary and usual meaning. An amputation 9 inches below the knee is a loss of a leg and not just loss of a foot. Moultrie v. Allegheny Warehouse Co., Inc., 38 O.I.C. 19 (1956).

    Where one physician rated the loss as 15% of the leg and another 35% of the foot but medical evidence failed to establish that a knee injury manifested itself in a loss of function of the foot, benefits were awarded for 15% loss of the leg. Hicks v. City of Alexandria, 48 O.I.C. 111 (1966).

    Rating placed on the leg when injury involves disability to the ankle. Hollins v. Scott Long Construction, Inc., 62 O.I.C. 218 (1983).

    Disability from heart disease does not affect right to compensation for permanent disability to leg. Loane v. The 3200 Club, 48 O.I.C. 157 (1966).

    The maximum disability rating is not limited to that provided by the American Medical Association Guidelines concerning knee replacement only, but may include the pain and physical limitations suffered by the injured worker. Haga v. Washington Metro Area Transit Authority, 73 O.W.C. 144 (1994).

    Vision Loss:

    Visual impairment is based upon deviation from normal visual acuity, ocular motility and vision fields. Loss of visual acuity of 10% on Snellen’s Chart, plus 5% due to impairment of visual field. Taylor v. Rockland, 52 O.I.C. 250 (1970).

    Where prior to accident, claimant was selling to industry defective but uncorrected vision, the degree of loss is determined without the use of glasses. Owen v. Chesapeake Corp. of Va., 198 Va. 440 , 94 S.E.2d 462, 1956 Va. LEXIS 227 (1956).

    Where his previous industrial blindness was corrected by glasses to normal, and after the accident lost all means of correcting the vision, compensation is due for total loss of vision of that eye. Walsh Constr. Co. v. London, 195 Va. 810 , 80 S.E.2d 524, 1954 Va. LEXIS 160 (1954).

    Where an eye is defective, but can be corrected by glasses, an injury to the eye which makes it impossible to correct the defective vision causes a permanent total loss vision in the eye. London v. Walsh Constr. Co., 195 Va. 810 , 80 S.E.2d 524 (1954); Barnette v. Thorington Constr. Co., 47 O.I.C. 23 (1965).

    Benefits denied because need for glasses was due to astigmatism and not because of accident. Doane v. Richmond Eng. Co., Inc., 51 O.I.C 73 (1969).

    Champagne cork suddenly erupted in eye; compensation awarded for total loss of vision in eye. Ross v. Marriott-Hot Shoppes, Inc., 50 O.I.C 279 (1968).

    Double vision, compensated for 90% permanent loss of vision of right eye. Messick v. Nance Fork Coal Co., 47 O.I.C. 226 (1965).

    Where use of both eyes together produces double vision, compensated for 100% loss of vision of one eye although the injury did not involve either eye. Graham v. Garst Bros. Dairy, Inc., 40 O.I.C. 52 (1958).

    Eyes not injured in head injury, but left eye blocked off with black lens due to nystagmoid movement therefore entitled to 100% loss of use of eye. Clark v. Sonoco Products, 55 O.I.C. 92 (1973).

    Unable to use injured eye with good eye, compensated for total loss of injured eye. Bowman v. French Frame & Wheel Service, 50 O.I C. 44 (1968); Hamilton v. Betty B. Coal Co., 48 O.I.C. 97 (1966).

    Total loss of eye where no useful vision in injured eye because glare required it be kept patched. Samuels v. Atkins, 52 O.I.C. 22 (1970).

    Scar on cornea overcome by accommodation with no loss of visual acuity was not compensable. Sirles v. Le-Wood Homes, Inc., 47 O.I.C 305 (1965).

    Compensation for 100 weeks for loss of vision to be paid if temporary total incapacity from heart attack terminates prior to payment of maximum under Act. Williams v. City of Alexandria, 56 O.I.C. 336 (1974).

    Cataracts:

    Where a claimant undergoes a cataract extraction as a result of an industrial accident, he is entitled to an award for permanent partial loss of use of the eye as determined without artificial correction. The improvement in the claimant’s vision through placement of a contact lens does not affect the total loss of use resulting from the removal of the lens. Pearson v. Virtexco Corporation, 67 O.I.C. 146 (1988).

    Bilateral cataracts result of treatment of dermatitis was compensable. McDaniel v. Folker, 49 O.I.C. 201 (1967).

    Traumatic cataract; undetermined whether corrective surgery would produce less than industrial blindness: compensation 100% loss of vision of right eye. Morris v. Charlottesville Constr. Co., Inc., 47 O.I.C. 246 (1965).

    Cataract extraction caused total loss of vision; time lost from work due to extraction not compensable; paid for loss of vision of eye. Crawford v. Grottoes Sand & Gravel Co., Inc., 50 O.I.C. 103 (1968).

    Traumatic cataract, but disability caused by eye pain, not by loss of vision. Milstead v. Reeves, 51 O.I.C. 184 (1969).

    Hearing Loss:

    The claimant, who had pre-existing hearing loss, suffered a compensable injury by accident when gunfire resulted in hearing loss. In determining claimant’s hearing loss from the accident the normal or non-material 26 decibel is subtracted from the pre-existing hearing loss. This number is then subtracted from the post-accident hearing loss. The resulting decibel loss is then compared to the chart in Rule 12 to determine the percent of hearing loss related to the compensable work accident. Macudzinski v. Omniplex World Service, Inc., VWC File No. 218-73-91 (Feb. 21, 2007).

    Virginia Workmen’s (now Workers’) Compensation Act does not provide compensation for hearing loss less than 27 decibels. Lawson v. Westmoreland Coal Company, 60 O.I.C. 275 (1981).

    Hearing loss is determined without hearing aid. McClanahan v. Greer & Savers Coal Co., 48 O.I.C. 159 (1966).

    Hot metal in ear caused 100% loss of hearing in that ear and 50% facial disfigurement. Eubank v. Murray Chevrolet, Inc., 53 O.I.C. 93 (1971).

    Hearing loss as a result of being struck on back of ear by tree limb while picking apples. Grant v. Brumback, 53 O.I.C. 117 (1971).

    Partial loss of hearing held result of occupational exposure to loud noise. Arnold v. Clinchfield Coal Co., 55 O.I.C. 15 (1973); Stallard v. Clinchfield Coal Co., 54 O.I.C. 358 (1972); McAllister v. Basic Constr. Co., 50 O.I.C. 238 (1968); Mullins v. Clinchfield Coal Co., 58 O.I.C. 253 (1978) (appeal denied).

    Evidence did not prove hearing loss due to noise hazard in employment. Stewart v. Reynolds Metal Co., 54 O.I.C. 363 (1972); Turpin v. Jefferson Mills, 51 O.I.C. 275 (1969); Simmons v. Basic Witz Furniture Co., 49 O.I.C. 301 (1967).

    Loss not due to one loud noise (fellow worker struck steel beam with heavy sledge). Reynolds v. Walder, 50 O.I.C. 277 (1968).

    Loss not proved due to working at high altitude in Bolivia or any condition at work. Maddox v. Telecom Inc., 52 O.I.C. 174 (1970).

    Employer in whose employment claimant is last injuriously exposed is employer responsible for compensation for compensable hearing loss. Lee v. Norfolk General Hospital, 57 O.I.C. 226 (1977); Brewer v. Sunrise Coal Co., et al., 59 O.I.C. 35 (1980).

    Also see Notes § 65.2-401 .

    Disfigurement:

    Prior to the 1975 amendment, disfigurement alone was not compensable. There had to be marked disfigurement which impaired future usefulness or occupational opportunities of employee. Stephens v. A.L. Wright & Co., 194 Va. 404 , 73 S.E.2d 399, 1952 Va. LEXIS 245 (1952).

    In order for benefits to be awarded under § 65.1-56(19) (now § 65.2-503 (16)) there must be “severely marked” disfigurement that is conspicuous or noticeable. Hall v. Newport News Shipbuilding & Drydock Co., 68 O.I.C. 154 (1989).

    Where requested by the claimant, the Commission may determine compensability of a disfigurement injury by viewing photographs of the scarring injury. Stockman v. CarTemps USA, 77 O.W.C. 232 (1998).

    Inasmuch as the physician considers disfigurement and pain in reaching a rating for permanency or loss of use, a claimant is not entitled to a separate disfigurement rating. Williams v. Mead Paperboard Products, 67 O.I.C. 156 (1988).

    An award for disfigurement will be made only where an award for the same member has not previously been made under (1) through (18) of § 65.1-56 (now § 65.2-503 ). Wendell v. Federal Mogul Corporation, 68 O.I.C. 153 (1989).

    An award for disfigurement does not prevent a subsequent award for “loss of use” of a member but such award would be subject to a deduction for the amount previously paid for disfigurement to the same body part. Smith v. Lynchburg Foundry, 67 O.I.C. 152 (1988).

    A claimant who receives temporary total benefits pursuant to the Longshoremen and Harbor Workers’ Compensation Act may be entitled to an award for permanent partial incapacity because there is no double recovery since the Federal Act does not provide for benefits for severely marked disfigurement. Robinson v. Norfolk Shipbuilding and Dry Dock Corporation, 66 O.I.C. 7 (1987).

    Whether a scar, or scars are a “severely marked disfigurement” is a legal determination by the Commission, not a medical issue to be determined by the approved treating physician. The treating surgeon opined that the employee’s scars should not be labeled “severely marked,” and the employer argued that the doctor was in the best position to assess this issue. Noting that the Commission relies on the treating physician for a description of the injury, and on his opinion regarding maximum medical improvement, the Commission nevertheless held that the question of marked disfigurement under the Act was a legal determination, not a medical one, and relied on its own assessment after direct observation of the scarring. Ward v. New Kent County Sheriff’s Office, VWC File No. 186-40-90 (July 31, 2001).

    In order for an award to be made for a surgical scar on the back it must meet the criteria of severely marked disfigurement. Martin v. Federal Reserve Bank of Richmond, 67 O.I.C. 149 (1988).

    In order for benefits to be awarded under Code § 65.2-503 (B)(16), there must be a “severely marked” disfigurement that is conspicuous or noticeable. A scar that is faint and barely discernable to the eye is not a severely marked disfigurement that qualifies for award of benefits under the Act. Stockman v. CarTemps USA, 77 O.W.C. 232 (1998).

    A scar that is faint and barely discernible to the eye is not severely marked disfigurement that would qualify for an award of benefits under the Compensation Act. However, an eight-inch surgical scar on the inner right arm was sufficiently severely marked to warrant a 10% disfigurement award. Holbert v. Royster Chesapeake, 70 O.I.C. 225 (1991).

    A claimant’s scarring has reached maximum medical improvement when the only recommended treatment to help it is a cosmetic procedure that has not been shown to be medically necessary. Price v. Davis H. Elliot Co., Inc., 76 O.W.C. 50 (1997).

    Where the claimant seeks and is awarded permanent partial disability benefits for scarring to the legs, he is precluded from any future claim for treatment of that scarring for cosmetic purposes. Price v. Davis H. Elliot Co., Inc., 76 O.W.C. 50 (1997).

    Marked disfigurement due to hyperpigmentation not established. Carter v. Lynchburg Foundry, 59 O.I.C. 49 (1980).

    Hypopigmentation of the leg constitutes severely marked disfigurement. Price v. Davis H. Elliot Co., Inc., 76 O.W.C. 50 (1997).

    An injury causing enucleation of a blind eye may be compensable as facial disfigurement. Jones v. Richmond Paper Co., Inc., 30 O.I.C. 574 (1948), 31 O.I.C. 323 (1949).

    Disfigurement of hand not compensable when paid for loss of use of same member. Blankenship v. County of Fairfax, 49 O.I.C. 32 (1967).

    Compensation for amputated finger prohibits award for disfigurement. Bevins v. Va. City Jawbone Coal Co., Inc., 50 O.I.C. 26 (1968).

    The claimant was not entitled to both permanent partial disability benefits and compensation for severely marked disfigurement. He received permanent partial disability benefits for the upper extremity, based upon a doctor’s opinion regarding permanent loss of use, including loss of range of motion in the shoulder. The Commission determined that the claimant was not entitled to disfigurement benefits related to a surgical scar on his shoulder, finding that the shoulder is part of the same member for which permanent partial disability benefits were already awarded. Fleming v. Heritage Hall Nursing Home, VWC File No. 200-19-53 (January 24, 2002).

    Section 65.2-503 does not provide compensation to injured workers for permanent loss of, or loss of function of their teeth. Therefore, any recovery for permanent impairment related to the loss of a tooth, or multiple teeth, is limited to the remedy provided by § 65.2-503 B 16. To succeed, the claimant must establish that his condition, after considering the ameliorative effect of dental implants, constitutes a severely marked disfigurement. Stanfield v. City of Hampton Fire and Rescue, VWC File No. 189-67-29 (January 23, 2002).

    Same,.Landrum v. Gunst Corp., 57 O.I.C. 222 (1977).

    Pneumoconiosis:

    Also see notes to § 65.2-404 through § 65.2-407 .

    Generic term covering group of pulmonary abnormalities from inhalation of dust particles: silicosis, siderosis, coal worker’s pneumoconiosis. Holmes v. Clinchfield Coal Co., 55 O.I.C. 176 (1973) (appeal denied) Reece v. Westmoreland Coal Co., 54 O.I.C. 312 (1972), (appeal denied); Shepherd v. Clinchfield Coal Co., 53 O.I.C. 329 (1971).

    Pneumoconiosis is a generic term defined as a chronic fibrous reaction in the lungs to the inhalation of dust. Powers v. Clinchfield Coal Co., 52 O.I.C. 200 (1970) (appeal denied).

    Pneumoconiosis diseases as defined in Code § 65.2-503 specifically include silicosis and asbestosis. White v. C. J. Coakley Co., Inc., 77 O.W.C. 209 (1998).

    Pneumoconiosis is detectable in life only by chest x-ray and occupational history. Brown v. Big Branch Coal Co., 53 O.I.C. 23 (1971); Burke v. Buckles Trucking Co., 53 O.I.C. 31 (1971).

    “Injurious exposure” means an exposure to the danger of the disease which proximately causes the malady or aggravates a preexisting condition. Mullins v. Beatrice Pocahontas Coal Co., 60 O.I.C. 313 (1981).

    Claimant has burden of proving existence of coal worker’s pneumoconiosis by competent evidence. Smith v. Lester, 52 O.I.C. 242 (1970).

    In affirming the Commission’s award of compensation benefits for first stage pneumoconiosis, the Court noted that a greater number of medical opinions does not necessarily constitute a preponderance of the evidence. Island Creek Coal Co. v. Honaker, 9 Va. App. 376, 388 S.E.2d 271 (1990).

    1. e.  A mere diagnosis and communication is not sufficient to prove an occupational disease. A preponderance of the evidence must establish the disease to be at a compensable level, Category I. Wood v. Todd Marine Enterprises, 74 O.W.C. 137 (1995).

    Pneumoconiosis, including asbestosis, is compensated in three stages. A person with compensable stage I asbestosis is entitled to 50 weeks of compensation. Stage II is compensated at 100 weeks and stage III at 300 weeks. Stage III asbestosis necessarily encompasses stage I. It is unlikely that the legislature intended for an employee who is diagnosed with stage I asbestosis, followed by a later diagnosis of stage II, to receive 150 weeks of compensation, while an employee whose condition advances more rapidly resulting in an initial diagnosis of stage II asbestosis would receive 100 weeks of compensation. Chitwood v. E. I. DuPont de Nemours and Co., Inc., 77 O.W.C. 179 (1998).

    The mere fact that pneumoconiosis does not rise to the level of a ratable permanent loss under § 65.2-503 B 17 does not automatically preclude entry of an award for medical benefits only. The Commission noted that the Court of Appeals earlier ordered entry of an award for medical benefits in a nearly identical case involving “asbestosis.” See Jones v. E.I. DuPont De Nemours , 24 Va. App. 36, 480 S.E.2d 129 (1997). Observing that “asbestosis” is but one of several occupationally-induced forms of pneumoconioses, the Commission refused to recognize a distinction between the different forms the disease may take. While not entitled to permanency, the claimant established the presence of compensable pneumoconiosis and was entitled to entry of an award of medical benefits. Reed v. Clinchfield Coal Company, VWC File No. 205-30-74 (June 6, 2002).

    Asbestosis:

    Compensation benefits may not be awarded to a claimant who is totally disabled from work as a result of asbestosis unless at least first stage has been diagnosed. Woody v. Charles Smith et al., 67 O.I.C. 120 (1988).

    It is appropriate to apply the Pneumoconiosis Guidelines to asbestos cases where a claim is made for Stage 1 benefits and there is no suggestion of either total or partial disability for work. Stoots v. Great Barrier Insulation Co., et al., 71 O.W.C. 179 (1992).

    There is no basis for vacating a State award for medical expenses incidental to claimant’s asbestosis on the ground that a subsequent Federal award against a different employer provided for the same medical benefits. Boykin v. Waco Insulation, Inc., 63 O.I.C. 32 (1984).

    Injurious exposure to asbestos proven. Morris v. Natkin and Co., 59 O.I.C. 218 (1980).

    Exposure to asbestos for as little as 5% of work time compensable. Daniel v. Porter Hayden Co., 58 O.I.C. 76 (1978); Mixon v. Caudle-Hyatt, Inc., 220 Va. 645 , 260 S.E.2d 193 (1979).

    Byssinosis:

    Disability was probably due to a non-compensable cause and not byssinosis. Simpkins v. Dan River, Inc., 59 O.I.C. 276 (1980).

    Compensation benefits for byssinosis were denied. Caskey v. Dan River Mills, Inc., 225 Va. 405 , 302 S.E.2d 507 (1983), 60 O.I.C. 81 (1981); Barrington v. Dan River Mills, Inc., 225 Va. 240 , 302 S.E.2d 505 (1983), 60 O.I.C. 32 (1981); Adkins v. Dan River Mills, Inc., 60 O.I.C. 9 (1981), 3 Va. App. 320, 349 S.E.2d 667; Smith v. Fieldcrest Mills, Inc., 224 Va. 24 , 294 S.E.2d 805, 1982 Va. LEXIS 267 (1982).

    Mesothelioma:

    The evidence established that the claimant’s death from mesothelioma was a result of exposure to asbestos which arose out of and in the course of his employment. Shank v. Newport News Shipbuilding and Dry Dock Company, 65 O.I.C. 181 (1986).

    Mesothelioma occurring after a first stage rating was awarded as a new accident. Brooks v. AC&S, etc., 57 O.I.C. 56 (1976).

    Silicosis:

    In finding that the evidence failed to establish silicosis, the Commission upheld the use of x-ray and the ILO classification for pneumoconiosis. Vest v. Lynchburg Foundry Co., 70 O.I.C. 179 (1991).

    Diagnosis of silicosis cannot be made if x-ray findings are not compatible with the disease. As a general rule, radiologists’ interpretation of x-rays prevail over reading of chest films by general practitioner. Smith v. Lester, 52 O.I.C. 242 (1970).

    Medically determined stage of silicosis requires specific medical evidence. Burgess v. Lynchburg Foundry Co., 47 O.I.C. 48 (1965).

    Claimant must prove change in stage of silicosis by medical evidence. McPeek v. P.W. & W. Coal Co., 210 Va. 185 , 169 S.E.2d 443, 1969 Va. LEXIS 219 (1969).

    Silicosis found to be compensable. Pocahontas Fuel Co. v. Godbey, 192 Va. 845 , 66 S.E.2d 859, 1951 Va. LEXIS 232 (1951).

    Silicosis related to employment as tombstone cutter was compensable. DeLoach v. Baer & Son Memorials, 56 O.I.C. 88 (1978).

    Silicosis claim was denied. Miller v. Galax Mirror Co., Inc., 36 O.I.C. 265 (1954); Aker v. Brunswick-Balke-Collender Co., 32 O.I.C. 1 (1950); McDaniel v. Lynchburg Foundry, 57 O.I.C. 240 (1977).

    Sarcoidosis:

    Injurious exposure in employment not shown. Compensation denied. Thomas v. Athy Upholstery Inc., 57 O.I.C. 346 (1977).

    Incapacity attributed to nonoccupational sarcoidosis rather than silicosis. Venable v. Lynchburg Foundry, 58 O.I.C. 345 (1979).

    Permanent and Total Incapacity:

    Claim for permanent total disability denied where evidence showed claimant who suffered a stroke could drive short distances and engage in meaningful community activities, notwithstanding permanent impairment ratings for left upper and lower extremities. Lillard v City of Chesapeake, JCN 2236201 (Feb. 2, 2016).

    In awarding permanent total benefits on a change in condition claim, it was found that the claimant’s brain injury was a compensable consequence of his work injury. While there was no physical trauma to the brain, structural changes as a result of histoplasmosis altered brainwave activity and caused a loss of brain function. Heller v. Powhatan Correctional Center/Commonwealth of Va., VWC File No. 174-73-32 (July 19, 2006).

    Benefits were awarded to the claimant, who as a result of a compensable back injury, suffered from chronic pain syndrome which resulted in an 18% loss of use to both his right and left lower extremities based on his inability to stand and nerve conduction studies. Whetzel v. Quail Ridge Construction Company, VWC File No. 172-67-18 (July 19, 2005).

    In determining the degree to which the loss of use of claimant’s legs prevented gainful employment, it was appropriate for the deputy commissioner to consider the impact on claimant’s daily life caused by the loss of use of the legs, including bowel and bladder difficulties. McCoy v. Wilson Tree Co., VWC File No. 165-13-70 (Oct. 19, 2004).

    An employee must show a quantifiable disability rating before permanent total disability benefits may be awarded, even if the medical evidence otherwise shows permanent total disability because of dysfunction to his legs. Lescallett v. Rozansky & Kay Construction Co., 75 O.W.C. 97 (1996).

    Permanent total disability, allegedly the result of a loss of two members, must be based upon a quantified, permanent, functional loss of use of the members. A disability rating based solely on the employee’s subjective complaints of pain is an insufficient basis upon which to base a claim for permanent total disability. The employee must demonstrate that he has suffered a functional loss of use of those members due to the pain, or due to some other accident-related cause, such that he cannot use those limbs to engage in gainful employment. Kincer v. Pendelton Construction Corp., VWC File No. 149-50-90 (September 12, 2001).

    A determination that an employee has not suffered a permanent total disability under § 65.1-56 (18) (now § 65.2-503 C) does not preclude the claimant from later re-filing for benefits at the expiration of 500 weeks of temporary total disability benefits. However, the claimant’s evidence must establish a change in condition that would support a finding of permanent and total disability and not merely that his physical condition remains the same as at the earlier hearing. Stratton v. Lynchburg Foundry Company, 69 O.I.C. 129 (1990).

    A clinical psychologist is qualified to express an opinion on causation of a brain injury alleged to be permanently disabling. Buracker v. C. W. Wright Const., 75 O.W.C. 365 (1996).

    The Commission declined to enter a permanent total award where the employee’s evidence established that he suffered a permanent and total disability brain injury from cryptococcal meningitis but there was no conclusive presumption that his physical and mental condition would not improve or that he could not be retrained to re-enter the work force prior to expiration of his temporary total award. Clark v. Mister Kleen Maintenance Co., Inc., 71 O.W.C. 196 (1992).(see also).Robinson v. Trego Stone Corporation, VWC # 146-52-30 decided 12/12/92.

    The loss of any two specific members in the same accident constitute total and permanent incapacity to be compensated under § 65.1-54 (§ 65.2-503 ). In determining the extent of loss or loss of use of such members, the capacity or incapacity of claimant to engage in gainful employment is a proper element for consideration. The Commission is not limited to the medical estimate of physical disability. Owen v. Chesapeake Corp. of Va., 198 Va. 440 , 94 S.E.2d 462, 1956 Va. LEXIS 227 (1956); Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954).

    In determining whether a claimant is entitled to an award under § 65.1-56 (18) (now § 65.2-503 C), the test is not whether the employee can engage in any type of gainful employment but rather whether he can use his affected members in such employment. Reed v. Hoerner Waldorf Corporation, 67 O.I.C. 140 (1988).

    Where employee sustained total loss of use of both legs as result of fracture of 5th and 6th dorsal vertebrae and, though confined to a wheelchair, he secured employment, he is entitled to compensation as provided in § 65.1-54 (now § 65.2-503 ) for total incapacity as the total loss of use of two members in the same accident creates a conclusive presumption of total incapacity. Employee does not and cannot use legs in any gainful employment. Wilkerson v. Monarch Elevator & Machine Co., 41 O.I.C. 148 (1959).

    In the absence of loss, or complete loss of use, of two rateable members, claimant’s ability to market his remaining capacity to work is the controlling issue. Felts v. Manpower, Inc., 60 O.I.C. 158 (1981).

    Ability to market remaining capacity to work is factual question to be determined in each case. Norman v. Borden, Inc., 57 O.I.C. 265 (1977); Southers v. Jones, 57 O.I.C. 339 (1977).

    Where the members are useless in any employment for which claimant is physically and mentally fitted, there has been a total loss of use. Greene v. Leas & McVitty, Inc., 36 O.I.C. 170 (1954).

    Lifetime benefits awarded to an employee who suffered one hundred percent loss of use of two members in different accidents in same employment. Howard v. Hercules, Inc., 62 O.I.C. 224 (1983).

    Lifetime benefits were denied an employee who alleged that his compensable back injury resulted in disability in both legs and work incapacity. Crist v. Allied Aviation Fueling Company, 63 O.I.C. 85 (1984).

    100% loss of use of one leg and 45% loss of use of other leg constituted total and permanent disability. Lewis v. Lewis Callis et al., 58 O.I.C. 216 (1978).

    Claimant as a result of 80% loss of use of each arm plus general disability from burns to chest and abdomen was totally and permanently disabled. Hubbard v. N. W. Martin & Bros., Inc., 53 O.I.C. 147 (1971).

    Later amputation of left leg due to amputation following original injury to right leg entitles claimant to compensation for total permanent disability under this provision. Horne v. Superior Life Ins. Co., 44 O.I.C. 142 (1962); Lewis v. Lewis Callis et al., 58 O.I.C. 216 (1978).

    Total and permanent disability not proven. Norman v. Borden, Inc., 57 O.I.C. 265 (1977); Southers v. R. Vaiden Jones, Inc., 57 O.I.C. 339 (1977).

    Combination of further amputation of injured leg and vascular problems in other leg resulting from accident constitutes total permanent disability. Chaney v. Butler Paper, 56 O.I.C. 48 (1975).

    Where the loss of use of the injured leg is partial, both medically and factually, compensation is payable under § 65.1-56 (15) (now § 65.2-503 (13) rather than § 65.1-56 (18) (now § 65.2-503 C). Schooler v. West Va. Paper Co., 44 O.I.C. 223 (1962). (Must consider fact as to remaining work capacity).

    If employee suffers loss or total loss of use of two members mentioned in paragraph 18 (now C) by two different accidents in the same employment he may claim total incapacity under § 65.1-60 (now § 65.2-502 ) though not under § 65.1-56 (now § 65.2-503 ). Morris v. Pulaski Veneer Corp., 183 Va. 748 , 33 S.E.2d 190, 1945 Va. LEXIS 222 (1945).

    While the injury sustained is equivalent to industrial blindness, making the loss medically total, if he is in fact using his eyes in employment, the degree of loss of use is less than total and his ability to engage in gainful employment is a factor to be considered. Owen v. Chesapeake Corp. of Va., 198 Va. 440 , 94 S.E.2d 462, 1956 Va. LEXIS 227 (1956).

    Where an employee, already blind in one eye loses the sight of the other by industrial accident, he cannot claim total disability. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942).

    The requirement that an employer provide vocational rehabilitation training services applies to all injured employees including those who are permanently and totally disabled. Meredith v. Independent Services, Ltd., 70 O.I.C. 320 (1991).

    A claimant who is permanently and totally disabled may not be denied vocational rehabilitation services solely on the grounds that his re-entry into the work force would not reduce the employer’s liability for compensation benefits. However, the relative cost and benefit to be derived from the program must be considered in determining whether vocational rehabilitation is justified. Judge v. Robert Whitmer & C. Kirk Reilly & Associates, 67 O.I.C. 205 (1988). (Affirmed by Court of Appeals May 20, 1989).

    In requiring the insurance carrier to pay the cost and fees for a quadriplegic to obtain a college degree, the Commission noted evidence of his ability to live independently, do volunteer work in the chosen field of study, and a specialist’s recommendation of further educational developments. The carrier’s liability for the cost of attending a program out of state could not exceed the cost of a comparable program at an in-state university. Meredith v. Independent Services, Ltd., 70 O.I.C. 320 (1991).

    Benefits for permanent total disability do not survive the death of an employee from causes unrelated to his work accident. Such benefits only “continue for the lifetime of the injured employee.” Flood v. Thomas Refuse Service, 77 O.W.C. 170 (1998).

    As a matter of practice, the Commission typically waits until near the expiration of the 500-week period, before converting a temporary total disability award to one for permanent total disability. However, the Commission considers a number of factors before determining if the claim for permanent total disability benefits is premature. The Commission considers whether the condition remains stable and permanent, whether the evidence suggests the condition may improve, whether the evidence suggests the possibility of a timely medical breakthrough that could impact the employee, and the number of weeks of temporary disability benefits remaining. This list is not exhaustive, and the Commission looks at the totality of the circumstances. Falls v. WEL, Inc., VWC File No. 184-39-89 (May 7, 2001) see also ; Edwards v. Great Coastal Express, Inc., 162-54-53 (December 6, 2000). (early claim for permanent and total disability found not to be premature).

    Proof of the employer’s “knowledge” or “notice” of a brain injury is insufficient to toll the two-year statute of limitations found in Virginia Code § 65.2-601 . The parties’ memorandum of agreement (MOA) and supplemental MOA noted injuries of the right wrist and back, suffered in 1991. The medical records generated within two years of the accident suggested the possibility of head trauma from the accident, but no specific claim was made for injury to the head or brain within those two years. The Commission, relying on Shawley v. Shea-Ball Construction Company, denied the employee’s March 2001 claim for permanent total disability, finding that he failed to make a claim for brain injury within two years of the accident. Jenkins v. Dynatran, Inc., VWC file No. 154-37-59 (October 12, 2001).

    Lump Sum Payment of Award:

    In order for a lump sum settlement to be approved, the Commission must be furnished sufficient information to determine if it is in the best interest of the employee. The information must include evidence that the employee’s injuries are stabilized, permanency exists, evidence of the employee’s capabilities to handle the funds, and a detailed plan of how the proceeds will be used or invested. Warrick v. Goodyear Tire & Rubber Co., 69 O.I.C. 131 (1990).

    Attorney Fees:

    As a guideline for administratively awarding attorney’s fees for representation involving awards for permanent partial disability, the Commission has adopted a fee of fifteen percent of the award as being reasonable. This is only a guideline, and the Commission reserves its right to exercise its discretion and award an attorney’s fee that varies from the fifteen percent guideline when circumstances warrant. Down v. Jim Price Chevrolet, 77 O.W.C. 91 (1998).

    § 65.2-503. (Effective July 1, 2022) Permanent loss.

    1. Compensation for permanent partial and permanent total loss and disfigurement shall be awarded as provided in this section.
    2. The following losses shall be compensated for the period specified at the rate of 66 2/3 percent of the average weekly wage as defined in § 65.2-101 : Click to view
    3. Compensation shall be awarded pursuant to § 65.2-500 for permanent and total incapacity when there is:
      1. Loss of both hands, both arms, both feet, both legs, both eyes, or any two thereof either from the same accident or a compensable consequence of an injury sustained in the original accident;
      2. Injury for all practical purposes resulting in total paralysis, as determined by the Commission based on medical evidence; or
      3. Injury to the brain which is so severe as to render the employee permanently unemployable in gainful employment.
    4. In construing this section, the permanent loss of the use of a member shall be equivalent to the loss of such member, and for the permanent partial loss or loss of use of a member, compensation may be proportionately awarded. Compensation shall also be awarded proportionately for partial loss of vision or hearing.
    5. Except as provided in subsection C, the weekly compensation payments referred to in this section shall be subject to the same limitations as to maximum and minimum as set out in § 65.2-500 .
      1. Compensation awarded pursuant to this section shall be payable after payments for temporary total incapacity pursuant to § 65.2-500 .
      2. Compensation pursuant to this section may be paid simultaneously with payments for partial incapacity pursuant to § 65.2-502 . Where compensation pursuant to this section is paid simultaneously with payments for partial incapacity pursuant to § 65.2-502 , each combined payment shall count as two weeks against the total maximum allowable period of 500 weeks.

    Loss Compensation Period 1. Thumb 60 weeks. 2. First finger (index finger) 35 weeks. 3. Second finger 30 weeks. 4. Third finger 20 weeks. 5. Fourth finger (little finger) 15 weeks. 6. First phalanx of the thumb or any finger one-half compensation for loss of entire thumb orfinger. The loss of more than one phalanx of a thumb or finger is deemedthe loss of the entire thumb or finger. Amounts received for loss ofmore than one finger shall not exceed compensation provided for theloss of a hand. 7. Great toe 30 weeks. 8. A toe other than a great toe 10 weeks. 9. First phalanx of any toe one-half compensation for loss of entire toe. The loss of more than one phalanx of a toe is deemed the loss of theentire toe. 10. Hand 150 weeks. 11. Arm 200 weeks. 12. Foot 125 weeks. 13. Leg 175 weeks. 14. Permanent total loss of the vision of an eye 100 weeks. 15. Permanent total loss of hearing of an ear 50 weeks. 16. Severely marked disfigurement of the body resulting from aninjury not otherwise compensated by this section not exceeding 60 weeks. 17. Pneumoconiosis, including but not limited to silicosis andasbestosis, medically determined to be in the a. First stage 50 weeks. b. Second stage 100 weeks. c. Third stage 300 weeks. 18. Byssinosis 50 weeks.

    History. Code 1950, § 65-53; 1964, cc. 116, 190; 1968, cc. 347, 660, § 65.1-56; 1970, c. 470; 1972, c. 229; 1975, cc. 446, 450; 1976, c. 655; 1982, c. 326; 1983, c. 287; 1987, c. 560; 1988, cc. 564, 596; 1991, c. 355; 1997, c. 511; 2000, c. 520; 2022, c. 530.

    § 65.2-504. Compensation for disability from coal worker’s pneumoconiosis; insurance of coal operator.

    1. An employee eligible for an award for coal worker’s pneumoconiosis benefits shall be compensated according to the following schedule:
      1. For first stage coal worker’s pneumoconiosis medically determined from radiographic evidence and classified under the current International Labour Office Classification of Radiographs of the Pneumoconioses where there is no present impairment for work, 66 2/3 percent of the average weekly wage as defined in § 65.2-101 , for fifty weeks, up to 100 percent of the average weekly wage of the Commonwealth as defined in § 65.2-500 .
      2. For second stage coal worker’s pneumoconiosis medically determined from radiographic evidence and classified under the current International Labour Office Classification of Radiographs of the Pneumoconioses where there is no present impairment for work, 66 2/3 percent of the average weekly wage as defined in § 65.2-101 for 100 weeks, up to 100 percent of the average weekly wage of the Commonwealth as defined in § 65.2-500 .
      3. For third stage coal worker’s pneumoconiosis medically determined from radiographic evidence and classified under the current International Labour Office Classification of Radiographs of the Pneumoconioses and involving progressive massive fibrosis or medically classified as being A, B or C under the International Labour Office (hereafter referred to as I.L.O.) classifications but where there is no apparent impairment for work, 66 2/3 percent of the average weekly wage as defined in § 65.2-101, for 300 weeks, up to 100 percent of the average weekly wage of the Commonwealth as defined in § 65.2-500.
      4. For coal worker’s pneumoconiosis medically determined to be A, B or C under the I.L.O. classifications or which involves progressive massive fibrosis, or for any stage of coal worker’s pneumoconiosis when it is accompanied by sufficient pulmonary function loss as shown by approved medical tests and standards to render an employee totally unable to do manual labor in a dusty environment and the employee is instructed by competent medical authority not to attempt to do work in any mine or dusty environment and if he is in fact not working, it shall be deemed that he has a permanent disability and he shall receive 66 2/3 percent of his average weekly wage as defined in § 65.2-101 during the three years prior to the date of filing of the claim, up to 100 percent of the average weekly wage of the Commonwealth as defined in § 65.2-500 for his lifetime without limit as to the total amount.
    2. In any case where partial disability as mentioned in subsection A of this section later results in total disability, the employer shall receive credit on any permanent disability payments by being allowed to deduct 25 percent of each weekly payment until payments for partial disability hereunder have been fully accounted for.
    3. In any case where there is a question of whether a claimant with pneumoconiosis is suffering from coal worker’s pneumoconiosis or from some other type of pneumoconiosis such as silicosis, it shall be conclusively presumed that he is suffering from coal worker’s pneumoconiosis if he has had injurious exposure to coal dust.
    4. In the event that any coal operator wishes to insure himself under standard workers’ compensation insurance rather than be self-insured against the risks and liabilities imposed by this section or by § 65.2-513 , any such insurance issued in this Commonwealth covering such risks shall be rated separately for premium purposes and shall not affect workers’ compensation rates for any other employers not exposed to such risks.
    5. All members of any panel or committee required to interpret or classify a chest roentgenogram for purposes of diagnosing a coal worker’s pneumoconiosis shall be B-readers approved by the National Institute for Occupational Safety and Health.

    History. 1972, c. 619, § 65.1-56.1; 1973, c. 436; 1974, cc. 201, 560; 1975, c. 447; 1990, c. 610; 1991, c. 355; 2000, cc. 408, 520; 2011, c. 513.

    The 2000 amendments.

    The 2000 amendment by c. 408 added subsection E.

    The 2000 amendment by c. 520 substituted “as defined in § 65.2-101 ” for “during the three years prior to the filing date” in subdivision A 1, and substituted “wage as defined in § 65.2-101 ” for “wages” in subdivisions A 2, A 3 and A 4.

    The 2011 amendments.

    The 2011 amendment by c. 513, in subdivisions A 1 through A 3, inserted “the current” and deleted “(1980)” following “Pneumoconiosis.”

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 21, 44, 65.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-56.1 or prior law.

    Exclusive remedy. —

    This section provides the exclusive remedy for the compensation due to coal miner’s pneumoconiosis. Virginia Pocahontas #1 v. Musick, No. 1896-89-3 (Ct. of Appeals Oct. 23, 1990).

    Words “and if he is in fact not working” in subdivision A 4 do not mean that the statute of limitations does not begin to run until a coal miner ceases work. This subdivision in no way prescribes the time period in which a claimant must file a claim after receiving a communication of a diagnosis of pneumoconiosis. Ratliff v. Dominion Coal Co., 3 Va. App. 175, 349 S.E.2d 147, 3 Va. Law Rep. 737, 1986 Va. App. LEXIS 349 (1986).

    An employer may credit awards for first- and second-stage pneumoconiosis against awards for second- and third-stage pneumoconiosis, respectively. To hold otherwise would create an irrational windfall for claimants whose diseases advance from an early finding of first-state pneumoconiosis as opposed to claimants who are initially determined to suffer from second- or third-stage pneumoconiosis. Chitwood v. E.I. Du Pont de Nemours & Co., 29 Va. App. 611, 513 S.E.2d 890, 1999 Va. App. LEXIS 235 (1999).

    This section must be construed according to its own language and is independent of § 65.2-503 . Chitwood v. E.I. Du Pont de Nemours & Co., 29 Va. App. 611, 513 S.E.2d 890, 1999 Va. App. LEXIS 235 (1999).

    Physician's opinion properly rejected. —

    Workers’ Compensation Commission rejected a physician’s opinion because it conflicted with the previously determined diagnosis that the claimant suffered from pneumoconiosis, and thus the Commission did not err in rejecting the physician’s opinion and accepting the other doctor’s opinion. Dickenson-Russell Coal Co., LLC v. Kiser, 2021 Va. App. LEXIS 161 (Va. Ct. App. Aug. 31, 2021).

    Consideration of non-radiographic evidence. —

    The provision of this section requiring that the diagnosis be based upon “radiographic evidence” does not proscribe or restrict consideration by the medical expert of other evidence also relevant and appropriate to the radiograpic studies. Cox v. Oakwood Mining, Inc., 16 Va. App. 965, 434 S.E.2d 904, 10 Va. Law Rep. 182, 1993 Va. App. LEXIS 407 (1993).

    Unnecessarily narrow construction of this section. —

    By declining to permit consideration of the autopsy evidence in conjunction with the several conflicting opinions from the radiographic evidence, through both direct and cross-examination of the experts, the commission adopted an unnecessarily narrow construction of this section. Cox v. Oakwood Mining, Inc., 16 Va. App. 965, 434 S.E.2d 904, 10 Va. Law Rep. 182, 1993 Va. App. LEXIS 407 (1993).

    Erroneous use of former § 65.1-56 (now § 65.2-503 ) rather than this section was harmless error. —

    Even assuming that the commission erroneously used former § 65.1-56 (now § 65.2-503 ) rather than this section to determine the entitlement and amount of the claimant’s award for coal miner’s pneumoconiosis, the error was harmless where the entitlement to compensation and amount of the award would have been the same for the initial level of the disease’s progression. Virginia Pocahontas #1 v. Musick, No. 1896-89-3 (Ct. of Appeals Oct. 23, 1990).

    Sufficiency of the evidence. —

    Because there was credible medical evidence to support the Virginia Workers’ Compensation Commission’s determination regarding a claimant’s pulmonary function loss, its decision to award of lifetime wage benefits was binding on appeal. Four \O\ Mining Corp. v. Deel, 2017 Va. App. LEXIS 158 (Va. Ct. App. June 27, 2017).

    Workers’ Compensation Commission properly awarded permanent total disability benefits to a miner because the miner established that he had “coal workers’ ” pneumoconiosis, obtained the restriction from work in a mine or dusty environment, and was, in fact, not working, the legislature’s use of “or” separated the ways in which an individual could satisfy the requirements of the statute, and there was nothing to suggest that the legislature’s “obvious intention” was for the statute to be read conjunctively. Paramont Coal Co. Va., LLC v. Vanover, 2018 Va. App. LEXIS 101 (Va. Ct. App. Apr. 17, 2018).

    Workers’ compensation claimant was entitled, based on the claimant’s pneumoconiosis, to permanent disability benefits because the claimant, who suffered loss of lung function due to exposure to coal dust over the course of the claimant’s employment in a coal mine, met the claimant’s burden of proving sufficient pulmonary function loss, as shown by approved medical tests and standards, due to the claimant’s exposure to coal dust and that the claimant’s pneumoconiosis rendered the claimant unable to perform manual labor in a dusty environment. Paramont Coal Co. Va., LLC v. McCoy, 69 Va. App. 343, 819 S.E.2d 831, 2018 Va. App. LEXIS 300 (2018).

    Record supported both the conclusion that claimant had suffered a 15 percent loss of lung function and that he was totally unable to perform manual labor in a dusty environment due to his pneumoconiosis; the doctor was not confined to the pulmonary function tests to conclude that claimant was unable to work. Instead, the doctor was permitted to rely on scans, spirometry, diffusion capacity, and other information in forming his conclusion. Dickenson-Russell Coal Co., LLC v. Kiser, 2021 Va. App. LEXIS 161 (Va. Ct. App. Aug. 31, 2021).

    In order to have the benefit of the presumption of § 65.1-56.1 (now § 65.2-504 ) a claimant must prove that he had injurious exposure to coal dust and suffered from some form of pneumoconiosis. Penley v. Island Creek Coal Company, 8 Va. App. 310, 381 S.E.2d 231, 5 Va. Law Rep. 2665, 1989 Va. App. LEXIS 70 (1989).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The disjunctive “or” between the first three elements of Va. Code § 65.2-504 (A)(4) clearly demonstrates the intention to require a claimant to meet only one of the first three elements when the claimant has proof of instruction by competent medical authority not to work in a mine or dusty environment, and the claimant is not working. The use of the conjunctive “and” prior to the last two requirements establishes both of those conditions must be met when the claimant satisfies any one of the first three elements for entitlement to an award of permanent total disability pursuant to Va. Code § 65.2-504 (A)(4). Prior holdings in Hobbs v. Joy Mining Machinery, VWC File No. 217-40-01 (Mar. 30, 2006), Roberson v. A & G Coal Co., VWC File No. 188-91-27 (May 10, 2005), and Salyers v. Middle Creek Energy, Inc., 77 O.W.C. 1 (1998), are specifically overruled. Vanover v. Paramount Coal Co., JCN VA02000020919 (Sept. 15, 2017), aff’d, No. 1658-17-3 (Ct. App. of Va., April 17, 2018) (unpublished opinion).

    The Commission is not prohibited from relying upon the numerical preponderance of negative or positive readings in determining the presence or absence of coal worker’s pneumoconiosis. Burke v. Dickenson-Russell Coal Company, JCN VA02000010648 (Oct. 31, 2013), Affirmed by unpublished opinion Va. Court of Appeals, Record No. 2196-13-3 (April 22, 2014).

    Deputy Commissioner erred in failing to give deference to medical opinion of physicians whose x-ray readings indicated review of higher quality of film than physicians with contrary opinions; evidence found to establish compensable pneumoconiosis because two readers of original, higher quality film both gave “positive” readings. Clark v. El Paso Coal, VWC File No. 212-63-00 (Dec. 31, 2003).

    Although employee did not show a level of coal-workers’ pneumoconiosis that would support an award of benefits under § 65.2-504 , the evidence showed the existence of pneumoconiosis, and therefore the employee was awarded medical benefits for this condition. Wheeler v. Paramount Coal Corp., VWC File No. 209-75-07 (July 7, 2003).

    The claimant who sought benefits under § 65.1-56.1 (now § 65.2-504 ) was conclusively presumed to be suffering from coal worker’s pneumoconiosis if the evidence established injurious exposure to coal dust and a diagnosis of pneumoconiosis. When the requirement for the presumption is met the existence of readings indicating “s”, “t” and “u” are irrelevant. Musick v. Virginia Pocahontas #1, 68 O.I.C. 146 (1989).

    In finding that the evidence failed to establish silicosis, the Commission upheld the use of x-ray and the ILO classification for pneumoconiosis. Vest v. Lynchburg Foundry Co., 70 O.I.C. 179 (1991).

    The various elements of Code § 65.1-56.1(A)(4) (now § 65.2-504 [A][4]) are stated in the disjunctive, and compensation may be awarded for permanent total disability if any one of the stated requirements are met. Flanary v. Moose Coal Co., 76 O.W.C. 119 (1997).

    Where there is a question whether the claimant has coal worker’s pneumoconiosis or another type of pneumoconiosis, Code § 65.2-504 (C) provides that it shall be conclusively presumed he has coal worker’s pneumoconiosis if he had injurious exposure to coal dust. Fleming v. Lambert Coal Company, 74 O.W.C. 183 (1995).

    Coal worker whose physicians diagnosed pneumoconiosis atypical for and questionably caused by coal dust is presumed to have coal worker’s pneumoconiosis because of the history of injurious exposure. Fleming v. Lambert Coal Company, 74 O.W.C. 183 (1995).

    Lifetime Benefits Award:

    After determining that the claimant’s employment as a computer analyst did not disqualify him from potential total disability benefits pursuant to § 62.5-504, the Commission subsequently denied benefits on the basis that the medical evidence demonstrated that the claimant possessed the pulmonary function to perform labor in a dusty environment, including his pre-injury employment in the mines. Roberson v. A & G Coal Corp., VWC File No. 188-91-27 (May 10, 2005).

    In order to qualify for lifetime benefits under § 65.2-504 , an employee must prove, in addition to coal workers’ pneumoconiosis medically determined to be A, B, or C under the I.L.O. classifications or progressive massive fibrosis as required for category three, that there is sufficient pulmonary function loss as shown by approved medical tests and standards to render him unable to do manual labor in a dusty environment, that he has been instructed not to work in a mine or dusty environment, and that he is not working. Salyers v. Middle Creek Energy, Inc., 77 O.W.C. 1 (1998).

    The provisions contained in § 65.2-504 B allow the employer to discount 25 percent of each weekly permanent disability payment until it recoups the payments it made for partial disability. Salyers v. Middle Creek Energy, Inc., 77 O.W.C. 1 (1998).

    There is no language in § 65.2-504 that a disabled employee who qualifies for lifetime benefits must receive a category or stage award before he can receive a lifetime award, merely to enable the employer to obtain the benefit of the credit provision. Salyers v. Middle Creek Energy, Inc., 77 O.W.C. 1 (1998).

    Section 65.2-504 does not require that, once the conditions for lifetime benefits have been met, an award for such benefits must be delayed until a scheduled award is fully paid. Salyers v. Middle Creek Energy, Inc., 77 O.W.C. 1 (1998).

    The logical intent of § 65.2-504 B is to allow the employer the benefit of a discount for having paid benefits for partial disability pursuant to the schedule, because they were being paid while the employee was still working, or was at least capable of working, at his occupation. Salyers v. Middle Creek Energy, Inc., 77 O.W.C. 1 (1998).

    § 65.2-505. Injuries in different employments; injury to employee with disability; subsequent permanent injury by accident in service to employer.

    1. Except for hearing or vision loss that has not reached a compensable level of disability, if an employee has a permanent disability or has sustained a permanent injury in service in the armed forces of the United States or in another employment other than that in which he receives a subsequent permanent injury by accident, such as specified in § 65.2-503 , he shall be entitled to compensation only for the degree of incapacity which would have resulted from the later accident if the earlier disability or injury had not existed.
    2. Except for hearing or vision loss that has not reached a compensable level of disability, if an employee has a permanent disability or has sustained a permanent injury in service to his employer and receives a subsequent permanent injury by accident, such as specified in § 65.2-503 , he shall be entitled to compensation only for the degree of incapacity which would have resulted from the later accident if the earlier disability or injury had not existed.

    History. Code 1950, § 65-55; 1968, c. 660, § 65.1-58; 1991, c. 355; 1996, c. 448.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 38, 43.

    CASE NOTES

    Employer liable only for amount of injury sustained in his business. —

    The provisions of this section and former § 65.1-56 (now § 65.2-503 ) show that the legislature intended to hold the employer liable only for the amount of injury sustained by the employee in the conduct of his particular business. Noblin v. Randolph Corp., 180 Va. 345 , 23 S.E.2d 209, 1942 Va. LEXIS 176 (1942) (decided under former § 65.1-58).

    The legislative intent behind this section extends only to preexisting injuries that place the employee’s disability at or above a defined level of compensability; where there was no dispute that defendant’s pre-employment hearing loss did not equal or exceed the 26 decibel loss required for compensation eligibility; he was entitled to compensation in an amount proportional to his percentage of hearing loss without offset for his pre-employment level of disability. Virginia Fibre Corp. v. Moore, 17 Va. App. 691, 440 S.E.2d 432, 10 Va. Law Rep. 875, 1994 Va. App. LEXIS 60 (1994), aff'd, 249 Va. 1 , 452 S.E.2d 360, 1995 Va. LEXIS 4 (1995).

    Commission required to distinguish between disability from a preexisting injury and disability from a compensable aggravating injury. —

    Workers’ Compensation Commission erred in failing to distinguish between the impairment rating attributable to an employee’s 2005 total knee replacement (a preexisting, non-work-related condition) and the rating attributable to a compensable, work-related aggravation injury, as required by subsection A of § 65.2-505 . Fairfax County Sch. Bd. v. Martin-Elberhi, 55 Va. App. 543, 687 S.E.2d 91, 2010 Va. App. LEXIS 3 (2010).

    Evidence supported finding of new injury rather than aggravation of prior injury. —

    Where a claimant’s doctor opined that his second knee injury was an aggravation of one sustained while working for his first employer, whose medical expert opined that the second injury was a new injury sustained while the claimant was working for a second employer, substantial evidence supported the Virginia Workers’ Compensation Commission’s acceptance of the latter opinion. Interstate Truck Serv. v. Ricketts, 2006 Va. App. LEXIS 348 (Va. Ct. App. Aug. 1, 2006).

    Pre-existing condition found. —

    Virginia Workers’ Compensation Commission did not err in finding that half of the permanent disability rating of 50 percent of claimant’s right lower extremity was attributable to her pre-existing degenerative disease of the right hip, and thus claimant was entitled to compensation only for the degree of incapacity that would have resulted from the work-related accident if the earlier disability had not existed and appellees were entitled to a credit for claimant’s pre-existing arthritic condition. Clements v. Augusta Health & Safety First Ins. Co., 2021 Va. App. LEXIS 148 (Va. Ct. App. Aug. 3, 2021).

    By subtracting worker’s pre-existing vision acuity reading (20/80) from his post-injury vision acuity reading (20/300), the employer was given the benefit of the provision of this section and worker was given the benefit of the deviation from normal vision as required by Rule 13 of the Rules of the Virginia Worker’s Compensation Commission. Accordingly, under a proper application of the rule and this section, worker’s loss of visual acuity resulting from the injury far exceeded the minimum threshold for industrial blindness and entitled him to one hundred percent permanent partial disability. Sinclair v. Shelter Constr. Corp., 23 Va. App. 154, 474 S.E.2d 856, 1996 Va. App. LEXIS 593 (1996).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    This section does not mention temporary total incapacity; however, if the specific injury compensable under § 65.1-56 (now § 65.2-503 ), together with the previously existing permanent disability, result in temporary total incapacity for work, employee may claim under § 65.1-54 (now § 65.2-500 ) and then, upon returning to work under § 65.1-56 (now § 65.2-503 ) for the specific injury arising out of his employment. Davidson v. Brooks-Calloway Co., 5 O.I.C. 138 (1923), 6 O.I.C. 432 (1924).

    § 65.2-506. Compensation after second injury in same employment.

    If an employee receives an injury for which compensation is payable while he is still receiving or entitled to compensation for a previous injury in the same employment, he shall not at the same time be entitled to compensation for both injuries, but if he is, at the time of the second injury, receiving compensation under the provisions of § 65.2-503 , payments of compensation thereunder shall be suspended during the period compensation is paid on account of the second injury, and after the termination of payments of compensation for the second injury, payments on account of the first injury shall be resumed and continued until the entire amount originally awarded has been paid. However, if, at the time of the second injury, he is receiving compensation under the provisions of § 65.2-502 , then no compensation shall be payable on account of the first injury during the period he receives compensation for the second injury.

    History. Code 1950, § 65-56; 1968, c. 660, § 65.1-59; 1991, c. 355.

    CASE NOTES

    Multiple conditions. —

    Although an employee suffered three work-related conditions when the employee was awarded workers’ compensation benefits, the employee was allowed to receive benefits for only one condition, so payments which the employer made were credited against the 500-week limit established by § 65.2-518 only for that condition, and the employee was entitled to receive benefits for the other conditions after the first condition no longer existed. E.I. du Pont de Nemours & Co. v. Eggleston, 264 Va. 13 , 563 S.E.2d 685, 2002 Va. LEXIS 75 (2002).

    Virginia Workers’ Compensation Commission properly found that carrier two was responsible for the claimant’s temporary total disability payments under § 65.2-506 , which required that the later injury be paid first, since the workers’ compensation claimant was disabled in part from his compensable work injuries from the March 19, 2011, work accident — the claimant’s right arm neuropraxia, for which carrier one was responsible — and in part from his compensable ordinary disease of life — the claimant’s bilateral carpal tunnel syndrome, for which carrier two was responsible; both conditions were independently compensable. S&S Elec., Inc. v. Markulik, 61 Va. App. 515, 738 S.E.2d 512, 2013 Va. App. LEXIS 78 (2013).

    Second injury, sustained at home, was compensable consequence of first injury, which arose out of employment. —

    Credible evidence supported the Virginia Workers’ Compensation Commission’s finding that a claimant’s first injury, sustained when the claimant tripped over a sliding glass door frame, was caused by a risk or hazard of the workplace, and his second injury, sustained at home, was a compensable consequence of the claimant’s first injury. City of Poquoson Law Enforcement v. Hooks, 2002 Va. App. LEXIS 732 (Va. Ct. App. Dec. 10, 2002).

    Relationship to limitations period. —

    Subsection A of § 65.2-708 limitations period was not tolled by § 65.2-506 as that statute addressed only how wage benefits were to be paid if a claimant simultaneously was otherwise entitled to wage benefits for two separate injuries that occurred at different times and did not reference filings, filing deadlines, statutes of limitations, tolling, or subsection A of § 65.2-708 . Morris v. Fed. Express Corp., 70 Va. App. 571, 829 S.E.2d 578, 2019 Va. App. LEXIS 167 (2019).

    Section § 65.2-506 did not provide a basis for equitable tolling given that the General Assembly explicitly tolled or otherwise limited the operation of subsection A of § 65.2-708 ’s limitations period in other provisions. Morris v. Fed. Express Corp., 70 Va. App. 571, 829 S.E.2d 578, 2019 Va. App. LEXIS 167 (2019).

    The Commission erred in assessing liability for the employee’s compensation equally between the first and second insurance carriers. The Commission should have applied the rationale of this section and held the insurers liable in inverse order. Greif Cos./Genesco, Inc. v. Hensley, 22 Va. App. 546, 471 S.E.2d 803, 1996 Va. App. LEXIS 437 (1996).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Second Accident While Claimant is Receiving Temporary Partial Benefits:

    When at the time of second injury employee is receiving compensation under § 65.1-55 (now § 65.2-502 ) for general partial incapacity he will be entitled to compensation for temporary total incapacity resulting from second injury and then compensation for increased loss of earnings under § 65.1-55 (now § 65.2-502 ) occasioned by additional general partial incapacity caused by second accident. Lambert v. Clinchfield Coal Corp., 28 O.I.C. 723 (1946).

    Where a claimant who was on temporary partial benefits suffered a second injury resulting in total disability, an award was made based on the wages earned prior to the first accident. The carrier at the time of the first accident was responsible for a sum equal to that being received by the claimant on temporary partial and the carrier at the time of the second accident was responsible for the difference between the pre-injury wage and the temporary partial. Donahue v. Clark Electric Contractors, Inc., 68 O.I.C. 256 (1989).

    When at the time of second injury employee is receiving compensation under § 65.1-56 (now § 65.2-503 ) for specific injury such payments will be suspended while employee is totally incapacitated for work as a result of the second accident. Butler v. Ballard Fish & Oyster Co., Inc., 22 O.I.C. 478 (1940).

    In view of the provisions of § 65.1-60 (§ 65.2-507 ), if the second accident results in another specific injury compensable under § 65.1-56 (now § 65.2-503 ), specific disability payments due to first injury will be suspended during temporary total incapacity for second; then specific resumed for first injury, followed by specific for second injury. Polson v. Gordonsville Industries, Inc., 55 O.I.C. 288 (1973).

    Other.

    Once disability from second accident ends, Commission has no authority to automatically reinstate or “unsuspend” award for total incapacity for first injury independent of proof of that incapacity. During period claimant was disabled from second accident, circumstances impacting claimant’s entitlement to disability for first may have changed. Crumpton v. City, JCN VA02000007014 (Oct. 1, 2018).

    Where a claimant is totally disabled as a result of two separate conditions, if the employee’s disability is related in part to the original work accident and in part to a second, subsequent compensable condition, ongoing compensation benefits may be assigned to the latter, second claim until disability abates. Markulik v. S & S Electric, Inc., JCN VA02000007765, and VA00000433920 (Aug. 9, 2012).

    An employer is not entitled to a credit for workers’ compensation benefits paid in another state for an overlapping period but for a different accident. The carrier would be entitled to a credit for payments made in another state for the same accident and same injuries. Harris v. Otis Elevator, 73 O.W.C. 223 (1994).

    § 65.2-507. Same employment; when both injuries permanent.

    If an employee receives a permanent injury as specified in § 65.2-503 , after having sustained another permanent injury in the same employment, he shall be entitled to compensation for both injuries, but the total compensation shall be paid by extending the period and not by increasing the amount of weekly compensation.

    History. Code 1950, § 65-57; 1968, c. 660, § 65.1-60; 1972, c. 619; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation in the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    CASE NOTES

    Editor’s note.

    The cases annotated below were decided under former § 65.1-60 or prior law.

    This section supplements former § 65.1-54 (now § 65.2-500 ). —

    This section is not in conflict with former § 65.1-54, providing compensation for total incapacity, but is merely supplementary to it and must be read in connection with it. Morris v. Pulaski Veneer Corp., 184 Va. 424 , 35 S.E.2d 342, 1945 Va. LEXIS 161 (1945).

    Limitation on amount and duration of payments. —

    In 1946 claimant sustained injuries and received compensation for 2071/2 weeks at $18 per week. In 1965 he was again injured, resulting in permanent and total disability. The Commission improperly awarded additional compensation at $39 per week but limited additional weeks so that overall weeks of compensation for both injuries were 400 or $39 divided into the then maximum statutory amount of $15,600. It was held that since claimant was compensated for the 1946 injury only at the rate of $18 per week, he should receive additional compensation for the 1965 injury on the basis of additional weeks up to 500 weeks as provided by statute. The 1946 injury compensation of $3,735 plus $11,407.50 for additional weeks for 1965 injury at $39 a week, amounting to a total of $15,142.50, was still within the then statutory maximum monetary limit. Barker v. APCO, 209 Va. 162 , 163 S.E.2d 311, 1968 Va. LEXIS 210 (1968) (decided prior to the 1972 amendment).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Lifetime benefits awarded to an employee who suffered one hundred percent loss of use of two members in different accidents in same employment. Howard v. Hercules, Inc., 62 O.I.C. 224 (1983).

    § 65.2-508. Foreign injuries.

    1. When an accident happens while the employee is employed elsewhere than in this Commonwealth which would entitle him or his dependents to compensation if it had happened in this Commonwealth, the employee or his dependents shall be entitled to compensation, if:
      1. The contract of employment was made in this Commonwealth; and
      2. The employer’s place of business is in this Commonwealth;provided the contract of employment was not expressly for service exclusively outside of the Commonwealth.
    2. However, if an employee shall receive compensation or damages under the laws of any other state, nothing herein contained shall be construed so as to permit a total compensation for the same injury greater than is provided for in this title.

    History. Code 1950, § 65-58; 1968, c. 660, § 65.1-61; 1976, c. 151; 1991, c. 355.

    Law Review.

    For survey of Virginia workers’ compensation and welfare law, see 62 Va. L. Rev. 1506 (1976).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 4, 38.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-61 or prior law.

    “Expressly” does not imply requirement that contract be in writing. —

    Nothing in the common law or the provisions of the Workers’ Compensation Act requires a contract of employment to be in writing, and the word “expressly” as used in the proviso in this section does not imply such a requirement. In the context in which it was used, it connotes nothing more than a meeting of the minds upon the exclusive situs of the workplace. The legislative intent was to exclude coverage of the Act when the parties to the employment contract mutually understood that no part of the employee’s services was to be performed inside the Commonwealth. Sorrels v. Foreign Mission Bd., 227 Va. 6 , 313 S.E.2d 370, 1984 Va. LEXIS 260 (1984).

    Contract not for services exclusively outside of commonwealth. —

    A coal miner’s employment contract was not exclusively for services outside of Virginia where the employer hired the claimant in Virginia approximately three years prior to his accident, the claimant worked in Virginia during that time for all but the week of his accident, the claimant testified that he was initially unaware that the position he was interested in was in Kentucky, and the employer testified that the employee was not exclusively a Kentucky employee and could be transferred between mines and shifts at any time, as had occurred in the past. Powell Mt. Coal Co. v. Mosko, 2001 Va. App. LEXIS 164 (Va. Ct. App. Mar. 27, 2001).

    Foreign contract outside scope of Virginia Act. —

    Where the plaintiff’s employment was under a Pennsylvania contract, with a Pennsylvania employer and embraced within the terms of the workman’s compensation act of that state, his contract of employment was entirely foreign to the State of Virginia and clearly outside of the Virginia Workmen’s (now Workers’) Compensation Act. Soloman v. Call, 159 Va. 625 , 166 S.E. 467 , 1932 Va. LEXIS 222 (1932).

    Because an employee admitted multiple times that the contract at issue was only for work in Delaware, the last prong of subsection A of § 65.2-508 was not met; therefore, his application for workers’ compensation benefits was properly dismissed for lack of jurisdiction. Anagua v. Sosa, 59 Va. App. 506, 721 S.E.2d 14, 2012 Va. App. LEXIS 21 (2012).

    Award under foreign statute does not bar tort action against third parties. —

    The acceptance by plaintiff of compensation under the workman’s compensation act of the state of Pennsylvania does not preclude him from maintaining an action in Virginia, in tort, against the defendants, who are third parties. Soloman v. Call, 159 Va. 625 , 166 S.E. 467 , 1932 Va. LEXIS 222 (1932).

    Award made by Congress which is mere gift cannot be set off. —

    Where an award was made by the Commission to the widow of a city policeman who was killed outside the city while assisting state and federal officers in making an arrest, and Congress made an award to the widow in full settlement of all claims against the federal government, it was held that since the federal government was under no obligation to make provision for decedent’s family, provisions made were but a gift to the widow, which could not be set off as against a right to recover. City of Alexandria v. McClary, 167 Va. 199 , 188 S.E. 158 , 1936 Va. LEXIS 293 (1936).

    Contract made in Virginia with employer doing business in Virginia. —

    The evidence conclusively established that a coal miner’s contract for employment was made in the commonwealth with an employer doing business here where the claimant testified he initially applied for and was interviewed for a transfer from a Virginia mine to a Kentucky mine at his employer’s place of business in Virginia and the employer testified that the claimant was hired in Virginia through its Virginia office, its place of business. Powell Mt. Coal Co. v. Mosko, 2001 Va. App. LEXIS 164 (Va. Ct. App. Mar. 27, 2001).

    Virginia Workers’ Compensation Commission had jurisdiction to hear a claim filed by a professional athlete who was traded to the Washington Redskins and injured while playling in a game in Pennsylvania. Pro-Football Inc. v. Paul, 39 Va. App. 1, 569 S.E.2d 66, 2002 Va. App. LEXIS 540 (2002).

    Employment contract did not exist. —

    Decedent had not completed all the steps necessary to enter into a valid employment contract with a farmer when he died en route to pick up a visa, and an employment contract, which was required under subsection A of § 65.2-508 for the Virginia Workers’ Compensation Commission to assert jurisdiction, did not exist; the decedent also had not filled out an I-9 form, actually gained entry to the United States, appeared at the job site, or signed an employment contract. de la Rosa Herrera v. Martin, 49 Va. App. 469, 642 S.E.2d 309, 2007 Va. App. LEXIS 117 (2007).

    The mere fact that employer was incorporated in Maryland does not require a holding that employee, as an officer of the corporation, was hired in Maryland, rather than Virginia. CLC Constr., Inc. v. Lopez, 20 Va. App. 258, 456 S.E.2d 155, 1995 Va. App. LEXIS 386 (1995).

    Place of business in Virginia shown. —

    Testimony coupled with the insurance documents, established that employer did not merely conduct business in Virginia, but that it actually maintained its place of business in Virginia. The bookkeeping functions, which included taxes and payroll, were performed in Virginia. Employer rented a construction yard in Virginia, where it stored its equipment and where employees met on a daily basis to go to job assignments. Employee testified that employer performed many projects in Virginia. This credible evidence was undisputed. CLC Constr., Inc. v. Lopez, 20 Va. App. 258, 456 S.E.2d 155, 1995 Va. App. LEXIS 386 (1995).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Jurisdiction:

    When all requirements of this section exist, namely, contract of employment made in this State and place of business of employer in this State, Virginia compensation benefits may be awarded even though the accident occurred in another state. Robinson v. Thompson & Litton, 44 O.I.C. 216 (1962); Davis v. Baker, 40 O.I.C. 26 (1958); Brill v. Windle, 35 O.I.C. 299 (1953) (appeal denied); Smith v. Bristol Steel & Iron Works, 22 O.I.C. 542, 592 (1940); Thigpen v. Gibbs & Hill, 6 O.I.C. 1101 (1924); Jones v. American Railway Express Co., 3 O.I.C. 637 (1921); Cook v. Hearing Conservation Noise Control, Inc., 56 O.I.C. 60 (1975), (affd. on review). Note: prior to 7/1/76 there was also a residency requirement .

    If any or all of these elements are lacking the Virginia Commission has no jurisdiction. Ryals v. Humble Oil & Refining Co., 52 O.I.C. 220 (1970); Levier v. Little Reno, Inc., 41 O.I.C. 93, 96 (1959); Gustafson v. Stuart, 36 O.I.C. 99 (1954).

    Section 65.2-508 (A)(2) clearly instructs that jurisdiction lies with the Workers’ Compensation Commission if “the contract of employment was not expressly for service exclusively outside of the Commonwealth.” In other words, where the employee is assigned to perform any work in the Commonwealth, however de minimis, the Commission has jurisdiction. Flores v. D B & A General Contractors, Inc., 79 O.W.C. 24 (2000).

    Commission lacks jurisdiction despite location of union headquarters in Norfolk where claimant resides and is hired in North Carolina to work in North Carolina by an employer with no place of business in Virginia. Waters v. Shook & Fletcher, 60 O.I.C. 463 (1981).

    Section 65.2-508 provides for concurrent jurisdiction between States for a compensable injury, but not for double recovery. Cash v. Food Lion #179, 76 O.W.C. 476 (1997).

    The claimant sustained a compensable injury in Texas and received compensation benefits pursuant to Texas compensation law. He also filed a claim in Virginia, and his award here acknowledged the Texas payments and was entered “For Record Purposes Only.” The claimant subsequently reached maximum medical improvement and his Texas award was converted to one for whole body permanent partial disability, and he filed a claim for penalties for late payment of his Virginia award. The Commission held that the employer was entitled to a dollar-for-dollar credit for moneys paid under the Texas Act, so no penalty was owed until the credit for the Texas award was exhausted. Cash v. Food Lion #179, 76 O.W.C. 476 (1997).

    In denying compensation benefits to a circus performer, the Commission noted that while the employer had a place of business in Virginia, the contract of hire was made in Poland and the claimant never worked in Virginia. Since jurisdiction cannot be conferred, the fact that the contract stated that it would be governed by the laws of Virginia is irrelevant. The employer had the option to accept the claim under Virginia but declined to do so. Bodlas v. Ringling Brothers Barnum & Bailey Combined Shows, 73 O.W.C. 9 (1994).

    Accident Location Out of State:

    Where all three jurisdictional requirements of § 65.1-61 (now § 65.2-508 ) have been met and employee was not expressly hired for work outside Virginia, carrier cannot contend that injury to claimant in another state was not covered in Virginia. Davis v. Baker, 40 O.I.C. 26 (1958).

    No significance that accident happened in North Carolina on a road that winds in and out of North Carolina and Virginia. Clary v. Clary Timber Sales, Inc., 55 O.I.C. 95 (1973).

    Contract of Employment:

    The Commission had no jurisdiction over a Maryland injury although the claimant lived in Virginia and was provided transportation to the work site because the contract for hire was made outside of Virginia. While the employer had multiple job sites in Virginia and claimant worked one day in Virginia, the company had no business location in the state. Smith v. Joseph J. Magnolia, Inc., VWC File No. 224-46-42 (Sept. 27, 2006).

    Under familiar principles of conflicts law, when the acts that constitute offer and acceptance are scattered over more than one state, the authorities are reasonably clear that the contract is “made” at the same time and place “where the last act necessary to the completion of the contract was done - that is, where the contract first creates a legal obligation.” Flores v. D B & A General Contractors, Inc., 79 O.W.C. 24 (2000) (see also Barnhart v. USA Truck, Inc., VWC File No. 200-15-91 (October 29, 2001)).

    The “mailbox rule” states that an acceptance of a contract is effectively communicated when it is put out of the possession of the offeree. Under this rule, acceptance by mail or facsimile transmission creates a contract at the moment of dispatch. The policy behind the mailbox rule is that after such acceptance, the offeree has done all that can be done and should be protected against an intervening revocation. Tummino v. Fleet Transit, Inc., 78 O.W.C. 48 (1999).

    Acceptance of a contract of employment must be dispatched in an authorized manner. Generally, the offer authorizes the means of communication that was used in transmitting the acceptance. In this case, because the offer was communicated via facsimile transmission, the employee could communicate his acceptance in the same manner. Tummino v. Fleet Transit, Inc., 78 O.W.C. 48 (1999).

    Although the contract of employment was not expressly for service exclusively outside Virginia, it was not made in this State within the meaning of statute. Shulte v. Piedmont Aviation, Inc., 50 O.I.C. 290 (1968).

    Fact that airline hostess was hired through Virginia office not sufficient to give Virginia jurisdiction when injury occurred in Michigan. Thomas v. Allegheny Airlines, 56 O.I.C. 309 (1975).

    Commission has jurisdiction where contract of employment made in state, but accident occurred outside of Virginia. Yovorsky v. Brown Steel Contractors, Inc., 58 O.I.C. 370 (1978).

    Where all agreements made for starting the company occurred in Virginia, there is no basis in law for asserting that the claimant as an officer of the corporation could be hired only in Maryland where the business was incorporated. To say that a “contract of employment” was not legally effective until the corporation was formed under the laws of the State of Maryland, and to require that the contract of employment occur in Maryland, are to ignore the practical realities of the inception of a business. Lopez v. CLC Construction, 73 O.W.C. 13 (1994).

    In finding it lacked jurisdiction, the Commission noted that while the employer had a place of business in the State, the contact of employment was made based on a conditional offer sent through the mail to the claimant in New Hampshire which was confirmed upon completion of a training course in Indiana. Keller v. North American Van Lines, 73 O.W.C. 11 (1994).

    An oral contract of hire made in Virginia is effective for the purposes of § 65.2-508 . Where the employer effectively came to the claimant’s Virginia home, in this case by telephone, and made a job offer, the acceptance by the claimant at that time constituted the completion of the contract of employment, in Virginia. Flores v. D B & A General Contractors, 79 O.W.C.24 (2000).

    The Maryland employer communicated by telephone and facsimile transmission to the Virginia claimant, offering work that was to be performed at a Virginia location. The evidence showed that the claimant was subsequently interviewed in Baltimore, but he did not accept employment at that time, because the terms of employment were not complete. The employer subsequently telefaxed a final offer to the claimant in Virginia, and the claimant telefaxed his acceptance from Virginia. The Commission found that the contract of employment was created in Virginia when the employee telefaxed his acceptance. Tummino v. Fleet Transit, Inc., 78 O.W.C. 48 (1999).

    Place of Business:

    Employee, a truck-driver who lived in Virginia and was injured in Oklahoma while unloading for his employer, based in Illinois, did not show that the employer had a place of business in Virginia based upon employee’s solicitation of business for employer from his wireless telephone, originating in Virginia and elsewhere; employee did not hold himself out as being employer’s Virginia-based agent during the calls and did not testify that his calls originated specifically from Virginia; therefore, Commission did not have jurisdiction. Mays v. K&F Transp., Inc., VWC File No. 207-69-30 (Aug. 15, 2003).

    The burden is on the claimant to prove that at the time of his foreign injury his employer had some place of business in Virginia. Shawver v. B. E. & K. Contractors, 60 O.I.C. 392 (1981).

    No ore tenus evidence was presented to establish that the employer had a place of business in Virginia. However, the claimant filed W-2 Tax Forms, time logs, and cancelled checks from the employer as evidentiary exhibits, which established that D B & A had places of business in McLean and in Manassas Park, Virginia. Even if these were established for bookkeeping and administrative purposes only, it sufficiently satisfies the requirements of § 65.2-508 A 2. Flores v. D B & A General Contractors, 79 O.W.C. 24 (2000).

    Jurisdiction over a subsidiary corporation cannot be based on the fact the parent corporation has a place of business within the Commonwealth. Worsham v. Transpersonnel, Inc./Location 7200, 71 O.W.C. 19 (1992).

    For jurisdictional purposes under § 65.1-61 (now § 65.2-508 ), a Military Reservation geographically located within the State is considered a place of business within the State. Coldtrain v. Starco, Inc., 65 O.I.C. 19 (1986).

    Commission has jurisdiction in the case of airlines stewardess who, although hired in another state, was a resident of Virginia at time of alleged accident and employer maintained business location within this State. Burke v. United Airlines, 57 O.I.C. 66 (1976) (aff’d on review, appeal denied).

    The Commission held that “a yard” located in Virginia where employees met each day to talk, pick up and drive off equipment was a place of business. There is no requirement that sums of money be exchanged at this location in order to be considered a place of business. Lopez v. CLC Construction, 73 O.W.C. 13 (1994).

    The employer’s business offices were located in Baltimore, Maryland. However, the employer worked from a desk provided at an Amoco facility in Fairfax, Virginia, where he supervised deliveries of gasoline from that facility to various stations in the Washington D.C. area. A desk and filing cabinet, and the office in Fairfax, was provided by Amoco, but the employer installed telephone and fax machine lines to that office. The employer also had three or four tanker trucks at the facility on a regular basis. The Commission found that what the employer provided on its own or through its arrangement with Amoco was more than just conducting business, but constituted a place of business in Virginia. Tummino v. Fleet Transit, Inc., 78 O.W.C. 48 (1999).

    Services Exclusively Out of State:

    Commission had jurisdiction over claim because employee not hired to work exclusively outside Virginia; Virginia-based employer hired Maryland employee, who was injured on job site in Maryland; interview and hiring occurred in Virginia; employer had other worksites in Virginia, and had policy to attempt to relocate employees, when job was completed, to work at other worksites, including those in Virginia; Commission found employee not hired to work exclusively on designated project outside Virginia. Caballero v. Southland Concrete Corp., VWC File No. 211-53-01 (Oct. 7, 2003).

    Even if the elements mentioned in this section are present, the Virginia Commission has no jurisdiction of a claim arising out of an accident happening in another state where the contract of employment was for services to be performed exclusively outside of Virginia. Bell v. Barnes Co., 20 O.I.C. 293 (1938); Clark v. Tidewater Const. Co., 20 O.I.C. 237 (1938); Kilby v. J.H. Addison & Sons, 59 O.I.C. 166 (1980).

    Jurisdiction exists if the contract of employment is for work primarily but not exclusively outside this State. McNair v. Clifton Forge Grocer Co., 2 O.I.C. 226, 295 (1920).

    Effect of Decision in Another Jurisdiction:

    Decision of Maryland Commission finding that claimant was an independent contractor entitled to full faith and credit in Virginia. O’Brien v. Alcan Aluminum Corporation, 58 O.I.C. 262 (1979).

    Longshore and Harbor Workers’ Act:

    Claim for injuries sustained while working on barge in James River repairing bridge between Newport News and Southampton County is compensable because Virginia jurisdiction is concurrent with that of Federal Longshoremen and Harbor Worker’s Act. Locklear v. Tidewater Klewit VII, 60 O.I.C. 284 (1981).

    Since jurisdiction is concurrent between Virginia and Longshoremen and Harbor Worker’s Act, injured employee may make claims under both but cannot make a double recovery. Mingo v. Norfolk Shipbuilding and Dry Dock Company, 60 O.I.C. 311 (1981).

    § 65.2-509. Commencement of compensation.

    No compensation shall be allowed for the first seven calendar days of incapacity resulting from an injury except the benefits provided for in § 65.2-603 ; but if incapacity extends beyond that period, compensation shall commence with the eighth day of disability. If, however, such incapacity shall continue for a period of more than three weeks, then compensation shall be allowed from the first day of such incapacity.

    History. Code 1950, § 65-59; 1968, c. 660, § 65.1-62; 1976, c. 165; 1991, c. 355.

    Law Review.

    For survey of Virginia workers’ compensation and welfare law, see 62 Va. L. Rev. 1506 (1976).

    CASE NOTES

    The Workers’ Compensation Act should be liberally construed. —

    Workers’ compensation commission did not err in construing the Virginia Workers’ Compensation Act (Act), § 65.2-100 et seq., liberally to allow the claimant’s second claim for worker’s compensation benefits where the second claim was timely filed, but lacked an allegation that the claimant had been disabled in excess of the seven days required to receive compensation; the requirement that more than seven days be alleged was not jurisdictional, the claimant subsequently amended his claims by alleging additional days that did not involve the pleading of a new cause of action, and allowing the claimant to receive benefits under such circumstances furthered the goal of liberally construing the Act in favor of a claimant. Hospice Choice, Inc. v. O'Quin, 42 Va. App. 598, 593 S.E.2d 554, 2004 Va. App. LEXIS 101 (2004).

    Filing claim alleging seven days of disability not jurisdictional. —

    Pleading the seven days of disability that were statutorily required to pass before a workers’ compensation claimant could receive compensation on a claim covered under the workers’ compensation law was not jurisdictional, and, thus, the claimant’s second claim, which was filed within the two-year limitations period for workers’ compensation benefits set forth in § 65.2-601 , was not time barred for only alleging one date in support of his request for temporary total benefits, where the claimant subsequently amended his second claim to include additional dates that exceeded the seven-day disability requirement since those amendments did not raise a new cause of action but instead, related back to the timely filed second claim. Hospice Choice, Inc. v. O'Quin, 42 Va. App. 598, 593 S.E.2d 554, 2004 Va. App. LEXIS 101 (2004).

    Res judicata. —

    Workers’ compensation benefits claimant’s argument that his period of disability was incorrectly calculated was barred by the principles of res judicata because the Workers’ Compensation Commission issued a review opinion affirming the deputy commissioner’s opinion regarding the period of disability, and neither party appealed the Commission’s review opinion. Wilson v. City of Chesapeake, 2019 Va. App. LEXIS 250 (Va. Ct. App. Nov. 5, 2019).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Benefits for First Seven Days Payable Af- ter Weeks of Disability:

    If the incapacity for work, whether total under § 65.1-54 (now § 65.2-500 ) or partial under § 65.1-55 (now § 65.2-502 ), shall continue beyond six (now three) weeks from date of accident, the employee is entitled to compensation for the first seven days of incapacity. Chesser v. Stonega Co., 3 O.I.C. 72 (1921).

    Because benefits paid under § 65.2-503 are not wage loss indemnity benefits paid to compensate a worker for his incapacity from work, benefits paid under this section should not be counted as payments for an incapacity that extends the claimant’s period of disability as contemplated in § 65.2-509 . Thus, the Commission held that such benefits under § 65.2-503 cannot be counted to determine whether the employee is entitled to payment for the first seven days of disability under § 65.2-509 . Boone v. Newport News Shipbuilding, 79 O.W.C. 133 (2000).

    Benefits under § 65.2-503 are fixed and payable, regardless of actual disability, and they are paid irrespective of continued employment, loss of wages, or other considerations. The benefits are payable for the loss of use of a body part based upon the statutory presumption that the employee will sustain a lifetime loss of economic benefit that would have derived from the injured body part. Boone v. Newport News Shipbuilding, 79 O.W.C. 133 (2000).

    An injured employee’s entitlement to compensation is not dependent on the economic or financial condition of the employer. Dawson v. Goodyear Tire & Rubber Company, 60 O.I.C. 132 (1981).

    A claim for initial disability benefits must be filed within two years of the work accident for compensable disability beginning within two years of that accident. The limitation period is not tolled where only medical benefits were initially awarded because disability did not exceed seven days. The change in condition claim for disability had to be filed within two years of the accident. Ashby v. West Point School Board, 74 O.W.C. 90 (1995).

    To be entitled to disability compensation, the claimant must not only file a timely application for hearing, he must also establish a basis upon which compensation may be awarded within the statutory time periods. Chisholm v. The Washington Post, 77 O.W.C. 85 (1998).

    Computing Time:

    This section refers to calendar days of incapacity. Therefore teacher who was injured on last day of school and returned to work on first day of Fall term was entitled to compensation for summer disability. Busbee v. Falls Church School Board, 47 O.I.C. 57 (1965).

    Where claimant was normally employed on a standby basis during weekends and Sunday was first day of disability, compensation begins on Sunday. Walton v. Pargas, Inc., 50 O.I.C. 334 (1968).

    Where the alleged disability during the first two years after the claimant’s accident does not exceed the seven day waiting period of Code § 65.2-509 , compensation cannot be awarded, even though the claimant is subsequently incapacitated for a longer period. Chisholm v. The Washington Post, 77 O.W.C. 85 (1998).

    § 65.2-510. Refusal of employment; compensation for partial incapacity.

    1. If an injured employee refuses employment procured for him suitable to his capacity, he shall only be entitled to the benefits provided for in §§ 65.2-503 and 65.2-603 , excluding vocational rehabilitation services provided for in subdivision A 3 of § 65.2-603 , during the continuance of such refusal, unless in the opinion of the Commission such refusal was justified.
    2. If an injured employee cures his unjustified refusal by accepting employment suitable to his capacity at a wage less than that originally offered, the employer shall pay or cause to be paid to the injured employee during his partial incapacity pursuant to § 65.2-502 , a weekly compensation equal to 66 2/3 percent of the difference between his average weekly wages before his injury and the average weekly wage the employee would have earned by accepting the original proffered light duty employment.
    3. A cure of unjustified refusal pursuant to subsection A may not be established if the unjustified refusal lasts more than six months from the last day for which compensation was paid before suspension pursuant to this section; however, the six-month period may be extended by the number of days a claimant is totally disabled if the disability commenced during such six-month period. When an injured employee is precluded from accepting employment as a result of pregnancy, the six-month period for curing the refusal may be tolled during such period as a physician certifies medical disability.

    History. Code 1950, § 65-60; 1968, c. 660, § 65.1-63; 1991, c. 355; 1995, c. 319; 1996, c. 252.

    Law Review.

    For note, “Partially Disabled and Religious: Virginia Workers’ Compensation and the Free Exercise Clause,” see 28 U. Rich. L. Rev. 763 (1994).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 38, 43, 74.

    CASE NOTES

  • Analysis
  • I.General Consideration.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-63 or prior law.

    Legislature intended to encourage injured employees to seek selective employment rather than to remain unemployed unless the employer finds such employment for them. Big D Quality Homebuilders v. Hamilton, 228 Va. 378 , 322 S.E.2d 839, 1984 Va. LEXIS 314 (1984); Washington Metro. Area Transit Auth. v. Harrison, 228 Va. 598 , 324 S.E.2d 654, 1985 Va. LEXIS 151 (1985).

    The legislature intended to foreclose benefits only so long as the unjustified refusal continued, regardless of whether the procured selective employment was available at the time the refusal ceased. Thompson v. Hampton Inst., 3 Va. App. 668, 353 S.E.2d 316, 3 Va. Law Rep. 1800, 1987 Va. App. LEXIS 155 (1987).

    This section permits an employee to cure a prior unjustified refusal to accept selective employment so that benefits may be resumed. Thompson v. Hampton Inst., 3 Va. App. 668, 353 S.E.2d 316, 3 Va. Law Rep. 1800, 1987 Va. App. LEXIS 155 (1987).

    This section allows an employee to cure an unjustified refusal of selective employment by obtaining equivalent selective employment. Food Lion, Inc. v. Newsome, 30 Va. App. 21, 515 S.E.2d 317, 1999 Va. App. LEXIS 320 (1999).

    Expiration of statutory period for cure bars future claim. —

    An employee who does not cure an unjustified refusal within the six months permitted by this section forever loses the right to additional temporary partial benefits; the restoration of partial disability benefits is barred even following an intervening period of compensable total disability. Hoy Constr., Inc. v. Flenner, 32 Va. App. 357, 528 S.E.2d 148, 2000 Va. App. LEXIS 326 (2000).

    Clear mandate of this section is to permit the employer to suspend payment of benefits to an employee who refuses selective employment procured for him which is within the employee’s capacity to perform. Thompson v. Hampton Inst., 3 Va. App. 668, 353 S.E.2d 316, 3 Va. Law Rep. 1800, 1987 Va. App. LEXIS 155 (1987).

    Section does not require that employers make selective employment available. But the relief thereby afforded an employer when an employee unjustifiably refuses to accept or continue selective employment is limited to those cases in which the employer has provided or procured such employment. Big D Quality Homebuilders v. Hamilton, 228 Va. 378 , 322 S.E.2d 839, 1984 Va. LEXIS 314 (1984).

    Section does not require that employers make selective employment available; it merely encourages employers to procure such work for partially incapacitated employees. Transfer v. Dicks, 229 Va. 548 , 331 S.E.2d 449, 1985 Va. LEXIS 230 (1985).

    In order to continue to receive benefits under the Act, a claimant who has been injured in a job-related accident must market his remaining capacity to work. A claimant must make a “reasonable effort” to find work suitable to his or her ability to perform. Herbert Brothers, Inc. v. Jenkins, 14 Va. App. 715, 419 S.E.2d 283, 8 Va. Law Rep. 3539, 1992 Va. App. LEXIS 172 (1992).

    A claimant is not required to relocate in order to accept selective employment. Houlihan's v. Slater, 1998 Va. App. LEXIS 489 (Va. Ct. App. Sept. 15, 1998).

    Probable cause for employer-requested hearing. —

    Workers’ Compensation Commission erred in refusing to hear an employer’s allegation that a claimant receiving temporary partial disability unjustifiably refused selective employment under § 65.2-510 on the ground there was insufficient probable cause for a hearing under Va. Workers’ Comp. Comm’n R. 1.4 and 1.5 because the employer did not submit medical evidence. Because the only allegation was a change in the conditions under which compensation was awarded, not a change in the claimant’s physical condition or work capacity, the employer was not required to submit medical evidence; the open award for itself provided the requisite probable cause. Food Lion, LLC v. Dalton, 50 Va. App. 713, 653 S.E.2d 611, 2007 Va. App. LEXIS 441 (2007).

    Commission may make discretionary judgments. —

    In any legislation as extensive as workers’ compensation, it is impossible to anticipate and legislate every potential event intended to be covered, therefore, phrases such as “unless in the opinion of the Commission such refusal was justified” are provided so that those appointed to implement the compensation laws may make discretionary judgments that carry out the legislative intent. DePaul Medical Ctr. v. Hamilton Brickhouse, 18 Va. App. 506, 445 S.E.2d 494, 10 Va. Law Rep. 1584, 1994 Va. App. LEXIS 379 (1994).

    Employment “suitable to [the employee’s] capacity” means employment within the employee’s residual capacity resulting from the industrial accident. The Act is based upon the premise that an employer is liable for the condition of an employee resulting from an industrial accident. But an employer is not liable for conditions not causally related to the employee’s work. American Furn. Co. v. Doane, 230 Va. 39 , 334 S.E.2d 548, 1985 Va. LEXIS 247 (1985).

    Employees are under no statutory duty to seek selective employment. When they do so, however, there are no statutory constraints inhibiting those who have found such employment for themselves. Big D Quality Homebuilders v. Hamilton, 228 Va. 378 , 322 S.E.2d 839, 1984 Va. LEXIS 314 (1984).

    Failure of employer to offer suitable work. —

    Though this section does not require an employer to make selective work available to a disabled employee, the fact that an employer seeking modification of an award for total incapacity did not offer such work may be considered on the question whether the employer had borne the burden of showing a change in claimant’s condition such as would enable him to do some kind of work. J.A. Foust Coal Co. v. Messer, 195 Va. 762 , 80 S.E.2d 533, 1954 Va. LEXIS 155 (1954).

    Workers’ compensation commission did not err in finding that the claimant was entitled to temporary total disability benefits for a disability resulting from an injury he sustained while making a delivery for the employer, despite the fact that the employer soon terminated him based on his chronic tardiness; the employer did not meet its burden of alleging that the employer would have had available to claimant, but for his termination for cause, employment suitable to his capacity. M & S Auto Parts, Inc. v. Presgraves, 45 Va. App. 455, 611 S.E.2d 655, 2005 Va. App. LEXIS 155 (2005).

    Employee entitled to benefits. —

    Because the record supported the Virginia Workers’ Compensation Commission’s determination that a claimant’s poor performance at work was attributable to a work injury and its residual involuntary effects (including memory problems and day-long headaches) and not attributable to purely voluntary misconduct, an award of post-termination partial disability benefits under subsection A of § 65.2-510 was proper. Pier 1 Imps., Inc. v. Wright, 2012 Va. App. LEXIS 177 (Va. Ct. App. May 29, 2012).

    Time limit for curing refusal irrelevant to change-in-condition application. —

    This section does not have any bearing upon a change-in-condition application for an employee who becomes totally disabled as a result of an industrial accident and who files an application for total disability benefits after the expiration of the period within which he could have cured his unjustified refusal of employment. Southwest Virginia Tire, Inc. v. Bryant, 31 Va. App. 655, 525 S.E.2d 563, 2000 Va. App. LEXIS 145 (2000).

    Change of condition claim not barred by refusal. —

    This section does not have any bearing upon a change-in-condition application for an employee who becomes totally disabled as a result of the industrial injury after having refused selective employment; the statute does not bar an award, upon proof of a change in condition resulting in temporary total disability, notwithstanding the claimant’s failure to cure an earlier unjustified refusal of within six months. Hoy Constr., Inc. v. Flenner, 32 Va. App. 357, 528 S.E.2d 148, 2000 Va. App. LEXIS 326 (2000).

    Use of section by employer as affirmative defense. —

    Nothing in this section prohibits its use by the employer as an affirmative defense rather than as a basis for an employer’s change-in-condition petition. Thus, the Commission is entitled to consider the tender and refusal of selective employment during a hearing on an application under former § 65.1-56 (now § 65.2-503 ), claiming incapacity to work. Talley v. Goodwin Bros. Lumber Co., 224 Va. 48 , 294 S.E.2d 818, 1982 Va. LEXIS 270 (1982).

    Responsibility for wage loss. —

    Where a disabled employee is terminated for cause from selective employment procured or offered by his employer, any subsequent wage loss is properly attributable to his wrongful act rather than his disability. The employee is responsible for that loss and not the employer. C & P Tel. Co. v. Murphy, 12 Va. App. 633, 406 S.E.2d 190, 7 Va. Law Rep. 2894, 1991 Va. App. LEXIS 136 (1991), limited, Tumlin v. Goodyear Tire & Rubber Co., 18 Va. App. 375, 444 S.E.2d 22, 10 Va. Law Rep. 1378, 1994 Va. App. LEXIS 305 (1994), limited, William Hazel Cos. v. Creswell, No. 2477-99-2, 2000 Va. App. LEXIS 395 (Va. Ct. App. May 23, 2000).

    Applicability of Murphy forfeiture rule. —

    Claimant’s post-employment total disability resulted from her prior compensable injury and, as such, her wage loss was properly attributable to her total disability and not to any employee misconduct. Although claimant’s misconduct was willful and certainly sufficient to justify her discharge from employer procured selective employment, her return to total disability was unrelated to her misconduct. Potomac Edison Co. v. Cash, 18 Va. App. 629, 446 S.E.2d 155, 11 Va. Law Rep. 27, 1994 Va. App. LEXIS 440 (1994).

    Agreement to rehabilitation held not to be later considered as evidence of facts stated therein. —

    A mere statement in letter form, placed in the Commission file and never formally offered in evidence, that a claimant “at this time” has agreed to cooperate with efforts at rehabilitation is not proper to be considered at another time, four months later, as substantive evidence of the facts stated in the letter. The letter was only a procedural allegation, or a statement of position, filed on behalf of the employee. Transfer v. Dicks, 229 Va. 548 , 331 S.E.2d 449, 1985 Va. LEXIS 230 (1985).

    Employer’s awareness of limiting condition. —

    Where plaintiff possessed a condition that limited his ability to work, and the employer was aware of such a condition at the time of hiring, the employer then must accept that condition as part of the employee’s abilities; thus if circumstances justified his refusal to cooperate fully in a job search and vocational rehabilitation offered, along with his failure to accept the full-time selective employment offered, then he is entitled to appropriate benefits. Moran v. R & W Constr., Inc., 21 Va. App. 195, 462 S.E.2d 919, 1995 Va. App. LEXIS 766 (1995).

    Relation to other provisions. —

    Section 65.2-712 did not prevent the Virginia Workers’ Compensation Commission from applying this statute as the two statutes did not conflict; therefore, the Commission did not err in applying this statute and the firing for cause doctrine. Barton v. Allied Waste Indus., 2013 Va. App. LEXIS 215 (Va. Ct. App. July 23, 2013).

    II.Refusal of Selective Employment.
    A.In General.

    To support a finding of refusal of selective employment the record must disclose (1) a bona fide job offer suitable to the employee’s capacity; (2) a job offer that was procured for the employee by the employer and (3) an unjustified refusal by the employee to accept the job. Rock City Mech., Inc. v. Barry, 2000 Va. App. LEXIS 815 (Va. Ct. App. Dec. 19, 2000); Newport News Shipbuilding & Dry Dock Co. v. Winston, 2003 Va. App. LEXIS 496 (Va. Ct. App. Sept. 30, 2003).

    Causation burden of claimant claiming free exercise of religion right. —

    Assuming without deciding, that burden of persuasion rests upon a claimant who relies on the constitutional right of free exercise of religion, such claimant was not required to show that his refusal of employment was causally related to his work injury. Ballweg v. Crowder Contracting Company, Inc., 247 Va. 205 , 440 S.E.2d 613, 10 Va. Law Rep. 960, 1994 Va. LEXIS 30 (1994).

    Proof of refusal of selective employment. —

    To support a finding of refusal of selective employment the record must disclose: (1) a bona fide job offer suitable to the employee’s capacity; (2) a job offer that was procured for the employee by the employer; and (3) an unjustified refusal by the employee to accept the job. Truax v. William A. Hazel, Inc., 2000 Va. App. LEXIS 521 (Va. Ct. App. July 18, 2000).

    Virginia Workers’ Compensation Commission erred in awarding an employee temporary partial disability benefits because under the facts of the case, an “actual” post-termination bona fide offer of suitable light-duty employment was not necessary to establish a constructive refusal of selective employment under § 65.2-510 , and the Commission found that the employer’s testimony that it would have offered the employee appropriate light-duty employment but for her termination for cause was uncontradicted and credible; to establish a constructive refusal of selective employment under subsection A of § 65.2-510 the employer could prove that the wage loss at issue was properly attributable to the employee by showing that, but for the employee’s earlier termination for cause from post-injury, full-duty employment, the employer would have had selective employment available for the employee during the post-termination period of her partial disability. Shenandoah Motors, Inc. v. Smith, 53 Va. App. 375, 672 S.E.2d 127, 2009 Va. App. LEXIS 54 (2009).

    Effect of refusal of suitable work. —

    Under this section, a partially disabled worker who refuses his employer’s offer of work suitable to his capacity loses his entitlement to all compensation during the continuance of such refusal. Washington Metro. Area Transit Auth. v. Harrison, 228 Va. 598 , 324 S.E.2d 654, 1985 Va. LEXIS 151 (1985).

    If an injured employee unjustifiably refuses selective employment offered by the employer, he or she is no longer entitled to receive disability compensation during the continuance of the refusal. ARA Servs. v. Swift, 22 Va. App. 202, 468 S.E.2d 682, 1996 Va. App. LEXIS 219 (1996).

    An employee who unjustifiably refuses selective employment forfeits his entitlement to wage-loss benefits, during the continuance of such refusal. Food Lion, Inc. v. Newsome, 30 Va. App. 21, 515 S.E.2d 317, 1999 Va. App. LEXIS 320 (1999).

    During the continuance of the refusal of selective employment, prior to the cure, the statute suspends benefits and relieves the pre-injury employer from any obligation to pay wage-loss benefits, but such benefits are suspended only during the continued unjustified refusal; once an employee has cured the unjustified refusal, he or she is entitled to reinstatement of benefits when the employee is disabled and reasonably markets his or her residual work capacity. Food Lion, Inc. v. Newsome, 30 Va. App. 21, 515 S.E.2d 317, 1999 Va. App. LEXIS 320 (1999).

    Where claimant secured selective employment without assistance from the employer, such claimant is entitled to compensation for total loss of earnings during his period of temporary unemployment. Big D Quality Homebuilders v. Hamilton, 228 Va. 378 , 322 S.E.2d 839, 1984 Va. LEXIS 314 (1984).

    Discharge from job obtained by employee’s own efforts. —

    Where the employee’s efforts directly brought about the job opportunity even though termination of the employment may have been due to the employee’s misconduct, the discharge did not amount to unjustified refusal of selective employment under this section. American Steel Placing Co. v. Adams, 230 Va. 189 , 335 S.E.2d 270, 1985 Va. LEXIS 268 (1985).

    Employer has burden. —

    The burden of persuasion to show that a job offer was tendered within the injured employee’s residual capacity is on the employer. If it carries this burden, the burden of persuasion then shifts to the injured employee to show that he was justified in refusing the offer of modified work. Talley v. Goodwin Bros. Lumber Co., 224 Va. 48 , 294 S.E.2d 818, 1982 Va. LEXIS 270 (1982).

    In order to obtain relief under this section, it is the employer’s burden to prove that a bona fide offer of selective employment has been procured by the employer and unjustifiably refused by the employee. Ellerson v. W.O. Grubb Steel Erection Co., 1 Va. App. 97, 335 S.E.2d 379, 1985 Va. App. LEXIS 69 (1985).

    In the case of a refusal of selective employment, the employer has the burden to show that the position offered is within the employee’s residual capacity. American Furn. Co. v. Doane, 230 Va. 39 , 334 S.E.2d 548, 1985 Va. LEXIS 247 (1985).

    The burden rests with the employer to show that it procured for the employee a bona fide offer, suitable to the employee’s capacity, which the employee unjustifiably refused. Padgett Mfg. Co. v. Wilfong, No. 1608-89-4 (Ct. of Appeals Aug. 28, 1990).

    Shifting of burden to employee. —

    Under this section, the burden of persuasion to show that a job offer was within the injured employee’s residual capacity is on the employer. It is only when this burden is met, that the burden shifts to the employee to show justification for refusing the offer of modified work. ITT Continental Baking Co. v. Thompson, No. 0058-85 (Ct. of Appeals Sept. 11, 1985).

    When the employer has shown that the position offered is within the employee’s residual capacity, the burden then shifts to the employee to show justification in refusing the selective work. American Furn. Co. v. Doane, 230 Va. 39 , 334 S.E.2d 548, 1985 Va. LEXIS 247 (1985); Jules Hairstylists, Inc. v. Galanes, 1 Va. App. 64, 334 S.E.2d 592, 1985 Va. App. LEXIS 62 (1985).

    Upon a showing by the employer of a bona fide offer of selective employment, the employee bears the burden of establishing justification for refusing such employment. Hillcrest Manor Nursing Home v. Underwood, 35 Va. App. 31, 542 S.E.2d 785, 2001 Va. App. LEXIS 97 (2001).

    Justified refusal of selective employment. —

    To support a finding of justification to refuse suitable selective employment, the reasons advanced must be such that a reasonable person desirous of employment would have refused the offered work. Hillcrest Manor Nursing Home v. Underwood, 35 Va. App. 31, 542 S.E.2d 785, 2001 Va. App. LEXIS 97 (2001).

    Advising claimant to seek job interview was not procurement of employment. —

    Where except for advising claimant to seek a job interview with another firm, the job placement specialist hired by the employer did nothing to locate the job opportunity, make initial contact with the company or even procure claimant’s doctor’s approval of the prospective work, all of which were accomplished solely by claimant, and although the job placement specialist attended the initial interview and in his testimony used the word “we” to describe his role in procuring the prospective employment, his assistance, if any, did not constitute “procured for him” within the meaning of this section. Ellerson v. W.O. Grubb Steel Erection Co., 1 Va. App. 97, 335 S.E.2d 379, 1985 Va. App. LEXIS 69 (1985).

    In deciding whether a partially disabled employee has made reasonable effort to find suitable employment commensurate with his abilities, the commission should consider such factors as: (1) the nature of and extent of employee’s disability; (2) the employee’s training, age, experience, and education; (3) the nature and extent of employee’s job search; (4) the employee’s intent in conducting his job search; (5) the availability of jobs in the area suitable for the employee, considering his disability; and (6) any other matter affecting employee’s capacity to find suitable employment. The commission, of course, determines which of these or other factors are more or less significant with regard to the particular case. Where the commission takes notice of employment conditions in a particular area, such should be stated in the findings of fact along with the findings regarding the other factors considered. National Linen Serv. v. McGuinn, 8 Va. App. 267, 380 S.E.2d 31, 5 Va. Law Rep. 2607, 1989 Va. App. LEXIS 60 (1989).

    When determining whether an employee has made a reasonable effort to market his remaining work capacity the trier of fact should compare the efforts of the employee to those of a reasonable employee in the same or similar circumstances seeking suitable employment in good faith. National Linen Serv. v. McGuinn, 8 Va. App. 267, 380 S.E.2d 31, 5 Va. Law Rep. 2607, 1989 Va. App. LEXIS 60 (1989).

    An injured employee who refuses employment procured for him suitable to his capacity is not entitled to any compensation during the period of refusal unless the Commission finds the refusal justified. A finding of unjustified refusal must be based upon “(1) a bona fide job offer suitable to the employee’s capacity; (2) procured for the employee by the employer; and (3) an unjustified refusal by the employee to accept the job.” United Parcel Service of America, Inc. v. Godwin, 14 Va. App. 764, 418 S.E.2d 910, 8 Va. Law Rep. 3600, 1992 Va. App. LEXIS 177 (1992).

    B.Bonafide Job Offer.

    Conditions for bona fide offer of selective employment. —

    To constitute a bona fide offer, the selective employment contemplated by this section must be upon terms and conditions sufficiently specific to permit informed consideration by an employee and comprised of duties consistent with employee’s remaining work capacity. Hillcrest Manor Nursing Home v. Underwood, 35 Va. App. 31, 542 S.E.2d 785, 2001 Va. App. LEXIS 97 (2001).

    As the Virginia Workers’ Compensation Commission was entitled to accept the employee’s testimony and to reject the contrary testimony of his supervisors regarding whether the light-duty job offered by the employer exceeded the employee’s restrictions, the employer’s evidence did not sustain its burden of proving it made a bona fide offer of selective employment to the employee; thus, the employer could not terminate the employee’s compensation benefits. Ace Carpentry, Inc. v. Mullins, 2002 Va. App. LEXIS 578 (Va. Ct. App. Oct. 1, 2002).

    Discharge for cause equated to refusal of selective employment. —

    An employee’s discharge for cause related to excessive absenteeism, although not constituting a wrongful act that justifies permanent forfeiture of benefits, is sufficient to find an unjustified refusal of selective employment that bars the employee from receiving benefits until the employee takes sufficient steps to cure the refusal. Taylor v. James Madison Univ., 2000 Va. App. LEXIS 812 (Va. Ct. App. Dec. 12, 2000).

    Where conduct equals unjustifiable refusal, actual offer is not needed. —

    Where commission determines on sufficient credible evidence that employee unjustifiably refuses to cooperate with placement efforts of employer, such conduct is tantamount to unjustified refusal of selective employment under this section and actual offer of employment is not prerequisite to finding of such refusal. Johnson v. City of Clifton Forge, 7 Va. App. 538, 375 S.E.2d 540, 5 Va. Law Rep. 1317, 1989 Va. App. LEXIS 2 (1989), different results reached on reh'g, 9 Va. App. 376, 388 S.E.2d 654, 6 Va. Law Rep. 1281, 1990 Va. App. LEXIS 2 0 (1990).

    The rule that an employee’s unjustified refusal to cooperate with the placement efforts of the employer is tantamount to an unjustified refusal of selective employment can apply to a situation where the employee fails to attend an interview arranged by a vocational rehabilitation counselor. To determine whether the employee is barred from receiving benefits, the Commission must consider the nature and prospects of the job interview, the justification asserted by the employee for missing the interview and whether the employee’s failure to attend the interview amounted to an unjustified refusal of procured employment. Newport News Shipbuilding & Dry Dock Co. v. Barnes, 32 Va. App. 66, 526 S.E.2d 298, 2000 Va. App. LEXIS 220 (2000).

    Submitting job description to physician for approval. —

    Although prior medical approval is required, where the attending physician has specified the limitations in detail and it is obvious that the proffered job fits these limitations, it may not always be necessary to submit the job description to the physician for what would be merely a “rubber stamp action.” Talley v. Goodwin Bros. Lumber Co., 224 Va. 48 , 294 S.E.2d 818, 1982 Va. LEXIS 270 (1982).

    Tender of employment must be based on medical opinion. —

    Whether refusal of selective employment is used offensively or defensively, the tender of limited employment must necessarily be based upon informed medical opinion. Talley v. Goodwin Bros. Lumber Co., 224 Va. 48 , 294 S.E.2d 818, 1982 Va. LEXIS 270 (1982).

    Claimant not required to move residence. —

    The Workers’ Compensation Act does not require that claimant move her residence to accept selective employment. Munford, Inc. v. Sink, No. 0804-85 (Ct. of Appeals Jan. 14, 1986).

    Tender of limited employment must be based upon informed medical opinion. ITT Continental Baking Co. v. Thompson, No. 0058-85 (Ct. of Appeals Sept. 11, 1985).

    Claimant not required to work on his sabbath. —

    The Court of Appeals and the Commission erred in denying employee’s workers’ compensation benefits because such denial violated his right of free exercise of religion where he refused employment which would have required him to work on his sabbath. Ballweg v. Crowder Contracting Company, Inc., 247 Va. 205 , 440 S.E.2d 613, 10 Va. Law Rep. 960, 1994 Va. LEXIS 30 (1994).

    Driving to and from work. —

    Employer’s burden of proving a bona fide offer of employment does not include establishing that employee was physically capable of driving to and from work unless employer provides the transportation or the transportation is an integral part of the job itself. Perrigan v. Clinchfield Coal Co., 1997 Va. App. LEXIS 419 (Va. Ct. App. June 24, 1997).

    Employer did not meet burden of proving valid offer made. —

    Employer did not meet its burden of proving that a valid offer had been made, where the employer’s letter directing the employee to return to work made no mention of restrictions placed on his return by the treating physician and did not describe the light duty work the employee was being asked to perform. Padgett Mfg. Co. v. Wilfong, No. 1608-89-4 (Ct. of Appeals Aug. 28, 1990).

    Claimant fully cured his unjustified refusal of selective employment because the jobs he obtained as a cure paid more than the selective employment with his former employer, and the employer failed to meet its burden to prove it made a bona fide offer of 40 hours per week of selective employment. Minton & Roberson, Inc. v. Wynter, 2006 Va. App. LEXIS 175 (Va. Ct. App. May 9, 2006).

    Bonafide offer not shown. —

    Where the evidence did not show an employer offered an employee information as to what a light duty position would be and/or what the position might entail, the employer failed to establish it had made a bona fide offer of employment within the confines of the employee’s residual capacity. Worksaver Material Handling Equip., Co. v. Epps, 2003 Va. App. LEXIS 1 (Va. Ct. App. Jan. 7, 2003).

    No bona fide offer of selective employment found. —

    Workers’ compensation commission properly determined that an employer failed to prove that an employee unjustifiably refused a bona fide offer of selective employment because there was no evidence that light-duty work within the employee’s restrictions was available. Because there was no offer of employment, there was no refusal of selective employment within the meaning of § 65.2-510 . Newport News Shipbuilding & Dry Dock Co. v. Winston, 2003 Va. App. LEXIS 496 (Va. Ct. App. Sept. 30, 2003).

    C.Unjustified Refusal.

    To support a finding of justification to refuse suitable selective employment, the reasons advanced must be such that a reasonable person desirous of employment would have refused the offered work. Rock City Mech., Inc. v. Barry, 2000 Va. App. LEXIS 815 (Va. Ct. App. Dec. 19, 2000).

    To constitute a bona fide offer, the selective employment contemplated by § 65.2-510 must be upon terms and conditions sufficiently specific to permit informed consideration by an employee, and comprised of duties consistent with the employee’s remaining work capacity. Newport News Shipbuilding & Dry Dock Co. v. Winston, 2003 Va. App. LEXIS 496 (Va. Ct. App. Sept. 30, 2003).

    Loss of benefits might justify refusal of selective employment. —

    Whether an injured employee unjustifiably refused to accept a permanent part-time job offer because the employee would have lost approximately $14,000 in accrued sick and vacation benefits should have been fully considered by the Virginia Workers’ Compensation Commission before granting the employer’s application for a change of condition based on the claimant’s unjustified refusal to accept a job offer; the loss of benefits could constitute justification for the refusal of selective employment. Clements v. Riverside Walter Reed Hosp., 40 Va. App. 214, 578 S.E.2d 814, 2003 Va. App. LEXIS 176 (2003).

    Discharged for cause. —

    An employee on selective employment offered or procured by the employer, who is discharged for cause and for reasons not concerning the disability, forfeits his or her right to compensation benefits like any other employee who loses employment benefits when discharged for cause. Timbrook v. O'Sullivan Corp., 17 Va. App. 594, 439 S.E.2d 873, 10 Va. Law Rep. 816, 1994 Va. App. LEXIS 21 (1994).

    An injured employee terminated from selective employment for misconduct forfeits his or her wage compensation benefits and is not eligible to cure his or her refusal of selective employment. Food Lion, Inc. v. Newsome, 30 Va. App. 21, 515 S.E.2d 317, 1999 Va. App. LEXIS 320 (1999).

    An employee’s workers’ compensation benefits will be permanently forfeited only when the employee’s dismissal is justified, the same as any other employee who forfeits her employment benefits when discharged for a justified reason. World Color Retail v. Pelzer-Pugliese, 2000 Va. App. LEXIS 370 (Va. Ct. App. May 16, 2000).

    When an employee is discharged from selective employment, in order to work a forfeiture, the wage loss must be properly attributable to the wrongful act for which the employee is responsible; the employer is not required, however, to prove that the employee’s wrongful act was intentional, willful or deliberate in order to justify a termination for cause and a forfeiture of compensation benefits. Muhammad v. VSI Group, 2001 Va. App. LEXIS 261 (Va. Ct. App. May 15, 2001).

    Refusal of employment because of unrelated physical condition. —

    An employer is absolved of liability for compensation if the employee refuses selective employment because of a physical condition unrelated to the original industrial accident and arising since the accident. American Furn. Co. v. Doane, 230 Va. 39 , 334 S.E.2d 548, 1985 Va. LEXIS 247 (1985).

    When a non-work-related disability prevents a partially disabled employee from returning to his or her pre-injury work or from accepting selective employment, the unrelated disability is not justification for the employee to refuse or not to perform selective employment or fail to market his or her residual work capacity. Eppling v. Schultz Dining Programs/Commonwealth, 18 Va. App. 125, 442 S.E.2d 219, 10 Va. Law Rep. 1098, 1994 Va. App. LEXIS 185 (1994).

    If a claimant fails without justification to keep a job interview, this amounts to a refusal of an offer of selective work suitable to his capacity. Jules Hairstylists, Inc. v. Galanes, 1 Va. App. 64, 334 S.E.2d 592, 1985 Va. App. LEXIS 62 (1985).

    Employee’s unreasonable behavior at job interview barred from further compensation. —

    An employee who so unreasonably behaves at a job interview that he undermines the prospect of getting job available to him is barred by this section from further compensation because his actions are the equivalent of unreasonably refusing selective employment. Johnson v. City of Clifton Forge, 9 Va. App. 376, 388 S.E.2d 654, 6 Va. Law Rep. 1281, 1990 Va. App. LEXIS 20 (1990).

    Conduct at interview held not to establish unjustifiable refusal. —

    Evidence was not sufficient to establish that worker’s conduct at interview in raising his concerns about his ability to perform job was tantamount to unjustified refusal of job where worker did not misrepresent extent of his disabilities, where there was no objective evidence that truthful discussion of his disabilities was reasonably expected to prevent offer of employment being made, and where subjective impression of prospective employer that he would not be good employee was formed on basis of poor interview. Johnson v. City of Clifton Forge, 7 Va. App. 538, 375 S.E.2d 540, 5 Va. Law Rep. 1317, 1989 Va. App. LEXIS 2 (1989), different results reached on reh'g, 9 Va. App. 376, 388 S.E.2d 654, 6 Va. Law Rep. 1281, 1990 Va. App. LEXIS 2 0 (1990).

    Refusal based on willful criminal conduct. —

    The employee, not the employer, was responsible for the wage loss properly attributable to his wrongful act rather than his disability where the employer offered the employee a job on the premises of one of its customers without knowledge that the employee had been convicted of stealing property from the customer and was barred from the customer’s premises by a restraining order. Shea v. Transportation Unlimited, Inc., 2000 Va. App. LEXIS 377 (Va. Ct. App. May 16, 2000).

    Lack of child care not ground for work refusal. —

    Lack of child care, while a legitimate concern of a parent, may not be the basis for refusing work offered within a claimant’s capabilities. To hold otherwise would be to impose a financial burden on the employer because of the inability to arrange child care and not because of disability flowing from the compensable injury. King v. Maryland Mae, Inc., No. 2245-91-4 (Ct. of Appeals June 30, 1992).

    It is neither logical nor just to expect employee to give up a full-time, higher-paying job to take a part-time, lower-paying job, especially when the same circumstances have existed since prior to commencement of employment in the lower-paying job and prior to the injury. DePaul Medical Ctr. v. Hamilton Brickhouse, 18 Va. App. 506, 445 S.E.2d 494, 10 Va. Law Rep. 1584, 1994 Va. App. LEXIS 379 (1994).

    Excessive absenteeism caused by non-work-related injury beyond the employee’s control is not the type of willful conduct or misbehavior that, upon termination, justifies a forfeiture of workers’ compensation benefits. Eppling v. Schultz Dining Programs/Commonwealth, 18 Va. App. 125, 442 S.E.2d 219, 10 Va. Law Rep. 1098, 1994 Va. App. LEXIS 185 (1994).

    Matter of transportation legitimate consideration in determining whether refusal justified. Where the job rejected by claimant was located in Chantilly, in western Fairfax County, which is a substantial distance from the claimant’s residence in the District of Columbia, the job did not constitute a reasonable offer of selective employment under the circumstances. S.C. Constr., Inc. v. Boyd, No. 0131-87-4 (Ct. of Appeals Feb. 10, 1988).

    Refusal of job offer justified. —

    Where the record was replete with numerous specific statements by the claimant that he would be making less money, would not be able to “make ends meet,” did not have funds to relocate, and would have additional living expenses, the evidence was sufficient to establish that the economic consequences were a consideration in claimant’s refusal of the job offer, and such refusal was justified. Ken Hurst Firearms Engraving Co. v. Guthrie, No. 1048-86-3 (Ct. of Appeals Sept. 11, 1987).

    Claimant was justified in refusing offered employment, where it served no legitimate rehabilitative purpose and was not appropriate vocational rehabilitation pursuant to subdivision A 3 of § 65.2-603 . City of Buena Vista Pub. Works v. Southers, 1999 Va. App. LEXIS 531 (Va. Ct. App. Sept. 14, 1999).

    Claimant failed to prove she was justified in refusing selective employment where, although both claimant and her treating physician had concerns about her ability to commute to job, he did not withdraw his previous approval of job description and claimant presented no evidence that she was unable to drive to job location. Krohn v. Mary Immaculate Hosp., 2000 Va. App. LEXIS 138 (Va. Ct. App. Feb. 29, 2000).

    The commission properly found that a claimant’s refusal of selective employment was justified where the record established that the claimant was restricted from walking the required distance from the parking lot to the job site while carrying his tool box. Although the employer claimed that the claimant could have kept his tool box at the work site in a “gang box,” the claimant’s unrefuted testimony was that some of his tools were irreplaceable, that the total value of the tools was from $2,000 to $4,000, that there had been thefts from the gang boxes and that the employer was not willing to reimburse employees or replace tools lost due to theft. Rock City Mech., Inc. v. Barry, 2000 Va. App. LEXIS 815 (Va. Ct. App. Dec. 19, 2000).

    Workers’ compensation claimant did not unjustifiably refuse an offer of light-duty employment, which required a 60 to 90 minute drive, where the claimant’s driving restriction was no more than 30 minutes with a 10 minute break in between. Chemed Corp. v. Borrell, 2010 Va. App. LEXIS 121 (Va. Ct. App. Mar. 30, 2010).

    Virginia Workers’ Compensation Commission’s finding that a workers’ compensation claimant justifiably refused suitable selective employment under subsection A of § 65.2-510 as: (1) an employer offered the claimant a desk job; (2) originally, the desk job provided the claimant with a reasonable amount of light-duty work suitable to the claimant’s restricted capacity; (3) the claimant completed all of the assigned tasks in less than two weeks, and despite repeated requests, was not given any more tasks for more than five weeks before the claimant left the job; (4) the claimant was not permitted to occupy the claimant in any other way during that period of time; and (5) the claimant suffered an emotional strain due to the lack of work, which was severe enough to cause the claimant to go home crying on a regular basis and to feel as if the claimant was being driven crazy. Rochester Cable v. Carpenter, 2010 Va. App. LEXIS 228 (Va. Ct. App. June 8, 2010).

    Refusal of job offer not justified. —

    Workers’ Compensation Commission properly found the worker was not justified in refusing to perform a cashier job that she was able to perform as her employer offered selective employment that complied with her restrictions as the worker was not temporarily totally disabled. Vance v. Lowes of Staunton, 2003 Va. App. LEXIS 455 (Va. Ct. App. Aug. 26, 2003).

    Virginia Workers’ Compensation Commission did not err in finding that the employer had made a bona fide offer when it offered selective employment within the employee’s medical restrictions and under the same geographic circumstances as the employee’s pre-injury offer and that employee’s refusal was unjustified. The employee offered no legitimate reason to support the employee’s claim that the employee was entitled to a geographic accommodation different from the one the employee arranged prior to the injury. Richardson v. Lensis Builders, Inc., 2007 Va. App. LEXIS 277 (Va. Ct. App. July 24, 2007).

    Claimant justifiably refused selective employment where she expected and was attempting to return to work for employer and in light of the relatively brief period of time that she was away from work. Retreat Hospital v. Hammersley, 1998 Va. App. LEXIS 117 (Va. Ct. App. Feb. 24, 1998).

    Workers’ Compensation Commission could consider a claimant’s unjustified refusal to cooperate with an employer’s placement efforts as tantamount to an unjustified refusal of selective employment, rendering the claimant ineligible for compensation. Newport News Shipbuilding & Dry Dock Co. v. Lawrence, 38 Va. App. 656, 568 S.E.2d 374, 2002 Va. App. LEXIS 496 (2002).

    Real and substantial reasons for refusal. —

    Employee put forward real and substantial reasons for his refusal to accept the suitable employment where he informed the rehabilitation counselor that he had to move and that he would accept limited employment at his new residence. Food Lion, Inc. v. Lee, 16 Va. App. 616, 431 S.E.2d 342, 9 Va. Law Rep. 1586, 1993 Va. App. LEXIS 202 (1993).

    Claimant did not meet his burden of persuasion to show justification for refusal of job because of his claimed inability to drive to job location, since the conflict in the medical evidence suggested that the best proof in the case would have been the result of a reasonable trial effort. Childers v. Georgia Pac. Corp., No. 0883-87-2 (Ct. of Appeals April 19, 1988).

    The record contained credible evidence supporting the commission’s findings that appellant unjustifiably refused the job as “detail man” where appellant never attempted to perform the job, unequivocally telling rehabilitation specialist that he intended to work on his father’s farm and misleading her that the farm work paid the same and involved the same number of hours as the “detail man” job. Wood v. Omega Interiors of Va., Inc., 1994 Va. App. LEXIS 211 (Va. Ct. App. Apr. 12, 1994).

    Once claimant unjustifiably refused the light-duty job offered to him by employer, his wage loss was attributable to his refusal and not to his injury; in light of the lack of credible evidence showing claimant’s marketing efforts, claimant’s age, education, and previous work experience, physician’s unequivocal opinion that claimant could perform light work, and the lack of any objective evidence of a disabling condition, then as a matter of law claimant’s evidence did not sustain his burden of proving that he made a good faith marketing effort sufficient to cure his unjustified refusal of light-duty work offered by employer. Jones Chem., Inc. v. Parson, 1997 Va. App. LEXIS 184 (Va. Ct. App. Apr. 1, 1997).

    Where a claimant returned to work for his employer at light duty after an injury, was terminated for excessive absenteeism, was unemployed for a time, worked for one month, and left that employment without explanation, the evidence supported the Virginia Workers’ Compensation Commission’s finding that he had not marketed his residual work capacity during his period of unemployment and was thus not entitled to disability compensation benefits during that period. Melton v. Atl. Group, Inc., 2004 Va. App. LEXIS 604 (Va. Ct. App. Dec. 7, 2004).

    Termination of the workers’ compensation benefits for a claimant, pursuant to subsection A of § 65.2-510 , was appropriate because the Virginia Workers’ Compensation Commission, which made a conclusion as to witness credibility, determined that the claimant refused selective employment from the claimant’s employer that was within the claimant’s physical capacity and was available to the claimant. Avila-Rivera v. Excel Masonry, Inc., 2011 Va. App. LEXIS 338 (Va. Ct. App. Nov. 8, 2011).

    III.Marketing Residual Capacity.

    Effort to market remaining work capacity must be made. —

    An employee who has reached maximum medical improvement and remains partially disabled must make a reasonable effort to market his remaining capacity to work in order to continue receiving workers’ compensation benefits. Virginia Wayside Furn., Inc. v. Burnette, 17 Va. App. 74, 435 S.E.2d 156, 10 Va. Law Rep. 217, 1993 Va. App. LEXIS 426 (1993).

    Totally disabled employee not required to market residual capacity. —

    An employee is only required to market his remaining work capacity if the employee is not totally disabled; where the commission has determined that an employee is totally disabled, the employer may not assert that the employee failed to market his remaining work capacity. Dan River, Inc. v. Giggetts, 34 Va. App. 297, 541 S.E.2d 294, 2001 Va. App. LEXIS 61 (2001).

    Employer who bars outside employment cannot assert failure to market defense. —

    Where the employer has a contractual provision which bars a claimant from working in outside employment while he remains in that employ, and refuses to waive that provision during a period of work-related disability without providing a legitimate business reason for that refusal, a claimant has no residual capacity and the employer may not assert a failure-to-market defense. USAIR, Inc. v. Joyce, 27 Va. App. 184, 497 S.E.2d 904, 1998 Va. App. LEXIS 222 (1998).

    Necessity of marketing residual capacity. —

    An employee working under restrictions attendant to a compensable injury may have benefits restored upon termination of such employment, provided the employee thereafter reasonably markets his or her residual earning capacity. Westmoreland Coal Co. v. Kilgore, 1997 Va. App. LEXIS 289 (Va. Ct. App. May 6, 1997).

    Effort to market remaining work capacity during brief disability periods. Although legislative intent behind this section has been interpreted as encouraging a disabled employee to make a reasonable effort to market remaining work capacity in order to receive continued workers’ compensation benefits, the Industrial Commission has, in turn, held that no such effort is required during brief periods of disability. Holly Farms Foods, Inc. v. Carter, 15 Va. App. 29, 422 S.E.2d 165, 9 Va. Law Rep. 191, 1992 Va. App. LEXIS 231 (1992).

    Failure to register with State Employment Commission no bar to benefits. —

    There is no per se rule that would bar employees with residual skills from receiving benefits under the Act if they fail to register with the State Employment Commission. There is no bright line test as to what constitutes marketing one’s residual capacity; it is better decided on a case-by-case basis. Herbert Brothers, Inc. v. Jenkins, 14 Va. App. 715, 419 S.E.2d 283, 8 Va. Law Rep. 3539, 1992 Va. App. LEXIS 172 (1992).

    “Able to earn” should not be construed to be synonymous with “earns” or “is paid” and a claimant who has the burden of proof, and who seeks compensation of the wage differential between his new and his old jobs, has the burden of proving that he has made a reasonable effort to market his full remaining work capacity. National Linen Serv. v. McGuinn, 8 Va. App. 267, 380 S.E.2d 31, 5 Va. Law Rep. 2607, 1989 Va. App. LEXIS 60 (1989).

    Evidence supported finding of reasonable efforts to use residual earning capacity. —

    Record supported the Virginia Workers’ Compensation Commission’s finding that a workers’ compensation claimant made reasonable and good faith efforts to use the claimant’s residual work capacity following a work-related back injury, as medical reports supported the Commission’s determination of the duration of the claimant’s periods of disability and the claimant’s participation in part-time work within the claimant’s restrictions followed by the claimant’s extensive efforts to re-establish the claimant’s own computer business showed the claimant’s good faith efforts to use the claimant’s residual work capacity. Jaunt, Inc. v. Clement, 2003 Va. App. LEXIS 20 (Va. Ct. App. Jan. 21, 2003).

    Workers’ compensation claimant reasonably marketed residual work capacity where the claimant made thirty-three employment contacts over the course of eleven weeks. Chemed Corp. v. Borrell, 2010 Va. App. LEXIS 121 (Va. Ct. App. Mar. 30, 2010).

    Virginia Workers’ Compensation Commission did not err in awarding a worker’s compensation claimant temporary total disability benefits under § 65.2-510 as: (1) the claimant completed a log documenting six of the claimant’s contacts seeking other employment, and estimated that the claimant had contacted between 40 to 50 businesses seeking work; (2) although the claimant merely telephoned the Virginia Employment Commission (VEC) and did not register with it, there was no per se rule barring employees who had otherwise marketed their residual work capacity from receiving workers’ compensation benefits for failing to register with the VEC; and (3) the claimant engaged in a bona fide search to find appropriate work given the claimant’s work restrictions, previous work experience, and the job market in the geographical area. Rochester Cable v. Carpenter, 2010 Va. App. LEXIS 228 (Va. Ct. App. June 8, 2010).

    Claimant did not fail to make reasonable efforts to market the claimant’s residual work capacity for the period of the claimant’s disability, as claimant testified that the claimant worked approximately the same amount of hours post-injury that the claimant worked pre-injury; however, the post-injury work was less lucrative, resulting in a smaller average weekly wage. Atlas Van Lines & Legion Ins. Co. v. Kerr, 2011 Va. App. LEXIS 127 (Va. Ct. App. Apr. 12, 2011).

    Outright unwillingness not shown. —

    Credible evidence supported commission’s determination that the claimant did not demonstrate an outright unwillingness to participate in a job search where employer failed to show that the jobs for which the claimant was told to interview were within the claimant’s residual capacity; claimant never received copies of any job descriptions that contained the treating physician’s signature and approval; and, any delay preventing claimant from securing full-time employment sooner than she did was due to the employer and its representatives. Ringling Bros. v. Gronski, 1995 Va. App. LEXIS 235 (Va. Ct. App. Mar. 14, 1995).

    IV.Curing Unjustified Refusal/Justified Termination.

    Cure available. —

    A claimant who has not engaged in willful misconduct may cure a prior unjustified refusal of employer-procured selective employment. Christiansen v. Metro Bldg. Supply, Inc., 18 Va. App. 721, 447 S.E.2d 519, 11 Va. Law Rep. 79, 1994 Va. App. LEXIS 532 (1994) (see also 19 Va. App. 513, 453 S.E.2d 302 (1995)).

    This section allows an employee to cure an unjustified refusal of selective employment by obtaining equivalent selective employment. Food Lion, Inc. v. Newsome, 30 Va. App. 21, 515 S.E.2d 317, 1999 Va. App. LEXIS 320 (1999).

    Effect of cure. —

    Once an employee has cured an unjustified refusal of selective employment, he or she is entitled to reinstatement of benefits if the employee reasonably markets his or her residual capacity; the parties are returned to their pre-refusal status and the employer is obligated to pay partial incapacity benefits. Food Lion, Inc. v. Newsome, 30 Va. App. 21, 515 S.E.2d 317, 1999 Va. App. LEXIS 320 (1999).

    When an employee has cured an unjustified refusal of selective employment, the Workers’ Compensation Act creates no ongoing obligation on the employee’s part to establish that he is still curing the earlier refusal, other than the requirement that the employee make reasonable efforts to market his residual capacity. Food Lion, Inc. v. Newsome, 30 Va. App. 21, 515 S.E.2d 317, 1999 Va. App. LEXIS 320 (1999).

    Authority to determine whether refusal cured. —

    The General Assembly in this section granted the discretion and authority to the Compensation Commission to determine whether the employee had “cured” his refusal or abandonment of selective employment. Hadder v. Prince William County School Bd., No. 0424-85 (Ct. of Appeals Dec. 4, 1985).

    Benefits resumed after claimant ceases refusal. —

    When compensation benefits are terminated pursuant to the provisions of this section, based upon a claimant’s unreasonable refusal to accept selective employment, benefits may be resumed when the claimant ceases his refusal. No distinction is made between a claimant’s entitlement to resumption of benefits upon obtaining other selective employment after having refused to accept a prior offer of selective employment, and such an entitlement following a discharge for cause. K & L Trucking Co. v. Thurber, 1 Va. App. 213, 337 S.E.2d 299, 1985 Va. App. LEXIS 88 (1985).

    Although employee’s benefits had been terminated when she accepted the offer of selective employment, in order to have her benefits reinstated, she must demonstrate that her situation has changed and that she has “cured” her inability to attend satisfactorily to selected employment. Eppling v. Schultz Dining Programs/Commonwealth, 18 Va. App. 125, 442 S.E.2d 219, 10 Va. Law Rep. 1098, 1994 Va. App. LEXIS 185 (1994).

    Failure to cure. —

    Commission did not err in finding that claimant’s application for benefits was barred because he failed to cure his refusal of selective employment within six-month limitation period set forth in subsection C of this section. Ambrogi v. Manpower, Inc., 1999 Va. App. LEXIS 647 (Va. Ct. App. Nov. 23, 1999).

    Forfeiture of right to cure termination of selective employment. —

    An employee who is terminated for justifiable cause from selective employment that is procured by the employer forfeits the right to cure this termination by obtaining other employment. Transp. Safety Contr. v. Martin, 2001 Va. App. LEXIS 271 (Va. Ct. App. May 22, 2001).

    Resumption of payments. —

    When an employee who previously unjustifiably refused selective employment which was procured for him, thereafter, in good faith, advises his employer that he is willing to accept such work or work of like kind, the employer must resume the payments for compensable injuries, even though the procured selective employment may no longer be available. Thompson v. Hampton Inst., 3 Va. App. 668, 353 S.E.2d 316, 3 Va. Law Rep. 1800, 1987 Va. App. LEXIS 155 (1987).

    A partially disabled employee can cure an unjustified refusal of selective employment of a job procured by his employer by obtaining other comparable employment. Virginia Wayside Furn., Inc. v. Burnette, 17 Va. App. 74, 435 S.E.2d 156, 10 Va. Law Rep. 217, 1993 Va. App. LEXIS 426 (1993).

    Must demonstrate “cure.” —

    Although employee’s benefits had been terminated when she accepted the offer of selective employment, in order to have her benefits reinstated, she must demonstrate that her situation has changed and that she has “cured” her inability to attend satisfactorily to selective employment. Eppling v. Schultz Dining Programs/Commonwealth, 18 Va. App. 125, 442 S.E.2d 219, 10 Va. Law Rep. 1098, 1994 Va. App. LEXIS 185 (1994).

    No “cure” upon discharge for cause from selective employment procured by employer. —

    An employee may cure his prior unjustified refusal of selective employment only where the employee is terminated for cause from selective employment procured by the employee rather than from selective employment procured or offered by the employer. C & P Tel. Co. v. Murphy, 12 Va. App. 633, 406 S.E.2d 190, 7 Va. Law Rep. 2894, 1991 Va. App. LEXIS 136 (1991), limited, Tumlin v. Goodyear Tire & Rubber Co., 18 Va. App. 375, 444 S.E.2d 22, 10 Va. Law Rep. 1378, 1994 Va. App. LEXIS 305 (1994), limited, William Hazel Cos. v. Creswell, No. 2477-99-2, 2000 Va. App. LEXIS 395 (Va. Ct. App. May 23, 2000) (decided under former § 65.1-63).

    Resumption of compensation not required where employment unjustifiably refused. —

    Neither this section nor former § 65.1-88 (now § 65.2-603 ), dealing with the employer’s duty to furnish medical attention and vocational rehabilitation, authorize the Commission to require the employer or its insurer to resume payment of compensation in the event selective employment cannot be procured, in the face of positive evidence that the employee has unjustifiably refused previous offers of selective employment or otherwise has failed to cooperate with the employer’s rehabilitative efforts. Transfer v. Dicks, 229 Va. 548 , 331 S.E.2d 449, 1985 Va. LEXIS 230 (1985).

    Abandonment not cured by request for reinstatement after retirement. —

    A claimant cannot cure his abandonment of his selective employment job, which had not been filled, by requesting reinstatement to it after he has voluntarily retired. Hadder v. Prince William County School Bd., No. 0424-85 (Ct. of Appeals Dec. 4, 1985).

    Failure to pass drug screening. —

    Where claimant’s employment was terminated because of his failure to pass a drug screening as a condition of employment pursuant to a written agreement, since such termination was for cause, any subsequent wage loss was due to claimant’s wrongful act rather than his disability, and thus, was not employer’s responsibility. Richfood, Inc. v. Williams, 20 Va. App. 404, 457 S.E.2d 417, 1995 Va. App. LEXIS 727 (1995).

    Where passing drug and alcohol screening is made a clear and unequivocal condition of employment, as in the instant case, pursuant to claimant’s contract with employer, failure to pass the screening is tantamount to misconduct for which an employee can be terminated. Accordingly, because the selective employment was procured and made available solely by the efforts of employer, claimant cannot not cure his termination for cause and, therefore, may not have his benefits reinstated. Richfood, Inc. v. Williams, 20 Va. App. 404, 457 S.E.2d 417, 1995 Va. App. LEXIS 727 (1995).

    The Commission’s determiniation that a claimant was not discharged for cause was supported by credible evidence where the claimant testified that she requested, to no avail, a repeat drug screen, because of what she believed to be a risk of a false positive based on her use of prescription drugs for her work-related injury, she also adamantly denied any use of drugs or alcohol between the time of her injury and the drug screen, there was no evidence of any drug use other than the results of the drug screen, the results of the drug screen were introduced by the employer through the claimant, who was unable to attest to their veracity or authenticity and the deputy commissioner specifically found that the claimant’s denial of drug use was credible. World Color Retail v. Pelzer-Pugliese, 2000 Va. App. LEXIS 370 (Va. Ct. App. May 16, 2000).

    Justified dismissal from selective employment. —

    A “justified” discharge, one which warrants forever barring reinstatement of workers’ compensation benefits, does not simply mean that the employer can identify or assign a reason attributable to the employee as the cause for his or her being discharged; whether the reason for the discharge is for “cause” or is “justified” for purposes of forfeiting benefits must be determined in the context of the purpose of the act and whether the conduct is of such a nature that it warrants a permanent forfeiture of those rights and benefits. Transp. Safety Contr. v. Martin, 2001 Va. App. LEXIS 271 (Va. Ct. App. May 22, 2001).

    When a disabled employee is discharged from selective employment, the inquiry focuses on whether the claimant’s benefits may continue in light of the dismissal; an employee’s workers’ compensation benefits will be permanently forfeited only when the employee’s dismissal is “justified,” the same as any other employee who forfeits benefits when discharged for a “justified” reason. Transp. Safety Contr. v. Martin, 2001 Va. App. LEXIS 271 (Va. Ct. App. May 22, 2001).

    Not every discharge, even if supported by a reason, is a “justified” discharge; not every type of willful conduct or misbehavior arises to the level that, upon termination, justifies a forfeiture of workers’ compensation benefits. Transp. Safety Contr. v. Martin, 2001 Va. App. LEXIS 271 (Va. Ct. App. May 22, 2001).

    Virginia Workers’ Compensation Commission did not err in determining that the claimant’s firing for dishonesty constituted termination for justified cause as the claimant was solely responsible for his wrongful act in failing to report overpayments of workers’ compensation benefits. Barton v. Allied Waste Indus., 2013 Va. App. LEXIS 215 (Va. Ct. App. July 23, 2013).

    Virginia Workers’ Compensation Commission did not err in concluding that the claimant’s employment was terminated for justified cause as the evidence supported the finding that the claimant was fired for dishonesty, not for an oversight regarding his compensation payments. The claimant testified that he knew he was being overpaid and that if he reported the overpayments, the overpayments would stop. Barton v. Allied Waste Indus., 2013 Va. App. LEXIS 215 (Va. Ct. App. July 23, 2013).

    Employee entitled to benefits. —

    Where employer terminated employee’s selective employment because employee was taking pain medication while working, the termination was not “with cause” because the pain medication was a direct result of a compensable injury. Skip's Auto Parts/ADP TotalSource v. Cline, 2002 Va. App. LEXIS 777 (Va. Ct. App. Dec. 31, 2002).

    Claimant was entitled to benefits because while the claimant unjustifiably refused selective employment offered by the claimant’s employer, as the claimant resigned in protest to avoid a disciplinary action, the claimant cured that refusal about an hour later by withdrawing the resignation and expressing a willingness to return to the employment. However, the claimant was terminated a short while later by the employer accepting the claimant’s resignation and holding the claimant to it. Power Distrib. Prods. v. Lockard, 2015 Va. App. LEXIS 100 (Va. Ct. App. Mar. 31, 2015).

    Failure to arrange transportation irrelevant where employment refused outright. —

    The Commission’s finding of justified refusal of employment, the basis for which was that the employee did not have her own transportation, and, further, that no arrangements had been made by the employer or the insurance carrier to provide claimant with transportation adequate to meet the job requirements, was incorrect, in view of the employee’s outright refusal to accept employment offers, which rendered consideration of the transportation aspect of the employment irrelevant. By unconditional rejection of the offers, the employee demonstrated an unwillingness to accept employment within her residual capacity. Klate Holt Co. v. Holt, 229 Va. 544 , 331 S.E.2d 446, 1985 Va. LEXIS 229 (1985).

    Looking in and copying documents from other employee’s personnel file. —

    Workers’ compensation benefits were properly terminated on the grounds that the employee had been discharged from selective employment for cause where the claimant was fired for looking inside another employee’s personnel file and for copying that employee’s driver’s license and social security card without the other employee’s or the employer’s permission. Muhammad v. VSI Group, 2001 Va. App. LEXIS 261 (Va. Ct. App. May 15, 2001).

    Continuing of benefits after dismissal from selective employment for misconduct. —

    Where an injured employee was dismissed from his selective employment for misconduct and subsequently sought unemployment benefits and reinstatement of his workers’ compensation benefits, the Virginia Employment Commission’s ruling that the claimant was guilty of misconduct was not binding upon the Compensation Commission, since that issue was not the same as the issue litigated by claimant before the Compensation Commission. The Compensation Commission’s inquiry focuses on whether the claimant’s benefits may continue in light of his dismissal from selective employment. The key determination is whether the dismissal was “justified.” Richmond Cold Storage Co. v. Burton, 1 Va. App. 106, 335 S.E.2d 847, 1985 Va. App. LEXIS 71 (1985).

    Subdivision C of this section was inapplicable because employee was not attempting to cure his previous unjustified refusal of selective employment, but was claiming he was temporarily totally disabled. Southwest Virginia Tire, Inc. v. Bryant, 31 Va. App. 655, 525 S.E.2d 563, 2000 Va. App. LEXIS 145 (2000).

    Partial cure by accepting part-time employment. —

    An employee’s continued part-time, selective employment, with the employer, following the employee’s unjustified rejection of an offer for full-time employment, constituted a partial cure of her prior refusal of such employment within the intendment of this section and the employee, therefore, was entitled to temporary benefits based on the difference between her preinjury average weekly wage and the wage she would have earned had she accepted full-time hours. Hillcrest Manor Nursing Home v. Underwood, 35 Va. App. 31, 542 S.E.2d 785, 2001 Va. App. LEXIS 97 (2001).

    Partial cure by accepting job at reduced pay. —

    Employee was entitled to continued temporary partial disability benefits after the employee retired from the selective employment the employer had placed the employee in and the employee partially cured the unjustified refusal of selective employment by obtaining employment with a friend’s company at a substantially lower weekly wage. Subsection B of § 65.2-510 did not require, as the workers’ compensation commission concluded, that the employee obtain a new position at a wage comparable to the previously refused selective employment position before a partial cure of the unjustified refusal could occur and only mandated that the wage in the new position be lower. Dowden v. Hercules, Inc., 51 Va. App. 185, 655 S.E.2d 755, 2008 Va. App. LEXIS 91 (2008).

    Calculation of time periods. —

    Workers’ compensation commission could calculate the six-month period a Workers’ Compensation claimant had, under subsection C of § 65.2-510 , to cure his constructive unjustified refusal of employment, based on his course of conduct refusing to cooperate with an employer’s placement efforts, as beginning at the culmination of the course of conduct. Newport News Shipbuilding & Dry Dock Co. v. Lawrence, 38 Va. App. 656, 568 S.E.2d 374, 2002 Va. App. LEXIS 496 (2002).

    Termination of benefits justified. —

    Since credible evidence in the record showed that the claimant voluntarily quit her work after she started receiving benefits even though she was able to perform work at the pizzaria she owned and operated with her husband, the workers’ compensation commission was justified in terminating her benefits since she was no longer entitled to them. Mileos v. Venus Pizza, 2003 Va. App. LEXIS 416 (Va. Ct. App. July 29, 2003).

    Attorney’s fees and costs. —

    Although the Workers’ Compensation Commission properly found that a claimant cured an earlier refusal of selective employment under subsection A of § 65.2-510 , because a reasonable and honest difference of opinion existed as to what legally sufficed as a cure, the claimant was not entitled to attorney’s fees and costs under subsection A of § 65.2-713 associated with the appeal. LPT, Inc./MSS, Inc. v. Voltaggio, 2007 Va. App. LEXIS 165 (Va. Ct. App. Apr. 17, 2007).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    SELECTIVE EMPLOYMENT.

    General:

    Where claimant is terminated for excessive absences, which were the result of non-work injury related health problem, his termination constitutes a constructive and unjustified refusal of selective employment. Elliott v. C & S Door Corp., VWC File No. 208-38-14 (March 10, 2006) (Settled while on remand).

    The claimant’s failure to report to work five times and tardiness four more times over a four-month period is equivalent to an unjustified refusal of selective employment. Beasley v. Norcraft Co., VWC File No. 220-58-38 (July 11, 2005).

    The controlling date for determining commencement of the 6 months period during which a refusal of selective employment may be cured is the last date for which compensation was paid before the suspension of the outstanding award because of the refusal and not the date compensation was actually paid pursuant to an award. Green v. The Salvation Army, VWC File No. 208-23-30 (July 19, 2005).

    Employee established work-related total disability as of October 1, 2001, and did not seek benefits before October 1, 2001, and thus employer’s defense of unjustified refusal of selective employment on September 13, 2000, was irrelevant to question before the Commission, which was limited to a showing of total disability as of October 1, 2001. Engle v. George Mason Univ., VWC File No. 199-76-84 (Sept. 8, 2003).

    Employer that agreed to entry of two awards and provided vocational rehabilitation to employee estopped from raising defense to later claim that employee unjustifiably refused light-duty work soon after accident; employer’s defense of refusal barred by agreement to compensation award covering same period. Ricks v. Goodwill Indus., VWC File No. 204-73-56 (Apr. 4, 2003).

    Employee released to pre-injury work and returned to such work for employer but later voluntarily resigned; employee later restricted to light-duty work and sought partial wage-loss benefits; light-duty restrictions found to be related to compensable accident, and no evidence of offer by employer within new restrictions; voluntary resignation of pre-injury job did not preclude later seeking benefits based on change in condition. Montoya v. Hardees of Little Creek, VWC File NO. 203-33-48 (Mar. 20, 2003).

    Employee, who was terminated from selective employment with employer for safety reasons, found to have refused selective employment, but not terminated for cause sufficient to warrant forfeiture of compensation; employee truck-driver terminated after three accidents. Ivy v. Spratt, Inc., VWC File No. 206-68-41 (Jan. 21, 2003).

    The 1991 amendment added to the language of Code § 65.2-101 “Change in condition” the reference to awards that had been “suspended,” and employees thereafter were required to prove continuing disability as well as a “cure” of an earlier refusal in order to have benefits reinstated. Perrigan v. Clinchfield Coal Co., 75 O.W.C. 324 (1996).

    The July 1, 1995 amendment to Code § 65.2-510 did not change the substantive rights of the parties, only the manner by which certain compensation benefits might be obtained. It was therefore a procedural and remedial statutory change to be applied retrospectively. However the 1995 amendment cannot have retrospective application to prior refusals. Its effect was to give notice that prior refusals had to be cured within six months of July 1, 1995, and subsequent refusals could not continue for more than six months without penalty. Perrigan v. Clinchfield Coal Co., 75 O.W.C. 324 (1996).

    Application for hearing on the basis of refusal of employment under § 65.1-63 (now § 65.2-510 ) or of medical attention or vocational rehabilitation training services under § 65.1-88 (now § 65.2-603 ) should be specifically labeled as to the issue presented. Rule 13 (now Rule 1.4) requires employers and employees to specify grounds for applications. Myers v. Grand Union Company, 63 O.I.C. 241 (1984).

    A finding of unjustified refusal must be based on (1) a bona fide job offer suitable to the employee’s capacity; (2) procured for the employee by the employer; and (3) an unjustified refusal by the employee to accept the job. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    Where the work allegedly refused by a claimant exceeds permanent restrictions imposed by the treating physician, a release to such work that is approved by the employer’s medical examiner does not establish sufficient probable cause to suspend compensation benefits pending a hearing. Arzola v. Cherner Lincoln Mercury, Inc., 77 O.W.C. 12 (1998).

    No retroactive award can be entered where employee unjustifiably refused to accept selective employment but payments had been made during this period. Stevens v Jewell Smokeless Coal Corp., 43 O.I.C. 105 (1961).

    The failure of an employee and his/her attorney to provide the employer, through its placement counselor, access to the employee for the pursuit of placement activities, is tantamount to refusal of employment under § 65.1-63 (now § 65.2-510 ). Barton v. Mullins Coal Co., 69 O.I.C. 159 (1990).

    While an allegation of refusal of employment, medical attention or examination requires that compensation be paid through the date of the refusal or fourteen days prior to the filing, whichever is later, an assertion of failure to cooperate with vocational rehabilitation efforts requires payment to be made to the date on which the application is received in the Commonwealth’s offices or posted by certified mail. Hajducsek v. Ames Department Stores, Inc., 71 O.W.C. 256 (1992).

    Burden of Proof/Persuasion:

    Medical evidence must be sufficiently detailed to show that the offered job is suitable to the claimant and this may be accomplished either through greater detail of the claimant’s physical limitations or greater detail of the physical demands of the job as set forth in the job offer. Sager v. Wal-Mart, VWC File No. 218-27-92 (Feb. 26, 2008).

    For benefits to be denied on the grounds that the employee refused employment, the employer must show that a bona fide offer of employment suitable to the employee’s capacity was procured for him by the employer. The burden then shifts to the claimant to prove that his refusal was justified. Cannon v. MacTavish Machine Manufacturing, Inc., 79 O.W.C. 128 (2000).

    The employer has the burden of proving a bona fide job offer suitable to the employee’s capacity, that was procured by the employer, and that the employee refused to accept the job offer. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    In the case of a refusal of selective employment, the employer has the burden to show that the position offered is within the employee’s residual capacity. The record must disclose (1) a bona fide job offer suitable to the employee’s capacity; (2) procured for the employee by the employer; and (3) an unjustified refusal by the employee to accept the job. There is no bona fide job offer that the claimant was merely urged to apply for a position that he was not guaranteed to get. His failure to apply for these positions is, at most, evidence of inadequate marketing. Since there was no offer of employment, there was no refusal of selective employment within the meaning of § 65.2-510 . McCullough v. Adelphia, 79 O.W.C. 116 (2000).

    Where an award has been entered, the burden of proof then shifts to the carrier to establish that the claimant is able to return to his regular work or has been offered appropriate selective employment. Where compensation has been voluntarily paid without an award for 13 months, the burden remains on the carrier. The doctrine of estoppel precludes the carrier from asserting as a defense the claimant’s failure to market his remaining skills. National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187, 4 Va. Law Rep. 1075, 1987 Va. App. LEXIS 239 (1987).

    Where the employer paid compensation for a period of eleven months after the accident, it was appropriate to shift the burden to the employer to establish that the employee’s disability had ended. While the Commission encourages prompt payment of compensation pending an investigation, and such payment for a reasonable period of time is not an admission of liability, thirty days is normally a sufficient period to investigate a claim. Smith v. The Southland Corp./Seven-Eleven, 71 O.W.C. 1 (1992).

    An employer may suspend compensation payments for a refusal of employment only if the work was provided or procured by the employer or its workers’ compensation carrier. Pauley v. Rokeby Farms, 75 O.W.C. 150 (1996).

    Duty to Offer and Accept Selective Employment:

    The employer offered the injured employee selective employment within his restrictions and the employee refused it, claiming he would have been forced into financial hardship if he were to accept it. The Commission ruled that the offer of selective employment was bona fide and the employee unjustifiably refused it. Barnes v. Department of Conservation and Recreation, VWC File No. 220-65-72 (Sept. 26, 2008).

    Obligation to secure selective employment for the injured employee rests with the employer or its workmen’s compensation insurance carrier. Bryant v. Ray Resources Corp., 57 O.I.C. 64 (1976).

    There is no mandatory requirement that selective work be offered to an employee. If the employee is capable of selective work and none is offered or made available by the employer, or if none is found by the employee on his own, the employer must continue to pay temporary total benefits. Warren v. Southwestern State Hospital, 52 O.I.C. 279 (1970).

    There must be an offer of selective work suitable to worker’s capacity. Where there is no offer of selective work, there can be no refusal. Dorsey v. Webster Brick Co., Inc., 46 O.I.C. 72 (1964); Wrenn v. Design Fabricators, 59 O.I.C. 305 (1980).

    No valid offer of selective work made; employment must be approved by physician familiar with employee’s condition and details of work offered. Gilbert v. Hyman Construction Co., 58 O.I.C. 149 (1978).

    Where the Commission had found in prior proceedings that the claimant did not refuse selective employment, the claimant had no duty to cure the alleged refusal to be entitled to a resumption of compensation benefits. She also had no obligation to contact the employer and request a light-duty job. For the employer to prove that the claimant abandoned her employment, it had to offer a suitable position after she was able to return to light duty. Thompson v. Newport News Inc./Spiegel, Inc., 79 O.W.C. 52 (2000).

    There was no unjustified refusal of selective employment when the employee made a reasonable and proper request that prior to acceptance of the position it be approved by the treating doctor since the original light duty job description involved duties beyond the employee’s restrictions. Aziz v. The Southland Corporation, 71 O.W.C. 274 (1992).

    If employee has fully recovered and is able to resume his regular employment, there is no duty on employer to offer him employment in any capacity. Hudlow v. Crompton-Shen Co., Inc., 33 O.I.C. 129 (1951).

    Once an employee is released to regular work the employer is not required to subsidize training in another field of employee’s personal desire. Griffith v. Memorial Hospital, 55 O.I.C. 143 (1973).

    When employee accepts selective employment which is subsequently terminated through no fault of the employee, the employer must obtain other selective employment or renew compensation payments. Oaks v. Commercial Contracting Corp., 56 O.I.C. 237 (1975); Grube v. Teeuwen, 57 O.I.C. 149 (1976).

    When the employer has furnished to physician familiar with the employee’s physical condition, a detailed description of the selective employment to be offered and obtained an opinion from that physician that the employee can perform the work described, the burden is upon the employee to attempt such work. Sassie v. Am. Tobacco Co., 56 O.I.C. 285 (1974).

    Although the claimant had concerns as to whether the job offered by the employer was suitable or that the offer was bona fide, it was unreasonable not to pursue the job offer to determine whether in fact the offer was suitable. Stimeling v. The Kroger Company, 76 O.W.C. 138 (1997).

    When a medically approved light duty position is offered to a disabled employee the burden shifts to the employee to accept the work and make a bona fide effort to perform it. If an employee refuses to accept the position until it has been approved by her attorney, compensation benefits will be denied. Ford v. Spencer of Virginia, Inc., 69 O.I.C. 174 (1990).

    Claimant not entitled to compensation where he accepts job at wage loss when employer offered selective work at no wage loss. White v. Expressway Constructors, 56 O.I.C. 33 (1975).

    Where a claimant was released to light work on a “trial basis” and experienced increased symptomatology upon attempting the work, there was no unjustified refusal of selective employment nor was there a change in condition justifying a termination of benefits when the work attempt was ended. Setliff v. Tultex Corporation, 68 O.I.C. 160 (1989).

    A medical release for a trial return to work in two weeks is anticipatory and too speculative to establish a release to light duty. Congleton v. Safeway Stores, Inc., 73 O.W.C. 203 (1994).

    A doctor’s release to return to work more than seven days after the examination is prospective and anticipatory, and is insufficient to establish an ability to work on the future date. Devault v. Virginia Imports, Ltd., 74 O.W.C. 174 (1995).

    Claimant’s refusal of selective employment justified where the selective employment offered was not consistent with the treating physician’s instructions. Burnette v. New Galax Mirror Corporation, 60 O.I.C. 66 (1981).

    The claimant was assigned repetitive job duties in selective employment that were not suitable to her residual capacity, and she was therefore justified in abandoning the work. Sands v. Alco Controls, 74 O.W.C. 16 (1995).

    Compensation was suspended where the uncontradicted medical evidence showed the claimant capable of performing light duty offered by the employer, and he did not make a bona fide effort to perform the work. Scott v. SW & B Construction Co., 74 O.W.C. 117 (1995).

    Offer By Employer:

    Employer proved employee’s unjustified refusal of selective employment; employer notified employee of appropriate light-duty work by certified mail, but evidence showed employee chose not to pick up certified letter, and he received copy of offer by first-class mail only after deadline to report to work passed; employee did not contact employer after receiving late copy, however, and employee’s actions held to constitute refusal. Harlow v. Atlantic Constructors, Inc., VWC File No. 213-39-49 (Apr. 26, 2004).

    A mere medical opinion that an employee can perform “light work” that is not based on a detailed description of job is not sufficient to shift the burden to employee. Thompson v. Masonry Contractors, Inc., 56 O.I.C. 314 (1974).

    Where there was no actual offer or availability of work, there can be no refusal. Stallard v. Hercules, Inc., 51 O.I.C. 257 (1969); Fauber v. Dozier Tire Co., 45 O.I.C. 81 (1963).

    No bona fide offer of selective employment where the carrier offers the position at the same time it requests a hearing. Employee did not remove himself from the labor market by involving himself in vocational retraining. Frankovic v. Giant Food, Inc., 60 O.I.C. 159 (1981).

    Carrier’s application for suspension of benefits based on claimant’s refusal to accept selective employment denied where nature of selective employment had changed between time carrier was made aware of it and the time it was offered to the claimant. Carter v. Alleghany Publishers, Inc., 60 O.I.C. 80 (1981).

    The Workers’ Compensation Act does not require that a selective employment position be approved by every physician who has evaluated the claimant without rendering treatment. Fleming v. Woodbridge Nursing Home, 61 O.I.C. 139 (1982).

    Where the employer offers work within the employee’s restrictions, even if such position has to be modified, it has established a bona fide job offer suitable to such restrictions. Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    The employer offered light duty work to the claimant, although it did not specifically describe the job or position it was offering. However, the employer did attach a copy of the restrictions that had been imposed by the treating physician to the job offer, and advised the claimant that the physician’s restrictions for “totally sedentary activity” would be accommodated. The claimant declined to accept the offer and did not report to work as scheduled, and the Commission found that the claimant had unjustifiably refused the employer’s offer of selective employment. Grant v. Arlington County School Board, 79 O.W.C. 170 (2000).

    Where an examining physician has specified work capacity limitations that are not inconsistent with the findings of treating physicians, and it is obvious that the proffered work satisfies those limitations, it is unnecessary for the employer to submit job descriptions to the physician for “rubber stamp” preapproval before the job interviews. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    A valid release to work is not dependent on the injured employee’s recovery to the point that no further medical treatment is required. Meekins v. Heritage Golf Club, 77 O.W.C. 81 (1998).

    Where the only work offered to an injured employee exceeds her medical restrictions, the work is unsuitable and the employee is justified in refusing it. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997).

    Where the work allegedly refused by a claimant exceeds permanent restrictions imposed by the treating physician, a release to such work that is approved by the employer’s medical examiner does not establish sufficient probable cause to suspend compensation benefits pending a hearing. Arzola v. Cherner Lincoln Mercury, Inc., 77 O.W.C. 12 (1998).

    Employer forwarding to claimant newspaper clippings of employment opportunities was not an offer of selective work. Martin v. Friedman Marks Clothing Co., 53 O.I.C. 196 (1971).

    There is no legal requirement that a claimant only be offered selective employment in accordance with his specifications or prior licensed skills. Teague v. Hampton Roads Sanitation District, 62 O.I.C. 453 (1983).

    “Volunteer work” for which wages are not anticipated is not selective employment under the Virginia Workers’ Compensation Act. Therefore, the employee’s failure to continue to volunteer his services was not an unjustified refusal of selective employment. Martin v. F & W Management Corp., 70 O.I.C. 324 (1991).

    There was no unjustified refusal on the part of employee where he reported for work but was not allowed by plant nurse to work as long as he took certain medication prescribed by attending plant physician. Lassiter v. Smithfield Packing Co., 57 O.I.C. 224 (1977).

    Reasons For Refusal:

    Generally:

    The Commission held that the claimant did not refuse vocational rehabilitation efforts where he failed to appear after short notice of a meeting and because of transportation difficulties, an illness and simple forgetfulness, especially when the claimant always timely communicated with the vocational rehabilitation counselor and resumed the vocational rehabilitation process. Dexter v. Day & Zimmerman NPS, Inc., VWC File No. 238-60-41 (August 13, 2010).

    To support a finding of justification to refuse selective employment, the reasons advanced must be such that a reasonable person desirous of employment would have refused the offered work. The determination of justification to refuse employment involves a much broader inquiry than merely considering whether the intrinsic aspects of the job are acceptable to the prospective employee. Justification to refuse an offer of selective employment may arise from factors totally independent of those criteria used to determine whether a job is suitable to a particular employee. Taylor v. Northern VA Regional Park Authority, 77 O.W.C. 63 (1998).

    The claimant was justified in his refusal of selective employment procured by the employer. The employer’s vocational rehabilitation provider found the claimant a job as a home-based fishing tackle assembler, providing evidence that the work duties were within the claimant’s residual capacity, and that it paid $6.00 per hour for six months, with earnings thereafter determined by a “piece rate.” The Commission found that the employer failed to demonstrate how the claimant was to be supervised, and whether any effort was made to determine whether the claimant possessed the skills necessary to perform work as an assembler. Before such an earnings arrangement will be found acceptable, the employer must demonstrate that the claimant is suited to the work. The employer offered no evidence suggesting how this work would help the claimant make the transition back to the work force. Silver v. King Koil Sleep Products, VWC File No. 178-90-09 (May 28, 2002).

    Medical Unsuitability:

    The Commission has consistently held that a claimant’s refusal or abandonment of selective employment is justified when the selective employment is inconsistent with the treating physician’s instructions. Since the claimant’s treating physician did not approve of the selective employment, the claimant’s resignation was justified. Taylor v. Northern VA Regional Park Authority, 77 O.W.C. 63 (1998).

    Where the actual job requirements do not conform to the job description provided to a claimant’s treating physician, his approval is invalid. In such cases, the employer fails to meet its burden of establishing that it made a bona fide offer of employment within the claimant’s residual capacity. Hernandez v. Moore Brothers Company, 78 O.W.C. 74 (1999).

    A bona fide attempt to return to work is better evidence than a medical opinion of the employee’s ability to do so. Meekins v. Heritage Golf Club, 77 O.W.C. 81 (1998).

    Telephone Solicitation:

    A telephone solicitation position is not an appropriate offer of selective work unless there is a demonstrated physical ability to perform the work and a special capacity as a sales person. The employee’s age, education, aptitude and pre-injury employment must also be considered. Faulkner v. Owens Interior Trim, 70 O.I.C. 232 (1991) (see also Diaz v. District Home for Augusta, 66 O.I.C. 118 (1987) (in addition to physical capacity must demonstrate special capability as sales person for telephone solicitation position to be legitimate job offer); Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996) (in absence of showing particular aptitude for telemarketing or soliciting there was no refusal)).

    Absent some showing that an employee has a particular aptitude for telemarketing or telephone soliciting, a refusal to accept such employment does not constitute a refusal of rehabilitation or selective work. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    Job Skills or Union Status:

    Selective work abandoned of claimant’s own volition to protect her union status was unjustified. Witt v. Kenrose Mfg. Co., Inc., 55 O.I.C. 381 (1973) (see also Fitzhugh v. Paul T. Roberson, 59 O.I.C. 82 (1980)).

    While collective bargaining agreements and other incidents of employment may be related to exercise by the parties of rights and duties, the Virginia Workers’ Compensation Act does not in any way define or guarantee the right of an employee to remain in the particular employment nor does it require an employer to keep an employee in a particular employment. Diehl v. Reynolds Metals Company, 67 O.I.C. 188 (1988).

    There is no legal requirement that a claimant only be offered selective employment in accordance with his specifications or prior licensed skills. Teague v. Hampton Roads Sanitation District, 62 O.I.C. 453 (1983).

    An employee is not justified in refusing appropriate selective employment because the position was not in his preinjury construction industry and acceptance would jeopardize his union pension benefits. Reynolds v. Gust K. Newberg Construction Co., 70 O.I.C. 236 (1991).

    Hours of Employment:

    Refusal to accept night shift work within the employee’s residual capacity is an unjustified refusal of work. Pauley v. Rokeby Farms, 75 O.W.C. 150 (1996).

    Refusal to accept selective work not justified merely because hours of employment not those desired by claimant. Emmerson v. Marshall Lodge Memorial Hospital, 51 O.I.C. 87 (1969).

    An employee who refuses an offer of selective employment for religious reasons has not unjustifiably refused selective employment. Ballweg v. Crowder Contracting Company, Inc., 247 Va. 205 , 440 S.E.2d 613, 10 Va. Law Rep. 960, 1994 Va. LEXIS 30 (1994); Ballweg v. Crowder Contracting Company, Inc., 16 Va. App. 31, 427 S.E.2d 731, 9 Va. Law Rep. 1045, 1993 Va. App. LEXIS 53 (1993), rev'd, 247 Va. 205 , 440 S.E.2d 613, 10 Va. Law Rep. 960, 1994 Va. LEXIS 30 (1994) (reversing 71 O.W.C. 279 (1992)).

    Aversion to weekend work and desire to attend church on Sunday carry no more weight than other personal reasons similar to those shared by a large segment of the population and will not constitute a justified refusal of selective work. Tedeton v. Messick, 60 O.I.C. 442 (1991).

    In the absence of evidence of any particular risk or a high crime area, the claimant was not justified in refusing employment because it would require her to work alone at night. Landy v. Eastern State Hospital, 69 O.I.C. 212 (1989).

    Compensation benefits may be suspended if a claimant refused selective employment because the working hours interfered with her ability to fix dinner for her spouse at the customary time. Depoy v. Woodrow Wilson Rehabilitation Center, 68 O.I.C. 188 (1989).

    Child Care:

    The claimant’s failure to report to work five times and tardiness four more times over a four-month period is equivalent to an unjustified refusal of selective employment. Beasley v. Norcraft Co., VWC File No. 220-58-38 (July 11, 2005).

    An employee’s inability to secure child care is not justification for refusing offered employment. To hold otherwise would result in requiring an employer to pay disability benefits because of an employee’s inability to find appropriate child care, and not upon the employee’s disability resulting from the compensable injury. Similarly, the inability to arrange care for a family member, in this case a mother suffering from Alzheimer’s disease, does not justify a refusal of selective employment. Cannon v. MacTavish Machine Manufacturing, Inc., 79 O.W.C. 128 (2000).

    Drug Use:

    Compensation benefits may be suspended where an employee is precluded because of failure of a drug screening test from being offered selective employment. The employee may cure his unjustifiable refusal by finding other light work at the same average weekly wage offered by his pre-injury employer. Williams v. Richfood, Inc., 71 O.W.C. 286 (1992).

    An employer clearly is justified in terminating a light-duty employee’s employment based on what it perceives to be a positive drug screen. Whether the employee is then entitled to compensation depends on whether the termination was for “justified cause,” and, if not, whether the claimant thereafter marketed her remaining earning capacity. Pelzer-Pugliese v. World Color Retail, 78 O.W.C. 278 (1999).

    Failure to pass a drug test whether conducted immediately after the accident or prior to offering employment is a basis for finding an unjustified refusal of selective employment. Whether the drug use occurred immediately before or some time after the injury is immaterial because the failure to pass the screening process prevents re-employment. Gardner v. Quikrete of Virginia, 73 O.W.C. 199 (1994).

    The claimant requested, to no avail, a repeat drug screen, because of what she believed to be a risk of a false positive based on her use of prescription drugs for her injury. She also adamantly denied any use of drugs or alcohol between the time of her injury and the drug screen. There was no evidence of any drug use other than the results of the drug screen, which was not done by SAMHSA-certified laboratory. The deputy commissioner found that the claimant’s denial of drug use was credible, and the Commission agreed that the termination was not for “justified cause” such that the claimant’s compensation benefits should be forfeited. Pelzer-Pugliese v. World Color Retail, 78 O.W.C. 278 (1999).

    Transportation, Economic and Distance Factors:

    The claimant was not justified in refusing the selective employment offered him, which was located 90 miles from his home, because the employer offered to provide transportation or to reimburse him for travel expenses and also offered to provide lodging. Fulcher, Jr. v. Swift Transportation Company, Inc., VWC File No. 233-44-72 (May 19, 2008).

    The claimant was justified in refusing selective employment that would require her to travel 37 miles one way for a total of 444 miles per week. Weaver v. Emco Enterprises, Inc., VWC File No. 211-50-17 (Sept. 15, 2005).

    An employer is not required to provide transportation to the selective work it procures for a claimant. Johnson v. City of Clifton Forge, 9 Va. App. 376, 388 S.E.2d 654, 6 Va. Law Rep. 1281, 1990 Va. App. LEXIS 20 (1990).

    Refusal justified where transportation not provided for employee with foot in cast. Wright v. Dan River Mills, Inc., 46 O.I.C. 265 (1964).

    When an employee refuses selective employment at the same location of his pre-injury employment because a shift change makes him unable to obtain transportation, compensation benefits may be terminated because the claimant’s inability to work was not the result of the accident but because of personal transportation problems. Chowdhury v. Hyatt Regency Crystal City, 67 O.I.C. 192 (1988).

    When an employee becomes medically unable to continue selective employment because of the exacerbation of his back injury in a bicycle accident and the bicycle is his only means of transportation to his employment, there has been no refusal of selective employment. Marrow v. Addington Beaman Lumber Co., Inc., 69 O.I.C. 195 (1990).

    Driving restrictions that present transportation difficulties will not justify failure to attend job interviews, where the employee’s home and the potential work locations were close to stops along a major bus route. An employee will not be heard to complain for the first time at a much later date that transportation difficulties prevented her appearance at job interviews, where the purported difficulty was not revealed when the interviews were scheduled and thus deprived the employer of a timely opportunity to provide transportation. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    In determining whether a refusal of selective employment is justified, the Commission will consider living and travel costs as well as the wage rate. If economic adversity would result, a person will not be required to move his residence in order to accept employment, nor will he be required to travel excessive distances. Guthrie v. Ken Hurst Firearms Engraving Company, 65 O.I.C. 221 (1986) (Affirmed by Court of Appeals 9/11/87).

    In the absence of evidence that the injured worker traveled some distance to work prior to the injury, the Commission will view skeptically potential job opportunities located a great distance from his home. Meyland v. Dittmar Company, 74 O.W.C. 5 (1995).

    The employee was justified in refusing medically approved light work where the pre-injury work required driving less than ten miles to meet a work crew and the selective employment required commuting more than eighty miles with no offer of transportation, travel expenses or relocation costs. Dotson v. The F. A. Bartlett Tree Expert Company, 71 O.W.C. 277 (1992).

    Except in unusual circumstances selective employment must be offered within a reasonable distance of the employee’s residence or place of injury. It is unreasonable to expect an employee, whether at his expense or the employer’s, to move from North Carolina to Florida to accept a light duty position. Mullins v. Misener Marine Construction, Inc., 69 O.I.C. 167 (1990).

    After noting that an employee was not required to move his residence to accept selective employment, the Commission found that the claimant was justified in terminating a job located sixty-five miles from his home when he ceased to have transportation. Seaborn v. Georgia Pacific Corporation, 68 O.I.C. 164 (1989).

    Relocation of Employee:

    Compensation suspended when an offer of selective employment was made in good faith and the claimant, after three days, discontinued employment and moved to another state where her husband had previously found employment. Raffield v. Prince William County School Board, 62 O.I.C. 362 (1983).

    The claimant was not justified in discontinuing selective employment for the reason that she is relocating with her spouse in another area of the country. Ramp v. Commonwealth Health Care, 64 O.I.C. 264 (1985).

    A move by a claimant from an area where numerous employment opportunities exist to an area where jobs may or may not be as plentiful is not a basis to suspend compensation benefits. Harkins v. J J & M Masonry, 65 O.I.C. 213 (1986).

    The claimant, who moved from Northern Virginia to accept a job which subsequently terminated in an area that has significant seasonal work, did not remove herself from the labor market. Walker v. Foodtown Stores, Inc., 73 O.W.C. 189 (1994).

    A reasonable person desirous of employment would have refused the work offered to the claimant, since the claimant’s family was moving to California and she had reasonably determined to accompany them. The “broad inquiry” of all the relevant factors in this case revealed that the claimant’s refusal of employment was justified. Taylor v. Northern VA Regional Park Authority, 77 O.W.C. 63 (1998).

    A claimant is not required to move back to her pre-injury residence and accept selective employment without evidence that placement efforts had been exhausted in the location where the employee currently resides. Similarly, a claimant is not required to move back to her pre-injury residence to accept vocational rehabilitation. Payne v. Buchanan General Hospital, 76 O.W.C. 131 (1997).

    An employee was justified in refusing a selective employment position offered by the pre-injury employer which would require either a move or a commute of 250 to 300 miles per day where relocation was required because of economic circumstances and the carrier failed to seek selective employment opportunities in the current location. Carder v. T. J. Maxx, 71 O.W.C. 253 (1992) [Affirmed Unpublished Memorandum Opinion October 12, 1992] .

    The claimant who moved five hours away from his pre-injury employment was not required to accept a light duty job offer at his previous place of employment. Posten v. Furnace Associates, Inc., t/a Lorton Landfill, 73 O.W.C. 187 (1994).

    Where a carrier has failed to exhaust job search possibilities in the locality where the employee currently lives, there has been no unjustified refusal of selective employment or job search efforts when the employee is furnished a bus ticket without arrangements for food and lodging and directed to return to the location where the injury occurred to interview with prospective employers. Gibson v. Painters Roofing & Heating, Inc., 71 O.W.C. 248 (1992).

    An employee after relocation was found to be justified in refusing selective employment or vocation rehabilitation efforts in the pre-injury geographic area. Robert J. Lee v. Food Lion, Inc., VWC #137-24-95 decided 6/12/92; Eleuterio Reveles v. Professional Grounds, Inc., VWC #146-37-84 decided 8/14/92; Randall Charles Fleming v. Manassas Masonry Construction, Inc., VWC #144-20-77 decided 9/18/92.

    The employee’s relocation to South Carolina for financial reasons did not justify refusing selective employment. Having refused a good faith offer of selective employment at his pre-injury wage, the employee was not entitled to temporary partial benefits upon curing his refusal by finding selective work in South Carolina. Port v. Suburban Grading and Utilities, Inc., 69 O.I.C. 169 (1990).

    Refusal of selective work because claimant could not afford to live with family in Norfolk was unjustified. Jones v. Allegheny Pepsi Cola Bottling Co., 59 O.I.C. 161 (1980).

    Sheltered Workshop:

    Referral to a Goodwill Industries assessment program paying $36.80 per week, compared to the employee’s pre-injury weekly wage of $975.94, was not a bona fide job offer, and the employee was justified in refusing to continue with the program. Markham v. Revco, 75 O.W.C. 180 (1996).

    Where the evidence established that the claimant had worked 15 years as a pipefitter, carpenter, and sheet metal worker, placement in a sheltered workshop with mentally retarded individuals and persons with severe mental handicaps was inappropriate vocational rehabilitation. Taylor v. B.W.B. Const. Corp., 75 O.W.C. 281 (1996).

    The vocational consultant located several positions with a company that manufactures and sells wedding favors, such as birdseed wrapped in small decorative bags. This company frequently employs individuals with disabilities, at wages less than the amount it would receive from the claimant’s employer for providing the employment. The Commission held that such employment did not provide meaningful benefits to either the claimant or the employer. The proposed employment offered no prospect for advancement, no teaching of necessary work skills, and no restoration to a productive place in the workforce, and the Commission held that the refusal of such work was justified. Dew v. Alleghany Regional Hospital, 77 O.W.C. 190 (1998).

    Retirement and Social Security Benefits:

    Claimant’s decision to retire due to her causally related disability when she was unable to work was not a refusal of selective employment. Salazar v. Henrico Cnty. Sch. Bd., JCN VA00001132912 (Sept. 13, 2017).

    Claimant unjustifiably refused selective employment by retiring. Dowden v. Hercules, Inc., VWC File No. 204-26-18 (Dec. 10, 2004).

    A claimant’s acceptance of social security benefits standing alone does not affect her entitlement to compensation. Before compensation benefits will be terminated, there must be evidence that the claimant is able to return to her regular work or has refused without justification an offer of employment within her physical capacity. Watson v. Sears, Roebuck and Company, 65 O.I.C. 215 (1986).

    In the absence of an offer of work within the claimant’s capacity or evidence of an unreasonable refusal of such work, an employee’s acceptance of retirement benefits is not a basis for terminating an outstanding award. Derting v. Scott, Dept. of Social Services, 69 O.I.C 162 (1990).

    Voluntary resignation from employment suitable to an injured employee’s residual capacity constitutes an unjustified refusal of employment. Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    An employee who earlier resigned from work within her physical capacities provided by her employer is not precluded from subsequently receiving an award for temporary total disability. Browder v. Southside Regional Medical Center, 71 O.W.C. 289 (1992).

    School Enrollment:

    To demonstrate that a full time college student is not available to the labor market, the evidence must establish that the employee’s student status interfered with vocational rehabilitation efforts. Helmick v. Rubbermaid Commercial Products, Inc., 71 O.W.C. 284 (1992).

    Award terminated because employee who was capable of selective duty but was not available for any type of employment because of enrollment in school. Once school year ended the employer must either provide suitable selective employment or reinstate benefits. Tessitore v. John A. Volpte Constr. Co., 51 O.I.C. 266 (1969).

    One cannot remove himself from labor market unless he is first available in that market; student physically unable to engage in employment remains entitled to benefits. Williamson v. Bryant Durham Elec. Co., 55 O.I.C. 377 (1973).

    The claimant was working in selective employment offered by the employer, but he quit that work to complete schooling that could lead to work as a self-employed heating and air conditioning contractor. The Commission held that this was an unjustified refusal of employment, because there was no medical evidence that the claimant was physically capable of performing such other work, nor was there evidence that the claimant could potentially earn more in such work, except as an employee of others, which would have required that he exceed his medical restrictions. Meade v. Clinchfield Coal Company, 76 O.W.C. 420 (1997).

    Claimant by refusing a bona fide offer of selective work and electing to enroll as a licensed practical nurse voluntarily removed herself from labor market. Griffith v. Memorial Hospital, 55 O.I.C. 143 (1973).

    A document signed by the claimant stating that she declined to participate in vocational rehabilitation efforts, because she intended “to continue as a full-time student at Concord College, and am therefore not available for work activities,” was interpreted by the Commission as meaning she would not participate in such efforts only in the area where she no longer resided. Payne v. Buchanan General Hospital, 76 O.W.C. 131 (1997).

    Illegal Alien Status:

    An illegal alien’s pursuit of unlawful employment is not an acceptable means of marketing his residual work capacity. While an employer under Federal law must inquire concerning work eligibility, a statutory employer, as in this case, has no such duty and is therefore not barred from raising the illegal alien status as a defense. Manis Construction Co. v. Arellano, 13 Va. App. 292, 411 S.E.2d 233, 8 Va. Law Rep. 1466, 1991 Va. App. LEXIS 301 (1991).

    Job Interviews:

    A potential employer has the right to expect a claimant to be forthright. Therefore, the claimant was justified in his candid expression of concern regarding the pay level and lack of fringe benefits, as well as advising the potential employer that he would continue to seek a better job. Jones v. Kroger Company, 65 O.I.C. 218 (1986).

    A claimant who was released to light work but was temporarily medically disabled from a non-work-related condition, was justified in failing to attend a job interview during the disability. American Furniture Company v. Doane, 230 Va. 39 , 334 S.E.2d 548 (1985), is applicable only when the non-work-related disability is for an extended period of time. Morrison v. Eastern State Hospital, 68 O.I.C. 183 (1989).

    Compensation suspended for employee’s unjustified refusal of selective employment suitable to his capacity based on his failure to attend interviews and giving incorrect information on his medical restrictions to prospective employers. (Other cases cited in opinion).Emert v. Dept. of State Police, 57 O.I.C. 110 (1977), (aff’d. on review).

    Section 65.2-510 C does not apply to the unjustified refusal of vocational rehabilitation that involves a failure to cooperate with job seeking activities. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    The language of Code § 65.2-510 (C) specifically limits its application to the failure to cure a refusal pursuant to “subsection A,” which refers to employment “procured” for the employee. It does not encompass an unjustified refusal involving vocational rehabilitation or a combination of job placement and vocational rehabilitation. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    Other:

    Claimant who worked in dissimilar pre-injury job with second employer and returned to full time work only with that employer still was required to market residual work capacity and cooperate with vocational rehabilitation. Crumpton v. City of Danville, JCN VA00001159204 (Apr. 26, 2018).

    Claimant justified in refusing to return to work at same store where he was assaulted and injured. Dillard v. Selective HR Solutions, Inc., VWC File No. 213-94-51 (July 9, 2004).

    Failure to pass written examination for chauffeur’s license to drive a cab is not unjustified refusal of employment. Thacker v. Buchanan Wholesale Co., Inc., 47 O.I.C. 329 (1965).

    Claimant justified in refusing delayed offer of selective work and retraining where she had already obtained suitable vocational retraining. Rocke v. Riverside Hospital, 58 O.I.C. 309 (1979).

    An employee who refuses to make available to his employer his personal vehicle regardless of the promise of reimbursement, has not refused selective employment nor refused to cooperate with vocational rehabilitation. Rouleau v. Gateway Distributors, Inc., 70 O.I.C. 231 (1991).

    The evidence failed to establish that the claimant unjustifiably refused selective employment as a seamstress based on a finding that the employer’s willingness to modify the job to accommodate the claimant’s medical needs was not communicated to the doctor. Hernandez v. Ringling Brothers/Barnum and Bailey Combined Shows Inc., 73 O.W.C. 20 (1994).

    The claimant interviewed for employment and a job offer was made. The claimant later advised his vocational rehabilitation counselor that he thought the job should pay more, and she agreed to discuss it with the new employer. She did, and was told the salary was not negotiable. The counselor never got back in touch with the claimant to tell him the offer was final, or to advise him to accept the job or lose compensation benefits. Because the counselor did not take these reasonable steps to encourage the claimant to take the job or to advise him of the carrier’s position, the claimant was never even given the opportunity to decide whether or not to accept the job, so there was no refusal. Sutphin v. Stanley Martin Companies, Inc., 76 O.W.C. 462 (1997).

    Discharge for Cause:

    A termination for poor job performance is sufficient to support a permanent forfeiture of benefits. Buraker v. Cam Repairs and Group Cam LLC, JCN VA00000643071 (Aug. 17, 2015).

    Where claimant’s light duty job was inconsistent with work restrictions and she informed her case worker of her absences from work, termination was not for “justified” cause sufficient to justify permanent forfeiture of benefits. Carter v. Georgia-Pacific Corp., VWC File No. 213-78-02 (March 11, 2005).

    Employer required to show some ability of employee to perform work in order to terminate award of temporary total disability benefits after finding of termination for justified cause; medical evidence showed employee continued to be totally disabled and thus employer did not prove benefits should be terminated. Waldrop v. Virginia Panel Corp., VWC File No. 193-84-21 (Nov. 14, 2003).

    Employee not terminated for justified cause for failing drug screen after accident; Deputy Commissioner believed employee’s testimony that he never used cocaine, which was corroborated by second negative drug screen and by medical evidence that positive screen was false due to use of narcotic pain medication after accident. Shrader v. Asplundh Tree Expert Co., VWC File No. 210-94-69 (Oct. 24, 2003).

    Employee’s conduct toward employer’s customers justified termination such that employee not entitled to temporary partial disability benefits; employer provided significant evidence of unsatisfactory conduct for several months, including numerous customer complaints and two complaint letters. Redford v. Richmond Harley-Davidson, VWC File No. 207-50-68 (Mar. 17, 2003).

    For appellate cases relating to discharge for cause see C & P v. Murphy, 12 Va. App. 633, 406 S.E.2d 190 (1991), affd. on reh’g en banc, 13 Va. App. 304, 411 S.E.2d 444 (1991); Timbrook v. O’Sullivan Corporation, 17 Va. App. 594, 439 S.E.2d 873 (1994); Eppling v. Shultz Dining Programs, 18 Va. App. 125, 442 S.E.2d 219 (1994); Tumlin v. Goodyear Tire & Rubber Company, 18 Va. App. 375, 444 S.E.2d 22 (1994); Potomac Edison Co. v. Cash, 18 Va. App. 629, 446 S.E.2d 155 (1994); Gainer v. National Boiler Service, Inc., Record No. 1736-93-2 (Ct. of Appeals, May 3, 1994).

    An employee is guilty of misconduct connected with her work when she violates a company rule reasonably designed to protect the legitimate business interests of her employer, or when her acts or omissions are of such a nature or so recurrent as to manifest a disregard of those interests and the duties and obligations she owes her employer. The employer does not have to prove that the employee’s wrongful act was intentional, willful, or deliberate in order to justify a termination for cause and a forfeiture of compensation benefits. Muhammad v. VSI Group, 79 O.W.C. 190 (2000) (see also Wheeler v. Waffle House, 77 O.W.C. 113 (1998)).

    The employer is reasonably entitled to expect that its employees will appear and work when and as scheduled, or that they will provide contemporaneous notice and explanations for absences, if instructed. The employer is justified in terminating the employee for cause if he ignores or disregards this obligation. Wheeler v. Waffle House, 77 O.W.C. 113 (1998).

    A finding by the Virginia Employment Commission that an employee was not fired for cause is not binding on the Commission. Drumheller v. Wampler Longacre Chicken, Inc., 73 O.W.C. 194 (1994).

    An employee who is discharged for cause may be entitled to reinstatement of compensation benefits upon a finding of total disability. Remmell v. The Glidden Company, 71 O.W.C. 261 (1992); Howke v. La Petite Academy, Inc., 73 O.W.C. 196 (1994). See also Arthur E. Parker v. Air Gate Service Corporation, VWC # 153-48-27 decided 11/20/92.

    A refusal of light work offered by the employer may be cured while termination for cause from light work procured by the employer may not be cured. Armstrong v. Londontown Corporation, 71 O.W.C. 265 (1992).

    An injured employee terminated for cause was later rehired by the employer. Thereafter, the employee was totally disabled because of his work injury, which the employer accepted as compensable. Upon his release to light work, the employer filed an application to suspend compensation, because of the earlier discharge for cause. Held, the employer forfeited no rights under the Act because it elected to rehire the employee, but the employee had forfeited his rights to future compensation for partial disability benefits. Purcell v. Tidewater Const. Corp., 75 O.W.C. 302 (1996).

    Voluntary actions leading to employee’s dismissal, preventing acceptance of selective work, tantamount to refusal of suitable employment. White v. Dixie Coca Cola Bottling Co., Inc., 53 O.I.C. 380 (1971); Surber v. Coleman Furniture Corp., 48 O.I.C. 236 (1966).

    Where the claimant’s termination was solely related to her failure to pay a child care debt and not to any willful misconduct or other dereliction of duties, there has been no justified termination for cause. Howke v. La Petite Academy, Inc., 73 O.W.C. 196 (1994).

    A claimant will permanently forfeit temporary partial disability benefits if his termination for cause “is justified.” The majority held that termination for poor work performance is not such conduct that warrants permanent forfeiture of those benefits. Corr v. American Vending Concepts, Inc., 74 O.W.C. 170 (1995).

    The employer cited the claimant’s alleged safety violation and alleged dishonesty in making his claim as justification for his termination. Because the Commission found no safety rule violation and concluded that “dishonesty” had not been demonstrated by a preponderance of the evidence, his termination was not for “justified” cause. Louderback v. Rocco Quality Foods, Inc., 76 O.W.C. 234 (1997).

    The claimant stayed out of work after reporting significant shoulder complaints, with the approval of his treating physician, but then performed manual labor that exceeded the physical requirements of his light duty job, even though he claimed disability for that day. He was videotaped by the employer, who then questioned the claimant about the activities before revealing the videotape evidence, and the claimant denied he had performed any manual labor. The Commission held that the employer was entitled to honest responses and found that the claimant was terminated for justified cause. Patterson v. Yokohama Tire Corp., 76 O.W.C. 397 (1997).

    Where the claimant’s termination was based on his apparent misrepresentation to his treating physician and his acknowledged misrepresentation to his employer, he is not entitled to a resumption of temporary total disability benefits by showing he may have adequately marketed his residual work capacity. Patterson v. Yokohama Tire Corp., 76 O.W.C. 397 (1997).

    Where the employer has a policy requiring an employee to call at least two hours before the start of a work shift if he is going to be absent from work, and so advises the employee, the employer is justified to terminate the claimant’s employment when he failed to call and report such absences on three consecutive days. Wheeler v. Waffle House, 77 O.W.C. 113 (1998).

    A “justified” termination for cause on the grounds of excessive absenteeism that would warrant permanent termination of compensation benefits is not established where evidence shows the absences were due to personal and family illnesses, family problems that required immediate attention, and inclement weather conditions. Sands v. Alco Controls, 74 O.W.C. 16 (1995).

    The claimant was fired because she looked in another employee’s personnel file, took a copy of that person’s driver’s license, and removed and copied documents from that file to use in making misrepresentations to induce a third party to hire the claimant as a caterer. The Commission held that protecting the privacy of employee records is a legitimate business interest, and that this was clearly an act that in itself was sufficiently egregious to demonstrate the requisite disregard of the employer’s legitimate business interest in protecting the privacy rights of its employees, such that the claimant’s termination was justified. Muhammad v. VSI Group, 79 O.W.C. 190 (2000).

    The claimant’s termination from light duty employment, for fighting on the job, constituted “justified cause” sufficient to bar any further claim for workers’ compensation benefits. That the employer subsequently went bankrupt, and ceased operations, is irrelevant. The plant closure does not negate the termination for justified cause, and does not become an “intervening cause” of her ongoing wage loss. Glass v. Tultex Corporation, VWC File No. 180-94-06 (January 26, 2001).

    Curing Refusal of Selective Employment:

    General:

    Claimant’s inability to obtain childcare was not a justification for refusal of selective employment requiring travel where claimant’s pre-injury work required travel. The employer is not responsible for conditions that are not causally related to the claimant’s injury and the results of that injury, which would prevent him from accepting light-duty employment within the restrictions outlined by his physician. Codey J. Brown v. Reich Installation Services, Inc., VWC File No. 233-45-82 (July 13, 2009).

    Because the claimant was terminated for absences for non-work injury related health problems and not for reasons of misconduct, poor performance or other circumstances within his control, he may cure his unjustified refusal of light duty by requesting his old job back and proving reasonable marketing if he is unable to return to work with his employer. This is an exception to the requirement set forth in MacWilliam v. Minton and Robertson, Inc., VWC File No. 192-19-71 (Feb. 9, 2001). Elliott v. C & S Door Corp., VWC File No. 208-38-14 (March 10, 2006) (Settled while on remand).

    Employee who unjustifiably refused selective employment with pre-injury employer established a partial cure of that refusal with evidence of marketing residual work capacity; however, deputy commissioner’s award of temporary total disability benefits improper because benefits should be based on the wages in the job that was refused. Robertson v. Sun States Maint. Corp., VWC File No. 210-95-35 (Sept. 12, 2003).

    The Workers’ Compensation Act was amended October 1, 1991 to include within the definition of “change in condition” an award that had been earlier “suspended.” This statutory change effectively vitiated the distinction between suspended and terminated. Employees thereafter were obliged to prove the extent of continuing disability through marketing efforts, in order to have compensation benefits reinstated. Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    An employee who constructively refused selective employment when he was terminated for “poor work attitude” could not prove he “cured” such refusal by marketing his residual work capacity. To cure his constructive refusal, and be entitled to resumption of compensation benefits when disabled, the employee actually had to find employment at a wage comparable to that which was constructively refused. Mere marketing, under such circumstances, is insufficient to prove a “cure.” MacWilliams v. Minton and Roberson, Inc., VWC File No. 192-19-71 (February 9, 2001).

    A refusal of light work offered by the employer may be cured while termination for cause from light work procured by the employer may not be cured. Armstrong v. Londontown Corporation, 71 O.W.C. 265 (1992).

    A claimant who does not receive a Murphy termination may be eligible to receive temporary partial benefits if he cures an unjustified refusal of work once he has procured comparable employment suitable for his disability or has made a good-faith effort to obtain suitable employment. Newsome v. Food Lion, Inc., 77 O.W.C. 173 (1998).

    A claimant is entitled to wage loss benefits during periods of unemployment after locating employment that constituted a cure of an earlier unjustified refusal. The statutory language of Code § 65.2-510 only prohibits receipt of wage loss benefits “during the continuance of such refusal.” Newsome v. Food Lion, Inc., 77 O.W.C. 173 (1998).

    Where disability benefits are suspended because an employee unjustifiably refuses selective employment, the employee will be entitled to resumption of disability benefits once he procures comparable employment suitable for his disability or has made a good faith effort to obtain suitable employment. Turnbull v. Northern Va. Consultants, 75 O.W.C. 240 (1996).

    A claimant who is discharged from light duty work because of an unrelated health problem is entitled to resume compensation benefits upon finding a comparable job or demonstrating a good faith effort. A job paying a difference of $18.26 per week is a comparable job. Waters v. Colonial Block Of Norfolk, Inc., 73 O.W.C. 191 (1994); 74 O.W.C. 43 (1995).

    A refusal of selective employment may be cured by accepting or agreeing to accept the position or by continued cooperation with the job placement counselor coupled with an individual effort to secure employment. Armstrong v. Londontown Corporation, 71 O.W.C. 265 (1992).

    The claimant proved a cure of her earlier refusal of employment where the medical evidence showed increased restrictions, with no evidence that the earlier job offer would have still been suitable. Stimeling v. The Kroger Company, 76 O.W.C. 138 (1997).

    When claimant has unjustifiably abandoned selective employment, he is not entitled to compensation until he can prove that he could perform neither his regular work nor the selective work procured for him and approved by the treating physician. Hughes v. Jones Masonry Company, Inc., 60 O.I.C. 216 (1981).

    Where the employer advised an injured employee that, once having resigned, he could return to work only by filing an application as a new hire, but that light duty work would not be offered under those circumstances, the employer effectively withdrew the prior offer of light duty work and put the injured employee on notice that any application for employment would have been futile. Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    Claimant’s long-term unjustified refusal of selective employment is not cured by his becoming totally incapacitated due to unrelated disability. Fogle v. C.E. Shirley Well Drilling, 61 O.I.C. 143 (1982).

    When compensation has been suspended for unjustified refusal of selective employment, the employer must offer the same or reinstate compensation benefits once the employee communicates his willingness to accept light work. Coker v. Commonwealth of Virginia, Virginia State Penitentiary, 62 O.I.C. 133 (1983).

    The claimant’s refusal of more lucrative selective employment at an earlier time does not preclude her eligibility for benefits for partial wage loss once she has cured her unjustified refusal. Ward v. Rappahannock General Hospital, 64 O.I.C. 326 (1985).

    When an employee refuses suitable employment, and later secures comparable employment at a lower wage, temporary partial benefits are calculated based upon the higher paying wage. Newsome v. Food Lion, Inc., 77 O.W.C. 173 (1998).

    An unjustified refusal of light duty employment may be cured by good faith efforts to find other suitable work or by finding comparable employment. If the comparable employment is at a lower wage than was paid in the selective employment, partial disability compensation is calculated based on the higher paying job. Therefore, no partial disability benefits are due to a claimant who cures a refusal of work by finding comparable employment if the earnings at the selective employment were at his pre-injury wage. Corr v. American Vending Concepts, Inc., 74 O.W.C. 170 (1995).

    A claimant who cured an earlier refusal of selective employment by finding another job was not entitled to temporary partial benefits until his wages reached that of the previously refused position. The wage loss was not a result of the accident but of his earlier refusal. Lawhorne v. H. F. Interiors, Inc., 68 O.I.C. 176 (1989).

    It is not necessary that the employee find work paying identical wages to the job that was refused in order to prove he has obtained “comparable employment.” The Commission found that a job paying $5.50 per hour was sufficiently comparable to the $6.00 per hour the employee would have earned in the refused employment and cured his earlier refusal. Turnbull v. Northern Va. Consultants, 75 O.W.C. 240 (1996).

    An employee who procures full-time selective employment after being injured performing seasonal work was not entitled to temporary partial benefits if he refused seasonal work within his physical capacity in order to remain in the year-round position. Yager v. Noah P. Turner Landscaping, Inc., 68 O.I.C. 7 (1989).

    Where the earnings to be paid at the refused employment is not established, where the claimant has fully cooperated with job placement efforts except for the single refusal, where he has diligently marketed his residual capacity both before and after the refusal, and where he subsequently located similar work as that earlier refused, work that even includes night work that was the basis of the earlier refusal, the employee has cured an unjustified refusal of work. Pauley v. Rokeby Farms, 75 O.W.C. 150 (1996).

    “Cure” is not a continuing obligation. Once an unjustified refusal is cured, the parties are placed in their usual procedural posture, and a claimant seeking additional temporary partial benefits or temporary total benefits when unemployed would only have to prove a change in condition and marketing. For the employer to file an Application to stop benefits, it would have to allege a new refusal, a failure to cooperate, or other legitimate grounds. Newsome v. Food Lion, Inc., 77 O.W.C. 173 (1998).

    Selective Employment Secured by Em- ployee:

    An employer may suspend compensation payments for a refusal of employment only if the work was provided or procured by the employer or its workers’ compensation carrier. Pauley v. Rokeby Farms, 75 O.W.C. 150 (1996).

    Where the employer pays for training for a new job, uses its influence to expedite a temporary license, and defers an offer of work so the employee may train for the similar work he located on his own initiative, the employer has established sufficient contacts with the job search to give it standing when the employee refuses that work. Pauley v. Rokeby Farms, 75 O.W.C. 150 (1996).

    The claimant, who secured appropriate selective employment on his own initiative, was justified in refusing selective work secured thereafter by the employer. While the employer secured position offered a higher wage, the prospect of future earnings was considerably more in the work he obtained on his own. Fantaski v. Arthur H. Fulton, Inc., 62 O.I.C. 165 (1983).

    Where a claimant on her own initiative engaged in a babysitting business at a wage less than her pre-injury employment the employer may continue to seek a selective employment position that would clearly outweigh the economic benefits and physical demands of the claimant’s alternative use of her capacities as a babysitter. Zimmer v. Capital Milk Producers Cooperative, Inc., 66 O.I.C. 123 (1987).

    Where an employee refuses an employer’s offer of selective employment at her pre-injury wage and elects to procure other employment at a lesser wage, she is not entitled to additional compensation benefits because her wage loss is no longer due to incapacity from the industrial accident. Weaver v. Beth Shalom Home of Central Virginia, 65 O.I.C. 229 (1986).

    MARKETING REMAINING CAPACITY. Note: An employee receiving benefits under an outstanding award who is released to light duty work is not required to market any remaining capacity but must cooperate with vocational rehabilitation and accept an offer of selective work within physical restrictions if located by the employer or his agent. An employee who is seeking compensation and is released to light duty must prove a reasonable effort to market remaining capacity during any period for which benefits are sought. See Washington Metro. Area Transit Auth. v. Harrison, 228 Va. 598 , 324 S.E.2d 654, 1985 Va. LEXIS 151 (1985).

    General:

    Rationale of King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133 (2016) inapplicable where only the partially disabled claimant’s selective employment was changed to part-time status and no other employees were affected by the change. Coffman v. Dollar Tree Stores, JCN VA00001141014 (Aug. 15, 2019).

    Deputy Commissioner erred in determining that King William Cnty. v. Jones, 66 Va. App. 531, 551-52, 789 S.E.2d 133, 143 (2016) [cert. denied (May 5, 2017), reh’g denied (June 30, 2017)] applied to this case requiring the claimant to present affirmative evidence that he would have been hired but for his disability. Here, the claimant’s was “a typical case of partial disability,” for which we apply the factors articulated in National Linen Service v. McGuinn, 8 Va. App. 267, 380 S.E.2d 31 (1989). Williams v. Spivey Rentals, JCN VA00000892170 (Sept. 18, 2017) see also Hall v. Dick Harris & Son Trucking, JCN VA00001259861 (Nov. 2, 2017); Sills v. Abacus Corp., JCN VA00001156102 (June 27, 2017).

    The Commission’s Marketing Guidelines are not statutory provisions, but rather a tool to better explain and assess the existence of an adequate marketing effort. Durham v. Swift Transportation Company, Inc., VWC File No. 239-45-99 (July 16, 2010).

    Neither the Commission nor its Marketing Guidelines require an injured worker to predict whether a potential employer has an opening and to only search with those employers with clearly delineated, available positions. Durham v. Swift Transportation Company, Inc., VWC File No. 239-45-99 (July 16, 2010).

    While the Commission’s marketing guidelines provide that a written job search log is recommended, where the claimant found employment within a month of his release to light duty and his testimony concerning his job search efforts was credible, the lack of a written job search log is not fatal to the claim. Reyes v. Winston’s of Northern Virginia, Inc., VWC File No. 233-88-37 (July 23, 2010).

    For a discussion on the admissibility of employer questionnaires as evidence of marketing efforts, see Conner v. Beamon & Johnson, Inc., VWC File No. 240-49-14 (September 10, 2010).

    The Guidelines for Vocational Rehabilitation require professional rehabilitation counselors to pre-screen jobs for suitability. A claimant is not required to pre-screen jobs in order to satisfy his obligation to adequately market his residual physical capacity. Smith v. Dickenson (County of) School Bd., VWC File No. 208-74-32 (May 11, 2005) aff’d No. 1379-05-3 (Ct. App. Va., Oct. 11. 2005) (Unpublished Opinion).

    Because a list of job contacts and the claimant’s deposition are not medical records, they are not part of the record unless they were moved into evidence. Even in on-the-record hearings the entirety of the file does not become part of the record. Owens v. Miners and Merchants Bank and Trust, VWC File No. 219-47-41 (Jan. 10, 2006).

    Employee excused from marketing for approximate 5-week period despite light-duty release; Deputy Commissioner found that claimant, who worked for employer for 30 years, credible; claimant testified he understood he would return to work for employer; claimant had returned to work after earlier injury, and employer stated it could not offer him work at that time. Fleshman v. Weyerhaeuser Co., VWC File No. 202-21-28 (Apr. 29, 2003).

    Where an award has been entered, the burden of proof then shifts to the carrier to establish that the claimant is able to return to his regular work or has been offered appropriate selective employment. Where compensation has been voluntarily paid without an award for 13 months, the burden remains on the carrier. The doctrine of estoppel precludes the carrier from asserting as a defense the claimant’s failure to market his remaining skills. National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187, 4 Va. Law Rep. 1075, 1987 Va. App. LEXIS 239 (1987).

    In an original claim, the claimant must show that he was either totally disabled or that he unsuccessfully marketed his residual capacity. Compensation was denied where evidence failed to show total disability and the claimant did not seek selective employment. Sawyer v. Mathews Masonry Co., 74 O.W.C. 124 (1995).

    If the employee restricts his job search to jobs which he cannot reasonably expect to perform, he may not have made a reasonable effort to market his residual capacity. Harvey v. Dean Steel Erectors Co., 76 O.W.C. 24 (1997).

    The claimant did not unduly restrict her job search by limiting her availability to night shift hours, where she had accepted the pre-injury work with the understanding that it would be for night shift only, to accommodate her child care situation. Stimeling v. The Kroger Company, 76 O.W.C. 138 (1997).

    The fact that an employer pays benefits under the laws of another state does not establish either directly or by inference that the parties have reached an agreement as to the payment of compensation under the Virginia Act. Payment of benefits in another state does not estop the employer from asserting the defense of failure to market remaining capacity. Johnson v. Associated Transportation Services, Inc., 69 O.I.C. 80 (1990).

    The defense of failure to market may be asserted where an employer voluntarily paid compensation to the claimant for three months but did not subsequently accept the claim or stipulate disability. The contesting of the claim distinguishes this case from National Linen Service v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187 (1987); Congleton v. Safeway Stores, Inc., 73 O.W.C. 203 (1994).

    The acceptance of a claim in Maryland is not the acceptance of a claim in Virginia and, therefore, National Linen Service v. McGuinn is not applicable. Lopez v. CLC Construction, 73 O.W.C. 13 (1994).

    Where the employee is under an open award, it is not proper for a vocational consultant to require the employee to market her residual capacity by registering with an employment service and by documenting contact with ten prospective employers each week. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    Since an employer is not required to provide vocational rehabilitation until ordered by the Commission, the employer is not estopped from asserting the defense of failure to market when such services are not provided. Congleton v. Safeway Stores, Inc., 73 O.W.C. 203 (1994).

    An employee whose benefits were terminated for failure to market his remaining capacity was not entitled to disability benefits for a subsequent period in which he was hospitalized to undergo diagnostic testing to determine the extent of incapacity when the test results failed to establish disability. Crystal Oil Co. v. Dotson, 12 Va. App. 1014, 408 S.E.2d 252, 8 Va. Law Rep. 410, 1991 Va. App. LEXIS 201 (1991).

    There is no requirement that an employee immediately register with the V.E.C. upon release to light duty. Such contact must be made within a reasonable time if other efforts at securing appropriate work have proved unsuccessful. Efforts to secure employment must be reasonable, considering all circumstances and do not necessarily have to be on a continuous daily basis. King v. Rinker-Detwiler and Associates, P.C., 71 O.W.C. 258 (1992).

    There is no per se rule barring employee’s with residual skills from receiving benefits under the Workers’ Compensation Act if they fail to register with the VEC. In so doing, the Court noted that each claim must be judged on a case-by-case basis. Herbert Brothers, Inc. v. Jenkins, 14 Va. App. 715, 419 S.E.2d 283, 8 Va. Law Rep. 3539, 1992 Va. App. LEXIS 172 (1992).

    The claimant submitted a list of job contacts, but he did not feel that he was physically capable of performing any of the jobs sought. The Virginia Court of Appeals has noted that a claimant must seek positions that he is physically qualified to perform in order to adequately market his residual capacity. Also, the claimant failed to apply for two openings available with the employer that were within his restrictions. Based on this evidence, the Commission found that the claimant’s marketing efforts were not reasonable. McCullough v. Adelphia, 79 O.W.C. 116 (2000).

    Section 65.2-510 C imposes a strict requirement on the employee to cure an unjustified refusal of selective employment within six months or forever lose any right to receive additional wage loss benefits. The statute encourages an employee who unjustifiably refuses employment to return to work. Implicit in this intent, however, is the expectation that the employee has sufficient knowledge that her actions are considered unjustified so that she may take appropriate action to cure her refusal. Where, as here, the employee was not put on notice that her refusal of selective employment was considered unjustified until the employer’s application was filed, she had six months from the date the application was filed to cure her unjustified refusal. Sigmon v. I A Construction Corp., VWC File No. 173-70-73 (February 16, 2001).

    When Employee Must Market Remaining Capacity:

    Claimant who worked in dissimilar pre-injury job with second employer and returned to full time work only with that employer still was required to market residual work capacity and cooperate with vocational rehabilitation. Crumpton v. City of Danville, JCN VA00001159204 (Apr. 26, 2018).

    Claimant under de facto award not required to market residual work capacity upon release to light duty. Orem v. Donnelly Concrete, Inc., JCN VA00000939277 (Apr. 7, 2017).

    Although claimant was aware of her release to light duty two days prior to the hearing and made no efforts to secure temporary employment during this two-day period, Commission found it unreasonable to expect her to market her residual capacities for such a brief period. Vincent v. Fairfax Cnty. Pub. Schs., JCN VA01002425752 (Aug. 26, 2014).

    Claimant was not required to market his residual capacity during the 23-day period he was released to light duty where he contacted employer and asked for light duty but was declined, testified he expected to return to work with employer, and returned to work for employer. Hughes v. Carry On Truck Repair, Inc., JCN VA02000017503 (Jan. 15, 2015).

    Where a collective bargaining agreement required the employer “as far as practical” to provide light duty work, it was reasonable that for a 3 week period after her surgery the claimant limited her light duty job search to the employer. However, after the employer continued to be unable to provide light duty, an eight week period was not a reasonable period for the claimant to expect to return to pre-injury or light duty work with the employer and she needed to expand her job search in order to establish reasonable marketing of her remaining capacity. Dillard v. Volvo Trucks North America, Inc., VWC File No. 223-89-06 (April 27, 2006).

    During brief period of temporary partial disability, claimant must contact employer to inquire if light duty work is available. Couch v. Dominion Virginia Power, VWC File No. 203-89-55 (Nov. 22, 2004).

    No duty to market during ten week period where claimant was eager to return to work, employer was pleased with claimant’s work and eager for his return, and claimant returned to work shortly after anticipated return date. Temple v. Halls Auto Body, Inc., VWC File No. 215-37-34 (Aug. 2, 2004).

    A claimant is required to market his remaining skills only after the evidence establishes that he is partially disabled and has been informed of his release to selective employment. Church v. Harman Mining Corporation, 66 O.I.C. 19 (1987).

    An employeee not under an open Award has an affirmative duty to market his residual capacity, and this includes a duty to make a reasonable inquiry of his physician to ascertain his capacity for work. Where the employee testified that he sought work at “many” restaurants, there was insufficient proof of marketing efforts. Ruiz v. Abbotts Upholstery, 75 O.W.C. 213 (1996).

    Where the claimant is laid off for economic reasons from his light duty work without being informed as to the anticipated length of the layoff, he has an obligation to market his residual capacity, even if events later show that the period of layoff was short. Evans v. Northshipco, 75 O.W.C. 165 (1996).

    A claimant who is laid off from light duty work for economic reasons must show marketing of remaining capacity when seeking temporary total. After receiving permanent partial benefits, a claimant must show marketing of remaining capacity to receive additional temporary total benefits if released to light duty work. Smith v. Wells Fargo Guard Service, 73 O.W.C. 201 (1994).

    A partially disabled employee who unsuccessfully markets his residual capacity is entitled to increased temporary partial disability benefits when light duty income is reduced for economic reasons. Mays v. Hanson Porcelain Co., Inc., 74 O.W.C. 146 (1995).

    In determining whether an employee has been released to light work, the facts and surrounding circumstances along with the employees perception of his condition, his employability, and the basis for that perception, must be considered. Specific notice by the doctor is not the determinative factor in determining whether an employee must market his residual skills. Ridenhour v. City of Newport News, 12 Va. App. 415, 404 S.E.2d 89, 7 Va. Law Rep. 2559, 1991 Va. App. LEXIS 88 (1991).

    An employee is not required to market remaining capacity during brief periods of partial disability. Holly Farms Foods, Inc. v. Carter, 15 Va. App. 29, 422 S.E.2d 165, 9 Va. Law Rep. 191, 1992 Va. App. LEXIS 231 (1992).

    Where the evidence shows that light duty work was difficult to find, and the employee could reasonably expect his disability to be short lived and that his doctors might consider adjustment of restrictions, at least on a trial basis, the fact that the employee actually found work without assistance from the employer is compelling evidence that he made his job search with the intent of locating employment, and the employee therefore proved he had made reasonable efforts to market his residual work capacity. Harvey v. Dean Steel Erectors Co., 76 O.W.C. 24 (1997).

    A claimant who is released to selective work six days prior to return to regular work has not had a sufficient time to market her remaining skills. Younger v. Ennis Business Forms, Inc., 66 O.I.C. 114 (1987).

    A claimant had no obligation to market his remaining capacity if he was specifically advised by his treating physician that he was unable to return to any work. However, if a claimant returned to work activity and the medical evidence demonstrated only partial incapacity, then a reasonable effort to market his remaining capacity must be established. Petrunak v. Clark Window Products, 68 O.I.C. 179 (1989).

    A medical release to perform light “supervisory” work does not provide a claimant with specific restrictions such as to enable him to engage in a thorough job search. Lopez v. CLC Construction, 73 O.W.C. 13 (1994).

    An employee has made a reasonable and successful effort to market his remaining capacity and has no obligations to seek other employment at a higher wage when he obtains work with his pre-injury employer of ten years at wages approximating his pre-injury wages. Russell v. Norris Trim, 71 O.W.C. 270 (1992).

    An employee who, after returning to selective employment, is laid off for economic reasons, must establish a reasonable effort to market his remaining capacity before additional compensation benefits will be awarded. Maney v. Gunther-Nash Mining Construction Co., 69 O.I.C. 176 (1990).

    Where an employee is seeking reinstatement of compensation benefits following an economic layoff from a light duty position, anticipation of being recalled by the employer is not justification for failure to market remaining capacity. Hall v. C.R. Hudgins Plating, Inc., 70 O.I.C. 237 (1991).

    An employee’s loss of selective employment through no fault of his own is a change in condition entitling him to a resumption of compensation benefits if he is partially disabled and has made a reasonable effort to market his remaining work capacity. Huffman v. Toney Arey Trucking, 70 O.I.C. 85 (1991).

    Although the Commission did not find the employee’s expectation of a return to work with the employer inconsistent or unreasonable, it denied his claim for temporary total disability benefits. The Commission has excused marketing where the disability period is relatively brief, and where the employee has a reasonable expectation of returning to his job. Even under those circumstances, however, the employee has an obligation to contact the employer to see if light duty work is available. Because he failed to contact the employer during the disputed period, the Commission found that he was not eligible for compensation benefits. Maloney v. Pepsi-Cola Bottling Company of Virginia, VWC File Nos. 191-76-24 and 198-42-77 (March 14, 2001).

    Effect of Pre-existing Condition on Marketing:

    Having hired the claimant with an obvious pre-existing condition that caused a speech difficulty, the employer cannot claim that the condition should not be considered in determining his current residual capacity. James v. Capitol Steel Construction Co., 8 Va. App. 512, 382 S.E.2d 487, 6 Va. Law Rep. 121, 1989 Va. App. LEXIS 99 (1989).

    The claimant, who could not satisfactorily perform selective work because of a pre-accident glaucoma condition, was entitled to resume temporary total benefits upon establishing an attempt to market his remaining capacity. Orange v. Tidewater Construction Corp., 68 O.I.C. 167 (1989).

    The employer remains liable for compensation benefits where an employee would be able to return to selective work except for a pre-existing back injury that was aggravated by the accident and is now disabling. Alonzo v. Dittmar Company, 71 O.W.C. 281 (1992).

    Examples:

    Given claimant’s lack of transferable work skills, the limited pool of available jobs on the Eastern Shore, and documented efforts, claimant’s marketing efforts were reasonable for period awarded. Claimant sought light duty work at a variety of places, including convenience stores, retail stores, motels, a laundry, a trucking company, automotive companies, and fast food and other restaurants, evidencing a serious effort to find employment. Somers v. Northampton Cty., JCN VA02000014429 (Mar. 2, 2015).

    Although the employee was released to a five-day work week, he reasonably marketed his remaining capacities by procuring a part-time position when full time employment within his medical restrictions could not be located. Harris v. Varina Bi Rite Food Store, 71 O.W.C. 90 (1992).

    Adequate marketing efforts cannot be limited to employment opportunities that have the same work hours as those of the pre-injury employment. Edwards v. Ramada Hotel Tyson/Richfield Hotel, 74 O.W.C. 216 (1995).

    After noting that the claimant sought only jobs for which he was not qualified by education, experience or physical limitations, the Court found that he had failed appropriately to market his remaining skills. Great Atlantic & Pacific Tea Co. v. Bateman, 4 Va. App. 459, 359 S.E.2d 98, 4 Va. Law Rep. 168, 1987 Va. App. LEXIS 199 (1987).

    An employee who accepted employment without regard to the salary but because of interest in the type of work and who made no other effort to explore the employment market, such as registering with the V.E.C., contacting employment agencies, or consulting newspaper classified ads, is not entitled to temporary partial disability benefits because he failed reasonably to market his residual skills. Cooper v. Loudoun County Sheriff ’s Dept., 69 O.I.C 180 (1990).

    Claimant was not entitled to compensation benefits during the period he failed to market his remaining skills because of time limitations imposed by the pursuit of a degree in geology. Rier v. Bradlees, 65 O.I.C. 211 (1986).

    Where an employee’s pre-injury construction position required out of town work, the employee may not limit his search for selective employment to a specific localized geographical area. Maney v. Gunter — Nash Mining Construction Company, 69 O.I.C. 176 (1990).

    Illegal Alien (see selective employment notes in above section).

    Where a claimant was placed on work restrictions for three weeks and anticipated returning to regular work with his preinjury employer, he made reasonable effort to market his remaining skills when he contacted his employer seeking selective work. St. Clair v. Kenan Transport Company, 67 O.I.C. 49 (1988).

    An employee who returns to his pre-injury dissimilar part-time employment has marketed his remaining capacity and is entitled to an award for temporary partial incapacity. City of Fairfax v. Massey, 11 Va. App. 680, 401 S.E.2d 439, 7 Va. Law Rep. 1578, 1991 Va. App. LEXIS 24 (1991).

    The claimant marketed his remaining capacity where the vocational rehabilitation counselor identified jobs for which he was qualified but was unable successfully to obtain employment. Moore v. Virginia International Terminals, Inc., 73 O.W.C. 46 (1994).

    After claimant’s work injury in evening hours employment, she also lost her dissimilar daytime job. The Commission did not agree that work she later found was a replacement for her second employment, rather than the results of successful marketing efforts following the work accident, and the wages earned were considered to determine the amount of any wage loss attributable to the work injury. Edwards v. Ramada Hotel Tyson/Richfield Hotel, 74 O.W.C. 216 (1995).

    For cases relating to refusal of vocational rehabilitation efforts see § 65.2-603 .

    The Commission found that the employee failed to market his residual work capacity appropriately. He testified that he made two job contacts per week. He called his union shop once per week, and placed one job application per week. He testified that he was able to market his capacity more aggressively, but did not do so because he was told by the Virginia Employment Commission (VEC) that these two job contacts per week were sufficient. The Commission held that compliance with VEC requirements does not establish, by itself, appropriate marketing efforts, and agreed that the claimant’s efforts were grossly inadequate. Miller v. Norfolk Shipbuilding & Drydock Corp., VWC File No. 195-65-79 (July 23, 2001).

    The Commission found that the employee’s limited marketing efforts were not reflective of those that would be employed by a reasonable person truly seeking employment. The employee’s only work limitation was a lifting restriction of 20-pounds with his non-dominant left hand. Over a 20-workday period, the employee made only one job contact on each of eight days, and made three job contacts on a ninth day. Proof of three job contacts per week is not, as a matter of law, a sufficient marketing effort under the Act. Farmer v. Buchanan Production, Co., Inc., VWC File No. 198-67-97 (January 8, 2001).

    The Commission found that the self-employed claimant did not satisfy his obligation to market his residual work capacity. The claimant, an accountant, was highly educated, with extensive job skills and experience. He preferred to remain self-employed, but the evidence established that he could make at least $15 to $20 per hour working for someone else, while his income from self-employment was significantly less than that. The Commission found his marketing efforts insufficient, noting that the insurer should not be the “guarantor” of the claimant’s pre-injury wage earning capacity when he has limited his post-injury wages by continuing only with marginally profitable self-employment activity. Miles v. Franklin A. Miles and Company, VWC File No. 147-11-61 (March 27, 2001).

    § 65.2-510.1. Employee imprisonment; suspension of benefits.

    1. Whenever an employee is imprisoned in a jail, state correctional facility, or any other place of incarceration and (i) the imprisonment resulted from the employee’s conviction of a criminal offense and followed his sentencing therefor by a court of competent jurisdiction, (ii) the employee is receiving compensation for temporary total incapacity pursuant to § 65.2-500 or temporary partial incapacity under § 65.2-502 , and (iii) the employee is medically released to perform selective employment, compensation benefits for wage loss shall be suspended under § 65.2-708 upon filing of a proper application to the Commission.
    2. If benefits are suspended for incarceration pursuant to this section and the employee’s conviction is subsequently reversed on appeal and no further appeals or prosecutions concerning such prior conviction are had, the employee’s benefits shall be restored under § 65.2-708 upon filing of a proper application to the Commission.
    3. The provisions of this section shall only apply to an employee who receives a workers’ compensation award after July 1, 1992.

    History. 1992, c. 466.

    CASE NOTES

    Doctrine of imposition improperly invoked. —

    Without seeking an order from the Virginia Workers’ Compensation Commission, the fund ceased paying the claimant his benefits because the fund was informed that the claimant was incarcerated. Upon entry of the temporary partial disability award, the claimant became vested with the right to receive compensation benefits because the award remained outstanding and he violated no duty imposed by the Commission’s rules and the Act; thus, the Commission improperly invoked the doctrine of imposition to uphold the fund’s unilateral suspension of benefits in violation of Va. Workers’ Comp. Comm’n R. 1.4(C). Uninsured Employer's Fund v. Peters, 43 Va. App. 731, 601 S.E.2d 687, 2004 Va. App. LEXIS 417 (2004).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Disability compensation may be suspended when an employee who is capable of performing selective employment is incarcerated. Steelman v. R. L. Rider & Company, 75 O.W.C. 261 (1996).

    Where jail confinement is not the result of conviction of a crime, compensation is payable. Knight v. Whitacre, 47 O.I.C. 197 (1965).

    Code § 65.2-510.1 provides that compensation benefits for wage loss shall be suspended whenever a partially disabled employee is imprisoned in a jail. Once suspended, a resumption of benefits is not automatic or self-executing upon release from incarceration. The claimant is required to prove that he is entitled to a resumption of benefits. Goddard v. Albrite Engine Works, 78 O.W.C. 256 (1999).

    Where a claimant is medically released to selective work, subsequent incarceration is a removal from the labor force. Baskerville v. Saunders Oil Co., 1 Va. App. 188, 336 S.E.2d 512, 1985 Va. App. LEXIS 83 (1985).

    An award for temporary total benefit may not be terminated solely on the grounds that the claimant was incarcerated. An employer has the burden to prove that the claimant was only partially incapacitated or refused an independent medical examination. Escobar v. L. M. Sandler & Sons, Inc., 68 O.I.C. 206 (1989).

    Code § 65.2-510.1 sets forth the provisions for the suspension of benefits when a claimant is imprisoned and is medically released to perform selective employment, upon filing of a proper application to the Commission. A proper application under Code Ann. § 65.2-708 requires compliance with Rule 1.4(C). Campbell v. Perdue Foods, Inc., 76 O.W.C. 157 (1997).

    Where the employer alleges that the employee was released to return to light duty and that he is incarcerated, compensation must be paid through the date the Employer’s Application For Hearing is filed, or it will be rejected. Campbell v. Perdue Foods, Inc., 76 O.W.C. 157 (1997).

    Compensation was terminated when penitentiary confinement prevented employer from offering selective work (King v. Trinkle, 47 O.I.C. 188 (1965); Faison v. Tishman, 47 O.I.C. 107 (1965); Revis v. Byrums, 4 O.I.C. 196 (1922)) or claimant from accepting selective work (Vann v. Babb, 47 O.I.C. 347 (1965)), or keeping medical appointment. (Crigler v. Shenandoah, 47 O.I.C. 89 (1965)).

    Incarceration pending a trial on criminal charges was found to be justification for failure to keep a scheduled medical appointment. Polly v. Servisco, 64 O.I.C. 261 (1985).

    Where claimant was in jail on appointment date and the judge refused him transportation, claimant did not unjustifiably refuse to report for medical examination. Blankenship v. Giles, 46 O.I.C. 23 (1964).

    A claimant who is precluded from receiving temporary partial compensation benefits because of incarceration is not entitled to temporary total benefits when surgery as a result of the industrial accident renders him unable to work. Jones v. D & F Plumbing, Heating and Repair, 67 O.I.C. 220 (1988). Subsequent to this case, the legislature enacted § 65.2-510.1 . In interpreting this statute, the Commission in Garrison v. MSJ Construction Company, Inc., VWC File No. 167-38-59 (June 28, 1996) found that an incarcerated claimant who became totally disabled could receive temporary total benefits .

    See also Notes to § 65.2-712 .

    § 65.2-511. Compensation to employee’s distributees upon his death from any other cause.

    When an employee receives or is entitled to compensation under this title for an injury covered by § 65.2-503 and dies from a cause other than the injury for which he was entitled to compensation, payment of the unpaid balance of compensation shall be made to his statutory dependents under this chapter, in lieu of the compensation the employee would have been entitled to had he lived. However, if the death is due to a cause that is compensable under this title and the dependents of such employee are awarded compensation therefor, all right to unpaid compensation provided by this section shall terminate.

    History. Code 1950, § 65-61; 1968, c. 660, § 65.1-64; 1991, c. 355.

    Law Review.

    For survey of Virginia law on governmental services and social welfare for the year 1977-1978, see 64 Va. L. Rev. 1461 (1978).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 46.

    CASE NOTES

    Dependent’s entitlement to scheduled benefits not claimed during employee’s lifetime. —

    This section permits a deceased employee’s dependents to collect the scheduled permanent partial loss benefits to which the employee was entitled at the time of his death, even though the employee had not made a claim for scheduled benefits and would also have qualified for permanent and total incapacity benefits. Thomas Refuse Serv. v. Flood, 30 Va. App. 17, 515 S.E.2d 315, 1999 Va. App. LEXIS 319 (1999).

    Employee not entitled to compensation. —

    Where the employee’s arm injury had not reached maximum medical improvement at the time of his death, the employee could not have been rated for benefits under former § 65.1-56 (now § 65.2-503 ), and he was not “entitled to compensation” for the injury within the meaning of this section. County of Spotsylvania v. Hart, 218 Va. 565 , 238 S.E.2d 813, 1977 Va. LEXIS 292 (1977) (decided under former § 65.1-64).

    Widow not entitled to benefits. —

    Credible evidence supported the commission’s factual finding that the widow was not a dependent as defined in subdivision A 1 of § 65.2-515 and was not entitled to an award of death benefits because at the time of the decedent’s death, the widow was neither receiving nor relying upon any financial support from the decedent; § 65.2-511 only authorized an award to a statutory dependent, and did not authorize the award of benefits to someone that did not fall into that category. The right of statutory dependents under § 65.2-511 to receive an award terminated if the decedent’s death was caused by a compensable injury and the statutory dependents had already received compensation, e.g., death benefits under § 65.2-512 . Runyon v. CBS Constr. Co., 2011 Va. App. LEXIS 64 (Va. Ct. App. Feb. 22, 2011).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Cross reference. — If death is due to a compensable cause survivors may be eligible for benefits under § 65.2-512 .

    Who is Eligible for Benefits:

    Commission dismissed estate’s claim for permanent partial disability benefits holding that the General Assembly specifically excluded workers’ compensation benefits from the general rules of descent and distribution under Title 64.2. § 65.2-511 does not create a right to benefits in someone other than a statutory dependent. Frankenberg v. Century Tile, Inc., VA0000048431 (Oct. 10, 2014).

    If an employee is entitled to compensation and dies from a cause other than the compensable injury, payment of the unpaid balance of compensation is made to his statutory dependents under the Workers’ Compensation Act. The right of a dependent to obtain unpaid compensation is determined by the facts as of the date of the work accident, not as of the date of death. Roberson v. Ice Follies, 75 O.W.C. 143 (1996).

    Child of deceased employee entitled to same conclusive presumption of total dependency under this section as if employee died as result of injury. Selph v. Univ. of Richmond, 56 O.I.C. 287 (1974).

    Award Under § 65.2-503 May Be Made Af- ter Death:

    Where employee was still drawing compensation for temporary total incapacity at the time of his death from another cause, or for any other reason his rights under § 65.1-56 (now § 65.2-503 ) were never determined, statutory dependents under workers’ compensation act may apply for a hearing to enforce their rights under this section. Stone v. Va. Lincoln Furniture Co., 24 O.I.C. 463, 589 (1942); Delph v. Va. Iron, Coal & Coke Co., 23 O.I.C. 54, 166 (1941); Jarvis v. Gayle, 20 O.I.C. 274, 310 (1938); Phillips v. Benson-Phillips Co., Inc., 14 O.I.C. 197 (1932).

    Entitlement to permanent partial disability benefits survives the claimant’s death. That is, the employee’s dependents may receive the permanent partial benefits to which the employee would have been entitled, had he not died. Flood v. Thomas Refuse Service, 77 O.W.C. 170 (1998).

    Benefits for permanent total disability do not survive the death of an employee from causes unrelated to his work accident. Such benefits only “continue for the lifetime of the injured employee.” Flood v. Thomas Refuse Service, 77 O.W.C. 170 (1998).

    The employee was a total quadriplegic when he died, and therefore met the requirements for permanent and total disability under § 65.2-503 (C). However, although the employee was eligible for benefits under § 65.2-503 (C)(2), he never was awarded those benefits, and the provision of § 65.2-511 limiting such benefits for the employee’s lifetime did not apply. Because the claimant’s award had not been converted to an award for permanent and total benefits before his death, his dependents are in the same legal posture as dependents of other employees who were receiving benefits for temporary total disability. If the employee was receiving compensation for temporary total disability at the time of his death from another cause, and for any reason his rights under § 65.2-503 were never determined, the dependent distributees could enforce their rights under § 65.2-511 . Flood v. Thomas Refuse Service, 77 O.W.C. 170 (1998).

    Past Due Benefits Payable to Estate:

    A claimant’s estate may recover temporary total disability benefits to which the claimant was entitled before death. Estate of Giers v. Francis N. Sanders Nursing Home, Inc., VWC File No. 200-72-25 (Jan. 30, 2008), aff’d, No. 0332-0801 (Ct. of Appeals, June 3, 2008, unpublished).

    A claim for temporary total benefits is not abated by the claimant’s intervening death. Any benefits accrued prior to the death are payable to the decedent’s personal representative for the estate and not to dependents. Carr v. Inova Alexandria Hospital, VWC File No. 196-10-72 (June 5, 2007).

    Compensation payments due during the lifetime of employee but unpaid whether awarded under § 65.1-56 (now § 65.2-503 ) or otherwise, are payable to his personal representative. Watson v. Cannon Constr. Co., 55 O.I.C. 365 (1973); Hamilton v. Big Branch Coal Co., 52 O.I.C. 128 (1970).

    Section 65.2-511 permits a claim for permanent partial disability benefits to survive the death of a claimant, but the Act does not contain a specific provision allowing a claim for unpaid temporary total benefits to survive the death of the injured worker. However, the Commission found that long-standing precedent allowed a claimant’s estate to recover temporary total disability benefits and related expenses to which the claimant was entitled before death. Echols v. Rite Aid Corporation, 78 O.W.C. 16 (1999).

    § 65.2-512. Compensation to dependents of an employee killed; burial expenses.

    1. Except as provided in subsections F, G and H, if death results from the accident within nine years, the employer shall pay, or cause to be paid, compensation in weekly payments equal to 66 and two-thirds percent of the employee’s average weekly wages, but not more than 100 percent of the average weekly wage of the Commonwealth as defined in § 65.2-500 nor less than 25 percent of the average weekly wage as defined therein:
      1. To those persons presumed to be wholly dependent upon the deceased employee as set forth in subdivisions A 1 and 2 of § 65.2-515 , for a period of 500 weeks from the date of injury; or
      2. If there are no total dependents pursuant to subdivision A 1 or 2 of § 65.2-515 , to those persons presumed to be wholly dependent as set forth in subdivision A 3 of § 65.2-515, and to those determined to be wholly dependent in fact, for a period of 400 weeks from the date of injury; or
      3. If there are no total dependents, to partial dependents in fact, for a period of 400 weeks from the date of injury.
    2. The employer shall also pay burial expenses not exceeding $10,000 and reasonable transportation expenses for the deceased not exceeding $1,000.
    3. Benefits shall be divided equally among total dependents, to the exclusion of partial dependents. If there are no total dependents, benefits shall be divided among partial dependents according to the dependency of each upon the earnings of the employee at the time of the injury, in the proportion that partial dependency bears to total dependency.
    4. If benefits are terminated as to any member of a class herein, that member’s share shall be divided among the remaining members of the class proportionately according to their dependency.
    5. When weekly payments have been made to an injured employee before his death, the compensation to dependents shall begin from the date of the last of such payments but shall not continue for a period longer than specified in subsection A.
    6. No benefits shall be paid pursuant to this section to the dependents of an AmeriCorps member as defined in subdivision 1 r of the definition of “employee” in § 65.2-101 .
    7. No benefits shall be paid pursuant to subsection A, C, D, or E to the dependents of a Food Stamp recipient participating in the work experience component of the Food Stamp Employment and Training Program as defined in subdivision 1 s of the definition of “employee” in § 65.2-101 .
    8. No benefits shall be paid pursuant to subsection A, C, D, or E to the dependents of a Temporary Assistance for Needy Families recipient participating in the work experience component of the Virginia Initiative for Education and Work as defined in subdivision 1 t of the definition of “employee” in § 65.2-101 .

    History. Code 1950, §§ 65-62, 65-65, 65-67; 1952, c. 226; 1954, c. 654; 1956, c. 243; 1958, c. 568; 1960, c. 556; 1962, c. 503; 1964, c. 94; 1966, c. 64; 1968, cc. 8, 660, §§ 65.1-65, 65.1-68, 65.1-70; 1970, cc. 470, 643; 1972, c. 229; 1973, cc. 401, 542; 1974, c. 560; 1975, c. 447; 1976, c. 166; 1981, c. 247; 1984, c. 409; 1985, c. 35; 1991, c. 355; 1992, cc. 2, 147; 1998, c. 100; 2004, c. 888; 2005, c. 472; 2019, c. 210; 2020, c. 900.

    Cross references.

    As to payments for burial expenses under the Line of Duty Act, see § 9.1-402.1 . As to amount of victim compensation award, see § 19.2-368.11:1 .

    The 1998 amendment, in subsection B, substituted “expenses not exceeding $10,000” for “expenses not exceeding $5,000,” and substituted “deceased not exceeding $1,000” for “deceased not exceeding $500.”

    The 2004 amendments.

    The 2004 amendment by c. 888, effective April 15, 2004, inserted “Except as provided in subsections F and G” in subsection A and added subsections F and G.

    The 2005 amendments.

    The 2005 amendment by c. 472 substituted “subsections F, G and H” for “subsections F and G” in subsection A; and added subsection H.

    The 2019 amendments.

    The 2019 amendment by c. 210 substituted “Virginia Initiative for Education and Work” for “Virginia Initiative for Employment Not Welfare Program” in subsection H.

    The 2020 amendments.

    The 2020 amendment by c. 900 substituted “66 and two-thirds percent” for “66 2/3 percent” in the introductory language of subsection A; substituted “subdivisions A 1 and 2” for “subdivisions A 1, A 2, and A 3” in subdivision A 1, substituted “subdivision A 1 or 2” for “subdivision A 1, A 2, or A 3” and “subdivision A 3” for “subdivision A 4” in subdivision A 2; in subsection E, deleted “of this section” at the end; in subsection F, substituted “subdivision 1 of the definition of ‘employee’ in” for “subdivision r of”; in subsections G and H, substituted “subsection” for “subsections” once each per subsection; in subsection G, substituted “subdivision 1 s of the definition of ‘employee’ in” for “subdivision s of”; and in subsection H, substituted “subdivision 1 t of the definition of ‘employee’ in” for “subdivision t of.”

    Law Review.

    For article on damages recoverable for wrongful death, see 5 U. Rich. L. Rev. 213 (1971).

    For article on compensation for black lung at the federal level, see 57 Va. L. Rev. 97 (1971).

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    For an article relating to the most significant developments in the law of workers’ compensation since September 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    Research References.

    Virginia Forms (Matthew Bender). No. 5-172 Divorce Decree Reflecting Contested Equitable Distribution Issues.

    Michie’s Jurisprudence.

    For related discussion, see 1B M.J. Aliens, § 11; 21 M.J. Workers’ Compensation, §§ 47, 73.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-65 or prior law.

    Children born long after the accident, are not dependent upon their father at the time of his accident, within the meaning of this section. Hatton, Brown & Co. v. Holbrook, 159 Va. 224 , 165 S.E. 403 , 1932 Va. LEXIS 184 (1932).

    Payments to widow and children begin from date of last payment to claimant. —

    Where an employee who is receiving compensation under the Workmen’s (now Workers’) Compensation Act dies from injuries suffered in the accident for which he was receiving compensation under the Act, compensation to his widow and dependent children shall begin from the date of the last payment to the claimant himself prior to his death, and continue for the remainder of the period from the date of the injury. Payment to the dependents commences where payment to the claimant left off. Hatton, Brown & Co. v. Holbrook, 159 Va. 224 , 165 S.E. 403 , 1932 Va. LEXIS 184 (1932).

    Citizens of Puerto Rico are citizens of United States. —

    Puerto Rico is one of the “territories” and is a part of the “United States” as defined by § 1-13.31 [see now § 1-255 ], and its citizens and residents are citizens and residents of the United States within this section. Alphonse Custodis Chimney Constr. Co. v. Molina, 183 Va. 512 , 32 S.E.2d 726, 1945 Va. LEXIS 197 (1945).

    Required proof. —

    A claimant for death benefits under this section is required to prove a causal connection between the accident and the subsequent death by a preponderance of the evidence. Lilly v. Shenandoah's Pride Dairy, 218 Va. 481 , 237 S.E.2d 786, 1977 Va. LEXIS 277 (1977).

    A claimant for death benefits under this section must prove that the employee’s death arose out of and in the course of the employment. Carlson v. Department of Military Affairs, 26 Va. App. 600, 496 S.E.2d 107, 1998 Va. App. LEXIS 91 (1998).

    While the wife and the decedent had entered into a written settlement agreement to resolve their respective rights and duties, the overwhelming, uncontroverted evidence clearly demonstrated that the wife relied on the decedent for her reasonable necessaries at the time of his death; therefore, the wife was an “actual dependent” of the decedent under subdivision A 1 of § 65.2-515 who was entitled to death benefits under § 65.2-512 . Sifford v. Sifford, 58 Va. App. 722, 716 S.E.2d 128, 2011 Va. App. LEXIS 305 (2011).

    Fewer than three employees. —

    Dismissal of worker’s compensation claim brought under subsection A of § 65.2-512 was affirmed where the employer presented evidence in the form of corporate minutes that it had fewer than three employees at the time of the claimant’s injury. Estate of Pelfrey v. Sorah, 2003 Va. App. LEXIS 387 (Va. Ct. App. July 8, 2003).

    Appellate court did not have jurisdiction over the claim made by the decedent’s estate for death benefits pursuant to § 65.2-512 of the Virginia Workers’ Compensation Act, § 65.2-100 et seq.; in order for decedent to have been an employee whose estate was eligible for death benefits, the employer had to have had three employees “regularly in service” in the Commonwealth at the time of the death of decedent, pursuant to § 65.2-101 , and the employer only had two such employees, including decedent himself. Uninsured Employer's Fund v. Gabriel, 272 Va. 659 , 636 S.E.2d 408, 2006 Va. LEXIS 98 (2006) (reversing 47 Va. App. 95, holding that evidence in the record did not support a finding that the Commission had jurisdiction.).

    No employment for 52 weeks prior to death. —

    Statutory beneficiaries were not entitled to benefits under the statute where: (1) the deceased employee voluntarily retired in 1993, (2) he was not employed at the time of his death in 1996, (3) he had not earned wages during the 52 weeks immediately preceding the communication of the diagnosis of his occupational disease or during the 52 weeks immediately preceding his death, and (4) he was not actively seeking employment at the time of his death. Newton v. Fairfax County Police Dept., 1999 Va. App. LEXIS 242 (Va. Ct. App. Apr. 27, 1999), aff'd, 259 Va. 801 , 529 S.E.2d 794, 2000 Va. LEXIS 80 (2000).

    Indemnity benefits are awarded to compensate for the economic loss sustained by an employee suffering from a work-related injury or by his statutory beneficiaries in the case of his work-related death and, where an employee has earned no wages during the 52 weeks preceding his death or the 52 weeks preceding the communication of the diagnosis of his occupational disease, there has been no economic loss and there is no basis for awarding indemnity benefits to the employee’s statutory beneficiaries. Newton v. Fairfax County Police Dep't, 259 Va. 801 , 529 S.E.2d 794, 2000 Va. LEXIS 80 (2000).

    Effect of preexisting heart condition. —

    Assuming that at the time of the accident the deceased was suffering from a heart condition which may have been congenital, this alone does not defeat his right to compensation. Lilly v. Shenandoah's Pride Dairy, 218 Va. 481 , 237 S.E.2d 786, 1977 Va. LEXIS 277 (1977).

    Compensable heart attack contributing to second fatal attack. —

    Where a claimant has suffered a heart attack which arose out of and in the course of his employment and which is determined to have been a producing or contributing factor in the second fatal heart attack, regardless of whether the second incident itself is compensable, death benefits are available to the dependent distributees under this section. Lilly v. Shenandoah's Pride Dairy, 218 Va. 481 , 237 S.E.2d 786, 1977 Va. LEXIS 277 (1977).

    Widow not entitled to death benefits. —

    Credible evidence supported the commission’s factual finding that the widow was not a dependent as defined in subdivision A 1 of § 65.2-515 and was not entitled to an award of death benefits because at the time of the decedent’s death, the widow was neither receiving nor relying upon any financial support from the decedent; § 65.2-511 only authorized an award to a statutory dependent, and did not authorize the award of benefits to someone that did not fall into that category. The right of statutory dependents under § 65.2-511 to receive an award terminated if the decedent’s death was caused by a compensable injury and the statutory dependents had already received compensation, e.g., death benefits under § 65.2-512 . Runyon v. CBS Constr. Co., 2011 Va. App. LEXIS 64 (Va. Ct. App. Feb. 22, 2011).

    Recovery not found for National Guard enlistee’s dependents. —

    Dependents of enlisted member of National Guard killed in traffic accident on public highway when returning to base from home for second day of inactive duty training could not recover workers’ compensation death benefits because deceased was not performing any task of employment at time of his death and therefore death did not arise out of and in the course of employment. Carlson v. Department of Military Affairs, 26 Va. App. 600, 496 S.E.2d 107, 1998 Va. App. LEXIS 91 (1998).

    Time limitations. —

    Widow’s claim before the Virginia Workers’ Compensation Commission for death benefits following the death of her husband was properly denied because the husband’s death occurred more than nine years after his compensable accident. Sturtz v. Chesapeake Corp., 38 Va. App. 672, 568 S.E.2d 381, 2002 Va. App. LEXIS 495 (2002).

    CIRCUIT COURT OPINIONS

    Section not applicable. —

    There was no basis for jurisdiction by the workers’ compensation commission because the employee and the employer never had a disagreement about compensation, the employee was not under a disability at the time of his death, and no compensation could be awarded because the employee had no dependents. Neither the policy behind the Workers’ Compensation Act nor its jurisdictional basis provided a statutory framework for resolution of the claims under the Act. Skopic v. Tate, 2009 Va. Cir. LEXIS 132 (Fairfax County Nov. 18, 2009).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Limitations Period for Filing Claim:

    Where employee filed no claim within the time period of § 65.1-87 (now § 65.2-601 ) for an accident, or § 65.2-406 for an occupational disease, his dependents have no claim. Winston v. City of Richmond, 196 Va. 403 , 83 S.E.2d 728 (1954); Butler v. Prince William County School Board, 44 O.I.C. 28 (1962); Dempsey v. City of Alexandria, 43 O.I.C. 28 (1961).

    The claimant died from unrelated causes prior to the evidentiary hearing. The employer argued that it would be severely prejudiced if the claim was allowed, because it could not cross-examine the claimant. The Commission disagreed that the contested issues could not be decided without the claimant’s testimony, since the Act’s liberal hearsay rule would allow the evidence to be presented through the testimony of other witnesses and other evidence in the record. The Commission acknowledged that the absence of a significant witness would affect the quality of the evidence in the record, but that such an obstacle was not so critical as to render the proceedings fundamentally unfair. Echols v. Rite Aid Corporation, 78 O.W.C. 16 (1999).

    The requirements of § 65.1-99 (now § 65.2-708 ) must also be satisfied in passing on the merits of the claim of dependents. The widow’s claim was barred where employee’s change in condition did not occur until more than one year (now two years) from date of last payment of compensation. Hinton v. Va. Smelting Co., 45 O.I.C. 109 (1963).

    Dependents of employee can have no greater right than employee himself. Hinton v. Va. Smelting Co., 45 O.I.C. 109 (1963).

    Burden of Proof:

    Burden of proof is on claimant to show causal connection by a preponderance of the evidence. When it is established that accident played a part in producing death or activated or accelerated a pre-existing disease which became the direct cause of death, causal connection is shown. Rogers v. Williams, 196 Va. 39 , 82 S.E.2d 601, 1954 Va. LEXIS 198 (1954).

    Burial Expense:

    Where deceased and his fellow employees had a burial insurance fund which was used to pay his burial expenses, the employer or his insurer must pay the statutory amount to the widow. Little v. Panther Coal Co., 21 O.I.C. 147 (1939).

    Retirement benefits are not earnings for the purpose of establishing an average weekly wage. They do not represent earnings from employment. If the decedent had been employed at the time of his death, retirement income would not have been includable for purposes of establishing an average weekly wage. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    The purpose of weekly death benefits, based on the decedent’s average weekly wage, is to replace the wages lost to the dependents as a result of the death. No indemnity benefits should be awarded if the decedent had no income for the 52 weeks preceding the communication of the diagnosis of an occupational heart disease. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Where there was a complete absence of earnings during the 52 weeks preceding death or communication of a diagnosis of an occupational heart disease, there are no earnings upon which an average weekly wage can be established to award weekly compensation benefits to statutory beneficiaries. The Commission distinguished Roller v. Basic Construction Company, 238 Va. 321 , 384 S.E.2d 323 (1989), as a case applying a statutory amendment to Code § 65.2-406 (C) pertinent only to asbestosis claims. Newton v. Fairfax County Police Dept., 77 O.W.C. 183 (1998).

    Calculating Benefits:

    If employee left a total dependent there can be no award in favor of a partial dependent. Am. Motorists Ins. Co. v. Summers, 183 Va. 428 , 32 S.E.2d 673 (1945); Gaddy v. Withers, 50 O.I.C. 148 (1968).

    Partial dependent cannot share in award with those wholly dependent: public policy prevents award to partially dependent common-law wife. Award made to mother of decedent. Ford v. American Original Foods, Inc., 58 O.I.C. 131 (1979). (Affirmed on issue of jurisdiction, 221 Va. 557 , 272 S.E.2d 187 (1980)).

    A partner in a common law marriage is precluded from qualifying as a dependent under either § 65.1-66 (now § 65.2-515 ) or § 65.1-67 (now § 65.2-516 ). However, the common law partner’s son from a previous marriage may be awarded proportional benefits if partial dependency can be established. Wingfield/Dawson v. Thomas Roofing, 65 O.I.C. 309 (1986).

    Where claimant receives some part of the amount necessary for support from a source other than the earnings of deceased employee and is, therefore, only partially dependent, the Commission determines the percentage of such total amount contributed by deceased workman and allows that portion of the amount which would have been due had claimant been a total dependent. Wright Motor Co. v. Steinhilber, 157 Va. 793 , 162 S.E. 192 (1932); Sullivan v. Va. Smelting Co., 16 O.I.C. 42 (1934); Whitt v. Pocahontas Corp., 9 O.I.C. 1072, 10 O.I.C. 82 (1928).

    A partial dependent is not limited in his recovery to the amount of actual contributions made by decedent to his support during his lifetime. Briggs v. Webb, 37 O.I.C. 210 (1955).

    If the person wholly dependent ceases to be entitled to the compensation benefits during the 300 (now 500) week period, as in the case of a child becoming eighteen years of age, a partial dependent may claim compensation. Gaylord v. City of Norfolk, 1 O.I.C. 101 (1919).

    § 65.2-513. Compensation for death from coal worker’s pneumoconiosis; determining whether death was due to pneumoconiosis or any chronic occupational lung disease.

    1. If death results from coal worker’s pneumoconiosis or if the employee was totally disabled by coal worker’s pneumoconiosis at the time of his death and claim for compensation is made within three years after such death, the employer shall pay or cause to be paid to the surviving spouse of the deceased employee until his death or remarriage or the minor dependents of the employee until such minor dependents reach the age of eighteen (or twenty-three, so long as they remain as full-time students in a generally accredited institution of learning) or such other legal dependents as the deceased employee might have had at the time of his death for the duration of such dependency, 66 2/3 percent of the employee’s average weekly wage during the last three years that he worked in the coal mines, up to 100 percent of the average weekly wage of the Commonwealth as defined in § 65.2-500 without any specific limit as to the number of such weeks.  However, any claim for compensation of an employee who was totally disabled by coal worker’s pneumoconiosis at the time of his death shall be paid only to the extent required by federal law.
    2. The Commission shall, by regulation duly drawn and published after notice and hearing, prescribe standards, not inconsistent with those prescribed by the Secretary of Health and Human Services under the 1969 Federal Coal Mine Health and Safety Act, as amended, for determining whether the death or total disability of an employee was due to pneumoconiosis or any chronic occupational lung disease.
    3. In prescribing such standards the following factors shall be included:
      1. If an employee who died from a respirable (respiratory) disease was employed for ten years or more in an environment where he was injuriously exposed to such a disease, there shall be a rebuttable presumption that his disease arose out of such employment, or if he became totally disabled from coal worker’s pneumoconiosis or if such disease significantly contributed to his death or disability, there shall be a rebuttable presumption that his death or disability was due to such disease.
      2. Where there is clear evidence of exposure to an occupational lung disease, the Commission may make its determination whether compensation is payable to the dependents based on the description of the employee’s symptoms, X-rays, and other competent medical evidence, and the opinion of experts as to whether those symptoms reasonably described the symptoms of such an occupational disease.
      3. The statement as to the cause of death on a death certificate may be considered as evidence in any such cases but shall not be controlling on the Commission’s findings.  The Commission may also, by regulation, establish standards, not inconsistent with those prescribed by the Secretary of Labor under the 1969 Federal Coal Mine Health and Safety Act as amended, for apportioning liability for benefits under this section and under § 65.2-504 A 4 among more than one operator, where such apportionment is appropriate, provided that no apportionment shall operate to deprive an employee of the full benefits due him under this title.

    History. 1972, c. 619, § 65.1-65.1; 1973, cc. 401, 436; 1974, c. 560; 1975, c. 447; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 47.

    § 65.2-514. Special provisions for coal worker’s pneumoconiosis claims for total disability or death.

    In the case of claims for death or total disability under subdivision A 4 of § 65.2-504 or § 65.2-513 , the following matters shall be required or effective only to the extent that they are allowed by the 1969 Federal Coal Mine Health and Safety Act as amended and the regulations issued thereunder:

    1. Notice to the employer under § 65.2-405 ;
    2. Any limitation for the filing of a claim for benefits for death or total disability under §§ 65.2-406 and 65.2-601 ;
    3. Waivers as provided under § 65.2-407 ;
    4. Settlements agreed to, allowed, or granted under § 65.2-701 ; and
    5. The right of an employer to refuse employment to an applicant or to discharge a claimant because he has or is susceptible to coal worker’s pneumoconiosis.

    History. 1973, c. 436, § 65.1-65.2; 1991, c. 355.

    CASE NOTES

    Once claimant received “a medical determination of total disability due to pneumoconiosis” via a U.S. Department of Labor letter, it was incumbent upon him to file a Virginia claim within three years in order to allow the Compensation Commission to determine whether, in addition to meeting the federal total disability standards, he also met the Virginia total disability standards. Ratliff v. Dominion Coal Co., 3 Va. App. 175, 349 S.E.2d 147, 3 Va. Law Rep. 737, 1986 Va. App. LEXIS 349 (1986) (decided under former § 65.1-65.2).

    § 65.2-515. Persons conclusively presumed to be wholly dependent.

    1. The following persons shall be conclusively presumed to be dependents wholly dependent for support upon the deceased employee:
      1. A spouse upon his deceased spouse whom he had not voluntarily deserted at the time of the accident or with whom he lived at the time of the accident, if he is then actually dependent upon his deceased spouse;
      2. A child under the age of 18 upon a parent and a child over such age if physically or mentally incapacitated from earning a livelihood or a child under the age of 23 if enrolled as a full-time student in any accredited educational institution; and
      3. Parents in destitute circumstances, provided that there are no total dependents pursuant to other provisions of this section.
    2. As used in this section, “child” includes a stepchild, a legally adopted child, a posthumous child, and an acknowledged illegitimate child, but does not include a married child, and “parent” includes stepparents and parents by adoption.

    History. Code 1950, § 65-63; 1968, c. 660, § 65.1-66; 1973, cc. 401, 542; 1991, c. 355; 2020, c. 900.

    Cross references.

    As to amount of victim compensation award, see § 19.2-368.11:1 .

    The 2020 amendments.

    The 2020 amendment by c. 900, in subsection A, deleted former subdivision A 1, which read: “A wife upon a husband whom she had not voluntarily deserted or abandoned at the time of the accident or with whom she lived at the time of his accident, if she is then actually dependent upon him” and renumbered the remaining subdivisions accordingly; in subdivision A 1, substituted “A spouse upon his deceased spouse” for “A husband upon a wife” and “the accident, if he is then actually dependent upon his deceased spouse” for “her accident, if he is then actually dependent upon her”; in subdivision A 2, substituted “18” for “eighteen” and “23” for “twenty-three”; in subdivision A 3, substituted “that there are” for “there be”; and in subsection B, substituted “ ‘child’ includes” for “the term ‘child’ shall include,” “does not include” for “shall not include” and “ ‘parent’ includes” for “the term ‘parent’ shall include.”

    Law Review.

    For article on damages recoverable for wrongful death, see 5 U. Rich. L. Rev. 213 (1971).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    For an overview of Virginia Supreme Court decisions on domestic relations, see 15 U. Rich. L. Rev. 321 (1981).

    Michie’s Jurisprudence.

    For related discussion, see For related provisions, see 14A M.J. Parent and Child, § 24; 21 M.J. Workers’ Compensation, §§ 47-50.21 M.J. Workers’ Compensation, §§ 47-50.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-66 or prior law.

    One of the purposes of the 1973 amendments to this section was to make uniform the requirements of dependency without regard to gender. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    Section eliminates conjecture as to status of persons enumerated. —

    By placing a wife, husband and designated children in a class to themselves, the legislature eliminated all conjecture concerning their status in regard to dependency, and left only for investigation as to them the question of whether or not the death of the employee arose out of and in the course of the employment. VEPCO v. Place, 150 Va. 562 , 143 S.E. 756 , 1928 Va. LEXIS 335 (1928).

    This section ought not require an employer to await the possible destitution of a parent of a deceased employee. Roanoke Belt Inc. v. Mroczkowski, 20 Va. App. 60, 455 S.E.2d 267, 1995 Va. App. LEXIS 307 (1995).

    “Dependency” defined. —

    The definition of dependency established by the Supreme Court in interpreting former § 65.1-67 (now § 65.2-515 ) is equally applicable to this section. Dependency means that the claimant looked to and relied on the contributions of the employee, in whole or in part, as a means of support and maintenance in accordance with his or her social position and accustomed mode of life. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    Status determined as of time of death. —

    Where a parent seeks to assert the conclusive presumption of dependency under subdivision A 4, the parent’s status is to be determined by the evidence viewed at the time of the employee’s death. Clark v. Lawhorne Bros., Inc., 2000 Va. App. LEXIS 724 (Va. Ct. App. Nov. 14, 2000).

    Credible evidence supported the commission’s factual finding that the widow was not a dependent as defined in subdivision A 1 of § 65.2-515 and was not entitled to an award of death benefits because at the time of the decedent’s death, the widow was neither receiving nor relying upon any financial support from the decedent; § 65.2-511 only authorized an award to a statutory dependent, and did not authorize the award of benefits to someone that did not fall into that category. The right of statutory dependents under § 65.2-511 to receive an award terminated if the decedent’s death was caused by a compensable injury and the statutory dependents had already received compensation, e.g., death benefits under § 65.2-512 . Runyon v. CBS Constr. Co., 2011 Va. App. LEXIS 64 (Va. Ct. App. Feb. 22, 2011).

    The crucial inquiry is whether evidence proved actual dependency upon the decedent for support even though she and the decedent had separated and were living apart when he died. To show actual dependency, claimants had to prove that the decedent contributed money to her with some degree of regularity and such contributions must have been relied upon by her for reasonable necessaries consistent with her station in life. Tharp v. City of Norfolk, 19 Va. App. 653, 454 S.E.2d 13, 1995 Va. App. LEXIS 140 (1995).

    Here the evidence of the mother’s financial position at the time of her son’s death was inadequate to classify her as financially vulnerable, and upon the record the Workers’ Compensation Commission had insufficient evidence before it to determine that she was in destitute circumstances as defined by this section. Oil Transp., Inc. v. Jordan, 22 Va. App. 633, 472 S.E.2d 291, 1996 Va. App. LEXIS 463 (1996).

    While the wife and the decedent had entered into a written settlement agreement to resolve their respective rights and duties, the overwhelming, uncontroverted evidence clearly demonstrated that the wife relied on the decedent for her reasonable necessaries at the time of his death; therefore, the wife was an “actual dependent” of the decedent under subdivision A 1 of § 65.2-515 who was entitled to death benefits under § 65.2-512 . Sifford v. Sifford, 58 Va. App. 722, 716 S.E.2d 128, 2011 Va. App. LEXIS 305 (2011).

    Wife need not show she was wholly dependent. —

    Although the language of this section no longer presumes a wife’s dependency upon her husband, it does not require the wife to establish that she was wholly dependent upon her husband’s earnings. It is highly unlikely that the General Assembly intended to restrict the conclusive presumption of total dependency to instances where the spouse had demonstrated that he or she was wholly dependent. Such a restriction would nullify the purpose for the conclusive presumption. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    Presumption arises even if actual dependency only partial. —

    The conclusive presumption of this section arises once actual dependency, even though only partial, has been established. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    Evidence that claimant and her deceased husband had both contributed funds towards the purchase of a new home, that they had commingled their funds, and that her husband’s salary enabled them to live a little bit above the standard of living otherwise attainable sufficiently demonstrated that, in actuality, she was at least partially dependent upon her husband; consequently, under the language of this section, she was conclusively presumed to be wholly dependent upon him. Caudle-Hyatt, Inc. v. Mixon, 220 Va. 495 , 260 S.E.2d 193, 1979 Va. LEXIS 289 (1979).

    The presumption of this section arises once actual dependency, even though only partial, has been established. The spouse must, however, establish that she relied on the decedent’s contributions as a means of support in accordance with her accustomed lifestyle. Armada, Inc. v. Lucas, 2 Va. App. 414, 345 S.E.2d 14, 1986 Va. App. LEXIS 288 (1986).

    No exception because of family relationship between employer and employee. —

    The provisions of this section and former § 65.1-67 (now § 65.2-515 ) make no exception because of family relationship between the employer and employee. Thus the fact that the employer is the husband of the claimant does not bar claimant from receiving death benefits payable to the dependents of a deceased employee. The rule that a wife may not sue her husband in tort does not bar such a recovery by the claimant, because a proceeding under the Workmen’s (now Workers’) Compensation Act is not based upon tort. Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    Voluntary desertion means same thing as in divorce cases. —

    Voluntary desertion in this section means the same thing that it means in divorce cases. Defonis v. Clinchfield Coal Corp., 186 Va. 715 , 43 S.E.2d 852, 1947 Va. LEXIS 192 (1947).

    Thus a forced separation is not voluntary abandonment. —

    A wife who was forced to separate from husband because of his cruelty did not abandon her husband voluntarily within the meaning of this section. Hundley v. Hundley, 182 Va. 14 , 27 S.E.2d 902, 1943 Va. LEXIS 125 (1943).

    And conduct of wife forcing husband to desert bars compensation. —

    When a wife voluntarily so behaves that her husband can no longer remain with safety in the marriage state, and is forced to go elsewhere for protection, the wife is guilty of desertion within the meaning of this section. And it matters not whether the husband is left in the home or is forced to leave by the behavior. Whether the desertion has continued a sufficient time for an absolute divorce, or only a temporary divorce, makes no difference. Defonis v. Clinchfield Coal Corp., 186 Va. 715 , 43 S.E.2d 852, 1947 Va. LEXIS 192 (1947).

    No credible evidence that wife was dependent upon husband. —

    Where there was no written agreement between decedent and his wife, from whom he was separated, calling for support, and the few instances where decedent gave his wife money occurred when she asked him for it, and where decedent made no contributions with any degree of regularity upon which his wife could have relied, and she was employed full time and assisted in the support of her father, there was no credible evidence upon which the Commission could have relied in finding that wife was actually dependent upon her deceased husband. Armada, Inc. v. Lucas, 2 Va. App. 414, 345 S.E.2d 14, 1986 Va. App. LEXIS 288 (1986).

    Evidence held insufficient to establish abandonment of marital status. American Motorists Ins. Co. v. Summers, 183 Va. 428 , 32 S.E.2d 673, 1945 Va. LEXIS 189 (1945).

    Evidence held to show actual desertion of husband by claimant. Kelly v. Pendleton Constr. Co., 182 Va. 191 , 28 S.E.2d 621, 1944 Va. LEXIS 167 (1944).

    The determination of whether a parent is in destitute circumstances depends upon various factors, including earnings or earning potential, amount of assets, health, age, level of formal education and number of dependents. Clark v. Lawhorne Bros., Inc., 2000 Va. App. LEXIS 724 (Va. Ct. App. Nov. 14, 2000).

    Necessary evidence when parent asserts financial vulnerability. —

    Where a parent asserts financial vulnerability, as opposed to present actual destitution, as a basis for an award of survivor’s benefits as a destitute parent under subdivision A 4 of this section, the evidence must establish that at the time of death of the employee, the parent faced a definite future event or one reasonably predictable that would place the parent in destitute circumstances. Roanoke Belt Inc. v. Mroczkowski, 20 Va. App. 60, 455 S.E.2d 267, 1995 Va. App. LEXIS 307 (1995).

    A parent with only the earning potential sufficient to provide no more than a bare existence and with no resources to provide against anticipated or inevitable financial emergencies is deemed “financially vulnerable” and, therefor, destitute for the purposes of subdivision A 4. Clark v. Lawhorne Bros., Inc., 2000 Va. App. LEXIS 724 (Va. Ct. App. Nov. 14, 2000).

    Father may be “destitute” though supported by wife. —

    The father of a deceased employee may be “in destitute circumstances” although his wife is employed and voluntarily supports him from her earnings. Bagwell v. Doyle, 187 Va. 844 , 48 S.E.2d 229, 1948 Va. LEXIS 273 (1948).

    And though he has other children capable of supporting him. —

    The parent of a deceased employee may be “in destitute circumstances” within the meaning of subdivision A 4 of this section, notwithstanding that he has other children who are capable of supporting him and whose legal and moral duty it is to do so. Bagwell v. Doyle, 187 Va. 844 , 48 S.E.2d 229, 1948 Va. LEXIS 273 (1948).

    Evidence supported award to deceased employee’s parents. —

    Evidence was sufficient to show that mother of deceased employee, a Korean immigrant, was destitute and that father was dependent upon deceased employee for between $500 and $600 monthly support, and thus the evidence supported an award granting compensation to the decedent’s parents. Kum Ja Kim v. Sportswear, 10 Va. App. 460, 393 S.E.2d 418, 6 Va. Law Rep. 2728, 1990 Va. App. LEXIS 115 (1990).

    Evidence that parent destitute insufficient. —

    An employee’s mother was not entitled to the conclusive presumption of dependency where, at the time of the employee’s death, his mother was sixty-three years old, worked twenty hours per week and earned $467 in the month before the employee’s death and where there was no evidence that she worked or sought employment after the employee’s death, she presented no medical evidence to substantiate her claim that her palpitations, high blood pressure and emotional state prevented her from working, she had substantial equity in the home she occupied and had no dependents to support. The employee’s mother also offered no documentary evidence to substantiate her claim that the employee gave her money toward her monthly expenses and she did not testify to any anticipated or inevitable financial emergency. Clark v. Lawhorne Bros., Inc., 2000 Va. App. LEXIS 724 (Va. Ct. App. Nov. 14, 2000).

    Classification of unemployment benefits. —

    Unemployment benefits differ from other forms of public assistance and should be considered as income in the dependency-destitution calculus. Roanoke Belt Inc. v. Mroczkowski, 20 Va. App. 60, 455 S.E.2d 267, 1995 Va. App. LEXIS 307 (1995).

    Designated children are placed in a common class. —

    It is clear that the legislative intent in this section was to place the designated children in a common class, and the Supreme Court should not permit the spirit and intendment of the statute to be whittled away by the keen edge of grammatical construction. Indemnity Ins. Co. v. Nalls, 160 Va. 246 , 168 S.E. 346 , 1933 Va. LEXIS 203 (1933).

    Children under 18 and incapacitated children are on same footing. —

    It was not the intention of the legislature by the enactment of this section to place a child under the age of 18 and a child physically or mentally incapacitated from earning a livelihood upon a different footing. Indemnity Ins. Co. v. Nalls, 160 Va. 246 , 168 S.E. 346 , 1933 Va. LEXIS 203 (1933).

    A daughter who has reached 18 years of age is no longer deemed a dependent unless she be physically or mentally incapable of earning a living. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940).

    Evidence of physical incapacity. —

    When the testimony of the physicians selected by the employer was excluded the uncontradicted evidence, including the testimony of reputable physicians, was that the claimant was physically incapable of earning a livelihood at the time of the accident to her father, the employee, and for more than three months prior thereto. It was held that she was entitled to compensation as a dependent of the deceased employee. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940).

    The evidentiary requirements of former § 20-61.1 do not apply to the Workers’ Compensation Act. Allstate Messenger Serv. v. James, 220 Va. 910 , 266 S.E.2d 86, 1980 Va. LEXIS 183 (1980).

    The term “posthumous child” referred to in this section includes an illegitimate, posthumous child and the Commission did not err in such an interpretation of the application of this provision of the Workers’ Compensation Act. Birdsong Peanuts v. Cowling, 8 Va. App. 274, 381 S.E.2d 24, 5 Va. Law Rep. 2653, 1989 Va. App. LEXIS 64 (1989).

    Posthumous and illegitimate child. —

    The legislature did not express an intention to exclude a child that was both a posthumous child and an acknowledged illegitimate child; instead, the terms are mutually inclusive. Birdsong Peanuts v. Cowling, 8 Va. App. 274, 381 S.E.2d 24, 5 Va. Law Rep. 2653, 1989 Va. App. LEXIS 64 (1989).

    An illegitimate, posthumous child is a dependent under subdivision A 3 who is entitled to benefits. Birdsong Peanuts v. Cowling, 8 Va. App. 274, 381 S.E.2d 24, 5 Va. Law Rep. 2653, 1989 Va. App. LEXIS 64 (1989).

    Acknowledgment of paternity of illegitimate child. —

    The Workers’ Compensation Act requires a claimant who purports to be an illegitimate child of an employee who has suffered a compensable accident to prove the employee’s acknowledgment of paternity. Whether there has been such an acknowledgment is a question of fact. Allstate Messenger Serv. v. James, 220 Va. 910 , 266 S.E.2d 86, 1980 Va. LEXIS 183 (1980).

    Except for the requirement of acknowledgment by the decedent, the act prescribes no test for determining paternity. Allstate Messenger Serv. v. James, 220 Va. 910 , 266 S.E.2d 86, 1980 Va. LEXIS 183 (1980).

    Putative father’s pre-birth acknowledgment of an illegitimate child may establish a child’s dependency for purposes of awarding workers’ compensation benefits. Birdsong Peanuts v. Cowling, 8 Va. App. 274, 381 S.E.2d 24, 5 Va. Law Rep. 2653, 1989 Va. App. LEXIS 64 (1989).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Spouse Must Show Some Degree of Depen- dency:

    There must be some degree of actual dependency in order for a widow to be conclusively presumed to be wholly dependent upon the deceased employee. Beverly v. F. A. Bartlett Tree Expert Company, 62 O.I.C. 56 (1983) (see also Kallam v. Prillman & Pace, Inc., 57 O.I.C. 213 (1975)).

    Proof of dependency of one spouse upon the other to any degree renders survivor wholly dependent and entitled to death benefits. Mixon v. Caudle-Hyatt, Inc., 220 Va. 645 , 260 S.E.2d 193 (1979); Farren v. Liberty House Nursing Home, 59 O.I.C. 80 (1980).

    Where a woman during the lifetime of her son and husband was in fact partially dependent upon both and was awarded compensation as a partial dependent of her son, upon the death of her husband by compensable accident she is entitled, additionally, to full compensation as a total dependent, in view of the conclusive presumption. Watson v. Va. Fertilizer Corp., 8 O.I.C. 2, 329 (1926).

    Husband was not dependent by law on deceased wife, because he was not dependent upon her for support; nor was he partially dependent upon her in fact, since the facts showed that he earned more than her and, had they shared equally from the total income, she would have been partially dependent upon him. Harriman v. Jackson Motel, 54 O.I.C. 158 (1972).

    Husband found to be “actually dependent” on wife. Owens v. Brunswick Corp., 55 O.I.C. 264 (1973).

    The evidence established that at the time of the accident the claimant resided with and was dependent on the decedent. Lee v. Osborne Trucking Company, Inc., 73 O.W.C. 107 (1994).

    Must Be Dependent on Date of Death:

    Circumstances after date of death not applicable. Nuckles v. Bechtel Corp., 51 O.I.C. 205 (1969).

    Employee killed three days after divorce decree entered; wife later obtained Court order vacating decree; divorced wife cannot claim compensation. Fulcher v. Powell, 53 O.I.C. 103 (1971) (appeal denied).

    Legal Marriage Requirement:

    A woman claiming compensation as wife of deceased workman must have been legally married to him. Davis v. Kellogg Co., 35 O.I.C. 304 (1953); Brown v. State Dept. of Highways & Transportation, 57 O.I.C. 58 (1977).

    There is no conclusive presumption of dependency when marriage is void under Virginia law, even though only voidable in the State where the ceremony was performed. Toler v. Oskwood Smokeless Coal Corp., 173 Va. 425 , 4 S.E.2d 364, 1939 Va. LEXIS 210 (1939).

    Marriage license issued in North Carolina; married in Virginia; validity determined by law of place of celebration. Testerman v. H. S. Williams Co., 55 O.I.C. 335 (1973).

    Acquittal of a charge of bigamy will not alone justify awarding compensation on account of death of a second husband; and where there was no proof of divorce from first husband or absence for sufficient time to create a presumption of his death, claimant must be regarded as a bigamous wife not within the Compensation Act. Ashby v. Red Jacket Coal Corp., 185 Va. 202 , 38 S.E.2d 436, 1946 Va. LEXIS 191 (1946).

    A presumption in favor of the validity of second marriage will support the claim of the alleged wife at time of accident where there is no proof that the first marriage was not terminated by divorce. Parker v. American Lbr. Corp., 190 Va. 181 , 56 S.E.2d 214, 1949 Va. LEXIS 273 (1949).

    Virginia does not recognize common law marriages which are contracted within its boundaries. Testerman v. H. S. Williams Co., 55 O.I.C. 335 (1973).

    A partner in a common law marriage is precluded from qualifying as a dependent under either § 65.1-66 or § 65.1-67. However, the common law partner’s son from a previous marriage may be awarded proportional benefits if partial dependency can be established. Wingfield/Dawson v. Thomas Roofing, 65 O.I.C. 309 (1986).

    The evidence failed to establish a valid common law marriage pursuant to the laws of Texas. Therefore the claimant was not entitled to benefits under the Virginia Workers’ Compensation Act. Teitsch v. SG Communications, 71 O.W.C. 52 (1992).

    The Commission declined to give full faith and credit to an order of a New York Court regarding the Texas common-law marriage of the decedent because a plea of res judicata would not have been sustained if the workers’ compensation action had been brought before the New York Workers’ Compensation Board. Teitsch v. SG Communications, 71 O.W.C. 52 (1992).

    Effect of Voluntary Separation or Desertion:

    Where the marital relation continues after separation the provision under consideration cannot be applied. American Motorists Ins. Co. v. Summers, 183 Va. 428 , 32 S.E.2d 673, 1945 Va. LEXIS 189 (1945).

    Living apart by agreement does not constitute voluntary desertion. Cooper v. Mutual Ins. Co., 14 O.I.C. 379 (1932) 15 O.I.C. 11 (1933) (appeal denied) Johnson v. Williams, 5 O.I.C. 21 (1923).

    Where after an agreed separation the worker requested his wife to return but she refused without justification or excuse voluntary desertion is established. Hayslett v. Block & Co., 29 O.I.C. 428 (1947) (appeal denied).

    If the wife has no proper justification for refusing to live with her husband, she is not entitled to compensation as his dependent. Kelly v. Pendleton Constr. Co., 182 Va. 191 , 28 S.E.2d 621, 1944 Va. LEXIS 167 (1944).

    The decedent’s wife who was living separate and not dependent upon her husband at the time of his death was not entitled to benefits. Robinson v. Sprinkle Masonry, Inc., 68 O.I.C. 156 (1989).

    There was no evidence of dependency by the wife on the deceased where by separation agreement she waived any right to support, alimony or maintenance and all payments thereafter were specifically designated for the maintenance of the home until it was sold. Murray v. County of Fauquier Sheriff ’s Office, 71 O.W.C. 50 (1992).

    Evidence did not prove that claimant had willfully deserted or abandoned husband prior to his death. Wilson v. Avtex Fibers, 58 O.I.C. 361 (1977).

    If the wife sends the worker away from his home and makes no effort to effect a reconciliation she is guilty of desertion. Ferguson v. Bee Tree Lumber Co., 2 O.I.C. 455 (1920).

    Effect of Child by Another:

    Where the husband deserted but subsequently the claimant wife had a child by another, she herself is guilty of desertion and abandonment and is not entitled to benefits. Adkins v. Vranich, Inc., 37 O.I.C. 141 (1955).

    Bearing of child not fathered by deceased constitutes desertion by wife. Murphy v. City of Franklin, 48 O.I.C. 173 (1966).

    Effect of Bigamy:

    Where the husband deserted and entered into a bigamous relationship with his wife’s cousin who knew of his desertion, and his first wife later married again, no divorce having been secured, neither woman was the legal widow entitled to compensation. The first wife was herself guilty of desertion and abandonment when she married the second time. Harris v. Henderson Van & Storage Co., Inc., 42 O.I.C. 65 (1960).

    Attempting two bigamous remarriages without any divorces constituted desertion and abandonment of deceased by alleged widow. Covington v. Blue Grass Cooperage Co., Inc., 49 O.I.C. 79 (1967).

    Effect of Incompetency:

    Widow because of incompetency was unable to form an intent to desert or abandon husband and entitled to compensation although living apart from him at time of death. McInturff v. Valley Builders Supply, 41 O.I.C. 104 (1959).

    Wife and son both mentally incompetent and conclusively presumed wholly dependent upon deceased employee. McFarland v. Elliott, 53 O.I.C. 180 (1971).

    Children:

    Deputy Commissioner did not err in allowing decedent’s son to produce additional evidence of dependency, after which the award would be automatically amended without a hearing. O’Connor (Deceased) v. Standard Marine, Inc., JCN 2377930 (Nov. 4, 2014).

    The 1973 amendment extended coverage to a child until the age of twenty-three if full-time student. Owens v. Brunswick Corp., 55 O.I.C. 264 (1973) 56 O.I.C. 238 (1974) Crocker v. Suffolk Oil Co., Inc., 56 O.I.C. 81 (1975) (aff’d. on review).

    Where the uncontradicted evidence established that a student once enrolled maintained full-time status despite the number of absences, the Deputy Commissioner properly concluded that the child beneficiary was entitled to benefits. Baker v. Consolidation Coal Co., 76 O.W.C. 111 (1997).

    A child beneficiary does not forfeit future benefits once she is not deemed to be a full-time student during a specific period. Baker v. Consolidation Coal Co., 76 O.W.C. 111 (1997).

    A child whose name was legally changed, but not legally adopted by his stepfather remained entitled to conclusive presumption of dependency upon natural father’s death. Clark v. Stone Transfer Corp., 48 O.I.C. 40 (1966).

    Where mother was deprived of custody of children, their portion of compensation directed to be paid to Department of Social Services for their sole use and benefit. Wilson v. Dean’s Steel Erection, 57 O.I.C. 391 (1977).

    A dependent child over the age of eighteen, who claims compensation benefits under § 65.2-515 A 3 as a full-time student at an accredited educational institution, has a duty to respond to the insurer’s requests for information about his educational status. Procedurally, if the dependent claimant refuses to respond to informal requests for information, the insurer should first propound discovery, seeking the claimant’s response under oath. If the dependent claimant continues to refuse efforts to ascertain whether he is enrolled, the insurer will have good cause to seek termination of the outstanding award. Witt v. Sea “B” Mining Company, VWC File No. 186-69-57 (October 23, 2002).

    Stepchildren:

    Stepchildren are presumed to be totally dependent. Gallimore v. City of Chesapeake, 56 O.I.C. 120 (1975) (aff’d. review, appeal denied); Walker v. Thompson-Starrett Co., Inc., 26 O.I.C. 584 (1944); Braun v. Robertson Constr. Co., 7 O.I.C. 556 (1925); Darby v. Fass, 7 O.I.C. 221 (1925); Wilson v. Dean’s Steel Erection, 57 O.I.C. 391 (1977).

    Stepchildren are not in fact “stepchildren” where the marriage of their mother and deceased was void. Fields v. Helen Coal Co., 47 O.I.C. 116 (1965).

    Adopted Children:

    Natural child of worker, upon legal adoption by others ceases to be the child of natural parent within meaning of this section and becomes instead, child of adoptive parent. Scott v. Charlie’s Trash Service, 52 O.I.C. 227 (1970).

    Child may not be conclusively presumed to be wholly dependent upon two fathers at same time. McInturff v. Valley Builders Supply Co., 41 O.I.C. 104 (1959).

    While this section makes an adopted child wholly dependent upon a foster parent, such child may, also have been dependent in fact under § 65.1-67 (now § 65.2-516 ) upon his natural father. Wilfong v. Scott Packing Co., 15 O.I.C. 303, 447 (1933) (appeal denied).

    Child legally adopted by deceased and first wife was entitled to share compensation with widow. Anz v. Fairfax Constr. Corp., 49 O.I.C. 10 (1967).

    Child being adopted by deceased is total dependent in fact. Figgins v. Grunley-Walsh Constr. Co., Inc., 50 O.I.C. 137 (1968).

    Death benefits to surviving child do not terminate upon the child’s adoption by step-parent but only upon attainment of eighteen years of age. Knox v. Virginia Sheet Metal Corporation, 60 O.I.C. 267 (1981).

    Posthumous Children:

    Posthumous children stand in the same position as children of employee in being at time of his death. The award usually makes a provision for the child to take effect when born alive. Calhoun v. American Oil Co., 13 O.I.C. 509 (1931); Stapleton v. Penn Lee Corp., 7 O.I.C. 385 (1925).

    Compensation to a posthumous child begins with date of birth but runs for the remainder of the 300 week period (now 500 weeks) from date of employee’s death (accident). McCray v. Concrete Structures, Inc., 44 O.I.C. 176 (1962) (appeal denied); Cantrell v. White Coal Co., 44 O.I.C. 31 (1962) (appeal denied).

    A posthumous child of a void marriage will be considered a dependent. Cantrell v. White Coal Co., 44 O.I.C. 31 (1962) (appeal denied).

    (See next section for posthumous illegitimate children.).

    Illegitimate Children:

    If the worker acknowledged his illegitimate child in his lifetime it will be considered conclusively dependent. Jordan v. Roeder, 50 O.I.C. 218 (1968); Haskins v. Case Constr. Co., 44 O.I.C. 118 (1962); McCray v. Concrete Structures, Inc., 44 O.I.C. 173 (1962) (appeal denied); Gatewood v. Skinker & Garrett, 32 O.I.C. 61 (1950); Jones v. Alward, Inc., 32 O.I.C. 42 (1950); Richardson v. Newport News S.B. & D.D. Co., 25 O.I.C. 411, 500 (1946) (appeal denied); Allstate Messenger Serv. v. James, 220 Va. 910 , 266 S.E.2d 86, 1980 Va. LEXIS 183 (1980).

    In awarding compensation benefits the Commission found sufficient evidence of acknowledgment by the decedent of the infant as his illegitimate child. Teitsch v. SG Communications, 71 O.W.C. 52 (1992).

    A posthumous illegitimate child is not a dependent if employee never acknowledged it. Walker v. Thompson-Starrett Co., Inc., 26 O.I.C. 584 (1944); Moseley v. Culbertson, 13 O.I.C. 484 (1931).

    Where the employee was legally separated from his wife, but tried to conceive a child by alternating sexual relations with another man, sufficient doubt is present to rebut the presumption of legitimacy in the course of a marriage. Further, the employee denied paternity, was not named on the child’s birth certificate, and did not pay child support. Thomas, et al. v. James City Co. Fire Dept., 75 O.W.C. 251 (1996).

    The illegitimate child of the estranged wife was not a child, stepchild or adopted child specified under the Act and therefore not entitled to benefits. Robinson v. Sprinkle Masonry, Inc., 68 O.I.C. 156 (1989).

    Incapacitated Children:

    Decedent’s 43 year old son was found mentally incapable of earning a living and conclusively presumed to be dependent. Hughes v. N.B. Handy Co., 51 O.I.C. 131 (1969).

    The presumption of dependency for an incapacitated child is conclusive and it is immaterial that claimant was not in fact dependent. Indemnity Ins. Co. v. Nalls, 160 Va. 246 , 168 S.E. 346 (1933); McFarland v. Elliott, 53 O.I.C. 180 (1971).

    Parents in Destitute Circumstances:

    Father found to be parent in destitute circumstances where his assets were insufficient to provide for reasonably anticipated financial emergencies. Ely v. McKinnon Corp., VWC File No. 210-89-13 (Aug. 31, 2004).

    In determining whether a parent is in destitute circumstance unemployment benefits are properly included as income but welfare benefits should not be considered. Where the evidence viewed at the time of death establishes that a survivor has only the earning potential sufficient to provide no more than a bare existence with no resources to provide against reasonably anticipated or inevitable financial emergencies, the claimant is determined to be financially vulnerable and destitute for the purposes of § 65.2-515 (A) (4). Roanoke Belt Inc. v. Mroczkowski, 20 Va. App. 60, 455 S.E.2d 267, 1995 Va. App. LEXIS 307 (1995).

    Section 65.2-515 allows a conclusive presumption that a parent is dependent on the deceased if found to be in destitute circumstances. The parent is not required to demonstrate actual dependency on the deceased and destitution. Ward v. B & B Steel Erectors, 73 O.W.C. 129 (1994).

    In determining whether the parent qualified for the presumption, it was appropriate to examine her circumstances during the three months prior to the decedent’s death. Ward v. B & B Steel Erectors, 73 O.W.C. 129 (1994).

    A family of three which has earning potential allowing it to eke out no more than a bare existence with no resource to provide against natural or inevitable emergencies such as medical emergency or breakdown of transportation, heating or electrical systems, is in destitute circumstances and entitled to benefits provided under § 65.1-66 (4) (now § 65.2-515 A 4). Covey v. Suburban Masonry, 70 O.I.C. 184 (1991).

    Employee’s father, by proving to be a parent in destitute circumstances and coming within the purview of this section, established his entitlement to conclusive presumption of being wholly dependent for support upon deceased employee. Question then one of law and not of fact. Carter v. Chewning, 57 O.I.C. 69 (1988).

    The decedent’s mother was in destitute circumstance and entitled to receive compensation benefits. Robinson v. Sprinkle Masonry, Inc., 68 O.I.C. 156 (1989).

    Eighty year old father of deceased worker who is incapacitated and receiving public welfare payments is a parent in destitute circumstances. Ruffin v. Merritt Chapman & Scott Corp., 40 O.I.C. 121, 122 (1958).

    Welfare and other public assistance payments excluded in dependency-destitution cases. Brandon v. Batcheler & Collins, Inc., 56 O.I.C. 37 (1974) (appeal denied).

    Elderly mother of deceased found to be in destitute circumstances. Ford v. American Original Foods, Inc., 58 O.I.C. 131 (1979). (Affirmed on jurisdictional issues, 221 Va. 557 , 272 S.E.2d 187 (1980)).

    In awarding compensation benefits to the mother of a deceased 15-year old, the Commission held that the fact that a parent is capable of working does not preclude a finding of destitute circumstances if, through education, experience and the economic conditions of the person and in the surrounding community, gainful employment cannot be found. Ward v. B & B Steel Erectors, 73 O.W.C. 129 (1994).

    Parents found to be in destitute circumstance are not entitled to compensation if there is a total dependent spouse or child. Aycock v. Tidewater Constr. Co., 36 O.I.C. 313; Roark v. Greene, 32 O.I.C. 194 (1950).

    Mother of deceased employee found not to be partially dependent upon him for support; mother’s standard of living not lowered by the death of her son. Cooper v. Alexandria Plumbing and Heating, Inc., 57 O.I.C. 81 (1977).

    § 65.2-516. Other cases of dependency.

    In all other cases questions of dependency in whole or in part shall be determined in accordance with the facts as the facts are at the time of the accident; but no allowance shall be made for any payment made in lieu of board and lodging or services and no compensation shall be allowed unless the dependency existed for a period of three months or more prior to the accident.

    History. Code 1950, § 65-64; 1968, c. 660, § 65.1-67; 1991, c. 355.

    Law Review.

    For article on damages recoverable for wrongful death, see 5 U. Rich. L. Rev. 213 (1971).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 47, 50.

    CASE NOTES

    Editor’s note.

    Most of the cases annotated below were decided under former § 65.1-67 or prior law.

    Liberally construed. —

    In determining questions of dependency the Act should be liberally construed. Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    This section does not define dependency or specify the indicia of that status. From the proof adduced upon the hearing, it is the province of the Commission to find as a fact whether the particular claimant is entitled to compensation and to determine the amount thereof. Dunivan v. Hunter, 197 Va. 194 , 89 S.E.2d 44, 1955 Va. LEXIS 211 (1955).

    And dependency under this section rests neither upon relationship nor presumption, but wholly upon the facts as they exist at the time of the death of employee, and is subject to change by the Commission as the condition of economic dependence or independence of the beneficiaries may vary from time to time. VEPCO v. Place, 150 Va. 562 , 143 S.E. 756 , 1928 Va. LEXIS 335 (1928); Commonwealth ex rel. State Hwy. Comm'n v. McGuire, 188 Va. 444 , 50 S.E.2d 284, 1948 Va. LEXIS 178 (1948); Dunivan v. Hunter, 197 Va. 194 , 89 S.E.2d 44, 1955 Va. LEXIS 211 (1955).

    But upon proof in particular case. —

    Whenever it appears that claimants come within the classification designated by former § 65.1-66 (now § 65.2-515 ), they are conclusively presumed, as a matter of law, to be dependent and no evidence is required to show the fact of such dependency. But the question of dependency under this section depends upon proof in the particular case. And by the language of this section a wide discretion is vested in the Commission. From the proof adduced upon the hearing, it is the province of the Commission to find as a fact whether the particular claimant is entitled to compensation, and to determine the amount thereof. VEPCO v. Place, 150 Va. 562 , 143 S.E. 756 , 1928 Va. LEXIS 335 (1928) (see Indemnity Ins. Co. v. Nalls, 160 Va. 246 , 168 S.E. 346 (1933); Commonwealth ex rel. State Hwy. Comm’n v. McGuire, 188 Va. 444 , 50 S.E.2d 284 (1948); Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843 (1953)).

    It is determined as of time of accident. —

    Under the terms of this section, questions of dependency must be determined as of the time of the accident. Holt v. Stone & Webster Eng’r Corp., 179 Va. 625 , 20 S.E.2d 498 (1942). But see VEPCO v. Place, 150 Va. 562 , 143 S.E. 756 (1928) stating that dependency is determined at the time of death .

    Nature of contributions by employee. —

    In applying this section, the employee must have contributed with some degree of regularity, and such contributions must have been relied upon by the claimant for reasonable necessaries consistent with his or her station in life. Miller & Long v. Frye, 215 Va. 591 , 212 S.E.2d 258, 1975 Va. LEXIS 193 (1975).

    While proof of absolute dependency for life’s necessities is not required, it must be shown that the claimant looked to and relied on the contributions of the employee, in whole or in part, as a means of support and maintenance in accordance with his or her social position and accustomed mode of life. Miller & Long v. Frye, 215 Va. 591 , 212 S.E.2d 258, 1975 Va. LEXIS 193 (1975).

    Lack of reliance is illustrated by the fact that no change was demonstrated in the family’s accustomed mode of living when employee’s contributions commenced before his death, or when they ceased as the result of his death. Miller & Long v. Frye, 215 Va. 591 , 212 S.E.2d 258, 1975 Va. LEXIS 193 (1975).

    Able-bodied grown child actually dependent on father not entitled to compensation. —

    In an appeal from an order of the Compensation Commission, claimant, the 26-year-old unmarried daughter of a deceased employee, contended that since this section, after the enumeration in former § 65.1-66 (now § 65.2-515 ) of the persons conclusively presumed to be dependent, states that “In all other cases questions of dependency, in whole or in part, shall be determined in accordance with the facts as the facts may be at the time of the accident,” she was entitled to compensation irrespective of whether she was physically incapacitated from earning a livelihood, because she was wholly dependent upon her father for support at the time of the accident. The court held that there was no merit in this contention. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940).

    Family relationship between employer and employee. —

    As to former § 65.1-66 (now § 65.2-515 ) and this section not making exceptions because of family relationship between employer and employee, see Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    Facts showing partial, not total, dependency of minor brother and sister. —

    Deceased and his minor brother and sister lived with an older sister and her husband and seven children. Deceased contributed to the expenses of the household, and at the time of his death was paying $18.00 a week to his sister while her husband contributed $45.00. These funds were commingled and used for the support of the entire household. On these facts the dependency of the minor brother and sister upon deceased was not total but partial, in the proportion that deceased’s contribution bore to the entire family income. Dunivan v. Hunter, 197 Va. 194 , 89 S.E.2d 44, 1955 Va. LEXIS 211 (1955).

    Facts showing parents partly dependent on child. —

    There was evidence that deceased and two of his brothers each contributed one third to the support of their father and mother; besides the sons, there were two daughters who worked but contributed nothing to the support of the family. The parents had no income except that the father received retirement pay from the navy yard. It was held that the father and mother of the deceased employee were one-third dependent upon him within the meaning of this section. Wright Motor Co. v. Steinhilber, 157 Va. 793 , 162 S.E. 192 , 1932 Va. LEXIS 328 (1932).

    Evidence held sufficient to warrant the finding that the claimant was partially dependent upon her son, the deceased employee. Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    The fact that the deceased employee made gifts of money to the claimant from time to time is not a sufficient basis for finding a dependency under this section. The employee must have contributed with some degree of regularity and such contributions must have been relied upon by the claimant for reasonable necessaries consistent with his or her station in life. Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843, 1953 Va. LEXIS 193 (1953).

    Facts demonstrated mutual assistance, not unilateral reliance. —

    Where an adult son received at home free the benefits (food, housing, use of a telephone and use of a motor vehicle) which one regularly employed would ordinarily pay for when living away from home, and in return for these benefits the son voluntarily performed services and made payments to aid the father, who earned a substantial income, in the support of a large family, this is a situation of mutual assistance and not one of unilateral reliance. Miller & Long v. Frye, 215 Va. 591 , 212 S.E.2d 258, 1975 Va. LEXIS 193 (1975).

    No obligation to provide support. —

    Friend of an employee who died at work was not entitled to receive workers’ compensation benefits as a dependent because there was no showing that the friend actually needed the employee’s support or that the employee had a legal and moral obligation to provide that support. Dunnavant v. Newman Tire Co., 51 Va. App. 252, 656 S.E.2d 431, 2008 Va. App. LEXIS 63 (2008).

    Where a friend’s testimony showed he had no more than the mere status of a housemate, a situation that arose under many circumstances, but did not indicate a dependent relationship on an employee beyond the sharing of a household, that fact alone could not qualify the friend as the employee’s dependent for the purposes of attaining statutory dependency status. Dunnavant v. Newman Tire Co., 51 Va. App. 252, 656 S.E.2d 431, 2008 Va. App. LEXIS 63 (2008).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    A person who is a total dependent in fact under this section may share equally with a person who is a statutory dependent under § 65.1-66 (now § 65.2-515 ). Jordan v. Roeder, 50 O.I.C. 218 (1968).

    The degree of dependency is based on the proportion of the sums contributed by the decedent to the claimant’s total income. Vong v. Waverly Textile Processing, Inc., 73 O.W.C. 135 (1994).

    Parents who are partial dependents do not share compensation with acknowledged illegitimate son, deemed by statute a total dependent. Gaddy v. Withers, 50 O.I.C. 148 (1968).

    Where minor brothers or sisters of deceased worker reside with their parents the presumption is that their father is carrying out his legal and moral duty to support them. Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573, 1946 Va. LEXIS 136 (1946); Clark v. Appalachian Power Co., 153 Va. 86 , 149 S.E. 613 , 1929 Va. LEXIS 243 (1929).

    Common-Law Wife:

    Public policy of Virginia precludes a common law wife from receiving benefits under this section. Bruce v. Taylor Inc., 50 O.I.C. 63 (1968); Ford v. American Original Foods, Inc., 58 O.I.C. 131 (1979).

    A partner in a common-law marriage is precluded from qualifying as a dependent under either § 65.1-66 (now § 65.2-515 ) or § 65.1-67 (now § 65.2-516 ). However, the common law partner’s son from a previous marriage may be awarded proportional benefits if partial dependency can be established. Wingfield/Dawson v. Thomas Roofing, 65 O.I.C. 309 (1986).

    Adopted Children:

    While § 65.1-66 (now § 65.2-515 ) makes an adopted child wholly dependent on foster parent, such child may also have been dependent in fact under this section upon his natural father. Wilfong v. Scott Packing, 15 O.I.C. 303, 477 (1933) (appeal denied).

    Child being adopted by deceased is totally dependent in fact. Figgins v. Grunley-Walsh Constr. Co., Inc., 50 O.I.C. 137 (1968).

    When Dependency Must Exist:

    Dependency in fact must have existed at time of accident. Testerman v. H.S. Williams Co., 55 O.I.C. 335 (1973); Harriman v. Jackson Motel, 54 O.I.C. 158, 161 (1972) (appeal denied).

    In finding that the claimant was partially dependent on the decedent, the Commission held that while dependency is determined as of the date of the accident, it must have existed for at least three months prior to that date. Payments by other people after the decedent’s death are not relevant except as evidence of reliance. Vong v. Waverly Textile Processing, Inc., 73 O.W.C. 135 (1994).

    There was no evidence of dependency by the wife on the deceased where by separation agreement she waived any right to support, alimony or maintenance and all payments thereafter were specifically designated for the maintenance of the home until it was sold. Murray v. County of Fauquier Sheriff ’s Office, 71 O.W.C. 50 (1992).

    Payment for Lodging Is Not Considered:

    In determining the extent of dependency from the amounts contributed by adult employee prior to his death, payments made for board and lodging will be deducted. Holt v. Stone & Webster Eng'r Corp., 179 Va. 625 , 20 S.E.2d 498, 1942 Va. LEXIS 256 (1942); Miller & Long v. Frye, 215 Va. 591 , 212 S.E.2d 258, 1975 Va. LEXIS 193 (1975).

    Sums paid by the decedent for room and board can not be considered in determining the degree of dependency. In the absence of other evidence, the Commission will apply its guidelines in determining the appropriate monetary degree of dependency. Vong v. Waverly Textile Processing, Inc., 73 O.W.C. 135 (1994).

    See notes to § 65.2-512 and § 65.2-515 .

    § 65.2-517. Termination of dependency.

    For the purpose of this title, the dependence of a widow or widower of a deceased employee shall terminate with death or remarriage, and the amount to be theretofore received by him or her shall be divided among the children or other dependents in the proportion of which they are receiving compensation, and the dependence of a child or any minor dependent, except a child or minor dependent physically or mentally incapacitated from earning a livelihood, or a full-time student, as defined in § 65.2-515 , shall terminate with the attainment of eighteen years of age.

    History. Code 1950, § 65-66; 1960, c. 298; 1968, c. 660, § 65.1-69; 1973, cc. 401, 542; 1991, c. 355.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 47.

    CASE NOTES

    This section delineates the only circumstances under which the commission may reapportion benefits. Benefits may be reapportioned when a recipient’s dependency has terminated due to: (1) death, (2) marriage, and (3) the attainment of 18 years of age. This section makes no provision for reapportionment upon a third party settlement which excludes some beneficiaries from further receipt of payments. ACB Trucking, Inc. v. Griffin, 5 Va. App. 542, 365 S.E.2d 334, 4 Va. Law Rep. 1860, 1988 Va. App. LEXIS 35 (1988), overruled in part, Liberty Mut. Ins. Co. v. Fisher, 263 Va. 78 , 557 S.E.2d 209, 2002 Va. LEXIS 15 (2002).

    Termination of dependency of child. —

    The former language of this section that “the dependency of a child, except a child physically or mentally incapacitated from earning a livelihood, shall terminate with the attainment of eighteen years of age” (“or minor dependent” was added after “child” in the quoted phrase by the 1960 amendment note) applies to a daughter whose right to compensation accrues by reason of the death of a parent after she becomes 18 years of age as well as to one who reaches that age while she is receiving compensation. Both are placed on the same footing. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940) (decided under prior law).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The death of the dependent spouse of deceased employee does not preclude an award of compensation to the estate of the deceased spouse if a compensable claim is established. Such claim is limited to the compensation payable from the death of the employee to the death of the dependent. Eagle v. Hampton Roads Educational Telecommunications Association, 64 O.I.C. 128 (1985).

    § 65.2-518. Limitation upon total compensation.

    The total compensation payable under this title shall in no case be greater than 500 weeks nor shall it exceed the result obtained by multiplying the average weekly wage of the Commonwealth as defined in § 65.2-500 for the applicable year by 500, except in cases of permanent and total incapacity as defined in § 65.2-503 C and in cases of permanent disability under subdivision A 4 of § 65.2-504 and death from coal worker’s pneumoconiosis under § 65.2-513 .

    History. Code 1950, § 65-68; 1952, c. 226; 1954, c. 654; 1956, c. 243; 1958, c. 568; 1960, c. 556; 1964, c. 94; 1966, c. 64; 1968, cc. 8, 660, § 65.1-71; 1970, c. 470; 1972, c. 229; 1973, c. 542; 1974, c. 560; 1975, c. 447; 1991, c. 355; 1997, c. 511.

    Law Review.

    For survey of Virginia law on workers’ compensation in the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    CASE NOTES

    Multiple conditions. —

    Although an employee suffered three work-related conditions when the employee was awarded workers’ compensation benefits, the employee was allowed to receive benefits for only one condition, so payments that the employer made were credited against the 500-week limit established by § 65.2-518 only for that condition, and the employee was entitled to receive benefits for the other conditions after the first condition no longer existed. E.I. du Pont de Nemours & Co. v. Eggleston, 264 Va. 13 , 563 S.E.2d 685, 2002 Va. LEXIS 75 (2002).

    Worker limited to one recovery. —

    Section 65.2-518 limits total compensation under this title to 500 weeks or the average weekly wage of the commonwealth for the applicable year multiplied by 500. Where a worker is covered by both the Longshore and Harbor Workers’ Compensation Act (LHWCA), 33 U.S.C.S. § 901 et seq., and the state act, the injured worker may proceed under either or both statutes but was entitled to only a single recovery for his injuries. Newport News Shipbuilding & Dry Dock Co. v. Holmes, 37 Va. App. 188, 555 S.E.2d 419, 2001 Va. App. LEXIS 652 (2001).

    Cost-of-living payments paid under former § 65.1-99.1 (now § 65.2-707 ) are not compensation within the meaning of the Workers’ Compensation Act. Bishopric Prods. Co. v. Brock, No. 1481-86-1 (Ct. of Appeals June 22, 1987) (decided under former § 65.1-71).

    Limitation period not reached. —

    Virginia Workers’ Compensation Commission’s finding that an employer had not paid a claimant 500 weeks of wage loss compensation benefits was affirmed as the appellate court’s previous decision that the employer’s payments to the claimant of benefits under the Longshore and Harbor Workers’ Compensation Act, 33 U.S.C.S. § 901 et seq., were voluntary, were not contemplated by § 65.2-518 , and could only be recouped under § 65.2-520 , was the law of the case. Newport News Shipbuilding & Dry Dock Co. v. Holmes, 2006 Va. App. LEXIS 128 (Va. Ct. App. Apr. 4, 2006).

    Permanent and total incapacity not proven. —

    Virginia Workers’ Compensation Commission did not err in denying the claimant permanent total disability benefits beyond the maximum 500 weeks she had already received and that were the most allowed as she did not meet her burden of proving permanent and total incapacity in both legs because the deputy commissioner never made a specific finding of fact at a hearing regarding whether the work-related accident caused any right leg disability; no treating physicians testified at the hearing before the deputy commissioner; and the deputy commissioner’s opinion stated that the claimant met with a doctor on July 25, 2013, who felt she had morbid obesity and that she had multiple MRIs of the lumbar spine which revealed degenerative disease. Roane v. Wash. Metro. Area Transit Auth., 2020 Va. App. LEXIS 263 (Va. Ct. App. Oct. 27, 2020).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The 1991 amendments to Code § 65.2-503 , which allow compensation for permanent partial disability beyond 500 weeks, are substantive changes to the Workers’ Compensation Act and are not retroactive. Hinton v. Southland Industries, Inc., 77 O.W.C. 117 (1998).

    An employee injured by accident before October 1, 1991 who has received 500 weeks compensation benefits cannot receive an additional award for permanent partial disability. Hinton v. Southland Industries, Inc., 77 O.W.C. 117 (1998).

    § 65.2-519. When limitations inapplicable to injuries arising out of pneumoconiosis.

    The limitations as to the maximum periods and maximum total amounts listed in §§ 65.2-500 , 65.2-512 , and 65.2-518 shall not apply to injuries arising out of pneumoconiosis.

    History. 1972, c. 615, § 65.1-71.1; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation in the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    § 65.2-520. Voluntary payment by employer.

    Any payments made by the employer to the injured employee during the period of his disability, or to his dependents, which by the terms of this title were not due and payable when made, may, subject to the approval of the Commission, be deducted from the amount to be paid as compensation, provided that, in the case of disability, such deductions shall be made by reducing the amount of the weekly payment in an amount not to exceed one-fourth of the amount of the weekly payment for as long as is necessary for the employer to recover his voluntary payment. However, any payments made to an injured employee under the Longshore and Harbor Workers’ Compensation Act of 1927, as amended, 33 U.S.C. § 901 et seq., may be deducted in full from the amount to be paid as compensation for the same injury under this title.

    History. Code 1950, § 65-69; 1968, c. 660, § 65.1-72; 1991, c. 355; 1998, c. 68; 2007, c. 356.

    The 1998 amendment deleted “by shortening the period during which compensation must be paid and not” preceding “by reducing the amount,” and added the language beginning “in an amount not to exceed one-fourth.”

    The 2007 amendments.

    The 2007 amendment by c. 356, effective March 13, 2007, inserted the last sentence.

    Law Review.

    For an article relating to the most significant developments in the law of workers’ compensation since September 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    CASE NOTES

    Editor’s note.

    Most of the cases below were decided prior to the 2007 amendment to this section, which provided that payments made to injured employee under federal Longshore and Harborworkers’ Compensation Act are deductible.

    This section does not authorize employer to ignore provisions of former § 65.1-93 (now § 65.2-701 ). Rather, it merely provides that payments voluntarily made prior to the rendition of an award may be deducted from the total amount of compensation due pursuant to the award subsequently entered. National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187, 4 Va. Law Rep. 1075, 1987 Va. App. LEXIS 239 (1987) (decided under former § 65.1-72).

    This section does not distinguish between types of voluntary payments; rather, it includes any type of payment not required under Act, whether payment is an overpayment as a result of mistake by employer, or a payment of benefits pursuant to another statute. Dodson v. Newport News Shipbuilding & Dry Dock, 1999 Va. App. LEXIS 493 (Va. Ct. App. Aug. 10, 1999).

    Payment of wages to the claimant based upon sick and annual leave may be credited to the department under the provisions of this section. Dyson v. Commonwealth/Department of Transp., No. 1554-88-3 (Ct. of Appeals Oct. 24, 1989) (decided under former § 65.1-72).

    Sick leave pay equivalent to payment of compensation. —

    Portion of a teacher’s sick leave pay was the equivalent of the school board’s payment of compensation on the teacher’s original worker’s compensation claim, pursuant to the terms of the parties’ stipulated order. Augusta County Sch. Bd. v. Humphreys, 53 Va. App. 355, 672 S.E.2d 117, 2009 Va. App. LEXIS 52 (2009).

    Overpayment not voluntary. —

    If the average weekly wage is miscalculated and the employer voluntarily has paid the claimant sums that were not due, the employer may recoup the sums; here, the claim had advanced beyond the provisions of this code section. An award based on an agreed memorandum had been made by the commission, and the overpayment was made pursuant to that award, not voluntarily. Collins v. Department of Alcoholic Beverage Control, 21 Va. App. 671, 467 S.E.2d 279, 1996 Va. App. LEXIS 128 (1996).

    Approval of commission required. —

    The statute permits recoupment by an employer of voluntary excess payments only with the approval of the Workers’ Compensation Commission. Childress, Jr. v. Appalachian Power Co., 1998 Va. App. LEXIS 673 (Va. Ct. App. Dec. 22, 1998).

    Applying the Holmes standard, the appellate court held that § 65.2-520 facilitated an employer’s right to collect Longshore and Harbor Workers’ Compensation Act credits by “deductions” from compensation due an employee under the Act, but expressly restricted such offsets to one-fourth of the “weekly payment,” and created no alternative or exception to the collection mechanism to redress circumstances that could result in a diminished recovery by the employer; while the pre-1998 version of the statute applied to the case, the outcome under the Holmes standard was the same. Newport News Shipbuilding & Dry Dock Co. v. Emerson, 2002 Va. App. LEXIS 139 (Va. Ct. App. Mar. 5, 2002).

    Credit to employer allowed. —

    Here the employer was entitled to credit for the amount it had paid under the LHWCA that exceeded its obligation under the Workers’ Compensation Act. Virginia International Terminals, Inc. v. Moore, 22 Va. App. 396, 470 S.E.2d 574, 1996 Va. App. LEXIS 368 (1996), aff'd, 254 Va. 46 , 486 S.E.2d 528, 1997 Va. LEXIS 55 (1997).

    Credit to employer improper. —

    Employer improperly took credit for payments made to injured employee under federal Longshore and Harborworkers’ Compensation Act, and employer was therefore required to pay twenty percent penalty for payments not paid within two weeks of becoming due. Dodson v. Newport News Shipbuilding & Dry Dock, 1999 Va. App. LEXIS 493 (Va. Ct. App. Aug. 10, 1999).

    When an employer sought a credit for workers’ compensation benefits it paid to a claimant after she returned to light-duty work, the employer was not entitled to such a credit, under § 65.2-520 , because the payments the employer made to the claimant were pursuant to an open award of workers’ compensation and, thus, were due and payable when made, so the employer was not entitled to a credit against future compensation. Newport News Shipbuilding & Dry Dock Co. v. Bailey, 2003 Va. App. LEXIS 681 (Va. Ct. App. Dec. 23, 2003).

    Express provisions of §§ 65.2-708 and 65.2-712 governing the termination of an award based on a change in condition controlled the issue of whether the employer was entitled to a credit for workers’ compensation benefits it paid to the claimant for nearly nine months following his return to work after he had sustained a compensable injury and since those provisions did not dictate that the employer was entitled to a credit for the payments it made to the claimant despite its knowledge that he had returned to full-duty work, the workers’ compensation commission erred in finding that under § 65.2-520 , the employer was entitled to a credit for having made such payments, as that statutory interpretation thwarted the legislature’s intention, as set forth in the other two statutes, that an award of benefits only be altered prospectively. McFadden v. Carpet House, 42 Va. App. 302, 591 S.E.2d 708, 2004 Va. App. LEXIS 28 (2004).

    Conventional meaning of compensation included only wage loss compensation, also known as “indemnity payments”; voluntary payments made to a claimant pursuant to an unapproved out-of-state settlement were not credited against an employer’s liability to provide medical benefits. Uninsured Emplrs. Fund v. Wilson, 46 Va. App. 500, 619 S.E.2d 476, 2005 Va. App. LEXIS 366 (2005).

    Employer was entitled to a credit under the § 65.2-520 for benefits paid under the Federal Longshore and Harbor Workers’ Compensation Act (LHWCA), 33 U.S.C.S. § 901 et seq., as benefits paid under LHWCA were voluntary, and a de facto state workers’ compensation award existed during the same period of time as the LHWCA benefits were being paid, since the employer conceded, in a writing filed with the Virginia Workers’ Compensation Commission, the compensability of the claimant’s disability under the Virginia Workers’ Compensation Act for that period. Lyons v. Newport News Shipbuilding & Dry Dock Co., 2005 Va. App. LEXIS 532 (Va. Ct. App. Dec. 28, 2005).

    Virginia Workers’ Compensation Commission’s finding that an employer had not paid a claimant 500 weeks of wage loss compensation benefits was affirmed as the appellate court’s previous decision that the employer’s payments to the claimant of benefits under the Longshore and Harbor Workers’ Compensation Act, 33 U.S.C.S. § 901 et seq., were voluntary, were not contemplated by § 65.2-518 , and could only be recouped under § 65.2-520 , was the law of the case. Newport News Shipbuilding & Dry Dock Co. v. Holmes, 2006 Va. App. LEXIS 128 (Va. Ct. App. Apr. 4, 2006).

    Virginia Workers’ Compensation Commission did not err in finding that the employer had not reinstated a claimant’s leave where the employer had been ordered to pay the claimant temporary total disability benefits for the agreed disability period, and the purely ceremonial reinstatement of her lost 2016 leave, which she could not use, had not restored her to her former position of having that amount of leave available for use. Since the Commission’s factual finding that the leave was not simultaneously reinstated was supported by credible evidence, the employer was required to pay the claimant the dollar value of the leave she had used. N. Va. Cmty. Coll. v. Easwarachandran, 2020 Va. App. LEXIS 209 (Va. Ct. App. July 21, 2020).

    Approval from Workers’ Compensation Commission not required before taking credit. —

    This section does not require that an employer seek approval from the Workers’ Compensation Commission before taking a credit for voluntary payments made to a claimant. Brackett v. Chesapeake Public Schools, 1998 Va. App. LEXIS 465 (Va. Ct. App. Aug. 25, 1998).

    Error in refusal to offset benefits by Longshore and Harbor Workers’ Compensation Act monies. —

    Commission erroneously refused to offset permanent partial disability benefits awarded claimant pursuant to the Virginia Workers’ Compensation Act by the temporary total disability monies previously paid under the Longshore and Harbor Workers’ Compensation Act. Ceres Marine Terms., Inc. v. Ward, 1997 Va. App. LEXIS 600 (Va. Ct. App. Sept. 23, 1997).

    Statute facilitated an employer’s right to collect credits under the Longshore and Harbor Workers’ Compensation Act, 33 U.S.C.S. § 901 et seq. by deductions from compensation due an employee under the statute, but expressly limited offsets; statute created no alternative or exception to the collection mechanism to redress circumstances that could result in a diminished recovery by an employer. Newport News Shipbuilding & Dry Dock Co. v. Holmes, 37 Va. App. 188, 555 S.E.2d 419, 2001 Va. App. LEXIS 652 (2001).

    Employer not entitled to credit. —

    Virginia Workers’ Compensation Commission properly found that an employer was not entitled to a credit for disability benefits received by a workers’ compensation claimant under § 65.2-520 since: (1) the claimant received short and long-term benefits through a plan funded by the Commonwealth, not a plan funded through the employer who was liable to the claimant for workers’ compensation benefits; (2) the issue was not whether the claimant was recovering twice, but was whether the employer was paying twice; (3) the employer paid only once for the claimant’s injury; (4) while the claimant might have received a temporary windfall, the claimant gained it at the expense of the Commonwealth, rather than the employer’s insurer, which only paid what it was obligated to pay under the Virginia Workers’ Compensation Act; and (5) it was not more equitable for the insurer, rather than the claimant, to benefit from the payment of supplemental benefits made to the claimant by a third party. B.P. Solar & Ace Am. Ins. Co. v. Jones, 49 Va. App. 322, 641 S.E.2d 124, 2007 Va. App. LEXIS 57 (2007).

    Circuit court properly dismissed a city’s complaint for a credit because, while the court erred in holding that the Workers’ Compensation Commission rather than the court had jurisdiction over the case, it reached the right result because the city’s sick leave payments to an employee were voluntary for purposes of the Workers’ Compensation Act, the Commission had no jurisdiction to consider the employer’s policies regarding sick leave, and the city did not have authority under the ordinance or regulations upon which it relied to recover sick leave pay from the employee on the basis that he had also received workers’ compensation for the same disability period. City of Danville v. Tate, 289 Va. 1 , 766 S.E.2d 900, 2015 Va. LEXIS 8 (2015).

    Claim waived. —

    Workers’ compensation claimant waived her claim that an employer was not entitled to a credit for an overpayment under § 65.2-520 where she did not argue the issue with any specificity, relying instead on a few broad, conclusory assertions, and she failed to provide any citation to controlling legal authority that supported her position as required by Va. Sup. Ct. R. 5A:20(e). Waters v. TGI Friday's, 2012 Va. App. LEXIS 129 (Va. Ct. App. Apr. 24, 2012).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The 2007 amendment to § 65.2-520 providing that payments made to an injured employee under LSHWA may be deducted in full from the amount to be paid as compensation for the same injury under the Virginia Act is not retroactive. Holmes v. Newport News Shipbuilding & Dry Dock Company, VWC File No. 167-38-58 (Dec. 21, 2007) (Dismissed by Court of Appeals on Feb. 26, 2008).

    The Commission’s jurisdiction is limited to compensation matters and does not include authority over the employer’s policies regarding sick leave such as to order reinstatement. However, the employer/carrier is not entitled to a credit for paid time off leave which consists of accrued sick, vacation and holiday time in the absence of evidence of reinstatement of any such deductions. Epps v. Inova Fair Oaks Hospital, VWC File No. 213-55-21 (March 23, 2007), aff’d on other issues, No. 0908-07-4 (Ct. App. Va., July 31, 2007).

    Section 65.2-520 applies where there has been an overpayment of cost of living benefits. Killen v. Westvaco Corp., VWC File No. 205-29-00 (Nov. 14, 2006).

    Payments made pursuant to a foreign jurisdiction’s statute are considered voluntary payments for purposes of the Virginia Act. The employer is entitled to a credit against the Virginia Award for those voluntary payments including the amount of overpayments. Beausoleil v. Plasser American Corp., VWC File No. 219-86-90 (March 31, 2006).

    Section 65.2-520 applies where an employer has made payments in excess of the awarded rate, irrespective of whether the overpayments were made before or after an Award. Although the overpayment was a result of the carrier’s mistake, the excess was so obvious that a full credit was appropriate. A repayment rate that was approximately 12 percent of the claimant’s weekly benefits and well below the 25 percent limitation in the statute was sufficient punishment to discourage future mistakes. Robinson v. Union Drill, Inc., VWC File No. 207-70-24 (Dec. 16, 2005).

    Where the carrier mistakenly failed to withhold an attorney’s fee previously awarded by the Commission, it was not equitable for the claimant to retain the overpayment and the attorney was entitled to a lump sum rather than payment over time. The carrier was ordered to pay the $1000 fee to the attorney and deduct $50 per week from ongoing payments to the claimant. Robinson v. Union Drill, Inc., VWC File No. 207-70-24 (Dec. 16, 2005).

    Employer allowed lump-sum credit against permanent partial award for overpayments made to employee after temporary total award terminated; employer’s application to terminate award on November 6, 2001, based on October 1, 2001, refusal of selective employment, granted, and award terminated as of November 6, 2001; employee later sought permanent partial benefits, and employer sought credit against award for overpayments made after November 6, 2001; employer allowed to take lump-sum credit against permanent partial award without weekly reduction as required by § 65.2-520 . McClain v. Norfolk Sheriff’s Office, VWC File No. 206-22-47 (Mar. 29, 2004).

    Employer, who overpaid employee for 18 weeks beyond statutory maximum of 500 weeks of benefits, allowed to take credit for the overpayment against unpaid cost-of-living payments, because overpayment was a voluntary payment and COLA payments are subject to statutory provision allowing credit for voluntary payments. Eghbal v. Boston Coach Corp., VWC File No. 167-35-41 (July 11, 2003).

    The purpose of the Workers’ Compensation Act is to compensate injured workers for lost wages, not to enrich them unjustly. The claimant admitted she received her full salary during each of the eleven days for which she sought benefits and was not charged with any sick leave. Allowing her to collect compensation benefits in addition would clearly amount to a double recovery. Brackett v. City of Chesapeake School Board, 77 O.W.C. 68 (1998), aff’d, No. 0466-98-1 (Ct. of Appeals, Aug. 25, 1998).

    In the absence of evidence establishing that payment was made in lieu of compensation or as a specific part of an employment contract, the employer is not entitled to a credit for “severance pay” paid to an employee upon termination of the employment. Monteith v. Genesco, Inc., 66 O.I.C. 175 (1987).

    In cases where there is concurrent jurisdiction between Virginia and the Federal Act, the employer will be given a credit under the Virginia Act for benefits paid under the Federal Act. The Virginia award will remain in effect and will not be suspended. Krise v. E. T. Gresham Company, 73 O.W.C. 222 (1994).

    Where an employer pays compensation benefits to a claimant under the Longshoremen and Harbor Workers’ Compensation Act and the award is subsequently overturned, there has been no voluntary payment under § 65.1-72, (now § 65.2-520 ), and the employer is not entitled to recoup the Federal payment by withholding compensation owed pursuant to an outstanding Virginia award if there is no evidence of double recovery. Humphries v. Cargill, Inc., 66 O.I.C. 179 (1987).

    Where an employee is paid pre-injury wages during disability, the employer is entitled to a credit limited to the amount payable under the Act. All payments made in excess of those prescribed by the Act are considered voluntary payments. Morton v. Davis Asphalt, 70 O.I.C. 240 (1991).

    Section 65.2-520 addresses the recovery of “voluntary” payments made before the entry of an award, which may be recovered by an employer in the form of a credit. However, once an award is made by the Commission, an overpayment made pursuant to that award is not made voluntarily, and § 65.2-520 does not apply. Sadler v. Middle Peninsula Regional Security Center, 78 O.W.C. 144 (1999).

    Where a deputy commissioner in earlier proceedings awarded the employer a credit for all overpayments of benefits it had paid to the claimant, because of a miscalculation of average weekly wage, which opinion was not appealed, the employer was entitled to a credit against its future obligations through the date on which it filed its change in condition application. Phares v. Big Meadows Lodge, 76 O.W.C. 154 (1997).

    An employer is not entitled to a credit for workers’ compensation benefits paid in another state for an overlapping period but for a different accident. The carrier would be entitled to a credit for payments made in another state for the same accident and same injuries. Harris v. Otis Elevator, 73 O.W.C. 223 (1994).

    In holding that it is not permissible to apply adjudicated credit to subsequent medical costs, the Commission noted that to do so would equate medical benefits with compensation. Compensation does not include voluntary medical payments and the twenty percent penalty may not be assessed against such payments. In addition, cost-of-living adjustments are not considered compensation. Mabe v. Happy Stores #494, 73 O.W.C. 175 (1994).

    The employer does not waive its right to a credit for the claimant’s reinstated sick leave where it fails to raise that issue at a compensation hearing or on subsequent review, nor is the employer required to seek prior approval before crediting itself. Such a requirement would discourage and delay the voluntary payment of benefits through salary continuation to employees. Brackett v. City of Chesapeake School Board, 77 O.W.C. 68 (1998), aff’d, No. 0466-98-1 (Ct. of Appeals, Aug. 25, 1998).

    Failure to seek the Commission’s approval before recouping payments made when they were not due and payable under an award may subject the employer or insurer to penalties. Although the evidence in this case clearly showed that the employer mistakenly overpaid compensation benefits, it was not entitled, unilaterally, to recoup such payments by reducing the weekly amount of later compensation benefits. Section 65.2-520 allows recoupment of voluntary payments “subject to the Commission’s approval.” By reducing the employee’s compensation benefits without approval, the employer failed to pay all current compensation benefits within two weeks after they became due, and the claimant was entitled to a 20% penalty on all such payments unilaterally withheld. Moore v. Deerfield Correctional Center, VWC File No. 170-78-73 (January 19, 2001).

    Compensation benefits paid by the insurer after a compromise settlement has been approved, but paid prior to the date they were due under § 65.2-524 , constitute voluntary payments pursuant to § 65.2-520 , for which the insurer is entitled to a credit. Here, the insurer paid four days of compensation benefits in advance of the dates they were due. When the lump-sum compromise settlement was eventually paid, the insurer reduced the amount owed to the claimant by the amount paid to him in advance of settlement. The Commission found that the Deputy Commissioner erred in ordering the insurer to pay the four days of benefits, plus a 20% penalty. The insurer was entitled to a credit for the four days of voluntary payments it made. Baber v. Roughton Pontiac Corporation, VWC File No. 179-44-26 (April 5, 2002).

    Uninsured Fund:

    The provision of § 65.2-520 limiting an employer’s recovery of voluntary payments to a reduction of ongoing weekly benefits by one-fourth, does not apply to claims for recovery of mistaken payments made by the Uninsured Employers’ Fund (“UEF”). The General Assembly created § 65.2-1206 , which allows the UEF to recover payments made to the employee procured through fraud, mistake or unreported change in condition. The UEF’s recovery of mistaken payments under § 65.2-1206 is not limited to a percentage reduction in weekly benefits, but is to be determined by the Commission. In this case, the Commission allowed the UEF to reduce weekly benefits by thirty percent until the overpayment was fully recovered. Bullington v. Marshall Boy’s Logging, VWC File No. 180-34-06 (March 7, 2001).

    Disability Benefits:

    The Commission has the authority to award a credit for payments made from an employer funded short-term disability plan but there must be evidence that the policy contained an exclusion for disability compensable under the Act. Pieters v. Wegman’s Food Markets, Inc., #4007, VWC File No. 227-86-93 (Oct. 4, 2007)(On remand to determine if policy contained an exclusion deputy commissioner on Apr. 2, 2008 found in defendant’s favor).

    Although premiums for disability insurance were paid by employer, payments made under such policy to injured worker cannot be credited against compensation due the worker by employer, who had no compensation insurance at time of accident. There is no provision for substitution in the Act. Definbaugh v. Wood, 57 O.I.C. 103 (1977); Parsons v. Auerbach Assoc., 57 O.I.C. 286 (1976).

    § 65.2-521. Time of payment.

    The Commission, upon application of either party, may, in its discretion, having regard to the welfare of the employee and the convenience of the employer, authorize compensation to be paid bi-weekly, monthly, or quarterly instead of weekly.

    History. Code 1950, § 65-70; 1968, c. 660, § 65.1-73; 1991, c. 355.

    § 65.2-522. Lump sum payments, generally.

    When the parties agree and the Commission deems it to be to the best interests of the employee or his dependents, or when it will prevent undue hardships on the employer, or his insurance carrier, without prejudicing the interests of the employee or his dependents, liability for compensation may be redeemed, in whole or in part, through payment by the employer of a lump sum which shall be fixed by the Commission, but in no case shall the sum awarded be less than a sum equal to the present value of future compensation payments commuted, computed at four percent true discount compounded annually.

    History. Code 1950, § 65-71; 1968, c. 660, § 65.1-74; 1972, c. 619; 1973, c. 401; 1991, c. 355.

    CIRCUIT COURT OPINIONS

    Worker’s compensation awards exempted. —

    All matters falling within the purview of the Virginia Worker’s Compensation Act, § 65.2-100 et seq., were the exclusive province of the Virginia Worker’s Compensation Commission, and a clear meaning of the words used exempted lump sum worker’s compensation awards from the Virginia Structured Settlement Protection Act, § 59.1-475 et seq.; a worker’s petition seeking approval of a transfer of a structured settlement payment rights relating to a worker’s compensation award in a circuit court was dismissed. In re Moore, 68 Va. Cir. 139, 2005 Va. Cir. LEXIS 67 (Portsmouth June 9, 2005).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    In order for a lump sum settlement to be approved, the Commission must be furnished sufficient information to determine if it is in the best interest of the employee. The information must include evidence that the employee’s injuries are stabilized, permanency exists, evidence of the employee’s capabilities to handle the funds, and a detailed plan of how the proceeds will be used or invested. Warrick v. Goodyear Tire & Rubber Co., 69 O.I.C. 131 (1990).

    § 65.2-523. Lump sum payments to trustees.

    Whenever the Commission deems it expedient, any lump sum subject to the provisions of § 65.2-522 shall be paid by the employer to some suitable person or corporation appointed by the circuit court in the county or city wherein the accident occurred, or by such other circuit court as may be designated by the Commission as more compatible with the interests and convenience of the beneficiaries, as trustee or guardian, to administer the same for the benefit of the person entitled hereto in the manner provided by the Commission. The receipt of such trustee for the amount as paid shall discharge the employer or anyone else who is liable therefor.

    History. Code 1950, § 65-72; 1968, c. 660, § 65.1-75; 1991, c. 355.

    § 65.2-524. Failure to pay compensation within two weeks after it becomes due.

    If any payment is not paid within two weeks after it becomes due, there shall be added to such unpaid compensation an amount equal to 20 percent thereof, unless the Commission finds that any required payment has been made as promptly as practicable and (i) there is good cause outside the control of the employer for the delay or (ii) in the case of a self-insured employer, the employer has issued the required payment to the employee as a part of the next regular payroll after the payment becomes due. No such penalty shall be added, however, to any payment made within two weeks after the expiration of (a) the period in which Commission review may be requested pursuant to § 65.2-705 or (b) the period in which a notice of appeal may be filed pursuant to § 65.2-706 . No penalty shall be assessed against the Commonwealth when the Commonwealth has issued a regular payroll payment to the employee in lieu of compensation covering the period of disability. As used in this section, a regular payroll payment issued by the Commonwealth includes payments issued net of deductions for elected and mandatory benefits and other standard deductions.

    History. 1970, c. 470, § 65.1-75.1; 1991, c. 355; 1994, c. 248; 1997, c. 383; 1999, c. 782; 2012, c. 270.

    The 1999 amendment, in the first sentence, inserted “unless the Commission finds that any required payment has been made as promptly as practicable and,” and added clauses (i) and (ii).

    The 2012 amendments.

    The 2012 amendment by c. 270 substituted “20 percent” for “twenty percent” in the first sentence, the clause (a) and (b) designators for former clause (i) and (ii) designators in the second sentence, and “payroll payment to the employee” for “payroll check to the employee” in the third sentence; and added the fourth sentence.

    Law Review.

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 51.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-75.1 or prior law.

    Legislative intent. —

    While penalty statutes are to be narrowly construed, the legislature clearly and unambiguously has imposed a penalty for nonpayment of benefits within 14 days from the date that payment was due without consideration for good cause or good faith. Weston v. B.J. Church Constr. Co., 9 Va. App. 283, 387 S.E.2d 96, 6 Va. Law Rep. 892, 1989 Va. App. LEXIS 153 (1989).

    Applicability of section. —

    The penalty provisions of this section are inapplicable to a lump-sum compromise settlement for which no payment date has been fixed in the approving order. Once a payment date has been set, the penalty statute will apply, and the two-week period within which payment must be made to avoid the penalty will begin to run from that date. Absent a payment date specified in or approved by the order, however, the employer was entitled to a reasonable time after entry of the order to make the required payment. Koppers Co. v. Brockenborough, 225 Va. 58 , 300 S.E.2d 755, 1983 Va. LEXIS 191 (1983).

    Where the employer paid under a compromise settlement with no specified payment date within three days after its counsel was notified that payment had not been made, payment was made within a reasonable time. To hold otherwise would be to construe the penalty statute broadly, contrary to general principles, and to change the terms of the compromise agreement which the parties freely negotiated. Koppers Co. v. Brockenborough, 225 Va. 58 , 300 S.E.2d 755, 1983 Va. LEXIS 191 (1983).

    The commission approved a compromise settlement between the claimant and employer by order entered December 1, 1994. On December 12, 1994, employer mailed the settlement check to the claimant at her last known address. The claimant received the settlement check on December 15, 1994. Upon deposit of the settlement check, the claimant’s bank advised her that it would take seven to eleven business days for the check to clear. Between December 16, 1994 and December 23, 1994, several checks written by the claimant on her account were returned for insufficient funds. Employer complied with its obligation pursuant to this section when it mailed the settlement check to the claimant eleven days after entry of the commission’s order approving the settlement. Contrary to the claimant’s assertions on appeal, no evidence before the commission indicated that the funds available in the insurer’s account of the payee bank were insufficient to pay the settlement check. Thus, the commission did not err in refusing to assess a twenty percent penalty against the employer. Sangster v. Triple H Properties, Ltd., 1996 Va. App. LEXIS 334 (Va. Ct. App. May 7, 1996).

    Workers’ compensation commission erred in denying the claimant’s request for a penalty award against the employer and its insurer for their late payment of attorney fees; where the workers’ compensation commission ordered the attorney fee to be paid out of the claimant’s accrued compensation, the fee remained “compensation” within the meaning of the penalty statute, and that was true even where the workers’ compensation commission ordered the employer to pay a particular portion of the penalty to the claimant’s attorney as a reasonable fee pursuant to § 65.2-714 . Roman v. Ondeo Degremont, Inc., 47 Va. App. 773, 627 S.E.2d 539, 2006 Va. App. LEXIS 108 (2006).

    Employer was required to pay compensation pursuant to an award of the Virginia Workers’ Compensation Commission, and assessed a 20 percent penalty on unpaid compensation pursuant to § 65.2-524 because the employer unilaterally ceased paying an employee benefits due and owed under an open award. The employer stopped paying the employee compensation benefits when he returned to full-duty work, and did not file appropriate paperwork or an application to terminate the award until well outside the two-year period provided for doing so under § 65.2-708 , and in violation of Va. Workers’ Comp. Comm’n R. 1.4. Washington Post v. Fox, 49 Va. App. 692, 644 S.E.2d 105, 2007 Va. App. LEXIS 185 (2007).

    The consequence of the penalty provision of this section is to impose on the employer and carrier the duty to monitor the entry of an order or award by the commission. Weston v. B.J. Church Constr. Co., 9 Va. App. 283, 387 S.E.2d 96, 6 Va. Law Rep. 892, 1989 Va. App. LEXIS 153 (1989).

    There is no savings provision or escape clause in this section. Weston v. B.J. Church Constr. Co., 9 Va. App. 283, 387 S.E.2d 96, 6 Va. Law Rep. 892, 1989 Va. App. LEXIS 153 (1989).

    For the purposes of this section, compensation is “due” on the date of the award. —

    This interpretation of when payment becomes due is reasonably related to a proper purpose, is not arbitrary or discriminatory and does not violate the constitutional rights of equal protection and due process. The fact that because of geographic location, some employers and insurers receive notice of an award by mail sooner than others, and thereby have more time to issue payment, does not constitute a denial of equal protection. Audobon Tree Serv. v. Childress, 2 Va. App. 35, 341 S.E.2d 211, 1986 Va. App. LEXIS 239 (1986).

    The workers’ compensation statute is a remedial statute, its purpose being the prompt payment of compensation to injured workers and the purpose of the penalty provision of this section is to compel prompt payment, by requiring compensation to be paid within 14 days after it becomes due and this 14-day time limit is designed to discourage “slow and circuitous” payment of benefits due and to discourage inaction or inattention to a claim. Weston v. B.J. Church Constr. Co., 9 Va. App. 283, 387 S.E.2d 96, 6 Va. Law Rep. 892, 1989 Va. App. LEXIS 153 (1989).

    Under this section a benefit is “paid” when payment is mailed directly to the claimant, at his current residential address, within two weeks after it becomes due. Audobon Tree Serv. v. Childress, 2 Va. App. 35, 341 S.E.2d 211, 1986 Va. App. LEXIS 239 (1986).

    Computation of time. —

    Section 1-13.3 [see now § 1-210 ] is applicable to payments made pursuant to the Workers’ Compensation Act, and the day following the award is the first day to be counted in computing the time allowed for making payments pursuant to an award. Audobon Tree Serv. v. Childress, 2 Va. App. 35, 341 S.E.2d 211, 1986 Va. App. LEXIS 239 (1986).

    Claimant was not entitled to 20 percent statutory penalty that the claimant requested, because payment of compromise settlement agreement was not late; § 65.2-524 allowed for 20 percent penalty for payment not made within two weeks after it became due, but the two week period did not apply if the employer could request review by the full workers’ compensation commission pursuant to § 65.2-705 , in which case the two week time period was extended by the 20-day time period the employer had for requesting review by the full workers’ compensation commission and the payment was made to the claimant within the two weeks plus that additional 20-day time period. Ratliff v. Carter Mach. Co., 39 Va. App. 586, 575 S.E.2d 571, 2003 Va. App. LEXIS 21 (2003).

    Where claimant’s check was not mailed directly to him, but instead, the insurer mailed it to his counsel, and claimant did not actually receive his check within the specified time period, the employer violated the provisions of this section. Audobon Tree Serv. v. Childress, 2 Va. App. 35, 341 S.E.2d 211, 1986 Va. App. LEXIS 239 (1986).

    Workers’ Compensation Commission erred in vacating 20% late payment penalty for payments made more than 2 weeks after Court of Appeals affirmation of benefit award, there being nothing in the statute permitting an inference that the legislature intended further relief from the statutory penalty to cover the appeal period to the Supreme Court. Cousar v. Peoples Drug Store, 26 Va. App. 740, 496 S.E.2d 670, 1998 Va. App. LEXIS 140 (1998).

    Taking improper credit. —

    Employer improperly took credit for payments made to injured employee under federal Longshore and Harborworkers’ Compensation Act, and employer was therefore required to pay twenty percent penalty for payments not paid within two weeks of becoming due. Dodson v. Newport News Shipbuilding & Dry Dock, 1999 Va. App. LEXIS 493 (Va. Ct. App. Aug. 10, 1999).

    Parties not relieved of order to comply. —

    That the insurance carrier, in tracking entry of the order approving a compromise settlement between the parties, may have relied on the commission’s practice of mailing first class notice of entry of the order did not relieve the parties of the duty to comply with the order or comply with this section since parties are not relieved of the obligation to comply with the commission’s order because the method chosen to monitor or fulfill that obligation proves ineffectual. Weston v. B.J. Church Constr. Co., 9 Va. App. 283, 387 S.E.2d 96, 6 Va. Law Rep. 892, 1989 Va. App. LEXIS 153 (1989).

    Order stated date certain upon which payment was due. —

    Where appellants contended that the order in the case did not specify a payment date, and thus, no penalty could be imposed as long as payment was made within a “reasonable time,” the court of appeals disagreed with appellants’ premise; the order in this case stated a date certain upon which payment was due, i.e., “upon approval of the settlement.” The July 17, 1991, order stated: “The aforesaid settlement is hereby approved. . . .” Thus, the lump sum payment was due upon entry of the order, and the penalty provided by this section accrued two weeks later, July 31, 1991. Western Steer v. Holley, No. 0429-92-1 (Ct. of Appeals Sept. 22, 1992).

    Penalty may not be assessed while case on appeal. —

    A penalty may not be assessed against an employer for failing to pay benefits where an appeal is pending before the court of appeals in that § 65.2-706 , provides that an employer’s duty to pay benefits is suspended while such an appeal is pending; such a suspension is not lifted until the questions at issue in the appeal have been “fully determined.” Childress v. Appalachian Power Co., 2001 Va. App. LEXIS 13 (Va. Ct. App. Jan. 16, 2001).

    No right to penalties where denial of benefits affirmed on appeal. —

    Affirmance of Commission’s decision denying compensation benefits necessarily established that employer had reasonable grounds for defending against employee’s claim, and therefore employee was not entitled to award of interest, penalties, or attorney’s fees and costs. Mubaidin v. Holiday Inn Alexandria, 1999 Va. App. LEXIS 707 (Va. Ct. App. Dec. 28, 1999).

    Illustrative cases. —

    When a workers’ compensation claimant notified the Workers’ Compensation Commission that his employer’s carrier was not paying workers’ compensation benefits he had been awarded, and sought additional compensation due to a change in condition, to which the employer responded that the claimant had returned to work and any change in his condition was unrelated to his compensable injury, the issue of causation of the change in condition was improperly considered by the Commission because the claimant did not concede it was properly before the Commission, it was not mentioned in the hearing notice, nor did the Commission say it was considering terminating the claimant’s award based on his change in condition application, under subsection A of § 65.2-708 , and the carrier did not seek permission to terminate the claimant’s benefits, so the only issue properly before the Commission was whether the carrier should be assessed a penalty under § 65.2-524 for not paying benefits, and, as the claimant’s award was valid and not paid, the Commission erred in not awarding this penalty. Washington v. UPS of Am., 267 Va. 539 , 593 S.E.2d 229, 2004 Va. LEXIS 31 (2004).

    Claimant’s request to have the wages from her two jobs combined to calculate her workers’ compensation benefit was properly denied where the two jobs were not sufficiently similar to justify combining the wages, despite some of the duties overlapping, in as much as the two jobs had different missions. Tate v. UPS, 2004 Va. App. LEXIS 382 (Va. Ct. App. Aug. 10, 2004).

    Because an employer had a continuing liability to pay wage benefits under an open award in favor of an injured employee, and it failed to timely file a changed-circumstance application, despite the fact that the employee failed to file for termination of said benefits, the Virginia Workers’ Compensation Commission properly assessed a 20 percent nonpayment penalty against it for its failure to pay the injured employee unpaid wage benefits. Wal-Mart Assocs. v. Cannon, 2007 Va. App. LEXIS 387 (Va. Ct. App. Oct. 23, 2007).

    OPINIONS OF THE ATTORNEY GENERAL

    “Regular payroll check.” —

    The term “regular payroll check” refers to both the timing of the check and the amount of the check, so that the proposed legislative change to § 65.2-524 adequately defines “regular payroll payment” to avoid any penalty. It makes no difference whether the deduction for the new retirement contribution begins before or after the injured employee is injured. See opinion of Attorney General to Sara Redding Wilson, Director, Department of Human Resource Management, and David Von Moll, State Comptroller, 11-113, 2012 Va. AG LEXIS 6 (2/7/12).

    Because neither the new 5 percent mandated member contribution toward retirement or other deductions elected by the employee, including health-care premiums and flexible reimbursement account deductions, constitute an assignment of benefits or a claim of a creditor, they are not prohibited by § 65.2-531 and may be deducted in appropriate circumstances. See opinion of Attorney General to Sara Redding Wilson, Director, Department of Human Resource Management, and David Von Moll, State Comptroller, 11-113, 2012 Va. AG LEXIS 6 (2/7/12).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    When the defendants do not offer any proof of the payments made or an explanation as to why an alleged overpayment occurred, without additional evidence it is impossible to determine if there is a bona fide overpayment that, if ignored, would result in a double payment to the claimant. Knowles v. Wawa, Inc., JCN VA00000281100 (Oct. 29, 2013).

    Where payment is required pursuant to an Award or Order that would be subject to the Review period set forth in § 65.2-705 of the Act, including an Order for a compromise settlement, payment is due within 14 days of the expiration of the Review period. The period begins to run from the date that counsel for the defendants receives the settlement Order not the date the carrier receives the Order. Swartz v. Home Depot, VWC File No. 200-65-49 (July 7, 2006).

    Where the claimant dies while the case is pending before the Court of Appeals, which ultimately affirms an Award for disability benefits, the decedent’s estate is entitled to the accrued benefits. Accrued compensation is payable to the personal representative of the estate. Although no executor or administrator has been named, the employer’s estate has standing to file a claim for penalties for late payment pursuant to § 65.2-524 . However, in the absence of evidence that a personal representative qualified and was appointed, no penalty for late payment is due because the insurer has established good cause outside of the employer’s control for the delay in paying benefits since there was no one to whom payments could be made. Looney et al, v. Apollo Mining Corp., VWC File No. 214-02-44 (May 2, 2006).

    Where the Commission orders the attorney fee to be paid out of the claimant’s accrued compensation, the fee remains compensation within the meaning of the penalty statute. Roman v. Ondeo Degremont, Inc. (March 28, 2006).

    Penalties may be assessed against the Guaranty Fund. Miller v. Potomac Hospital (Dec. 11, 2007). (Note: The opinion suggests that penalties may be assessed against the Uninsured Employer’s Fund.).

    The penalty provisions of § 65.2-524 are inapplicable to reimbursement of attorney fees and costs pursuant to § 65.2-311 because the payments are not compensation, but rather are reimbursements of the defendants’ pro rata share of the attorney fees and costs incurred by the claimant in settling his third party action. Sheets v. J G Sheets & Sons, Inc., VWC File No. 208-23-77 (June 17, 2005).

    For cases in which no appeal is taken to the Court of Appeals, a penalty is assessed if payment is not paid within two weeks after 30 days, or 44 days. For cases that are appealed, §§ 65.2-706 (C) and 8.01-685 stay the award and a penalty does not apply until two weeks after the appellate decision is received by the Commission’s clerk. Bartley v. Henrico County, 76 O.W.C. 407 (1997).

    The failure to timely file an appeal to the Court of Appeals is a jurisdictional defect. An appeal that is dismissed because it was not timely filed was never within that Court’s jurisdiction, and a penalty is owed on compensation not paid within 44 days of the date of notice to the employer of the Commission’s decision. Bartley v. Henrico County, 76 O.W.C. 407 (1997).

    The tolling provision of Code § 65.2-524 deferring the due date for payment of compensation until the period within which a review of an award may be filed is applicable to awards made pursuant to agreements filed by the parties. Hall v. The Weather Conditions Co., Inc., 75 O.W.C. 66 (1996).

    An employer has 34 days to make payment after an award is entered pursuant to a compromise settlement, since the award is reviewable and penalties cannot be assessed unless payment is not made within two weeks after expiration of the appeal period. Hansberry v. Computer Engineering Systems, 75 O.W.C. 141 (1996).

    The Commission approved a compromise settlement to be paid within a reasonable time after the order entered on June 25, 1996. The 20 days allowed for an appeal of that order expired on July 15, 1996, and the employer had an additional two weeks to make payment, to July 30, 1996, even if the order was not appealed. Hunt v. Southern Industrial At Union Camp, 76 O.W.C. 215 (1997).

    Commission has no authority to assess a penalty where no award has been entered. Haney v. Thyssen Mining Construction, Inc., 58 O.I.C. 164 (1978).

    The Uninsured Employers’ Fund is not subject to the penalty provision of § 65.2-524 . Morton v. Henry Davis t/a Davis Asphalt, 71 O.W.C. 309 (1992). [See Miller v. Potomac Hospital, — Va. App. —, Dec. 11, 2007, which suggest that penalties may be assessed against the Fund.] .

    Imposition of twenty percent penalty on compensation more than two weeks in arrears is mandatory and not subject to Commission discretion even where carrier alleges “extenuating circumstances.” Haskins v. Goodyear Tire & Rubber Company, 61 O.I.C. 187 (1982).

    In holding that it is not permissible to apply adjudicated credit to subsequent medical costs, the Commission noted that to do so would equate medical benefits with compensation. Compensation does not include voluntary medical payments and the twenty percent penalty may not be assessed against such payments. In addition, cost-of-living adjustments are not considered compensation. Mabe v. Happy Stores #494, 73 O.W.C. 175 (1994).

    Where the date a payment ordered by the Commission pursuant to a judicial proceeding occurs on a Saturday, Sunday, legal holiday or other day in which the Clerk’s Office is closed, section 1-13.3:1 [see now § 1-210 ] applies. No penalty is due if payment is made on the next business day. Leigh v. Mid-Atlantic Coca Cola, 70 O.I.C. 248 (1991).

    Effect of Review Request:

    Where an employer withdraws a request for review, payment does not become due until the date of the withdrawal. No penalty is due if payment is made within 14 days of the date of the withdrawal. Jordan v. City of Norfolk School Board, VWC File No. 203-40-31 (March 27, 2006).

    So long as any portion of an award is under review or subject to the review process, the employer and carrier are not required to make payment pursuant to the award and cannot be penalized for payment not made within two weeks of the award under review, even if the review was requested by the claimant. Dees v. Crown, Cork and Seal Co., 75 O.W.C. 48 (1996).

    Code § 65.2-524 provides that compensation must be paid “within two weeks after it becomes due,” unless the compensation is to be paid pursuant to an award that is subject to review. Under such circumstances, compensation must be paid within two weeks of the running of the review period. Shepherd v. Claiborne Textiles, Inc., 78 O.W.C. 103 (1999).

    The penalty for nonpayment of an award within fourteen days is mandatory. Therefore when a request for Review is withdrawn by an employer and payment of compensation is made under a prior award more than fourteen days following entry of award, the employer is not sheltered by § 65.1-75.1 (now § 65.2-524 ) and payment of the penalty is mandatory. Hodge v. Great Coastal Express, 63 O.I.C. 182 (1984).

    Where an employer requests a Review of the Claims Division’s rejection of an application, the outstanding award remains in effect pending the Review decision. If the employer does not prevail at Review, a penalty may be assessed on all compensation more than two weeks in arrears commencing on the day the application was rejected. Wadley v. Camelot Hall Nursing Home, 69 O.I.C. 191 (1990).

    Sick/Annual Leave:

    When a claimant receives full wages as the result of sick and annual leave benefits, a penalty for late payment of compensation may not be assessed if the sick and annual leave is reinstated. Dyson v. Commonwealth of Virginia-Dept. of Transportation, 67 O.I.C. 237 (1988).

    Penalty Assessed:

    In some cases it is appropriate to penalize an employer/carrier for its unilateral suspension of benefits by requiring benefits to be paid beyond the date on which compensation could have been timely terminated had an application been filed. Carter v. Giant Food, Inc., VWC File No. 199-87-97 (July 29, 2004).

    Compensation benefits are “paid” when payment is sent to the claimant at his current address. A penalty is not assessed where the compensation check was delivered by Federal Express Overnight Mail to the wrong address. Stadtherr v. Southern Air, Inc., 74 O.W.C. 24 (1995).

    The requirement contained in Code § 65.2-524 that compensation be “paid” within a certain period is not satisfied by an employer mailing payments to counsel for the claimant. Instead, payments must be mailed “directly” to the claimant “at his current residential address.” Shepherd v. Claiborne Textiles, Inc., 78 O.W.C. 103 (1999) (see also Higgins v. Inspection Enterprises, Inc., 77 O.W.C. 273 (1998)).

    Where the employee notifies the employer of his new address, and payment is mailed to his old address, the employer is liable for the 20% penalty for late payment. Hall v. Catercorp, Inc., 75 O.W.C. 5 (1996).

    Dispute as to date of claimant’s recovery does not mitigate carrier’s failure to pay compensation when due pursuant to award of Commission; carrier liable for 20% penalty for delay. Harrod v. Burton & Robinson, Inc., 60 O.I.C. 184 (1981).

    A 20% penalty may be assessed on compensation unpaid after an Employer’s Application For Hearing is rejected by a claims examiner. Payment is due and the penalty is usually calculated from the date the application is rejected. Couey v. Dale B. Coleman Masonry, 74 O.W.C. 140 (1995).

    Penalty assessed under this section against employer who failed to pay amount due under award of Commission to claimant who had recovered funds in third party action. Bishop v. C. & P. Tel. Co., 57 O.I.C. 40 (1976).

    Penalty for late payment of compensation is assessed where carrier improperly mailed and issued sight drafts which caused a delay in receipt of payment by claimant. Ravizza v. Tidewater Psychiatric Institute, 60 O.I.C. 351 (1981).

    Rule 9.2 requires that all compensation due must be paid or mailed directly to the claimant, but neither the Code nor the Commission Rules make any distinction as to who makes the payment. Hunt v. Southern Industrial At Union Camp, 76 O.W.C. 215 (1997).

    Where the claimant alleged nonpayment of compensation, not merely late payment, the employer was in the only position to show, by check stubs, endorsed checks, computer printouts, or other such evidence, proof of payment. The employer was invited by the Commission on two occasions to produce such evidence. When it failed to do so, the Commission held that the assessment of a penalty for the full amount of the awarded benefits was appropriate. Eghbal v. Boston Coach Corp., 79 O.W.C. 113 (2000).

    Where an employer unilaterally suspends compensation on the basis that a credit is due without filing an application for hearing, the claimant is entitled to an assessment of a twenty percent penalty for all compensation due and unpaid within fourteen days of the due date. Payne v. W. M. Brown & Son, Inc., 66 O.I.C. 173 (1987).

    No Penalty Assessed:

    The insurer incorrectly mailed payment under the Commission’s Award to counsel for the claimant at least 18 days before payment was due, together with a separate check for the attorney fee. The claimant was not given the payment until 28 days after counsel for the claimant received it, and no explanation was provided for the delay. The Commission found that there was ample time for counsel for the claimant either to forward the payment to the claimant or return the payment to the insurer, so that payment could be timely made. The Commission further held that it was unreasonable for counsel for the claimant to take no action on the incorrectly mailed payment for 28 days, and it declined to impose a penalty upon the employer. Shepherd v. Claiborne Textiles, Inc., 78 O.W.C. 103 (1999).

    Where the evidence showed that the employer mailed the check to the claimant’s address of record on or before the payment due date, and the check was promptly reissued when advised of its nondelivery, the employer satisfied its obligation under the Act and the Commission’s open award. Had the claimant or his counsel directly contacted the carrier rather than waiting for the grace period to pass and then filed a penalty request, the carrier would have remitted payment within the allotted time and the proceeding would be unnecessary. On these facts the Commission declined to impose a penalty. Robbins v. Greater Wise, Inc., 79 O.W.C. 67 (2000).

    Va. Code Ann. § 65.2-712 requires a dependent to notify the Commission of her status as a student, but neither Code § 65.2-712 nor Code § 65.2-711 , which requires the reporting of an address change by an employee, specifically requires that a dependent notify either the Commission or the employer of an address change. However, the dependent is required to provide a current residential address so that the defendants can make the required payment. Higgins v. Inspection Enterprises, Inc., 77 O.W.C. 273 (1998).

    Compensation benefits paid by the insurer after a compromise settlement has been approved, but paid prior to the date they were due under § 65.2-524 , constitute voluntary payments pursuant to § 65.2-520 , for which the insurer is entitled to a credit. Here, the insurer paid four days of compensation benefits in advance of the dates they were due. When the lump-sum compromise settlement was eventually paid, the insurer reduced the amount owed to the claimant by the amount paid to him in advance of settlement. The Commission found that the Deputy Commissioner erred in ordering the insurer to pay the four days of benefits, plus a 20% penalty. The insurer was entitled to a credit for the four days of voluntary payments it made. Baber v. Roughton Pontiac Corporation, VWC File No. 179-44-26 (April 5, 2002).

    Remedy for Failure to Pay Penalty:

    Where an employer/insurer fails to remit payment of a penalty pursuant to an award or order of the Commission, a finding of contempt and accompanying punishment is the only available sanction. An additional twenty percent penalty may not be assessed even when the initial twenty percent penalty remains unpaid. Steen v. Norfolk Sheet Metal Works, Inc., 65 O.I.C. 320 (1986).

    § 65.2-525. Who may receive payment and receipt therefor.

    1. Whenever payment of compensation is made to a surviving spouse or parent for his use, or for his use and the use of a minor child, or the use of a minor child and such payments are made in the form of periodic weekly, monthly or quarterly payments, the written receipt thereof of such surviving spouse or parent shall acquit the employer. The Commission, however, may require annual written certifications from the surviving spouse or parent confirming that the portion of such payments for the benefit of the minor child has been used for the benefit of such minor child.
    2. Whenever payment is made to any person eighteen years of age or over, the written receipt of such person shall acquit the employer. If a minor shall be entitled to receive a lump sum payment amounting to not more than $15,000 as compensation for injuries, or as a distributive share by virtue of this title, the parent or natural guardian upon whom such minor shall be dependent for support shall be authorized and empowered to receive and give receipt for such moneys to the same extent as a guardian of the person and property of such minor duly appointed by proper court, and the release or discharge of such parent or natural guardian shall be a full and complete discharge of all claims or demands of such minor thereunder.
    3. Whenever any lump sum payment greater than $15,000 is due to a minor or to an incapacitated person as defined in § 64.2-2000 , the same shall be made to the guardian of the property of such minor or the conservator of such incapacitated adult or, if there is none, to some suitable person or corporation appointed by the circuit court as a trustee, and the receipt of such trustee shall acquit the employer.

    History. Code 1950, § 65-73; 1968, c. 660, § 65.1-76; 1972, c. 825; 1973, c. 401; 1991, c. 355; 1997, c. 921; 1998, c. 94; 2002, c. 301.

    Editor’s note.

    At the direction of the Virginia Code Commission, the reference to “37.2-1000” was changed to “64.2-2000” to conform to the recodification of Title 64.1 by Acts 2012, c. 614, effective October 1, 2012.

    Acts 2002, c. 301, cl. 2, provides: “That the provisions of this act shall apply to payments received by a surviving spouse or parent for the use of a minor child on and after the effective date of this act.”

    The 1998 amendment, in subsection B, in the second sentence, substituted “$10,000 in the aggregate” for “$300,” and inserted “give”; and in subsection C, substituted “$10,000 in the aggregate” for “$300.”

    The 2002 amendments.

    The 2002 amendment by c. 301, in subsection A, in the first sentence, substituted “spouse or parent” for “spouse” in two places and substituted “or the use of a minor child and such payments are made in the form of periodic weekly, monthly or quarterly payments” for “or children,” and added the second sentence; substituted “lump sum payment amounting to not more than $15,000” for “sum amounting to not more than $10,000 in the aggregate” in the second sentence of subsection B; and substituted “lump sum payment greater than $15,000” for “payment of over $10,000 in the aggregate” in subsection C.

    Law Review.

    For survey of Virginia law on workers’ compensation in the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    For an article relating to the most significant developments in the law of workers’ compensation since September 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    CASE NOTES

    Guardian. —

    The legislature clearly envisioned the need for a guardian with a legal obligation to protect the minor’s property and pursue his claims when the minor dependent is entitled to sums exceeding $300 (now a lump sum payment greater than $15,000). ACB Trucking, Inc. v. Griffin, 5 Va. App. 542, 365 S.E.2d 334, 4 Va. Law Rep. 1860, 1988 Va. App. LEXIS 35 (1988), overruled in part, Liberty Mut. Ins. Co. v. Fisher, 263 Va. 78 , 557 S.E.2d 209, 2002 Va. LEXIS 15 (2002) (decided under former § 65.1-76).

    Payment to guardian or trustee. —

    Under subsection C of § 65.2-525 , wherever payment of compensation over $300 (now a lump sum payment greater than $15,000) is due to a minor, the payment should be made to the guardian of the property of the minor or to such suitable person appointed by the circuit court as trustee. Boys & Girls Club of Va. v. Marshall, 37 Va. App. 83, 554 S.E.2d 104, 2001 Va. App. LEXIS 590 (2001).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Cost of qualifying as a guardian is to be deducted from the compensation awarded. Wheat v. Coleman, 50 O.I.C. 335 (1968).

    § 65.2-526. Payment to junior dependents in good faith.

    Payment of death benefits by an employer in good faith to a dependent subsequent in right to another or other dependents shall protect and discharge the employer unless and until such dependent or dependents prior in right shall have given him notice of his or their claim. In case the employer is in doubt as to the respective rights of rival claimants, he may apply to the Commission to decide between them.

    History. Code 1950, § 65-74; 1968, c. 660, § 65.1-77; 1991, c. 355.

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Payments made in good faith to a woman appearing to be the widow of deceased workman will be allowed as a credit in an award afterwards entered finding such woman to have been a bigamous wife and directing the balance of compensation due paid to the true widow. Wyche v. Colonial Pine Co., 30 O.I.C. 162 (1948).

    The employer or his insurer are not entitled to credit for a payment due the employee before his death where the payment is not made to a proper personal representative of the deceased. Eley v. Spire, 5 O.I.C. 89 (1923).

    Continued payment of benefits to the widow after her remarriage, does not relieve the carrier from paying the total amount of compensation accruing after the date of the remarriage to the infant children of the deceased worker. The responsiblity of paying compensation to the proper parties when benefits are terminated by operation of law is on the employer. Therefore the employer is responsible for any diversions of funds to the incorrect party. Finney v. Va. Elec. & Power Co., 11 O.I.C. 252 (1929); Phillips v. Va. Banner Coal Corp., 7 O.I.C. 527 (1925).

    § 65.2-527. When employee’s rights exercised by guardian or trustee.

    If an injured employee is incapacitated or is under eighteen years of age at the time when any right or privilege accrues to him under this title, his guardian, trustee or conservator may in his behalf claim and exercise such right or privilege.

    History. Code 1950, § 65-75; 1968, c. 660, § 65.1-78; 1991, c. 355; 1997, c. 801.

    Editor’s note.

    Acts 1997, c. 801, cl. 2, provides: “That the provisions of this act shall become effective on January 1, 1998. The powers granted and duties imposed pursuant to this act shall apply prospectively to guardians and conservators appointed by court order entered on or after that date, or modified on or after that date if the court so directs, without regard to when the petition was filed. The procedures specified in this act governing proceedings for appointment of a guardian or conservator or termination or other modification of a guardianship shall apply on and after that date without regard to when the petition therefor was filed or the guardianship or conservatorship created.”

    CIRCUIT COURT OPINIONS

    Employer could not force state to litigate. —

    There was no basis for jurisdiction by the workers’ compensation commission because the employee and the employer never had a disagreement about compensation, the employee was not under a disability at the time of his death, and no compensation could be awarded because the employee had no dependents. Neither the policy behind the Workers’ Compensation Act nor its jurisdictional basis provided a statutory framework for resolution of the claims under the Act. Skopic v. Tate, 2009 Va. Cir. LEXIS 132 (Fairfax County Nov. 18, 2009).

    § 65.2-528. Time limitations on persons under disability.

    No limitation of time provided in this title for the giving of notice or making claim under this title shall run against any person who is incapacitated or under eighteen years of age, so long as he has no guardian, trustee, or conservator.

    History. Code 1950, § 65-76; 1968, c. 660, § 65.1-79; 1991, c. 355; 1997, c. 801.

    Editor’s note.

    Acts 1997, c. 801, cl. 2, provides: “That the provisions of this act shall become effective on January 1, 1998. The powers granted and duties imposed pursuant to this act shall apply prospectively to guardians and conservators appointed by court order entered on or after that date, or modified on or after that date if the court so directs, without regard to when the petition was filed. The procedures specified in this act governing proceedings for appointment of a guardian or conservator or termination or other modification of a guardianship shall apply on and after that date without regard to when the petition therefor was filed or the guardianship or conservatorship created.”

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 58.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-79 or prior law.

    Construction with other law. —

    Existence of specific tolling provisions in this section and § 65.2-602 precluded Commission from applying § 8.01-229 A 1, a statute of general application, to toll limitation period in workers’ compensation proceeding. Whetzel v. Waste Management of Virginia, 1999 Va. App. LEXIS 496 (Va. Ct. App. Aug. 10, 1999).

    Guardian. —

    The definition of “guardian” in the decision of Ingram v. Marvel Poultry Co., 58 O.I.C. 192 (1978) affords the level of protection needed for infants who unknowingly possess compensable claims. The guardian should have a legal duty to pursue the minor’s workers’ compensation claim. Where an infant had no such guardian from the time of his father’s death until the date he filed for compensation benefits, the statute of limitations delineated in former § 65.1-87 (now § 65.2-601 ) did not run against him. ACB Trucking, Inc. v. Griffin, 5 Va. App. 542, 365 S.E.2d 334, 4 Va. Law Rep. 1860, 1988 Va. App. LEXIS 35 (1988), overruled in part, Liberty Mut. Ins. Co. v. Fisher, 263 Va. 78 , 557 S.E.2d 209, 2002 Va. LEXIS 15 (2002).

    Mental incompetency to toll running of statute. —

    A claimant is not required to show that he or she was continuously mentally incompetent during the entire limitations period in order to toll the running of the statute, nor is the claimant required to be committed to a hospital in order to prove mental incompetency. Rather, the claimant must prove by credible evidence that he or she did not have sufficient mind or reasoning powers to comprehend the ordinary affairs of life, or that he or she had lost control of his or her mental power to such a degree as to deprive him or her of sane and normal action during the alleged period or periods of incompetency. Via v. Citicorp Mtg., Inc., 10 Va. App. 572, 394 S.E.2d 505, 7 Va. Law Rep. 47, 1990 Va. App. LEXIS 128 (1990).

    Proof of mental incompetency. —

    The burden of proving mental incompetency so as to toll the running of the statute, is upon the injured employee. It is not necessary that it be proven that he is a lunatic or that he has been confined in a mental institution, but it must be proven by credible evidence that the injured employee did not have sufficient mind or reasoning powers to comprehend the ordinary affairs of life, or that he had lost control of his mental power to such a degree as to deprive him of sane and normal action. Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953) (holding that the proof in the case did not measure up to this test).

    The burden of proving mental incompetency so as to toll the running of the statute of limitations is on the claimants. Winston v. City of Richmond, 196 Va. 403 , 83 S.E.2d 728, 1954 Va. LEXIS 234 (1954).

    Mental incompetency not proven. —

    Virginia Workers’ Compensation Commission’s finding that a claimant failed to prove that he was incapacitated during the time period in which he was required to file his application so as to toll, under § 65.2-528 , the statute of limitations provided in subsection A of § 65.2-708 for a change-in-condition application was supported by credible evidence where: (1) The claimant’s treating physician opined after the fact that the claimant was incapacitated, but his contemporaneous treatment notes did not reflect an incapacity; (2) The treating physician conceded that his after-the-fact opinion letter might have been a little overstated; and (3) The employer’s expert opined that the claimant had not been incompetent or incapacitated during the relevant period. Walker v. General Shale Prods. Corp., 2003 Va. App. LEXIS 411 (Va. Ct. App. July 22, 2003).

    Incarceration. —

    Incarceration was not an “incapacity” tolling statute of limitations under this section. Whetzel v. Waste Management of Virginia, 1999 Va. App. LEXIS 496 (Va. Ct. App. Aug. 10, 1999).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    The burden to prove incompetency so as to toll the statute of limitations is on the claimant. He must prove insufficient mind or reasoning powers to comprehend the ordinary affairs of life, or that loss of mental power deprived him of sane and normal action. Thomas v. Southwestern Virginia Mental Health Institute, 74 O.W.C. 219 (1995) (see also Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195 (1953); Harriman v. Jackson Motel, 54 O.I.C. 158, 161 (1972); (appeal denied) Jackson v. New Jersey Zinc Company, 61 O.I.C. 221 (1982)).

    An employee seeking to set aside a settlement award on the grounds of incompetency has the burden to prove by clear and convincing evidence that he was incompetent at the time of the agreement. The law presumes competency, and it is not enough that the employee proves weakness of mind, absence of experience, or immaturity of reason. Where the claimant was found in a psychotic state only 19 days after meeting with a Deputy Commissioner and the carrier, and where the medical evidence showed that he was schizophrenic for a year before the settlement meeting and was not capable of independently contracting on a sophisticated legal question during the month prior to the date he was found in the psychotic state, it was proper to vacate the settlement award. Pretlow v. Tidewater Construction Corp., 75 O.W.C. 115 (1996).

    Statute of Limitation:

    In the case of an injured employee under eighteen years of age, the time limitation begins to run as of the date such employee attains the age of eighteen. Florence v. Petersburg Coca-Cola Bottling Co., 49 O.I.C. 106 (1967); Wilson v. Hall Products, Inc., 40 O.I.C. 174 (1958).

    Statute does not run against minor dependent without guardian though review not timely requested. Claim on behalf of adopted son filed less than a year from appointment of guardian. Anz v. Fairfax Constr. Corp., 49 O.I.C. 10 (1967).

    Statute of limitations is tolled as to persons under disability until such time a guardian is appointed. Ingram v. Marval Poultry Co., 58 O.I.C. 192 (1978).

    The Virginia Workers’ Compensation Act has its own independent tolling provisions in Va. Code Ann. §§ 65.2-528 and 65.2-602 . The presence of these specific provisions included as part of this statutorily-created remedy precludes application of the general tolling provisions of Title 8.01. Furthermore, because the claimant was not incarcerated at the time of his work-related injury, the alleged incapacity would not have existed at the time of the “accrual” of the right to the remedy, thus rendering Va. Code Ann. § 8.01-229 (A)(1) expressly inapplicable. Whetzel v. Waste Management of Virginia Blue Ridge, 78 O.W.C. 12 (1999), aff’d, No. 0352-99-3 (Va. Ct. of Appeals, Aug. 10, 1999).

    § 65.2-529. Joint service.

    Whenever any employee for whose injury or death compensation is payable under this title shall at the time of the injury be in the joint service of two or more employers subject to this title, such employers shall contribute to the payment of such compensation in proportion to their wage liability to such employee. However, nothing in this section shall prevent any reasonable arrangement between such employers for a different distribution as between themselves of the ultimate burden of compensation.

    History. Code 1950, § 65-77; 1968, c. 660, § 65.1-80; 1991, c. 355.

    CASE NOTES

    Credible evidence supported the Commission’s finding that claimant was working for both employers at the time of the accident where claimant admitted he was engaged in the work of both employers when he was ascending the ladder to inspect the chimney and stud wall. Twenty-First Century Concrete, Inc. v. Giacchina, 20 Va. App. 326, 457 S.E.2d 379, 1995 Va. App. LEXIS 438 (1995).

    § 65.2-530. Preferences and priorities.

    All rights of compensation granted by this title shall have the same preference or priority for the whole thereof against the assets of the employer as is allowed by law for any unpaid wages for labor.

    History. Code 1950, § 65-78; 1968, c. 660, § 65.1-81; 1991, c. 355.

    § 65.2-531. Assignments of compensation; exemption from creditors’ claims.

    1. No claim for compensation under this title shall be assignable. All compensation and claims therefor shall be exempt from all claims of creditors, even if the compensation is used for purchase of shares in a credit union, or deposited into an account with a financial institution or other organization accepting deposits and is thereby commingled with other funds. However, benefits paid in compensation or in compromise of a claim for compensation under this title shall be subject to claims for spousal and child support subject to the same exemptions allowed for earnings in § 34-29 .
    2. Upon an order of garnishment, attachment or other levy addressed to a financial institution in which the principal defendant claims to have exempt funds hereunder, the principal defendant may file an answer asserting the exemption hereunder. From the time of service of such garnishment, attachment or levy, the financial institution, until further order of the court, shall hold the amount subject to such garnishment, attachment or levy, or such lesser amount or sum as it may have, which amount shall be set forth in its answer. It shall hold such amount free of any person drawing against such funds whether by check against such account or otherwise. The financial institution shall be subject to such further order or subpoena for discovery of its records, for which it shall be entitled an order or agreement for compensation for the expense of such service, and in a case deemed appropriate to the court by such an order directing deposit of funds or further security prior to such records being ordered produced.

    History. Code 1950, § 65-79; 1968, c. 660, § 65.1-82; 1987, c. 331; 1990, c. 747; 1991, c. 355; 1997, cc. 796, 895.

    Cross references.

    As to notice of exemptions from garnishment and lien, see § 8.01-512.4 . As to awards for birth-related neurological injuries, see § 38.2-5009 . As to remedies for delinquency in support obligations, including attachment of unemployment benefits and workers’ compensation benefits and suspension of an individual’s driver’s license, see § 63.2-1941 .

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For article on the need for reform of and a proposed revision of Virginia’s Exemption Statutes, see 37 Wash. & Lee L. Rev. 127 (1980).

    For note on bank’s right of setoff in Virginia, see 41 Wash. & Lee L. Rev. 1603 (1984).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 18 Enforcement of Judgments and Decrees. § 18.01 Exemptions from executions. Bryson.

    Enforcement of Judgments and Liens in Virginia (Matthew Bender). Chapter 3 The Writ Firea Facies: Execution. § 3.3 Relief from Levy. Rendleman.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 22 Enforcement of Judgments. § 22.08 Garnishment. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 52.

    CASE NOTES

    Construction. —

    General Assembly’s use of “all” to modify “compensation” and “even if” in this section must be read and considered together. Additionally: (i) the use of “all” demonstrates that the General Assembly intended for all workers’ compensation to be exempt from creditors’ claims, (ii) the phrase “even if,” in its normal convention, indicates that, despite the usage of the funds in either of the delineated examples, the totality of the funds will remain exempt, and (iii) the wording of the statute and the well-established principle of liberal statutory construction regarding exemption statutes indicate the General Assembly did not intend for its enumerated examples to signal an exclusion of other similar possibilities. In re: Apfel, 565 Bankr. 349, 2017 Bankr. LEXIS 445 (Bankr. E.D. Va. 2017).

    Child support order. —

    When workers’ compensation carriers received an administrative order from the Department of Child Support Enforcement stating a claimant owed a child support arrearage in the amount of $22,784.46 and the carriers paid that amount from the claimant’s $30,000 settlement proceeds, the Virginia Workers’ Compensation Commission properly determined it lacked authority to invalidate the Department of Child Support Enforcement administrative support order because the validity of the order was not a question “arising under” or “otherwise provided for” the Workers’ Compensation Act, § 65.2-700 . Minor v. Aramark/VCU & Indem. Ins. Co. of N. Am., 59 Va. App. 622, 721 S.E.2d 818, 2012 Va. App. LEXIS 48 (2012).

    Mobile home and lot. —

    A mobile home and lot upon which the same is located is exempt property where it was purchased by workmen’s compensation benefits. In re Nelson, 179 Bankr. 811, 1994 Bankr. LEXIS 1321 (Bankr. W.D. Va. 1994).

    Use of proceeds to make business loan was proper. —

    Debtor’s use of his workers’ compensation proceeds to make a business loan was proper, and debtor could properly exempt the asset, scheduled as a business loan, under § 65.2-531 . A literal reading of the statute necessitated this determination. In re: Apfel, 565 Bankr. 349, 2017 Bankr. LEXIS 445 (Bankr. E.D. Va. 2017).

    OPINIONS OF THE ATTORNEY GENERAL

    Mandated member contribution toward retirement or other deductions elected by the employee. —

    The term “regular payroll check” refers to both the timing of the check and the amount of the check, so that the proposed legislative change to § 65.2-524 adequately defines “regular payroll payment” to avoid any penalty. It makes no difference whether the deduction for the new retirement contribution begins before or after the injured employee is injured. See opinion of Attorney General to Sara Redding Wilson, Director, Department of Human Resource Management, and David Von Moll, State Comptroller, 11-113, 2012 Va. AG LEXIS 6 (2/7/12).

    Because neither the new 5 percent mandated member contribution toward retirement or other deductions elected by the employee, including health-care premiums and flexible reimbursement account deductions, constitute an assignment of benefits or a claim of a creditor, they are not prohibited by § 65.2-531 and may be deducted in appropriate circumstances. See opinion of Attorney General to Sara Redding Wilson, Director, Department of Human Resource Management, and David Von Moll, State Comptroller, 11-113, 2012 Va. AG LEXIS 6 (2/7/12).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Where a Virginia court has held that Virginia did not have the authority to disturb, modify, or dismiss a child support Order entered in Minnesota, the Commission entered an Order to the insurer to deduct amounts from the disability compensation of the claimant until the Minnesota child support arrearage was satisfied. Graham v. Roanoke Valley Resource Authority, 78 O.W.C. 107 (1999).

    Compensation is not assignable. Claimant’s agreement to make an equal division with Aetna of all sums received from Standard Accident Insurance Company under the Workers’ Compensation Act may be null and void under this section. Horne v. Superior Life Ins. Co., 203 Va. 282 , 123 S.E.2d 401, 1962 Va. LEXIS 140 (1962).

    Advance or loans made to employee not in lieu of compensation, but while he was receiving compensation, create only a debtor-creditor relationship and the Commission may not direct a deduction from compensation to satisfy this debt. Francis v. McKimmie Motor Co., Inc., 44 O.I.C. 95 (1962).

    The carrier is entitled to a credit against its obligation to pay compensation benefits for all sums paid to the Division of Child Enforcement pursuant to a valid Order to Withhold. Section 65.2-531 A specifies that an injured worker’s compensation benefits shall be subject to claims for spousal and child support payment. Because the Division’s administrative orders have the force and effect of a court-issued support order, and workers’ compensation benefits are specifically encompassed by the Division’s statutory jurisdiction, the employer and carrier are legally bound to comply with Order to Withhold. No Commission action is necessary, as it is without power to review or modify the Division’s withholding orders. Quinn v. Flowers Transport, Inc., VWC File No. 197-02-82 (September 17, 2002).

    Chapter 6. Notice of Accident; Filing Claims; Medical Attention and Examination.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 57.

    § 65.2-600. Notice of accident.

    1. Every injured employee or his representative shall immediately on the occurrence of an accident or as soon thereafter as practicable, give or cause to be given to the employer a written notice of the accident. If notice of accident is not given to any statutory employer, such statutory employer may be held responsible for initial and additional awards of compensation rendered by the Commission if (i) he shall have had at least sixty days’ notice of the hearing to ascertain compensability of the accident, and (ii) the statutory employer was not prejudiced by lack of notice of the accident.
    2. The notice shall state the name and address of the employee, the time and place of the accident, and the nature and cause of the accident and the injury.
    3. The employee shall not be entitled to physician’s fees nor to any compensation which may have accrued under the terms of this title prior to the giving of such notice, unless it can be shown that the employer, his agent or representative had knowledge of the accident or that the party required to give notice had been prevented from giving notice by reason of physical or mental incapacity or the fraud or deceit of some third person.
    4. No compensation or medical benefit shall be payable unless such written notice is given within thirty days after the occurrence of the accident or death, unless reasonable excuse is made to the satisfaction of the Commission for not giving such notice and the Commission is satisfied that the employer has not been prejudiced thereby.
    5. No defect or inaccuracy in the notice shall be a bar to compensation unless the employer shall prove that his interest was prejudiced thereby and then only to such extent as the prejudice.

    History. Code 1950, §§ 65-82, 65-83; 1968, c. 660, §§ 65.1-85, 65.1-86; 1991, c. 355; 1997, c. 288.

    Law Review.

    For survey of Virginia law on torts for the year 1969-1970, see 56 Va. L. Rev. 1419 (1970).

    For article, “Recovery for Accidental Injuries Under the Virginia Workmen’s Compensation Act,” see 14 U. Rich. L. Rev. 659 (1980).

    CASE NOTES

  • Analysis
  • I.In General.

    Editor’s note.

    Some of the cases annotated below were decided under former §§ 65.1-85, 65.1-86, or prior law.

    Filing of claim invokes jurisdiction of Commission. —

    The jurisdictional nature of a filing under former § 65.1-87 (now § 65.2-601 ) is not affected by any notice that may previously have been given to the employer. Thus, while this section requires that the employer be promptly notified of an accident, it is the filing of a claim under former § 65.1-87 that invokes the jurisdiction of the Industrial Commission to award compensation. Garcia v. Mantech Int'l Corp., 2 Va. App. 749, 347 S.E.2d 548, 3 Va. Law Rep. 333, 1986 Va. App. LEXIS 327 (1986).

    In this section and former § 65.1-94 (now § 65.2-702 ) the legislature used the word “employer” in a generic sense to describe whichever employer, actual or statutory, from whom the worker seeks workers’ compensation benefits. Race Fork Coal Co. v. Turner, 237 Va. 639 , 379 S.E.2d 341, 5 Va. Law Rep. 2382, 1989 Va. LEXIS 70 (1989).

    Claim must include certain information. —

    A claim for employee’s right to compensation must identify the employer, the date of the accident, the location of the accident, and the injuries suffered; also, it must fairly apprise the Workers’ Compensation Commission that a claim is being made. Cheski v. Arlington County Pub. Schs., 16 Va. App. 936, 434 S.E.2d 353, 10 Va. Law Rep. 157, 1993 Va. App. LEXIS 373 (1993).

    Information submitted did not constitute a claim. —

    Neither the material employee gave to her employer nor copies of two letters about the employee’s injuries written to the employee by the employer’s risk management agent that were sent to the Workers’ Compensation Commission were sufficient to constitute a claim where the two letters did not identify the location of the accident or the injuries suffered, and more importantly, they did not apprise the commission that a claim on behalf of the employee was being made. Cheski v. Arlington County Pub. Schs., 16 Va. App. 936, 434 S.E.2d 353, 10 Va. Law Rep. 157, 1993 Va. App. LEXIS 373 (1993).

    Notice required for actual and statutory employers. —

    If a claim is made against both actual and statutory employers, notice to each employer is required. Wagner Enterprises, Inc. v. Brooks, 12 Va. App. 890, 407 S.E.2d 32, 8 Va. Law Rep. 213, 1991 Va. App. LEXIS 159 (1991) (decided under former § 65.1-85).

    Statutory employer’s right to notice. —

    The legislative, administrative and judicial history of this section clearly suggests that the legislature intended that the potential responsibility of a statutory employer for a claim under the act, absent timely notice of the related accident, be resolved upon considerations different from those applicable to actual employers and, while mandating notice of an accident within thirty days of the occurrence to both statutory and actual employers, this section fashioned a threshold inquiry specific to a determination of responsibility under the act upon a statutory employer without timely notice of the accident. Under such circumstances, the statutory employer must have received at “least sixty days notice of the hearing to ascertain compensability of the accident” and suffered no prejudice from “lack of notice.” Uninsured Employer's Fund v. Edwards, 32 Va. App. 814, 531 S.E.2d 35, 2000 Va. App. LEXIS 527 (2000).

    Section 65.2-600 A requires an employee to immediately on the occurrence of an accident or as soon thereafter as practicable, give or cause to be given to the employer a written notice of the accident, and § 65.2-600 B, requires that the notice state the nature and cause of the accident and the injury; § 65.2-600 D sets a 30-day time limit for the required notice. Allyn v. Hanover County Soc. Servs., 2003 Va. App. LEXIS 73 (Va. Ct. App. Feb. 11, 2003).

    Notice to insurer not required. —

    The Commission properly rejected appellants’ argument that this section required defendant to give notice to the insurer; this section requires notice to the employer. Solid Gold Corp. v. Wang, 18 Va. App. 66, 441 S.E.2d 643, 10 Va. Law Rep. 1070, 1994 Va. App. LEXIS 126 (1994).

    The legislature did not contemplate that registered agents, directors, and shareholders of corporations must give notice to the insurance carrier. Solid Gold Corp. v. Wang, 18 Va. App. 66, 441 S.E.2d 643, 10 Va. Law Rep. 1070, 1994 Va. App. LEXIS 126 (1994).

    The phrase “prejudiced thereby” in subsection D of this section does not encompass a statutory employer’s economic loss from the inability to obtain indemnification. Batal Bldrs., Inc. v. Hi-Tech Concrete, Inc., 18 Va. App. 401, 444 S.E.2d 555, 10 Va. Law Rep. 1406, 1994 Va. App. LEXIS 331 (1994).

    Employer must show prejudice from late notice. —

    Compensation will not be barred for failure to give timely notice unless the employer can prove it was prejudiced by such lack of notice. Goodyear Tire & Rubber Co. v. Harris, 35 Va. App. 162, 543 S.E.2d 619, 2001 Va. App. LEXIS 148 (2001).

    Employer not prejudiced by delay in receiving written notice. —

    Commission correctly found that the employer was not prejudiced by the delay in receiving written notice from employee; no testimony or other medical evidence was presented to establish that employee’s injury would have been less severe had medical attention been sought prior to August 1988, or that employee’s continuing to work aggravated his condition from a medical standpoint; furthermore, employee’s failure to give timely notice did not hinder the employer’s investigation or preparation of the case since all witnesses were available for examination. Barnhill Constr. Corp. v. Martin, No. 0470-89-3 (Ct. of Appeals May 15, 1990).

    Burden of proof. —

    While the burden of showing a reasonable excuse for delay in giving notice of an accident is upon the claimant, after this is shown to the satisfaction of the Commission the burden is upon the employer to show that he has been prejudiced by the delay. In the instant case notice was given as soon as practicable, the excuse for the delay was fully explained, and the employer was not prejudiced. Maryland Cas. Co. v. Robinson, 149 Va. 307 , 141 S.E. 225 , 1928 Va. LEXIS 367 (1928).

    While the burden of showing a reasonable excuse for a delay in giving notice is upon the claimant, after this is shown to the satisfaction of the Commission then the burden is upon the employer to show that he has been prejudiced by the delay. Lucas v. Research Analysis Corp., 209 Va. 583 , 166 S.E.2d 294, 1969 Va. LEXIS 146 (1969).

    The burden of showing a reasonable excuse for delay in giving notice is on the employee; on the other hand, the burden of showing prejudice caused by the delay is upon the employer. Westmoreland Coal Co. v. Coffey, 13 Va. App. 446, 412 S.E.2d 209, 8 Va. Law Rep. 1616, 1991 Va. App. LEXIS 325 (1991).

    An employer’s burden of proving prejudice caused by a claimant’s delay in giving timely notice is not applicable until the claimant has established a reasonable excuse for the delay to the satisfaction of the Commission and, where a claimant does not establish a reasonable excuse for failing to give an employer notice of his work-related accident within thirty days of its occurrence, the employer is not required to show prejudice. Lawhorne v. Tri-State Cable Communs./ T.W. Fanch One Co., 2000 Va. App. LEXIS 574 (Va. Ct. App. Aug. 1, 2000).

    In applying this section, the principles are well established that the burden of showing a reasonable excuse for delay in giving notice is upon the employee and that the burden is upon the employer to show that the employer has been prejudiced by the delay. Smith v. Augusta Med. Ctr., 2001 Va. App. LEXIS 259 (Va. Ct. App. May 15, 2001).

    Workers’ Compensation Commission erred in finding that the employer’s filing of an accident report beyond the two-year statute of limitations “per se” prejudiced the claimant who file her application for benefits more than two years after she was injured at work. Instead, the claimant had the burden of proving that she was actually prejudiced by the employer’s filing of the accident report beyond the time for filing a claim itself, as the claimant had a previous claim barred on limitations grounds, and, thus, may have known of the need to file a claim within two years of the date the injury occurred. Hall v. Winn-Dixie Stores, Inc., 41 Va. App. 835, 589 S.E.2d 484, 2003 Va. App. LEXIS 642 (2003).

    Injuries resulting in hernia are not excepted from this section or former § 65.1-88 (now § 65.2-603 ). Commonwealth v. Granger, 188 Va. 502 , 50 S.E.2d 390, 1948 Va. LEXIS 184 (1948).

    Treatment of application for hearing as petition for review on change of condition — Authority of Commission. —

    The Commission may, under circumstances which accord at least the minimal notice requirements that due process demands, treat an application for hearing as a petition for review on change of condition. In fact, the Commission is authorized to conduct a review for change of condition on its own motion at any time, subject to due process limitations. Sergio's Pizza v. Soncini, 1 Va. App. 370, 339 S.E.2d 204, 1986 Va. App. LEXIS 209 (1986).

    Same — Due process safeguards. —

    The Commission’s authority to consider an application for original injury benefits as an application for review on change of condition is not without limitation. The procedure utilized must afford the parties minimal due process safeguards. Sergio's Pizza v. Soncini, 1 Va. App. 370, 339 S.E.2d 204, 1986 Va. App. LEXIS 209 (1986).

    Same — Remand for additional evidence. —

    Although claimant’s application for hearing could and should have been considered a petition for review on change of condition, and although the Commission had the authority to so consider it by consolidating the application with the prior claim or by adopting a procedure which would have provided the employer minimal notice to permit an adequate defense at some stage of the proceedings, where it was first determined by the Commission on review to address the claim as one for change of condition, and the Commission did not permit or require either party to present additional evidence, although it was empowered to do so, the case would be remanded so that both parties could be afforded the opportunity to present evidence on the issue of whether claimant’s condition was a compensable result of her prior injury or the result of her medical treatment for that injury. Sergio's Pizza v. Soncini, 1 Va. App. 370, 339 S.E.2d 204, 1986 Va. App. LEXIS 209 (1986).

    Employer was justified in discharging employee for dishonesty in giving a false answer to a material question on his employment application and in making a false statement that he had reported alleged injury to his supervisor. Marval Poultry Co. v. Johnson, 224 Va. 597 , 299 S.E.2d 343, 1983 Va. LEXIS 166 (1983).

    Plumber’s helper sustained a compensable injury when he twisted his knee while digging a ditch, even though he could not relate the exact date of the accident, since he had informed his immediate supervisor shortly after the accident. Kane Plumbing, Inc. v. Small, 7 Va. App. 132, 371 S.E.2d 828, 5 Va. Law Rep. 220, 1988 Va. App. LEXIS 88 (1988).

    Claimant must establish three requirements. —

    Notice, specified conduct and prejudice are the “three criteria” that must be established by a claimant seeking relief pursuant to either § 65.2-602 or repealed § 65.1-87.1. Bristol Newspapers, Inc. v. Shaffer, 16 Va. App. 703, 432 S.E.2d 23, 10 Va. Law Rep. 6, 1993 Va. App. LEXIS 248 (1993).

    Benefits held proper. —

    Commission’s award of benefits for the period prior to appellant’s receipt of notice under subsection C was proper where claimant was prevented from giving notice by deceit. C. Richard Bogese Bldr., Inc. v. Robertson, 17 Va. App. 700, 440 S.E.2d 622, 10 Va. Law Rep. 895, 1994 Va. App. LEXIS 68 (1994).

    II.Notice Requirement.

    Written and actual notice accorded equal dignity. —

    In adjudicating claims arising under the act, the Commission and judiciary have accorded equal dignity to written and actual notice to employers. Uninsured Employer's Fund v. Edwards, 32 Va. App. 814, 531 S.E.2d 35, 2000 Va. App. LEXIS 527 (2000).

    Requirement of notice implies knowledge by claimant. —

    The requirement of notice within 30 days necessarily implies knowledge by the claimant of the injury for which the claim is made. Maryland Cas. Co. v. Robinson, 149 Va. 307 , 141 S.E. 225 , 1928 Va. LEXIS 367 (1928).

    The requirement of notice necessarily implies knowledge of the injury for which claim is made. Lucas v. Research Analysis Corp., 209 Va. 583 , 166 S.E.2d 294, 1969 Va. LEXIS 146 (1969).

    Waiver of notice defense for failure to post compliance notice. —

    Under Rule 7.2 of the Rules of the Workers’ Compensation Commission, the commission has discretion to find that an employer has waived its “notice defense” under this section as a sanction for failing to “post and keep posted, conspicuously, in the ... place of business at a location frequented by employees, notice of compliance with the provisions of the Act.” Family Health Care Assocs. v. Perkins, 1997 Va. App. LEXIS 774 (Va. Ct. App. Dec. 23, 1997).

    Where a foreman or superior officer of the employer had actual knowledge of the occurrence of an accident or death within a reasonable time after the accident or death occurred, and no prejudice to the employer’s rights is shown, that is sufficient notice under this section. Department of Game & Inland Fisheries v. Joyce, 147 Va. 89 , 136 S.E. 651 , 1927 Va. LEXIS 287 (1927).

    Lack of written notice does not bar recovery if the employer has actual notice of the injury and is not prejudiced. Newport News Shipbuilding & Dry Dock Co. v. Barnes, 32 Va. App. 66, 526 S.E.2d 298, 2000 Va. App. LEXIS 220 (2000).

    This section requires an employee to give written notice of an accident to the employer within thirty days of the occurrence of the accident but written notice is unnecessary if the employer has actual notice through a foreman or other superior officer. Goodyear Tire & Rubber Co. v. Harris, 35 Va. App. 162, 543 S.E.2d 619, 2001 Va. App. LEXIS 148 (2001).

    Time for giving notice of new and separate injury. —

    An employee who suffers a new and separate injury, not a “change in condition” arising out of the first injury, is required to give notice of the accident to his employer, his agent or representative, and to file an application for compensation with the Commission within the time limitations prescribed by this section and former § 65.1-87 (now § 65.2-601 ). Leonard v. Arnold, 218 Va. 210 , 237 S.E.2d 97, 1977 Va. LEXIS 180 (1977).

    Employee aware of relationship between his employer and third party. —

    Where claimant, who worked as a cable installer for a cable company was injured in a work-related accident and claimant knew that the cable company had a contract with his statutory employer, which held a cable franchise to install cable television in the area where claimant worked, he lacked a reasonable excuse for failing to notify his statutory employer within 30 days of his work-related injury. Uninsured Employer's Fund v. Time Warner, Inc., 1995 Va. App. LEXIS 293 (Va. Ct. App. Mar. 28, 1995).

    If an employee can show that he was unaware of the relationship between his employer and some third party, who was his statutory employer at the time of his injury, and could not reasonably have known of it within 30-day period, he has the right under this section to introduce evidence in an attempt to satisfy the Industrial Commission that there was a reasonable excuse for not giving the notice. Race Fork Coal Co. v. Turner, 237 Va. 639 , 379 S.E.2d 341, 5 Va. Law Rep. 2382, 1989 Va. LEXIS 70 (1989).

    Notice held sufficient. —

    An employer’s first report of accident form, which showed that claimant reported the incident to his foreman on the day it occurred, and a recorded statement obtained from claimant by his employer, which described with particularity the circumstances surrounding the occurrence of the injury, provided employer with sufficient notice of the time, place, nature and cause of claimant’s accident, as required by former §§ 65.1-85 and 65.1-86. Virginia Energy Co. v. Clay, No. 0726-85 (Ct. of Appeals March 10, 1986).

    Where claimant was misled as to the identity of the general contractor and upon receipt of that information, he gave notice within two weeks, the commission did not err in finding his excuse reasonable. C. Richard Bogese Bldr., Inc. v. Robertson, 17 Va. App. 700, 440 S.E.2d 622, 10 Va. Law Rep. 895, 1994 Va. App. LEXIS 68 (1994).

    Where a claimant completed an employer’s accident report almost two years after the accident, the Virginia Workers’ Compensation Commission properly found that he met § 65.2-600 ’s notice requirement, because the employer’s president and director — i.e., the claimant — received immediate and actual notice of the accident and injury. He was not obliged to file a notice of accident directly with the carrier “as soon as practicable” under § 65.2-101 , since that statute was limited to sole proprietors and partners who elected to be covered as employees. B & H Constr., Inc. v. Baker, 2006 Va. App. LEXIS 153 (Va. Ct. App. Apr. 25, 2006).

    Whether the workers’ compensation claimant’s workplace injury occurred on April 2 or 9, 2009, the notice of injury to the employer was timely as the claimant told her supervisor about her injury on the day it occurred; the supervisor filed an accident report listing April 11, 2009, as the date of the injury and stated that the claimant was having stomach pain and two days later the claimant said she pulled a muscle. Meidan, Inc. v. Leavell, 62 Va. App. 436, 749 S.E.2d 201, 2013 Va. App. LEXIS 291 (2013).

    Virginia Workers’ Compensation Commission reasonably inferred from a claimant’s testimony and the medical records that the claimant promptly informed the claimant’s employer of a workplace accident. The Commission’s factual finding that the claimant reported the accident to the claimant’s supervisor by telephone on the morning after the accident, despite the supervisor’s denial, was supported by credible evidence, and no prejudice to the employer resulted from the claimant’s failure to give written notice of the accident and injury. Smith v. Dominion Tech. Solutions, 2015 Va. App. LEXIS 24 (Va. Ct. App. Jan. 27, 2015).

    Employee gave an employer notice of an accident because he identified the time, place, and source of his injury to pulling cable, and the employee reported the injury to his supervisor the day after it occurred; because the employer did not contest notice of the employee’s injury it was disingenuous for the employer to argue that his injury was not work-related. Verizon Va. v. Saliard, 2019 Va. App. LEXIS 117 (Va. Ct. App. May 14, 2019).

    Credible evidence supported the Workers’ Compensation Commission’s finding that timely notice was given to the employer; claimant testified that she reported the accident within a couple of days, and her supervisor remembered speaking to claimant about the accident and filed an incident report shortly thereafter. Food Lion, LLC v. Toehlke, 2020 Va. App. LEXIS 108 (Va. Ct. App. Apr. 14, 2020).

    Notice held insufficient. —

    A workman who sought compensation for an injury from escaping gas, while informing the foreman and the employer’s physician on several occasions that he suffered from a severe cold and thought the gas was affecting him, complained of no accident, nor of his nose bleeding, nor of becoming very sick at any particular time. The notice was not sufficient, where he admitted that the complaints were not made within 30 days. Clinchfield Carbocoal Corp. v. Kiser, 139 Va. 451 , 124 S.E. 271 , 1924 Va. LEXIS 122 (1924).

    Where employee reported accident to his supervisor, who was an eyewitness, this served as notice to employer pursuant to this section, and fact that employee asked supervisor not to report accident did not equate to a failure to give notice of accident. Harman Ceiling & Partitioning Co. v. Lusk, 1999 Va. App. LEXIS 441 (Va. Ct. App. July 20, 1999).

    Reasonable excuse justifying delay not established. —

    See Mayo v. Chesapeake Paper Stock Co., 183 Va. 177 , 31 S.E.2d 574, 1944 Va. LEXIS 141 (1944).

    Claimant knew of his work-related injury before the 30-day period ran and did not establish a reasonable excuse for the delay in giving the required notice. Alter v. VSE Corp., No. 0230-92-4 (Ct. of Appeals Nov. 3, 1992).

    Here plaintiff failed to give timely notice of his alleged accident as required by this section and he failed to show a reasonable excuse for the late notice. Blevins v. Giles County Technical Ctr./Giles County Pub. Sch., 1996 Va. App. LEXIS 27 (Va. Ct. App. Jan. 23, 1996).

    An employee who alleged that he injured his back when he slipped on ice and fell in his driveway while in the process of storing his work tools failed to establish any reasonable excuse for failing to give his employer notice of the alleged work connection until more than three months following the accident. In light of the treatment the employee received in the interim period, it was clear that this was not a trivial injury that slowly worsened over time and it was also not an injury which the employee did not know was employment-related; the employee’s testimony that he was unfamiliar with workers’ compensation laws and that finally his father advised him to report the incident was not a sufficient excuse. Lawhorne v. Tri-State Cable Communs./ T.W. Fanch One Co., 2000 Va. App. LEXIS 574 (Va. Ct. App. Aug. 1, 2000).

    Credible evidence supported the affirmance by the Virginia Workers’ Compensation Commission of the deputy commissioner’s finding that the claimant’s workers’ compensation claim was time-barred due to the failure of the claimant to provide notice to her employer within 30 days, as required by subsection D of § 65.2-600 , of the claimant’s post-traumatic stress disorder (PTSD) diagnosis, although the employer knew of the accident by the claimant’s husband, which led to the claimant’s PTSD, without a reasonable excuse for the delay. Allyn v. Hanover County Soc. Servs., 2003 Va. App. LEXIS 73 (Va. Ct. App. Feb. 11, 2003).

    Reasonable excuse justifying delay established. —

    Claimant had a reasonable excuse for his failure to provide timely notice of his injury to his statutory employers where he immediately reported his injury to direct employer who informed claimant that he was covered by their insurance policy and that notice to them was all he had to do to be covered, and claimant had only eight years of education in El Salvador and did not speak English. Batal Bldrs., Inc. v. Hi-Tech Concrete, Inc., 18 Va. App. 401, 444 S.E.2d 555, 10 Va. Law Rep. 1406, 1994 Va. App. LEXIS 331 (1994).

    A claimant offered a reasonable excuse for not reporting an injury to her shoulder until more than two weeks after the expiration of the 30 day period provided by the statute where she did not think that she had done any major injury to her shoulder, she reported the injury as soon as her arm became swollen and hot, and the employer was not prejudiced by the delay. Philip Morris USA v. Peterson, 1998 Va. App. LEXIS 628 (Va. Ct. App. Dec. 8, 1998).

    Claimant’s excuse for not reporting injury within thirty days was reasonable, where she was a registered nurse and believed her injury was not severe enough to warrant seeking medical attention, and that it would resolve on its own through self-administered treatment. Danville Regional Med. Ctr. v. Pearce, 1999 Va. App. LEXIS 608 (Va. Ct. App. Oct. 26, 1999).

    Award of benefits to the claimant in a workers’ compensation action was appropriate because the Workers’ Compensation Commission did not err in finding that the claimant’s initial belief that his injury was trivial reasonably excused his untimely notice of the injury to employer. The employer also failed to meet its burden to overcome the excuse by demonstrating prejudice because it failed to present evidence on that point. Va. Int'l Terminals v. McCarthy, 2011 Va. App. LEXIS 216 (Va. Ct. App. June 28, 2011).

    Late reporting of accident unexcused. —

    Where worker felt immediate pain when the incident occurred and he experienced intense pain over the next two months, but did not report the accident to his employer until after he saw doctor, there was no justification for the delay in reporting. Alexander v. Purnell Bros., No. 2068-91-4 (Ct. of Appeals May 19, 1992).

    Trivial nature of injury may justify employee’s failure to notify. —

    The court of appeals found no error in the commission’s finding that the trivial nature of an injury may constitute a reasonable excuse sufficient to justify an employee’s failure to timely notify his employer. Barnhill Constr. Corp. v. Martin, No. 0470-89-3 (Ct. of Appeals May 15, 1990).

    Notice is reasonably excused if an accident, first regarded as trivial, is later learned through medical diagnosis to be serious. Westmoreland Coal Co. v. Coffey, 13 Va. App. 446, 412 S.E.2d 209, 8 Va. Law Rep. 1616, 1991 Va. App. LEXIS 325 (1991).

    Commission’s finding that claimant failed to meet his burden of proving reasonable excuse, rejecting his contention that he did not give timely notice because he felt his injury was trivial, was supported by credible evidence. Richardson v. Happy Trucker Trucking, Inc., No. 2041-93-3 (Ct. of Appeals Apr. 5, 1994).

    Where evidence established that employee did not immediately report the accident because the pain diminished and he thought the problem to be trivial, this evidence supported the commission’s finding that employee had a reasonable excuse for not reporting the accident to his employer earlier. Trump, Inc. v. Lee, 1994 Va. App. LEXIS 289 (Va. Ct. App. May 10, 1994).

    Notice to insurer not required. —

    Although the insurance carrier did not receive notice of the accident until a year after the incident, the employee was only required to provide notice to her employer. Food Lion, LLC v. Toehlke, 2020 Va. App. LEXIS 108 (Va. Ct. App. Apr. 14, 2020).

    CIRCUIT COURT OPINIONS

    Notice requirement. —

    Virginia Workers’ Compensation Act (originally enacted in 1950) requires an employee to give written notice of an accident to the employer within thirty days of the occurrence of the accident. The written notice shall state the name and address of the employee, the time and place of the accident, and the nature and cause of the accident and the injury; however, written notice is unnecessary if the employer has actual notice through a foreman or other superior officer. AMEC Civil, L.L.C. v. Commonwealth, 74 Va. Cir. 492, 2008 Va. Cir. LEXIS 64 (Norfolk Feb. 12, 2008).

    In adjudicating claims arising under the Workers’ Compensation Act, the commission and judiciary have accorded equal dignity to written and actual notice to employers. Actual notice is an effective substitute for written notice when the purpose behind the Act’s notice provision is achieved; namely, to apprise the Workers’ Compensation Commission that a claim is being made, enable the employer to adequately investigate the accident and injuries, and permit the employer to provide appropriate medical care. AMEC Civil, L.L.C. v. Commonwealth, 74 Va. Cir. 492, 2008 Va. Cir. LEXIS 64 (Norfolk Feb. 12, 2008).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Purpose of Notice:

    Claimant, president and sole shareholder of a subchapter S corporation, was not required to give notice of his accident and injury directly to the insurer. Baker v. B & H Constr., Inc., VWC File No. 216-56-07 (April 18, 2005), aff’d, — Va. App. — (2006).

    Section 65.2-600 B requires the employer be given notice not only of the accident but also of the nature and cause of the injury. Hall v. A. Bertozzi, Inc., 76 O.W.C. 415 (1997).

    Notice of an accident and the form of such notice, is to enable the employer promptly to investigate the facts concerning the alleged accident and to give immediate first aid or other needed medical attention, so as to prevent infection or otherwise minimize the effects of the injury. Notice provisions of statute are mandatory. Church v. Briar Coal Co., 55 O.I.C. 87 (1973).

    Section 65.2-600 requires that an injured employee shall immediately on the occurrence of an accident give or cause to be given to the employer notice of the accident . The notice must include the nature and cause of the accident and the injury. However, this necessarily includes only the nature of injury that is manifest at the time of the accident or notice. It is only necessary that the employee claim other injuries within two years thereafter. It is this initial notice to the employer and his insurance carrier that gives them knowledge of the accident and of their potential liability. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    Section 65.2-600 requires an injured employee to give immediate notice of a work accident to his employer, which should prompt the employer to make an investigation to determine its potential liability. The employer cannot be blind to reports of alleged incidents that should be investigated, or ignore reports that the employee’s medical condition is deteriorating, presumably from effects of the work accident. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    Notice of injury in the reports of a physician treating the effects of a work accident is sufficient notice to the employer for the purposes of § 65.2-600 . Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    When a partner or sole proprietor who has workers’ compensation coverage is injured, notice of the injury shall be given to the insurance carrier. Marchiafava v. Lance Marchiafava, Inc., 76 O.W.C. 124 (1997).

    The failure of an employer to post notices of coverage and reporting requirements pursuant to Rule 7.2 may constitute a waiver of the notice defense. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997), aff’d, Nos. 1238-97-3, 1290-97-3 (Ct. of Appeals, Dec. 23, 1997).

    Employee failed to provide employer timely notice of accident, when employee struck wrist at work, received emergency treatment, and inquired of employer whether treatment would be “covered by workers’ compensation”; although employee’s inquiry was timely, employer asked whether injury happened at work, and employee stated she did not know; employee notified employer that injury occurred at work thirty-three days after accident, and thus claim was barred; question of whether employer prejudiced by late notice irrelevant unless employee showed reasonable excuse for failure to provide notice. Bradley v. Stride Rite Corp., VWC File No. 211-69-03 (Feb. 20, 2004).

    Employee’s claim of knee injury not barred by § 65.2-600 even though original notice to employer was of workplace fall, causing shoulder injury; notice had provided general nature of injury, and only shoulder injury was manifest at time of accident; later claim for knee injury filed within two years of accident. Ghoreishi v. CVS, VWC File No. 203-12-19 (Jan. 22, 2004).

    Failure to give notice within 30 days of an accident is not fatal to a claim if the employee has a reasonable excuse and the employer has not been prejudiced by the delay in receiving notice. The employee has the burden of proving a reasonable excuse for the delay in giving notice; when that burden has been satisfied, the burden of proving prejudice caused by that delay is on the employer. Montgomery v. Garten Ford, Inc., 78 O.W.C. 281 (1999).

    A claimant’s ignorance of the workers’ compensation law, and his obligation to file a timely claim, does not estop an employer from raising the limitation period as a defense. To hold otherwise would be to reward employees who neglect to learn or inform themselves about applicable law, or those who pretend such lack of knowledge. Belter v. Hampton Roads Custom Painting, 77 O.W.C. 119 (1998).

    The claimant, an officer of the corporate employer, testified that he failed to give timely notice of his accident because he was not aware that he was a covered employee. The Commission held that it must presume that parties are aware of their rights and responsibilities under law, and the claimant’s failure to give notice because he was unaware of his legal responsibility was not justified. Belter v. Hampton Roads Custom Painting, 77 O.W.C. 119 (1998).

    Unless employee can establish the existence of one of the exceptions to the requirement for immediate notice, or notice as soon after the accident as practicable, no benefits under the Act can be awarded him prior to date of his giving notice. Fuquay v. Industrial Sheet Metal Works, Inc., 45 O.I.C. 87 (1963).

    The provision of § 65.1-86 (now § 65.2-600 ) limiting any denial of compensation benefits to the period in which the employer did not have notice of the injury is applicable only where the notice itself is defective and does not apply when the claimant fails to provide timely notice. Hughes v. Mark Winkler Management, Inc., 66 O.I.C. 62 (1987).

    Code § 65.2-600 , Sections C - E, provides that an employee shall not be entitled to physicians’ fees prior to giving notice of the accident, as well as the nature and cause of the accident and the injury, unless it is shown that the employer had knowledge of the accident or that the party required to give notice had been prevented from giving notice by reason of physical or mental incapacity. Further, no medical benefits shall be payable unless reasonable excuse is made for not giving notice and the Commission is satisfied that the employer has not been prejudiced. This section requires that the employer prove the extent of any prejudice due to the failure of the claimant to give notice. Hall v. A. Bertozzi, Inc., 76 O.W.C. 415 (1997).

    Where the employer was not told that the claimant suffered an injury that required medical care until after an operation to re-attach a retina had been performed, the Commission found that the employer was prejudiced because it was denied the opportunity to offer a panel of physicians to evaluate and treat the injury, and that the employer was not liable for medical treatment prior to the date it received notice of the injury. Hall v. A. Bertozzi, Inc., 76 O.W.C. 415 (1997).

    The claimant’s back pain did not begin until February 10, 1999, but she first questioned whether her back condition was related to the December 1998 accident on May 4, 1999, when she called her treating physician. When he refused to see the claimant for more than two months, she sought out another doctor, who examined her on May 12, 1999. Twelve days later, at the claimant’s request, the new physician advised the employer that her back injury was related to the December 1998 accident. This notice was clearly within 30 days of the date the claimant learned that her back condition was related to the compensable accident. On these facts, the Commission found that any delay in giving notice to the employer was excused. Redford v. Stafford County School Board, 79 O.W.C. 85 (2000).

    The purpose of the notice requirement is to enable the employer adequately to investigate the accident and injuries, and to enable the employer to provide appropriate medical care. Once the injured worker provides notice of the work accident, along with a general description of her injuries, she has no obligation to provide continuing “updates” of her initial notice under § 65.2-600 , as her diagnosis changes. Once appropriate initial notice is given under § 65.2-600 , if the claimant’s medical treatment reveals that additional body parts were injured in the accident, she need only seek to amend her claim within two years of the accident to toll the statute of limitations under § 65.2-601 . Saul v. Total Action Against Poverty, VWC File No. 196-47-46 (September 27, 2002).

    Actual Knowledge by Employer or His Representative:

    Claimant’s descriptions of his mental state to college president and supervisor following a campus shooting considered with employer’s knowledge of the assault were sufficient to satisfy Act’s notice requirement. Faigle v. New River Community College, JCN VA02000024395 (Dec. 28, 2019).

    Written notice of an accident is unnecessary, where actual notice is given to the employer. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    Where the employer or foreman or other superior officer of employee has actual knowledge of the occurrence of the accident or death within a reasonable time after same takes place, and no prejudice to employer’s rights is shown, this is sufficient compliance with all the requirements of this section. Davis v. Dan River, Inc., 58 O.I.C. 82 (1979); Yeary v. County Sheriff ’s Dept., 59 O.I.C. 309 (1980).

    Where the claimant’s supervisor saw her fall, helped her up, and asked her if she was okay then and several times throughout the day, her claim is not barred by any deficiencies in the notice required by Code § 65.2-600 . There is sufficient notice when a supervisor has actual knowledge of an accident. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    An employer cannot be blind to reports of alleged incidents that should be investigated. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997).

    A joke to coworkers about a fall and generalized complaints of pain are insufficient to put an employer on notice of a workers’ compensation claim, where the claimant does not attribute his generalized complaints of pain to the fall. Montgomery v. Garten Ford, Inc., 78 O.W.C. 281 (1999).

    Where the contract for the lease of employees purported to require that notice of an accident be given to the leasing company, but such language was ambiguous, notice of the accident given to the company exercising control over the claimant’s work was effective notice under the Act. McClellan v. H.L. Yoh Company, 77 O.W.C. 141 (1998).

    Notice to physician selected by employer is sufficient. Dowdy v. Giant of Va., Inc., 210 Va. 408 , 171 S.E.2d 254, 1969 Va. LEXIS 257 (1969).

    Although notice to an insurance agent may satisfy the notice requirement of the Act under certain circumstances, the claimant in this case neither told the agent that his accident was work related nor gave the agent information from which a person could conclude that the accident was work related, and the Commission held that notice subsequently given was untimely. Marchiafava v. Lance Marchiafava, Inc., 76 O.W.C. 124 (1997).

    Statutory Employers:

    Section 65.2-600 A, clause (i), which refers to 60-days notice to the statutory employer, and (ii), which speaks of prejudice to such employer, are presented in the conjunctive, and both conditions must be established before the statutory employer can obtain relief for lack of notice. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    An employee is not required to file a claim against his immediate employer but may elect to file a claim against any statutory employer in the ascending employment hierarchy who receives timely notice of the accident as required by statute. Where the statutory employer received timely notice of the accident but the immediate employer was not provided notice within the required time frame and no reasonable excuse was provided, it is appropriate to enter the award against the statutory employer and dismiss the claim against the direct employer. Wagner Enterprises, Inc. v. Brooks, 12 Va. App. 890, 407 S.E.2d 32, 8 Va. Law Rep. 213, 1991 Va. App. LEXIS 159 (1991).

    Where the employee is unaware of a relationship between his employer and some third party, who is a potential statutory employer at the time of his injury, and the employee does not discover that relationship within 30 days after his work accident, these facts constitute a reasonable basis for failure to give notice, and benefits may still be awarded, unless the statutory employer shows it was prejudiced by the untimely notice. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    Failure to Give Notice of Minor Injury:

    An injury that causes unrelenting symptoms for a period of months cannot be regarded as sufficiently trivial to excuse the failure to give notice as required by the Act. Further, merely thinking an injury will improve also does not adequately explain a failure to provide timely notice. Ragnar v. Hampton Christian Schools, Inc., JCN VA00000588150 (Sept. 13, 2013).

    The claimant failed to give a reasonable excuse for failing to give his employer timely notice, and his claim was found to be barred, where he initially believed the injury to be minor, learned otherwise two months later, and his employer received notice four months after the accident. Robbins v. Lee (County of) School Board, VWC File No. 239-90-42 (July 20, 2009).

    Where an accident appeared trivial and the resulting injury did not manifest itself within thirty days, this section did not bar an award where employee sought medical attention two days after accident and employer was not prejudiced. Hampton v. Game Commission, 37 O.I.C. 55 (1955).

    Failure to give notice of accident within thirty days was excused where the claimant thought his injury was trivial until a hernia was diagnosed 45 days later. Bartley v. Super Fresh Food Markets, Inc., 74 O.W.C. 121 (1995).

    Benefits awarded where claimant treated herself, thinking it was a bruise. Blick v. Southampton Textile Co., 52 O.I.C. 26 (1970).

    The employee who felt a tear in his shoulder while lifting and subsequently was diagnosed with a traumatic fistula of the ear drum was excused from timely filing notice of the injury because of the reasonable belief that the incident was momentary, trivial and without injurious effect. Coffey v. Westmoreland Coal Co., 13 Va. App. 446, 412 S.E.2d 209 (1991), 70 O.I.C. 203 (1991).

    Failure to give notice within thirty days is justified where claimant believed the problem was arthritis, and he was only later diagnosed to have a herniated disc caused by the fall at work. Bailey v. Shaw Paint & Wall Paper Co., Inc., 74 O.W.C. 179 (1995).

    Employee who was originally treated for gout could not give notice until aware that the injury was a fracture of metatarsal bone. In re Crompton-Shenandoah Co., 54 O.I.C. 310 (1972).

    If a claimant is ignorant of the fact that an accident caused or precipitated a hernia, his failure to give notice to his employer is excused. Mitchell v. Clinch River Corporation, 61 O.I.C. 304 (1982).

    The claimant was not excused from the notice requirements of Code § 65.2-600 on the ground that she hoped her injury would improve or resolve, where the evidence revealed that she sought medical care only six days after her injury, at which time the doctor suggested several differential diagnoses of serious injury, of which the employer was entitled to notice. Rottier v. City of Alexandria School Board, 78 O.W.C. 232 (1999).

    Since the seriousness of the claimant’s injury did not manifest itself until nine days after accident, he was excused from immediately notifying the employer but his failure to notify his employer for another five days after he became aware of the true nature of his injury resulted in forfeiture of medical expenses and compensation up to the time of notification. Winslow v. Newport Datsun, Ltd., 61 O.I.C. 427 (1982).

    The claimant argued that his failure to give notice should be excused because he first thought the injury to be trivial. The evidence showed that the claimant became aware of the relationship between the January 1996 fall and his back condition by May 1997, and the Commission found that notice given to the employer 90 days later in August 1997 was not reasonable. Montgomery v. Garten Ford, Inc., 78 O.W.C. 281 (1999).

    Where an employer has knowledge of the occurrence of an accident but is unaware of any injury until thirty days after the incident compensation benefits may still be awarded if the claimant provides a reasonable excuse for failing to give notice of the injury and the evidence establishes that the employer was not prejudiced by the delay. Payne v. Ocean Atlantic Development, 66 O.I.C. 67 (1987).

    What Constitutes Prejudice:

    The burden of establishing prejudice for untimely notice rests with the statutory employer. The prejudice contemplated by § 65.2-600 D consistently falls within either of two categories: (1) harm flowing from the employer’s inability to provide immediate medical treatment to reduce the seriousness of the injury; and (2) harm attributable to the employer’s inability to sufficiently investigate a claim or prepare a defense because of the delay. Here, where the statutory employer presented no evidence to show that it could have or would have done anything differently to reduce the seriousness of the claimant’s injury, or that it was unable to prepare a defense to the claim, the notice defense was rejected. Kosma v. Bellamy, 79 O.W.C. 10 (2000).

    Where employee’s failure to report accident within thirty days deprives employer of the opportunity to investigate the facts of alleged accident or deprives him of the right and duty to furnish medical attention at a time when same would have been effectual in preventing or minimizing the incapacity resulting from an injury received in the course of the employment, prejudice will be considered as established. Hart v. American National Red Cross, 36 O.I.C. 25 (1954).

    Notice of the accident and injury was delayed for more than one year, during which period the claimant had already undergone back surgery. The recorded statement which the claimant gave on December 21, 1995, more than one year after the accident, was inconsistent with his hearing testimony and with the histories recorded by treating physicians. If the carrier had been able to investigate this accident while memories were fresher, these inconsistencies might have been resolved. Also, the carrier was prevented from providing immediate medical treatment, and was not able to participate in the selection of the treating physician, actions which could have affected the claimant’s disability. The Commission found on these facts that the employer proved it had been prejudiced by the late notice. Belter v. Hampton Roads Custom Painting, 77 O.W.C. 119 (1998).

    No prejudice where employer could have done nothing significant to minimize the claim had an earlier notice of accident been received. Smith v. Amel Co., Inc., 51 O.I.C. 250 (1969).

    Compensation denied where claimant did not offer reasonable excuse for his failure to comply with this section’s notice requirement, which resulted in prejudice to employer. Stanford v. Jewell Coal & Coke Company, 61 O.I.C. 368 (1982).

    Where the employee reports a work accident and the circumstances under which it occurred, it is of no consequence that she mistakenly assumes that her accident and injury were not compensable under the Virginia Workers’ Compensation Act. This was not a stipulation or agreement upon which the employer could rely, since it was a mistaken conclusion of law. The fact that the employer alleges that it accepted that representation is of no import. The employer and its workers’ compensation carrier were presumably in a better position than the claimant to determine whether or not the accident was compensable under the Act. Spiroff v. Medshares Home Care, 78 O.W.C. 182 (1999).

    Burden of Proof:

    The claimant has the burden to prove that timely notice was given, or that such failure to give notice to the employer was justified. Although notice of this injury was given to the employer within one or two days, the claimant could not say that she at that time related the injury to her work activities. A report of injury, without notice of an accident, is not sufficient to satisfy the claimant’s burden to give notice of the accident and injury under the Act. Rottier v. City of Alexandria School Board, 78 O.W.C. 232 (1999).

    While the burden of showing reasonable excuse for delay in giving notice of injury is upon claimant, after this is shown to the satisfaction of the Commission, the burden is upon employer to show he has been prejudiced by the delay. Maryland Cas. Co. v. Robinson, 149 Va. 307 , 141 S.E. 225 (1928); Hobbs v. AAA, Inc., 59 O.I.C. 131 (1980).

    The claimant’s failure to give notice within 30 days of her accident is not fatal to her claim if she has a reasonable excuse and the employer has not been prejudiced by the delay in receiving notice. The burden of proving a reasonable excuse for the delay in giving notice is on the claimant; when that burden has been satisfied, the burden of proving prejudice caused by that delay is on the employer. Redford v. Stafford County School Board, 79 O.W.C. 85 (2000).

    Prejudice to the employer must be shown only after a claimant provides a reasonable explanation for a delay in reporting the accident in a timely fashion. Hughes v. Mark Winkler Management, Inc., 66 O.I.C. 62 (1987).

    The burden is on an employee to explain or justify his failure to give written notice of an injury by accident. He also has the burden of establishing that the employer failed to comply with the posting requirements. Sleeper v. Newport News Shipbuilding & Dry Dock Company, 62 O.I.C. 417 (1983).

    Where employer failed to post notice advising employees of compensation rights, he is barred from raising defense of lack of notice. Berrios v. City of Richmond, 58 O.I.C. 19 (1979).

    Claimant’s testimony and its corroboration by co-employees persuasively established compliance with notice requirements notwithstanding employer’s contention that notice was not tendered within thirty days of alleged accident. Thomas v. American Safety Razor Company, 61 O.I.C. 383 (1982).

    § 65.2-601. Time for filing claim.

    The right to compensation under this title shall be forever barred, unless a claim be filed with the Commission within two years after the accident. Death benefits payable under this title shall be payable only if: (i) death results from the accident, (ii) a claim for benefits under this title has been filed within two years after the accident, and (iii) the claim for such death benefits is filed within two years from the date of death.

    History. Code 1950, § 65-84; 1968, c. 660, § 65.1-87; 1975, c. 471; 1984, c. 231; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1972-1973, see 59 Va. L. Rev. 1632 (1973).

    For survey of Virginia workers’ compensation and welfare law, see 62 Va. L. Rev. 1506 (1976).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 6 Pleading. § 6.03 Defendant’s pleadings. Bryson.

    Virginia Forms (Matthew Bender). No. 1-224 Statute of Limitations for Miscellaneous Actions — Va. Code References.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 58, 72.

    CASE NOTES

  • Analysis
  • I.In General.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-87.

    Purpose of section. —

    It is the intent of this section that within the time prescribed by this section from the date of an accident, an employee must assert against his employer any claim that he might have for any injury growing out of an accident. Shawley v. Shea-Ball Construction Co., 216 Va. 442 , 219 S.E.2d 849, 1975 Va. LEXIS 312 (1975).

    The intent of the Act is that the injured employee assert, within the limitation period, the existence of a claim growing out of a compensable injury by accident. Hungerford Mechanical Corp. v. Hobson, 11 Va. App. 675, 401 S.E.2d 213, 7 Va. Law Rep. 1582, 1991 Va. App. LEXIS 23 (1991).

    The purpose of § 65.2-601 is to provide the parties with notice of the potential issues in a case; proper notice enables an employer to determine whether an employee has in fact been injured, the nature of the injury, whether it arose out of and in the course of the employee’s employment, whether permanent or temporary, and whether compensable or not. Hardee's of Clintwood v. Robinson, 2003 Va. App. LEXIS 70 (Va. Ct. App. Feb. 11, 2003).

    The special limitation under this section is part of the right as well as the remedy, as integral part of the Workmen’s (now Workers’) Compensation Act, and a condition precedent to maintenance of the claim. Barksdale v. H.O. Engen, Inc., 218 Va. 496 , 237 S.E.2d 794, 1977 Va. LEXIS 279 (1977).

    The right to compensation under the workmen’s compensation law is granted by statute, and in giving the right the legislature had full power to prescribe the time and manner of its exercise. Thus the time limitation is a part of the new substantive right. Barksdale v. H.O. Engen, Inc., 218 Va. 496 , 237 S.E.2d 794, 1977 Va. LEXIS 279 (1977).

    And is jurisdictional. —

    The limitation provision of this section is jurisdictional and failure to file within the prescribed time will bar a claim. Barksdale v. H.O. Engen, Inc., 218 Va. 496 , 237 S.E.2d 794, 1977 Va. LEXIS 279 (1977).

    The jurisdictional nature of a filing under this section is not affected by any notice that may previously have been given to the employer. Thus, while former § 65.1-85 (now § 65.2-600 ) requires that the employer be promptly notified of an accident, it is the filing of a claim under this section that invokes the jurisdiction of the Compensation Commission to award compensation. Garcia v. Mantech Int'l Corp., 2 Va. App. 749, 347 S.E.2d 548, 3 Va. Law Rep. 333, 1986 Va. App. LEXIS 327 (1986).

    The time limitation provided in this section is jurisdictional. The jurisdictional effect of the statute on a filing is not affected by any notice that may have been previously given to an employer; it is not the fact of prior notice, but rather the filing of a claim that invokes the jurisdiction of the commission to award compensation. Broadus v. Shields Sec. Serv. & Clark Enter., Inc., No. 1275-89-4 (Ct. of Appeals Apr. 24, 1990).

    Commission lacked subject matter jurisdiction to award medical benefits for injuries for which no claim was filed until more than fifteen years after compensable accident. Safeway Stores, Inc. v. McGowan, 2000 Va. App. LEXIS 140 (Va. Ct. App. Feb. 29, 2000).

    To perfect a claim for benefits under the Virginia Workers’ Compensation Act, § 65.2-100 et seq., an employee must file notice of the claim with the commission within two years of the accident, including all specific injuries an employee contends are compensable; timely filing of an original claim is jurisdictional, and a claimant bears the burden of proving his claim is timely filed. Johnson v. Paul Johnson Plastering, 37 Va. App. 716, 561 S.E.2d 40, 2002 Va. App. LEXIS 183 (2002), aff'd in part and rev'd in part, 265 Va. 237 , 576 S.E.2d 447, 2003 Va. LEXIS 28 (2003).

    When a workers’ compensation claimant did not seek permanent and total disability benefits for a brain injury within two years of the accident which allegedly caused the injury, the fact that he had been awarded benefits for the treatment of that injury did not preclude his employer’s denial of responsibility for this latest claim because the award for medical treatment was made more than two years after the accident and, thus, without jurisdiction, so it could have no preclusive effect. Weikle v. Southland Corp., 2003 Va. App. LEXIS 126 (Va. Ct. App. Mar. 11, 2003).

    The language of this section is clear. Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    And the reason for the limitation prescribed by this section is a compelling one. Shawley v. Shea-Ball Construction Co., 216 Va. 442 , 219 S.E.2d 849, 1975 Va. LEXIS 312 (1975).

    No directive as to which party must mail claim. —

    Workers’ compensation claimant was found to have timely filed a claim for benefits, pursuant to § 65.2-601 and Va. Workers’ Comm’n R. 1.1, where she executed a memorandum of agreement and forwarded it to her employer for purposes of mailing to the Workers’ Compensation Commission; there was no directive as to who had the obligation of mailing the memorandum, and although an award based on the memorandum had been vacated, the actual memorandum itself had not been withdrawn or dismissed. Fairfax County Sch. Bd. v. Humphrey, 41 Va. App. 147, 583 S.E.2d 65, 2003 Va. App. LEXIS 396 (2003).

    A timely claim for benefits, standing alone, fulfills the purpose of this section and the supporting medical documentation and the request for a hearing may be filed at a later date. Metro Mach. Corp. v. Sowers, 33 Va. App. 197, 532 S.E.2d 341, 2000 Va. App. LEXIS 591 (2000), overruled in part, King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016) (applying an economic loss test as opposed to loss of earning capacity analysis).

    In the absence of an order from the commission dismissing claim for failure to prosecute, the commission has jurisdiction to hear the pending case. Kennedy v. Aceves Constr. & Maintenance Co., 1995 Va. App. LEXIS 16 (Va. Ct. App. Jan. 3, 1995).

    Withdrawal of “Application for Hearing” did not constitute withdrawal of claim. —

    Withdrawal of an “Application for Hearing,” where the “application” did not serve to file the “claim,” does not constitute withdrawal of the claim, for purposes of applying the statutory time limitation. Keenan v. Westinghouse Elevator Co., 10 Va. App. 232, 391 S.E.2d 342, 6 Va. Law Rep. 2276, 1990 Va. App. LEXIS 75 (1990).

    Insufficient claim termination. —

    Where the commission, responding to a claimant’s request, entered an order withdrawing an application for hearing, that order was insufficient to terminate the fact of the claim having been filed. Kennedy v. Aceves Constr. & Maintenance Co., 1995 Va. App. LEXIS 16 (Va. Ct. App. Jan. 3, 1995).

    Claim must name correct employer. —

    Although the statute does not give a definition of “claim,” in order to have any legal effect a claim filed pursuant to this section must name the correct employer. This conclusion is aided by consideration of the function served by the notice requirement of this section. Garcia v. Mantech Int'l Corp., 2 Va. App. 749, 347 S.E.2d 548, 3 Va. Law Rep. 333, 1986 Va. App. LEXIS 327 (1986).

    A claim under this section must be directed against the correct employer. By requiring an initial claim under this section to state the correct employer, the Commission was not adding a requirement, but was merely stating that which is implicit in the language of the statute. Garcia v. Mantech Int'l Corp., 2 Va. App. 749, 347 S.E.2d 548, 3 Va. Law Rep. 333, 1986 Va. App. LEXIS 327 (1986).

    The filing of a claim which does not name the correct employer does nothing to accomplish the purposes of the notice. Since the Commission has no authority to award benefits against an employer having no employment relationship with a claimant, the filing of a claim naming the wrong employer cannot set in motion the machinery for determining the merits of the case. In addition, such a claim does not provide notice to the actual employer that the claimant is seeking an award from the Commission. Garcia v. Mantech Int'l Corp., 2 Va. App. 749, 347 S.E.2d 548, 3 Va. Law Rep. 333, 1986 Va. App. LEXIS 327 (1986).

    Letter of counsel may be regarded as a “claim.” —

    A letter from counsel for the employer, written within a year from the time of the injury and after a verdict had been returned in favor of the employee in an action at law against the employer, requesting a hearing under former § 65.1-94 (now § 65.2-702 ), could be denominated a claim by the employer and was sufficient to stop the running of the statute of limitations set up by this section, so that a claim filed by the employee after reversal of the judgment in the action at law on appeal was not barred. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947).

    Section applies only to claim for compensation under Act. —

    This section has no application to any right of action except the employee’s action for compensation under the Workmen’s (now Workers’) Compensation Act against his employer or his insurance carrier. United States Fid. & Guar. Co. v. Blue Diamond Coal Co., 161 Va. 373 , 170 S.E. 728 , 1933 Va. LEXIS 327 (1933).

    Application of 1975 amendment. —

    The 1975 amendment to this section raising the time limit for filing a claim to two years did not apply to an injured employee’s claim where the injury was sustained prior to the amendment since the contractual obligations of the employer and employee and the employee’s substantive right to recover were fixed at the time of the injury. Barksdale v. H.O. Engen, Inc., 218 Va. 496 , 237 S.E.2d 794, 1977 Va. LEXIS 279 (1977).

    Compensability and time limitations are separate issues. —

    Compensability and the time limitations within which a compensable claim must be asserted are separate and distinct issues. Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    A claimant under the workmen’s (now workers’) compensation law must show that his original claim was timely filed, for such filing within the statutory period is jurisdictional. Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    Time limit applicable to all aspects of primary injury. —

    Where a claimant did not indicate that she suffered injury to her neck in her original claim and the neck injury was not reported in the medical documents submitted within the two-year limitation period following the date of the accident the claimant was not entitled to benefits. The claimant was required to assert the claim for her neck injury within the limitation period because, according to her testimony, she suffered the neck injury on the date of the accident. Fleetwood Homes of Va., Inc. v. McNeal, 2001 Va. App. LEXIS 311 (Va. Ct. App. June 5, 2001).

    The provisions of this section apply to the original claim, etc. for compensation for injuries by accident arising out of and in the course of the employment. Allen v. Mottley Constr. Co., 160 Va. 875 , 170 S.E. 412 , 1933 Va. LEXIS 264 (1933).

    In a workers’ compensation case in which the claimant alleged that reflex sympathetic dystrophy in the claimant’s right arm related to a 1994 work injury had spread to her left arm, the statute of limitations that applied was § 65.2-708 , which related to a claim based on a change of condition, rather than § 65.2-601 , which related to original claims; because the employer did not base its argument on § 65.2-708 , any argument regarding the statute of limitations was waived under Va. Sup. Ct. R. 5A:20(e) for failure to discuss the relevant legal principles and under Va. Sup. Ct. R. 5A:18 because no statute of limitations argument was made before the Workers’ Compensation Commission. Mount Vernon Hosp. v. Devers, 2008 Va. App. LEXIS 494 (Va. Ct. App. Nov. 4, 2008).

    Employee’s claim regarding her spinal injuries was filed as an initial claim rather than as a change in condition, and thus she was not required to prove a change in her condition since the entry of the award order, and the employer’s reference to review based on a change in condition was misdirected. Advance Auto & Indem. Ins. Co. v. Craft, 63 Va. App. 502, 759 S.E.2d 17, 2014 Va. App. LEXIS 250 (2014).

    They are not applicable to claims for increases in compensation. —

    Where by an agreement a settlement was made between employer and employee, which was confirmed by the Commission, the provision in this section that a claim must be filed within one year from the accident was inapplicable to an application for an increase in compensation due to a change in the employee’s condition. Wise Coal & Coke Co. v. Roberts, 157 Va. 782 , 161 S.E. 911 , 1932 Va. LEXIS 327 (1932).

    Former § 65.1-55.1 (now subsection C of § 65.2-708 ) applies only to proceedings under former § 65.1-99 (now § 65.2-708 ), relating to changes in condition, and it has no application to the jurisdictional time bar imposed by this section for the filing of an original application. Rose v. Red's Hitch & Trailer Serv., Inc., 11 Va. App. 55, 396 S.E.2d 392, 1990 Va. App. LEXIS 162 (1990).

    “Compensation.” —

    The phrase “and although no award has been entered” as used in former § 65.1-87.1 (now § 65.2-602 ) evinced a legislative intent that the word “compensation” applied to cases where payments were made in lieu of an award to which the employee would have been entitled under the Virginia Act. Bowden v. Newport News Shipbuilding & Dry Dock Co., 11 Va. App. 683, 401 S.E.2d 884, 7 Va. Law Rep. 1588, 1991 Va. App. LEXIS 27 (1991).

    There was nothing in former § 65.1-87.1 (now § 65.2-602 ) to indicate that the legislature intended the term “compensation” to apply to payments other than those mandated by Chapter 5, i.e., lost wages or a percentage thereof paid in lieu of an award by the Commission. The lack of an expressed contrary intent was evidence of the legislature’s intent not to broaden the statute to include payments made outside the requirements of the Virginia Act. Bowden v. Newport News Shipbuilding & Dry Dock Co., 11 Va. App. 683, 401 S.E.2d 884, 7 Va. Law Rep. 1588, 1991 Va. App. LEXIS 27 (1991).

    The running of the time limitation in this section for new injuries is from the date of the new injury rather than from the date of the initial injury. Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    Where the facts establish a new and separate compensable injury rather than a compensable change in condition, the time limitations of this section are applicable and the claimant may not use a change in condition application to invoke the time limitations of former § 65.1-99 (now § 65.2-708 ). Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    To estop the employer from pleading the statute of limitations, the employee must present clear, precise, and unequivocal evidence that he refrained from filing a claim because he relied to his detriment upon the acts or statements of the employer. If the employer’s representation induced the employee to refrain from filing a claim, it does not matter whether the employer harbored such intent. Strong v. Old Dominion Power Co., 35 Va. App. 119, 543 S.E.2d 598, 2001 Va. App. LEXIS 141 (2001).

    Workers’ compensation commission erred in finding that a per se prejudice standard applied to toll the two-year statute of limitations that would otherwise operate against the claimant’s application for workers’ compensation benefits because the employer did not file the accident report it was statutorily required to file until more than two years from the time of the accident had passed, and, thus, the claimant filed her application more than two years after the accident at issue. The law required that an “actual prejudice” standard be applied because the claimant might not have been prejudiced by the employer’s late filing of the accident report due to the fact that she had a previous claim barred on statute of limitations grounds where she had argued that she had not received a notification letter from the workers’ compensation commission about her right to file a claim and the workers’ compensation commission concluded she had in fact received the letter and knew she only had a specified amount of time in which to file an application for benefits. Hall v. Winn-Dixie Stores, Inc., 41 Va. App. 835, 589 S.E.2d 484, 2003 Va. App. LEXIS 642 (2003).

    No actual notice exception. —

    When a workers’ compensation claimant did not seek permanent and total disability benefits for a brain injury within two years of the accident which allegedly caused the injury, his employer’s alleged actual notice of the injury within that two-year period did not relieve the claimant of the obligation to file his claim within two years, as there was no “actual notice” exception to this statute, so the Workers’ Compensation Commission had no jurisdiction to consider the claim. Weikle v. Southland Corp., 2003 Va. App. LEXIS 126 (Va. Ct. App. Mar. 11, 2003).

    The doctrine of compensable consequences is applicable both to aggravation of a prior compensable injury and a new injury for the purpose of establishing compensability of the subsequent injury. Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    Noncompensable subsequent injury. —

    Shooting incident did not constitute an injury by accident arising out of and in the course of the decedent’s employment where the decedent had years earlier suffered a compensable injury at work. Sturtz v. Chesapeake Corp., 38 Va. App. 672, 568 S.E.2d 381, 2002 Va. App. LEXIS 495 (2002).

    Where an employee’s claim for permanent total workers’ compensation disability under subdivision C 3 of § 65.2-503 was untimely pursuant to § 65.2-601 and the workers’ compensation commission’s factual finding that the employee’s brain injury did not arise from a work injury was never set aside, the appellate court erred by remanding the matter for further factual findings. Paul Johnson Plastering v. Johnson, 265 Va. 237 , 576 S.E.2d 447, 2003 Va. LEXIS 28 (2003).

    Because an employee’s leg and back were injured in the same accident, the leg injury did not arise out of the back injury, therefore, the two-year limitation period in this section, rather than the limitation period in § 65.2-708 applied; consequently, the employee’s claim for benefits was time-barred. Arias v. United Masonry of Va., Inc., 2006 Va. App. LEXIS 227 (Va. Ct. App. May 23, 2006).

    The basic nature of the notice required by this section and the necessity for an applicable jurisdictional limitation are apparent. Such notice is often the first knowledge that an employer and his insurance carrier have of an accident and of their potential liability. It is this notice that sets in motion the machinery to determine whether or not an employee has in fact been injured, the nature of the injury, that it arose out of and in the course of his employment, whether permanent or temporary, and whether compensable or not. This is the notice which activates the right of the employee to compensation and which invokes the jurisdiction of the Compensation Commission. Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    Failure to give notice within the time prescribed by this section from an accident would seriously handicap the employer and the carrier in determining whether or not there was in fact an injury, the nature and extent thereof, and if related to the accident. Shawley v. Shea-Ball Construction Co., 216 Va. 442 , 219 S.E.2d 849, 1975 Va. LEXIS 312 (1975).

    Voluntary payment of medical bills by carrier did not operate as a matter of law to toll the two-year statute of limitations or to estop employer and carrier from availing themselves of the benefit of the limitation provided by this section. Stuart Circle Hosp. v. Alderson, 223 Va. 205 , 288 S.E.2d 445, 1982 Va. LEXIS 192 (1982). But see § 65.2-602 .

    Voluntary payment of benefits by employer does not toll statute of limitations. —

    Employer was not estopped from asserting the statute of limitations as a defense to claim for workers’ compensation, although employer voluntarily made payment of benefits; record revealed neither fraud nor concealment nor any act by the employer which was reasonably calculated to induce or did in fact induce claimant to refrain from filing her claim within two years from the date of her injury. Bristol Newspapers, Inc. v. Shaffer, 16 Va. App. 703, 432 S.E.2d 23, 10 Va. Law Rep. 6, 1993 Va. App. LEXIS 248 (1993).

    An employer is not estopped from asserting the statute of limitations defense merely because it voluntarily paid medical bills, wages or benefits. The employer’s payment of benefits and medical bills and its participation in the employee’s medical care for two years are not sufficient conduct upon which the employee can rely to excuse his failure to file a claim. Strong v. Old Dominion Power Co., 35 Va. App. 119, 543 S.E.2d 598, 2001 Va. App. LEXIS 141 (2001).

    Time for giving notice of new and separate injury. —

    An employee who suffers a new and separate injury, not a “change in condition” arising out of the first injury, is required to give notice of the accident to his employer, his agent or representative, and to file an application for compensation with the Industrial Commission within the time limitations prescribed by former § 65.1-85 (now § 65.2-600 ) and this section. Leonard v. Arnold, 218 Va. 210 , 237 S.E.2d 97, 1977 Va. LEXIS 180 (1977).

    Benefits claim time barred for injuries not included in original award. —

    Where an employee injured the employee’s coccyx in a work accident, but sought benefits for injuries not included in the memorandum of agreement with the employer or the original award, the two-year statute of limitations barred the claim. Hardee's of Clintwood v. Robinson, 2003 Va. App. LEXIS 70 (Va. Ct. App. Feb. 11, 2003).

    Disability need not be proved within limitations period. —

    Although disability must have occurred prior to the expiration of the statute of limitations, it need not be established until the request for hearing is filed and the matter is brought before the Commission; there is no requirement that actual proof of disability be presented within two years. Metro Mach. Corp. v. Sowers, 33 Va. App. 197, 532 S.E.2d 341, 2000 Va. App. LEXIS 591 (2000), overruled in part, King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016) (applying an economic loss test as opposed to loss of earning capacity analysis).

    Fraud of employer or insurance carrier works estoppel. —

    Fraud of the employer and the insurance carrier estops them from asserting the limitation prescribed under this section. American Mut. Liab. Ins. Co. v. Hamilton, 145 Va. 391 , 135 S.E. 21 , 1926 Va. LEXIS 399 (1926).

    Imposition doctrine. —

    Under the doctrine of imposition, the commission’s jurisdiction to do full and complete justice includes the power to render decisions based on justice shown by the total circumstances even though no fraud, mistake or concealment has been shown. Odom v. Red Lobster #235, 20 Va. App. 228, 456 S.E.2d 140, 1995 Va. App. LEXIS 371 (1995).

    The doctrine of imposition does not apply where a carrier’s or employer’s acts are consistent with an endeavor to comply with the act. Odom v. Red Lobster #235, 20 Va. App. 228, 456 S.E.2d 140, 1995 Va. App. LEXIS 371 (1995).

    Under the doctrine of imposition, unlike estoppel, a claimant’s receipt of the standard “blue letter” from the commission does not create a de jure bar to a finding that claimant suffered prejudice. Rather, receipt of the “blue letter” is simply one circumstance among others to be considered. Odom v. Red Lobster #235, 20 Va. App. 228, 456 S.E.2d 140, 1995 Va. App. LEXIS 371 (1995).

    The theory of “imposition” empowers the Workers’ Compensation Commission in appropriate cases to render decisions based on justice shown by the total circumstances even though no fraud, mistake or concealment has been shown rather than permit the statute of limitations to be successfully pled. Avon Prods., Inc. v. Ross, 14 Va. App. 1, 415 S.E.2d 225, 8 Va. Law Rep. 2299, 1992 Va. App. LEXIS 73 (1992).

    Imposition elements. —

    Although employer neither complied with the commission’s reporting requirements nor filed a memorandum of agreement after accepting claimant’s claim as required by § 65.2-701 , these actions by themselves do not necessarily constitute a de jure case of imposition. Westvaco Corp. v. Linkenhoker, 1996 Va. App. LEXIS 764 (Va. Ct. App. Dec. 31, 1996).

    The commission correctly concluded that the claimant was simply seeking further treatment for the exact same injury which was the subject of his compensable claim more than two years earlier, a factual finding clearly supported by credible evidence. Gwaltney of Smithfield, Ltd. v. Tynes, 1997 Va. App. LEXIS 68 (Va. Ct. App. Feb. 11, 1997).

    For discussion of the limitation prescribed in this section in relation to that provided in former § 65.1-99 (now § 65.2-708 ), see Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    Guardian. —

    The definition of “guardian” in the decision of Ingram v. Marvel Poultry Co., 58 O.I.C. 192 (1978) affords the level of protection needed for infants who unknowingly possess compensable claims. The guardian should have a legal duty to pursue the minor’s workers’ compensation claim. Where an infant had no such guardian from the time of his father’s death until the date he filed for compensation benefits, the statute of limitations delineated in this section did not run against him. ACB Trucking, Inc. v. Griffin, 5 Va. App. 542, 365 S.E.2d 334, 4 Va. Law Rep. 1860, 1988 Va. App. LEXIS 35 (1988), overruled in part, Liberty Mut. Ins. Co. v. Fisher, 263 Va. 78 , 557 S.E.2d 209, 2002 Va. LEXIS 15 (2002).

    II.Illustrations.
    A.Applicability.

    Applicability. —

    Even though a workers’ compensation claimant received awards from wage loss and medical benefits claims first, there was no change in claimant’s condition in regards to permanent disability because the permanency claim remained open and ongoing; therefore, the statute of limitations period from the date of the accident under § 65.2-601 applied. Howard v. Cost Plus World Mkt., 2011 Va. App. LEXIS 182 (Va. Ct. App. May 24, 2011).

    Limitation period inapplicable. —

    Virginia Workers’ Compensation Commission correctly viewed the claimant’s sexual dysfunction as a change in condition, not a new and separate injury, which tracked the treating physician’s opinion attributing the sexual dysfunction to a combination of the chronic pain syndrome/complex regional pain disorder caused in part by the workplace accident and the medications used to treat them. As a result, his claim was not subject to the statute of limitations period in this section, but was subject to the statute of limitations period codified in subsection A of § 65.2-708 . Berglund Chevrolet, Inc. v. Landrum, 43 Va. App. 742, 601 S.E.2d 693, 2004 Va. App. LEXIS 418 (2004).

    Applying statute of limitations under § 65.2-601 to an employee’s claim for workers’ compensation benefits would have been improper because the employee’s symptoms remained constant with his original timely claim for benefits and the only thing that changed was the diagnosis concerning the symptoms. Hitt Constr. v. Pratt, 2010 Va. App. LEXIS 98 (Va. Ct. App. Mar. 16, 2010).

    United States’ claim under 10 U.S.C.S. § 1095 could not be dismissed as time barred under § 65.2-601 because the United States was not seeking relief under that statute and the United States was not bound by state statutes of limitations. United States v. Chartis Ins. Agency, Inc., 834 F. Supp. 2d 459, 2011 U.S. Dist. LEXIS 117628 (E.D. Va. 2011).

    B.Notice.

    Letter to Commission constituted filing of a claim. —

    Letter to Industrial (now Workers’ Compensation) Commission from injured’s attorney, which identified the employer, the date of the accident, the location of the accident, the injuries that resulted, and stated that his client had a claim, constituted the filing of a claim for the purposes of this section. Trammel Crow Company, Inc. v. Redmond, 12 Va. App. 610, 405 S.E.2d 632, 7 Va. Law Rep. 2750, 1991 Va. App. LEXIS 118 (1991).

    Letter by an injured employee’s counsel to the Virginia Worker’s Compensation Commission, the employer, and the insurance carrier was sufficient to constitute a valid new claim for benefits, rather than a compensable change in condition, and the claim was filed within the two-year statute of limitations under § 65.2-601 . Masonite Holdings, Inc. v. Cubbage, 53 Va. App. 13, 668 S.E.2d 809, 2008 Va. App. LEXIS 510 (2008).

    Notice sufficient. —

    An employee’s claim letter satisfied the filing requirement where it advised the Commission that he suffered an injury to his back within the past two years while working for the employer and stated a claim for all workers’ compensation benefits to which he was or might be entitled. Metro Mach. Corp. v. Lamb, 33 Va. App. 187, 532 S.E.2d 337, 2000 Va. App. LEXIS 598 (2000), overruled in part, King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016) (applying an economic loss test as opposed to loss of earning capacity analysis).

    That a claimant and employer’s memorandum of agreement did not include the date and nature of the injury did not mean the claimant had not timely filed a claim with the Virginia Workers’ Compensation Commission, as other documents previously filed with the Commission contained the missing information. Therefore, the parties complied with Va. Workers’ Comp. Comm’n R. 1:1(A) and the claim had not been time-barred. Giant Food, Inc. v. Webb, 2005 Va. App. LEXIS 16 (Va. Ct. App. Jan. 11, 2005).

    Deputy workers’ compensation commissioner found that the claimant’s request was barred on the ground that the claimant did not suffer any wage loss within the two-year limitations period; the claimant’s timely filing of his claim for temporary and permanent disability benefits was sufficient to meet the requirements of a proper filing under the statute because it placed the employer on notice of the claim. Keith v. Ball Metal Bev. Container Corp., 45 Va. App. 50, 608 S.E.2d 501, 2005 Va. App. LEXIS 39 (2005).

    Where a claim for a consequent injury was filed within 24 months of the last date for which disability compensation was paid, the Virginia Workers’ Compensation Commission properly reviewed claimant’s change-in-condition application pursuant to § 65.2-708 and not § 65.2-601 . Lite-Tech, Inc. v. Charles, 2005 Va. App. LEXIS 114 (Va. Ct. App. Mar. 22, 2005).

    Claimant’s action for workers’ compensation benefits was not barred by two-year statute of limitations of § 65.2-601 because: (1) the employer was immediately notified that the claimant hurt her neck lifting suits from a rack when the accident happened; (2) the claimant’s medical records consistently identified the date of the work-related accident and described the claimant’s condition as involving her neck; and (3) the claim form properly listed claimant’s name, employer’s name, the location of the store where the injury occurred, and how the injury occurred, provided sufficient information to enable the employer to recognize the injury for which it was potentially liable. The claim form’s inclusion of the wrong year in the accident date and the wrong letter in the spelling of the injury — entries that were obvious oversights — did not negate that notice. Joseph A. Bank Clothiers, Inc. v. Morton, 2007 Va. App. LEXIS 187 (Va. Ct. App. May 8, 2007).

    Medical evidence and the claimant’s uncontradicted testimony, including his statement that he was never released to work capacity, which was found credible, supported the Virginia Workers’ Compensation Commission’s finding that there was no change in the claimant’s condition and that his treatment remained at a status quo until he could undergo the surgery recommended by his treating physician. Sam Moore Furniture Indus. v. Smith, 2008 Va. App. LEXIS 98 (Va. Ct. App. Feb. 26, 2008).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s decision that the statute of limitations did not bar the claimant’s shoulder claim; claimant’s timely filing of a claim for injury to his right arm was sufficient to constitute timely filing of a claim for injury to his right shoulder, as the treating physician opined that the injuries to the elbow and shoulder were sustained at the same time, and that the injury to the shoulder could have been a contributing cause of the claimant’s elbow pain from the beginning. Sam Moore Furniture Indus. v. Smith, 2008 Va. App. LEXIS 98 (Va. Ct. App. Feb. 26, 2008).

    Claim timely filed. —

    Virginia Workers’ Compensation Commission erred in denying a workers’ compensation claimant permanent disability benefits because claimant timely filed her claim within two years of the accident pursuant to § 65.2-601 ; the joint stipulation claimant and her employer entered into did not operate as an abandonment or waiver of claimant’s permanency claim because it did not contain a clear showing that the claim had been withdrawn, and thus, the permanency claim remained ongoing and uninterrupted since claimant first filed the claim. Howard v. Cost Plus World Mkt., 2011 Va. App. LEXIS 182 (Va. Ct. App. May 24, 2011).

    No consequence when doctor unable to rate degree of permanent disability within limitations period. —

    It was of no consequence that the claimant’s doctor was unable to rate the degree of permanent disability within the statute of limitations. What was determinative was that the application for benefits was timely filed, that the credible evidence before the Commission proved the claimant suffered a permanent impairment, and that the Commission’s award satisfied the requirements of the Act. Hungerford Mechanical Corp. v. Hobson, 11 Va. App. 675, 401 S.E.2d 213, 7 Va. Law Rep. 1582, 1991 Va. App. LEXIS 23 (1991).

    Claim for medical benefits. —

    An employee’s claim for benefits related to an injury to his left leg was properly dismissed where no evidence in the record established that the employee filed a claim for medical benefits related to treatment of his left leg within the limitations period provided in this section; all benefits claimed within the statutory limitations period related to an injury to the employee’s right leg. Campbell v. Lyntool, Inc., 2000 Va. App. LEXIS 706 (Va. Ct. App. Oct. 31, 2000).

    When an employer agreed to pay a claimant benefits as a result of an industrial accident resulting in a “head trauma,” the claimant’s request for reinstatement of therapy sessions for treatment of the claimant’s traumatic brain injury was not time-barred because (1) undisputed medical evidence showed the employer had timely notice of the injury when the employer agreed to pay benefits for the “head trauma,” and (2) the employer’s conduct since the accident showed the agreement included the brain injury, since the employer paid for procedures characterized as traumatic brain injury treatment and did not object to this characterization when the employer had the opportunity. Philip Morris USA, Inc. v. Mease, 62 Va. App. 190, 745 S.E.2d 155, 2013 Va. App. LEXIS 206 (2013).

    Claim sufficiently established. —

    Counsel’s letter and accompanying “Application for Hearing,” followed by the Commission’s approval of a compensation agreement, styled “AWARD,” sufficiently established the claim. Constantino v. Pito’s Constr. Co., No. 1413-92-4 (Ct. of Appeals Dec. 4, 1992).

    This section provides that compensation shall be forever barred, unless a claim is filed with the Commission within two years after an accident; during this period an employee must assert against his employer “any claim” that he might have for an injury growing out of the accident. However here, claimant made an original claim for medical mileage and prescriptions which was satisfied voluntarily by the employer without an award, and then made a formal claim under § 65.2-503 in which a 36-month filing period is allowed pursuant to § 65.2-708 ; thus claimant properly received permanent partial disability award. Lynchburg Foundry Co. v. McDaniel, 22 Va. App. 307, 469 S.E.2d 85, 1996 Va. App. LEXIS 266 (1996).

    Letter to the Workers’ Compensation Commission from an injured employee, which was sent within the limitations period together with a copy of the first report of injury previously filed by the employer, met the requirements for an original claim for benefits; the fact that a commission employee erroneously interpreted the documents as an incomplete first report was not controlling. Massey Builders Supply Corp. v. Colgan, 36 Va. App. 496, 553 S.E.2d 146, 2001 Va. App. LEXIS 549 (2001).

    Because the employer agreed that the claimant sustained multiple injuries within the two-year period following her compensable injury by accident and the employer had knowledge and notice of the claimant’s potential claim for work-related hyperacusis and tinnitus within that period, the Workers’ Compensation Commission did not err in invoking its jurisdiction and in considering the claimant’s claim for those conditions. Va. Dep't of Health/Va. v. Elmore, 2002 Va. App. LEXIS 783 (Va. Ct. App. Dec. 31, 2002).

    When a claimant, who worked as a tailor, injured her neck while lifting suits form a clothing rack, the claimant sustained an injury by accident arising out of the claimant’s work within the meaning of § 65.2-601 because, while not a task exclusive to tailors, the claimant’s act of lifting two suits with one hand constituted a significant work-related exertion and presented an injurious risk to which, apart from the claimant’s employment, she, like the general public, would not have been exposed. Joseph A. Bank Clothiers, Inc. v. Morton, 2007 Va. App. LEXIS 187 (Va. Ct. App. May 8, 2007).

    Workers’ compensation coverage for the claimant’s neck injury was not barred by the statute of limitations, as the employer accepted as compensable the claimant’s chronic symptoms, documented throughout the claimant’s medical records as consistently involving pain in both the claimant’s shoulder and neck. The subsequent determination that those symptoms emanated from an injury to the claimant’s neck rather than to the claimant’s shoulder did not negate the employer’s acceptance of the symptoms as a compensable injury or the Virginia Workers’ Compensation Commission’s entry of an award. Corporate Res. Mgmt. v. Southers, 51 Va. App. 118, 655 S.E.2d 34, 2008 Va. App. LEXIS 10 (2008).

    Claimant not entitled to compensation for total disability. —

    Although plaintiff filed his initial application for medical expenses within the prescribed time period, he neither made a claim for, nor incurred, any lost wages within the two year period and no award was ever entered by the commission; because plaintiff did not file a timely application or demonstrate any disability during the two-year period, he could not be awarded compensation for total disability. Mayberry v. Alcoa Bldg. Prods., 18 Va. App. 18, 441 S.E.2d 349, 10 Va. Law Rep. 1042, 1994 Va. App. LEXIS 106 (1994), limited, Prince William County Sch. Bd. v. Rahim, 58 Va. App. 493, 711 S.E.2d 241, 2011 Va. App. LEXIS 235 (2011).

    C.Timeliness.

    Claim not time-barred where same injury involved. —

    Workers’ compensation claim on right-foot condition was not time-barred under § 65.2-601 , as such was causally related to a compensable left foot injury and was aggravated by the claimant having to shift to the right foot because of pain on the left. Hyters Coal Co. v. Bragg, 2002 Va. App. LEXIS 539 (Va. Ct. App. Aug. 27, 2002).

    Although a workers’ compensation claim will be barred if an employee fails to assert a claim with respect to a particular injury within two years from the date of the accident, where evidence demonstrated that employee’s neck and shoulder injuries constituted the same injury as lower back injury, which was timely filed, employee was not required to file a separate claim for the shoulder injuries, and his claim was not time-barred. Safeway Stores, Inc. v. Larrick, 2001 Va. App. LEXIS 415 (Va. Ct. App. July 17, 2001).

    Pleading the seven days of disability that were statutorily required to pass before a workers’ compensation claimant could receive compensation on a claim covered under the workers’ compensation law was not jurisdictional, and, thus, the claimant’s second claim, which was filed within the two-year limitations period for workers’ compensation benefits set forth in § 65.2-601 , was not time-barred for only alleging one date in support of his request for temporary total benefits, where the claimant subsequently amended his second claim to included additional dates that exceeded the seven-day disability requirement since those amendments did not raise a new cause of action but instead, related back to the timely-filed second claim. Hospice Choice, Inc. v. O'Quin, 42 Va. App. 598, 593 S.E.2d 554, 2004 Va. App. LEXIS 101 (2004).

    Virginia Workers’ Compensation Commission’s finding that the Uninsured Employer’s Fund was not liable for medical treatment a workers’ compensation claimant received for his neck and shoulder pain since a compensation award was limited to his back was not supported by credible evidence, and claimant failed to file a claim for injury to his shoulder or neck within two years of the workplace injury in violation of the Workers’ Compensation Act, § 65.2-601 , because claimant did not suffer injuries to two separate body parts; claimant complained of and was treated for pain in the upper back following his workplace injury, and although the language of the compensation award stated only that claimant’s injury to the back was compensable, the injury had always been identified as an injury to the thoracic spine. Knott v. Va. Beach Mariners, Inc., 2009 Va. App. LEXIS 535 (Va. Ct. App. Dec. 8, 2009).

    Employee’s May 18, 2012 claim was not a new claim, but only a claim for compensation for medical bills incurred as a result of the compensable work injury for which an original claim for benefits was timely filed within the two-year statute of limitations, and the statute did not bar compensation for the medical bills incurred and claimed after the original award and more than two years after the accident. Target Corp. v. Hussein, 2014 Va. App. LEXIS 279 (Va. Ct. App. Aug. 12, 2014).

    Claim for continuing treatment. —

    Because an employer’s denial of continuing treatment caused a worker to seek unauthorized treatment for seven years without requesting either payment from his employer or assistance from the Workers’ Compensation Commission, the worker’s request for authorization for continuing treatment was not barred by the equitable doctrine of laches. Dagenhart Sprinkler Co. v. Hurst, 2012 Va. App. LEXIS 78 (Va. Ct. App. Mar. 20, 2012).

    Timely filing of evidence and facts established by evidence are operative considerations. —

    A medical rating of the employee’s disability is evidence which an employee offers in order to meet the burden of proof. The Code does not require that this evidence be established before the statute of limitations expires. The timely filing of evidence in accordance with the Commission’s rules and the facts established by that evidence are the operative considerations in determining whether a claimant is entitled to compensation benefits. Hungerford Mechanical Corp. v. Hobson, 11 Va. App. 675, 401 S.E.2d 213, 7 Va. Law Rep. 1582, 1991 Va. App. LEXIS 23 (1991).

    Partly completed claim form. —

    Virginia Workers’ Compensation Commission properly held a worker timely filed a claim under § 65.2-601 , when the worker partly completed a claim form, because, while the worker did not identify benefits sought, the worker identified the employer, accident date and location, and injuries, and fairly apprised the Commission that a claim was made, which was sufficient under Va. Workers’ Comp. Comm’n R. 1.1, defining “claim,” as the Commission was not bound by technical rules of pleading or practice. Cochran Indus. VA v. Meadows, 63 Va. App. 218, 755 S.E.2d 489, 2014 Va. App. LEXIS 116 (2014).

    Claim barred by statute of limitations. —

    Workers’ compensation claimant’s claim for a herniated cervical disk was barred by the statute of limitations as: (1) the claimant was not prejudiced by the late filing of the employer’s first report of accident, but even if the limitations period was tolled until the date of the claimant’s first claim for benefits, the claim was filed more than two years later, (2) the doctrine of equitable estoppel did not apply as the employer did not misrepresent or conceal material facts that caused the claimant to refrain from filing her claim, and (3) the doctrine of imposition did not apply because the employer did not mislead the claimant or use superior knowledge of or experience with the Virginia Workers’ Compensation Act to deprive the claimant of her claimed compensation. Tuck v. Goodyear Tire & Rubber Co., 47 Va. App. 276, 623 S.E.2d 433, 2005 Va. App. LEXIS 527 (2005).

    Pursuant to the two-year statute of limitations, the Virginia Workers’ Compensation Commission had no jurisdiction to award compensation for a worker’s neck injury because the only timely claim asserted by the worker identified a shoulder injury; the worker sought compensation for her alleged cervical spine injury more than two years after the accident. The two-year statute of limitations had never been dispensed with altogether on any actual notice theory of de facto compliance. Corporate Res. Mgmt., Inc. v. Southers, 50 Va. App. 20, 646 S.E.2d 10, 2007 Va. App. LEXIS 229 (2007), different results reached on reh'g, 51 Va. App. 118, 655 S.E.2d 34, 2008 Va. App. LEXIS 10 (2008).

    Statute of limitations barred a claimant’s amended claim for workers’ compensation benefits where more than two years had passed between the time of an accident and claimant’s attempt to amend the claim to conform to the correct date, and claimant could have ascertained the correct accident date before the expiration of the statute because he knew the game in which he was injured and, after his deposition, was able to determine the date from information on the Internet. Peron v. Roanoke Express, 2008 Va. App. LEXIS 60 (Va. Ct. App. Feb. 5, 2008).

    Although a claimant had proven that (1) the claimant’s employer received notice of the claimant’s accident and (2) the employer failed to timely file the first accident report, the claimant had not proven that the employer’s failure to timely file the first accident report prejudiced the claimant’s rights with respect to the filing of a claim prior to expiration of the statute of limitations; therefore, the Workers’ Compensation Commission did not err in holding that the claimant’s claim was barred by the statute of limitations. Williams-Davidson v. Inova Fairfax Hosp. & Inova Health Sys. Found., 2013 Va. App. LEXIS 60 (Va. Ct. App. Feb. 26, 2013).

    Workers’ Compensation Commission lacked jurisdiction over an employee’s claim filed on October 27, 2010, because the claim did not correctly identify the date of the injury, and, as such, the filing did not satisfy a Commission rule; the Commission also lacked jurisdiction over the employee’s attempt to amend the date in an April 11, 2011, filing because the filing constituted a new claim made after the two-year time limitation had run and did not relate back to an initial valid claim. Hogan v. NPC Int'l, Inc., 2013 Va. App. LEXIS 361 (Va. Ct. App. Dec. 10, 2013).

    Workers’ Compensation Commission properly found that an employee’s claim for permanent partial disability benefits was barred because she failed to establish a permanent partial disability that existed or developed within the two-year limitations period where her doctor’s note did not establish a permanent disability and none of the medical evidence prior to her surgery established that a permanent disability existed or developed prior to the passage of the two-year statute of limitations. Holyfield v. Sentara Healthcare, 2014 Va. App. LEXIS 194 (Va. Ct. App. May 20, 2014).

    Denial of an employee’s claim for alleged injury by accident was appropriate because the claim was untimely filed well beyond the two-year statute of limitations. Iglesias v. QVC Suffolk, Inc., 2019 Va. App. LEXIS 86 (Va. Ct. App. Apr. 16, 2019).

    Because the statute of limitations had run and, therefore, expired when the claims of an employee’s estate were withdrawn and dismissed by the Virginia Workers’ Compensation Commission, the estate was forever barred from prosecuting a claim for the employee’s death under the Workers’ Compensation Act; consequently, the employer was not subject to liability under the Act for the employee’s death, and its request that the Commission determine the compensability of the claim was moot. Intercept Youth Servs. v. Estate of Lopez, 71 Va. App. 760, 840 S.E.2d 25, 2020 Va. App. LEXIS 99 (2020).

    Virginia Workers’ Compensation Commission did not err in concluding that it lacked jurisdiction to consider the case because an employer’s request was not timely filed within the statute of limitations; thus, after the claims of an employee’s estate claims were dismissed, there was no timely filed claim for the Commission to consider. Intercept Youth Servs. v. Estate of Lopez, 71 Va. App. 760, 840 S.E.2d 25, 2020 Va. App. LEXIS 99 (2020).

    Virginia Workers’ Compensation Commission did not err by denying the employee’s claim for additional workers’ compensation benefits for injuries sustained in a work-related accident on April 10, 2015 because the employee’s right shoulder claims were barred by the two-year statute of limitations, as he needed to assert or refile the parts of the July 2015 and April 2016 claims that were not awarded in the Commission’s award order, but he failed to refile those claims until November 2018 and February 2019, well more than two years after the statute of limitations had run. Lazo v. Wholesome Energy, LLC, 2020 Va. App. LEXIS 305 (Va. Ct. App. Dec. 15, 2020).

    Claimant could not recover for a causally related new injury under the compensable consequence doctrine because claimant could not recover on the original claim; if negligent first-aid theory was a new and separate injury by accident, that claim was time-barred because the injury by accident was not encompassed in the claim form, and claimant did not otherwise file within the applicable statute of limitations. Johnson v. Gen. Dynamics Corp., 2022 Va. App. LEXIS 61 (Va. Ct. App. Mar. 8, 2022).

    Claim not barred by statute of limitations. —

    Award to the claimant of wage compensation and medical benefits for a neck and upper back work-related injury was proper because the Workers’ Compensation Commission’s ruling on whether the statute of limitations barred recovery was based solely on the efficacy of the supplemental agreement, which both parties agreed was filed within two years of the injury. Tyco Elecs. & Ins. Co. of the Pa. v. Vanpelt, 62 Va. App. 160, 743 S.E.2d 293, 2013 Va. App. LEXIS 185 (2013).

    Res judicata did not bar the employee’s claim for benefits based on her spinal injuries, and as she filed her claim for such benefits within two years of the accident, she timely filed her claim, which was properly before the Workers’ Compensation Commission, and the Commission had jurisdiction to award the employee the requested benefits. Advance Auto & Indem. Ins. Co. v. Craft, 63 Va. App. 502, 759 S.E.2d 17, 2014 Va. App. LEXIS 250 (2014).

    Workers’ Compensation Commission did not err in finding that an employee’s injuries to his bilateral sacroiliac joints (SI joints) were not barred by the applicable statute of limitations because, while the employee’s initial filing indicated he suffered broken ribs and lacerations from a compensable accident, he had a previous back injury, and filed a claim relating to his sacroiliac joints more than two years after the date of the accident, application of the statute of limitations would be inconsistent with the humane and beneficent purposes of the Workers’ Compensation Act. J. L. Kent & Sons, Inc. v. Kilby, 2015 Va. App. LEXIS 25 (Va. Ct. App. Jan. 27, 2015).

    D.Estoppel.

    Equitable estoppel proved. —

    Where employee’s testimony established clear, concise and unequivocal evidence that she reasonably relied upon the statements of her supervisor and therefore did not file her claim, although the employer did not have fraudulent intent to mislead the claimant, the supervisor’s statements did, in fact, induce the claimant to understand that she needed to take no further action in order to perfect her claim. Home Benefit Corp. v. Jackson, 2000 Va. App. LEXIS 412 (Va. Ct. App. May 30, 2000).

    Evidence supported a decision finding that an employer was estopped from asserting a statute of limitations defense in an untimely filed workers’ compensation claim under circumstances in which a representative of the employer told the worker that her medical bills would be paid and that the employer would “handle everything”; there was credible evidence to support a finding that in telling the worker it would “handle everything” the employer caused her to refrain from filing a claim herself and misrepresented that it would file the worker’s claim for her. The employer then did not, in fact, file the workers’ compensation claim. Tidewater Acad., Inc. v. Evans, 2007 Va. App. LEXIS 138 (Va. Ct. App. Apr. 3, 2007).

    Prejudice not shown. —

    Because an employee never testified that the employee was prejudiced by the employer’s failure to file the first report of accident, the Workers’ Compensation Commission did not err in finding that the employee’s claim for benefits was not tolled by § 65.2-602 , but was barred by the statute of limitations contained in § 65.2-601 . Ayala v. Hann & Hann, Inc., 2008 Va. App. LEXIS 87 (Va. Ct. App. Feb. 19, 2008).

    The fact that the employer voluntarily paid the benefits to the employee following injury did not as a matter of law operate to toll the statute of limitation or estop the employer from availing itself of the limitation provided by former § 65.1-87. Bowden v. Newport News Shipbuilding & Dry Dock Co., 11 Va. App. 683, 401 S.E.2d 884, 7 Va. Law Rep. 1588, 1991 Va. App. LEXIS 27 (1991).

    The voluntary continuation of an injured employee’s wages and payment of his medical expenses does not estop the employer from claiming the benefit of this section. But see § 65.2-602 . Rose v. Red's Hitch & Trailer Serv., Inc., 11 Va. App. 55, 396 S.E.2d 392, 1990 Va. App. LEXIS 162 (1990).

    Employer not estopped from raising statute of limitations as defense. —

    Because company did nothing to induce claimant to refrain from filing a timely claim with the commission, company was not estopped from raising the statute of limitations as a defense to claim. Atkins v. Latex Constr. Co., No. 0611-92-4 (Ct. of Appeals Jan. 19, 1993).

    Employer was not estopped to assert the statute of limitations against injured employee’s claim for worker’s compensation benefits where employer’s conduct in controlling his medical treatment did not as a matter of law induce him to believe he was not required to file a worker’s compensation claim; where employer’s notation after the statue of limitations had expired that the claim was accepted and that voluntary payment of compensation would begin on a certain date did not induce claimant to refrain from filing a timely claim; and where employer’s failure to file a memorandum of agreement or first report did not induce claimant to refrain from filing a claim. Jenkins v. Ford Motor Co., 27 Va. App. 281, 498 S.E.2d 445, 1998 Va. App. LEXIS 262 (1998).

    E.Imposition.

    “Imposition” found. —

    Where representations were made by employer that whatever needed to be done had been done, these representations justified claimant’s actions in not following up to see that the original memorandum of agreement had been filed, and to permit the statute of limitations to be successfully pled would be an imposition on the Commission, the actions of the employer and its insurance carrier created an imposition on the Commission and the claimant which empowered the Commission do full and complete justice. Therefore, although the statute of limitations had expired, the Commission had jurisdiction to hear worker’s claim for additional benefits. Avon Prods., Inc. v. Ross, 14 Va. App. 1, 415 S.E.2d 225, 8 Va. Law Rep. 2299, 1992 Va. App. LEXIS 73 (1992).

    Because the acts and omissions of the carrier for claimant’s employer, and the acts of the employees of the commission served to prejudice the claimant, the doctrine of imposition should be applied to the facts of the instant case. Odom v. Red Lobster #235, 20 Va. App. 228, 456 S.E.2d 140, 1995 Va. App. LEXIS 371 (1995).

    “Imposition” not found. —

    Because claimant was aware of the existence of procedural requirements necessary to preserve his claim and because he had a prior relationship with an attorney familiar with the Workers Compensation Act, the current statutory bar of claimant’s claim was not caused by the employer imposing upon the commission or upon the claimant. Westvaco Corp. v. Linkenhoker, 1996 Va. App. LEXIS 764 (Va. Ct. App. Dec. 31, 1996).

    The doctrine of imposition does not apply to circumvent expiration of the statute of limitations where failure of employee to timely file a claim did not result from the employer’s or the Commission’s use of superior knowledge or economic leverage. Jenkins v. Ford Motor Co., 27 Va. App. 281, 498 S.E.2d 445, 1998 Va. App. LEXIS 262 (1998).

    Where employee did not file a claim alleging a neck injury until more than two years after the employee’s compensable accident, and the evidence did not prove that the doctrine of imposition tolled the statute of limitations as nothing in the record established that the employer used economic language or knowledge of the act to effect an unjust deprivation of benefits or that the employer did not endeavor to comply with the act, Commission’s decision denying benefits for the neck injury would be affirmed. Mills v. Falling Creek Sportswear, Inc., 2002 Va. App. LEXIS 390 (Va. Ct. App. July 16, 2002).

    Imposition doctrine did not save an untimely workers’ compensation claim from being barred under the two-year limitation period as: (1) neither the employer nor the Virginia Workers’ Compensation Commission prevented the claimant from filing a timely claim or led him to reasonably believe that he did not need to do so, (2) the Commission was entitled to find that the claimant received the blue letter as it was not returned to the sender, (3) a failure to receive a blue letter, alone, would not support the application of the imposition doctrine, (4) the employer endeavored to comply with the Virginia Workers’ compensation Act, and (5) the claimant did not respond for over three years to a letter inviting a written explanation for the untimely filing. Burroughs v. Frederick Sch. Bd., 2004 Va. App. LEXIS 448 (Va. Ct. App. Sept. 14, 2004).

    CIRCUIT COURT OPINIONS

    Time-barred claim may support legal malpractice claim. —

    Client properly pleaded a legal malpractice claim arising out of the failure of her attorney to file her workers’ compensation claim within the statute of limitation under § 65.2-601 where the statute of limitations barred the client from filing for workers’ compensation and, according to the pleadings, the failure of the attorney to make a timely filing caused the statute of limitations to expire. Lockney v. Vroom, 61 Va. Cir. 359, 2003 Va. Cir. LEXIS 263 (Norfolk Mar. 21, 2003).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Jurisdiction:

    The initial claim listed left knee and right hip injuries but the Stipulated Award Order referenced injuries to the left lower extremity. A claim for a right hip filed almost three years after the accident was barred by the statute of limitations. With the entry of the Stipulated Award Order listing only the left lower extremity, the claim for a right hip injury was merged into that award, waived, or abandoned. As distinguished from facts in similar cases, the insurance carrier did not pay benefits for a brief period of treatment to the right hip. Swain v. City of Petersburg Social Services, VWC File No. 214-93-41 (Sept. 4, 2007).

    Imposition applied to preserve untimely claim where Commission sent the informational guide required by Va. Code § 65.2-201 (D) and claim form to an incorrect address for the claimant. Lee v. HCA Patient Account Serv. Ctr., JCN 2408830 (Sept. 25, 2017).

    A majority held that where the initial award was for a left leg injury, a claim for a back injury filed almost nine years after the accident date is barred by the statute of limitations. The payment of medical expense for the back is not sufficient to establish estoppel, imposition, or a basis for a de facto award. Brickley v. Pardee Coal Company, Inc., VWC File No. 186-35-42 (April 4, 1997), aff’d, No. 116-07-3 (Ct. App. of Va., Sept. 11, 2007) (unpublished opinion).

    A majority found that the claimant’s 2005 claim for a shoulder injury was barred by the statute of limitations because the compensable back injury from the 1998 accident was a separate and distinct injury. Moyer v. David A. Nice Builders, VWC File No. 194-62-94 (Mar. 12, 2007). (Dismissed by Ct. of App., June 4, 2007).

    An executed Agreement to Pay Benefits form that was filed with the Commission within two years of the accident constituted a timely claim for benefits because it contained all the information typically expected of a claim even though an Award could not be entered because of the need to clarify the seven-day waiting period. Belmonte-Arwood v. Net2000 Group, Inc., VWC File No. 206-54-65 (July 26, 2005).

    Deputy Commissioner erred by refusing to approve parties’ compromise settlement; employee injured in 1986 and filed claim in 2002; employer filed first report in 2002; parties reached compromise settlement; Commission found jurisdiction was not being conferred by consent of parties because parties disputed whether statute of limitations would bar claim. Owens v. American of Martinsville, VWC File No. 210-14-35 (May 27, 2003).

    Employee injured in 1992 and submitted letter of representation and defective agreement forms, which nevertheless were approved in 1993 but vacated in 1994 due to defect; claimant requested hearing in 1996 and filed claim in 1997, but no action taken; claimant filed claim in 2001, which Commission found not barred by 65.2-601 , as letter of representation and agreement forms constituted valid claim, but barred by laches, because claim not prosecuted diligently and employer showed prejudice from delay. Davis v. Ricks, Inc., VWC File No. 161-22-22 (May 6, 2003).

    Employee who initially sought and was awarded benefits for head injury later (within two years of accident) filed claim and sought benefits for hip and back injuries; Deputy Commissioner’s decision that later claim was precluded by employee’s failure to pursue such benefits at first hearing, thereby avoiding piecemeal litigation, found to be incorrect; employee may seek to amend or supplement prior adjudication within two years of accident. Sparks v. Food Lion, VWC File No. 204-28-96 (May 2, 2003).

    Code § 65.2-601 provides that a claim is barred if not filed within two years after the accident. This limitation is jurisdictional, unless the bar has been tolled, or the employer is equitably estopped from asserting the defense, or the limitations period is extended under the doctrine of imposition. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    No statutory provision sets forth a specific statute of limitations for responding to a letter decision from a Claims Examiner. Rule 1.6 provides that a request for review of a decision accepting or rejecting a change in condition claim or application must be filed within twenty days from the date of the decision, but that Rule specifically does not refer to initial claims for benefits. The Commission’s Rule 1.1 states that an employee’s original claim for benefits shall be filed within the applicable statutes of limitations; however, this Rule does not establish a specific time in which the employee must respond if the Claims Examination Department questions whether his claim has been filed within the statute of limitation period. The Commission found that the employee’s response to the Claims Examiner thirty-three days after the claim was rejected was timely filed. Tang v. Progressive Engineering Co., 77 O.W.C. 276 (1998).

    Jurisdiction cannot be conferred by consent of the parties. Ryals v. Humble Oil & Refining Co., 52 O.I.C. 220 (1970); Nicholas v. Lynchburg Training School & Hospital, 44 O.I.C. 198 (1962).

    Jurisdiction cannot be enlarged by “judicial inclination.” Scott v. Trego Stone Corp., 52 O.I.C. 225 (1970); Ryals v. Humble Oil & Refining Co., 52 O.I.C. 220 (1970); Stark v. Blevins Tire & Recapping Co., 52 O.I.C. 245 (1970); Jamerson v. Professional Tree Care Co., 59 O.I.C. 147 (1980).

    Once the period provided for enforcement of the right established by the Workers’ Compensation Act expired, the right expired with it and may not be revived by subsequent legislation. Nicholson v. Lynchburg Training School & Hospital, 44 O.I.C. 198 (1962).

    Failure to file original claim within statutory period barred any future claims on changes in condition. Davis v. Jefferson Mills, 58 O.I.C. 80 (1978).

    A claim for a back injury was time barred when not filed within two years of the accident, where that injury was incurred in the work accident but not listed with the injuries on a memorandum of agreement filed for entry of an award. Williams v. Capital Distributors, 74 O.W.C. 79 (1995).

    Original claim accepted by memorandum of agreement for injury to right hip and left ankle. Period of thirteen months before any mention of back or right leg injury. Held compensation barred for such injuries as no claim filed within one year (now two). Shawley v. Shea-Ball Construction Co., 216 Va. 442 , 219 S.E.2d 849, 1975 Va. LEXIS 312 (1975).

    The description of the injury on a Memorandum of Agreement, while important, is not required to be precise. People without a medical background routinely prepare Memoranda of Agreement, and the injured worker usually does not have any medical expertise. Thus, the language describing the injury should not be strictly construed. Strict construction under such circumstances defeats the purpose of the Act. The claimant’s injury was described in the Employer’s First Report as “lumbar & cervical strains,” and the Claim For Benefits filed by the employee alleged “acute lumbar & cervical sprain.” However, the Memorandum of Agreement endorsed by the parties and filed with the Commission identified only a “back strain.” The Commission held on these facts that the employer acknowledged in its First Report the lumbar and cervical injuries, that the initial claim was clearly for lumbar and cervical injuries, that there was no evidence that the employer had disputed the claim for a cervical injury, that the omission of a cervical sprain from the Memorandum was inadvertent, and that the employer was liable for treatment of the cervical injury. McCracken v. Life Ins. Co. of Georgia, 79 O.W.C. 104 (2000), affirmed in an unpublished Court of Appeals opinion issued February 13, 2001. [But see the unpublished Court of Appeals opinions in Fleetwood Homes of Virginia, Inc. v. McNeal, Record No. 2236-00-3 (June 5, 2001), and McKee Foods Corporation v. Atkins, Record No. 2727-00-3 (July 3, 2001), both opinions reversing the Commission and holding that the employer’s acceptance of a shoulder injury cannot be so broadly construed as to include adjacent body parts, i.e., a cervical injury.] [See also Corporate Resource Mgmt. Inc. v. Southers, 51 Va. App. 118, 655 S.E.2d 34 (2008) (en banc) where a claim for a shoulder injury preserved a claim for a neck injury and Sam Moore Furniture Industries v. Smith, Record No. 0685-07-3 (Feb. 26, 2008) where an award for an arm was sufficient to include a timely claim for a shoulder injury] .

    Application for hearing withdrawn at claimant’s request; effect same as though application had not been filed; second application not timely filed. Brown v. Eastern Isles Mfg. Corp., 52 O.I.C. 44 (1970).

    Where counsel for an employee through the use of a letter and a form entitled “Claim and Agreement to Retain Counsel” files a claim and subsequently files an “Application for Hearing” on the Commission’s pre-printed form, the withdrawal of the application for hearing does not constitute a withdrawal of the claim since the application did not serve to file the “claim.” Keenan v. Westinghouse Elevator Co., 10 Va. App. 232, 391 S.E.2d 342, 6 Va. Law Rep. 2276, 1990 Va. App. LEXIS 75 (1990).

    Statute in effect on date of accident controls rights of parties throughout the life of the case. Tomlin v. Betts, 57 O.I.C. 352 (1976).

    Defendants contended that inasmuch as claimed injury had been denied by Maryland Industrial Commission, the claim was barred in Virginia. This defense denied, claimed accident occurred in Virginia and case had never been heard in Virginia. Vecchiarello v. Nat-Pac South, Inc., 57 O.I.C. 362 (1977) (affd on review).

    Timely submission to the Commission of a letter, advising that the pro se claimant’s condition is still being treated, and that further surgical correction was anticipated, satisfied the filing requirements of Code § 65.2-601 . While the Commission has adopted specific claim forms for the use of employees and employers, the filing of less formal documents, such as letters sent to the Commission from employees or their attorneys, informal notices styled as “claims,” or even letters from the employer’s attorney, have been held sufficient to meet the requirement for filing a claim. The key determination to be made is whether the claimant fairly apprised the Commission that a claim was being made. Colgan v. Massey Builders Supply Corp., VWC File No. 188-97-98 (January 4, 2001), aff’d sub nom. Massey Builders Supply Corp. v. Colgan, 30 Va. App. 496, 553 S.E.2d 146 (2001).

    In Code § 65.2-101 , the General Assembly clearly defined how a document is to be “filed” with the Commission. Properly “filing” a claim within the statute of limitations of Code § 65.2-601 is a jurisdictional requirement, and the Commission has no power to accept an alternate filing that is untimely. Claimant’s counsel chose to use a private delivery service to attempt to file a claim within the statue of limitations. Due to a national emergency that brought all airborne shipping to a halt, the claim was delayed in transit, arriving after the statute of limitations had run. The Commission held that the claimant chose to use an alternate delivery method at her own risk, noting that the claim would have been automatically “filed” when delivered to a local post office and placed into certified mail.Hundley v. Williamsburg Community Hospital, VWC File No. 197-64-42 (February 5, 2002).

    The purpose of the notice requirement is to enable the employer to adequately investigate the accident and injuries, and to enable the employer to provide appropriate medical care. Once the injured worker provides notice of the work accident, along with a general description of her injuries, she has no obligation to provide continuing “updates” of her initial notice under Code § 65.2-600 , as her diagnosis changes. Once appropriate initial notice is given under Code § 65.2-600 , if the claimant’s medical treatment reveals that additional body parts were injured in the accident, she need only seek to amend her claim within two years of the accident to toll the statute of limitations under Code § 65.2-601 . Saul v. Total Action Against Poverty, VWC File No. 196-47-46 (September 27, 2002).

    General:

    Claims for a “head injury” were sufficient to preserve claim for brain injury where defendants had actual knowledge of that injury and were fairly on notice of the assertion of a claim for a brain injury within the period of limitations. Castillo v. Zavala-Umana, VA00000924865 (March 27, 2017).

    Claim for shoulder injury not time-barred as evidence established causally related condition remained undiagnosed until after limitations period expired. Similar to facts in Corporate Resource Management v. Southers, 51 Va. App. 118, 655 S.E.2d 34 (2008) (en banc). Ellis v. Nestle USA, Inc, JCN VA0000053886 (Mar. 5, 2015).

    Claim for cervical injury time-barred as there was no evidence claimant’s right or left shoulder pain masked a neck injury. Distinguished Corporate Resource Management v. Southers, 51 Va. App. 118, 655 S.E.2d 34 (2008) (en banc). Mallory v. Dominion Resources Servs., JCN VA00000193754 (Oct. 7, 2014).

    Limitations period set forth in § 65.2-708 , and not § 65.2-601 , applies to claim for benefits arising out of compensable consequence of original compensable injury. Hardy v. Commonwealth of Virginia, VWC File No. 151-08-12 (Jan. 4, 2005).

    Claimant has the burden of timely filing his claim regardless of any party’s knowledge of claimed injury, and the employer is not estopped from asserting a statute of limitations defense because it knew of and paid for expenses related to such injury. Dash v. Coalfield Servs., Inc., VWC File No. 166-28-15 (Jan. 3, 2005), aff’d, No. 0245-05-3 (Ct. App. Va., June 21, 2005).

    Employee’s claim for neck injury timely and not barred by res judicata, despite earlier entry of stipulated order describing injury as limited to lower back; employee filed claim for back injury, resulting in stipulated order; employee later filed claim for neck injury, and employer objected to claim as barred by res judicata ; Commission found that because neck-injury claim was filed after stipulated order was entered, claim was not barred, and because claim was filed within two years of accident, it was timely. Kanzig v. H.E. Sargent, VWC File No. 212-08-79 (Mar. 19, 2004).

    Employee’s claim for prescription expenses caused by compensable consequence not barred by statute of limitations; employee suffered 1994 back injury and was awarded benefits; he developed symptoms of erectile dysfunction shortly after accident, but it became “major problem” in 2001 and he was prescribed corrective medication in 2002; Commission found problem not immediate result of accident but eventual compensable consequence thereof and thus not barred by statute of limitations.).Landrum v. Berglund Chevrolet, VWC File No. 171-85-74 (Oct. 15, 2003), aff’d, 43 Va. App. 742, 601 S.E.2d 693 (2004).

    A change in condition application cannot be substituted for an original claim. An application for compensation based on a “change in condition” cannot be used as a substitute for an original hearing on a new and separate accident.” Pullen v. Stackhouse, Inc., 78 O.W.C. 59 (1999).

    A change in condition is different from the right to recover for the injury itself. It is impossible to have a change in condition without a prior award. A change in condition is based upon an award in a compensable case. Its object is purely remedial, as it enlarges or diminishes the former award to meet the circumstances of a particular case. Pullen v. Stackhouse, Inc., 78 O.W.C. 59 (1999).

    The Act does not require that an employee send a copy of a claim to the insurance carrier. Trammel Crow Company, Inc. v. Redmond, 12 Va. App. 610, 405 S.E.2d 632, 7 Va. Law Rep. 2750, 1991 Va. App. LEXIS 118 (1991).

    The Commission will permit an amendment to an application that changes the date of accident if the correction does not produce a new and different claim. Ashley v. Westmoreland, 70 O.I.C. 58 (1991).

    If supporting evidence is not filed within 90 days after an employee’s claim is filed, the claim may be dismissed after notice is given by the Commission to the parties. Corley v. Lafferty, 75 O.W.C. 30 (1996).

    After a claim is dismissed without prejudice, it is treated as if no claim had been filed. Bryant v. Fieldcrest Cannon, Inc., 75 O.W.C. 184 (1996).

    Dismissal of a claim is the appropriate sanction where the prosecuting party fails to appear without justification. However, where a claimant fails to appear because notices were sent to the wrong address, because of a mistake of the Commission, the claimant should not be penalized. Hare v. Jani King of Hampton Roads, 78 O.W.C. 180 (1999).

    The Commission is not bound by statutory or common law rules of pleading or evidence, nor by technical rules of practice. Statements on a Claim For Benefits form may be used to impeach or corroborate testimony, but the Commission’s jurisdiction is determined by the entire record. A claimant is not limited by statements in her Claim For Benefits form that allege only a cumulative trauma injury, and she may present evidence at an evidentiary hearing of a specific injury by accident. Isbell v. Bank of America Mortgage Co., 76 O.W.C. 103 (1997).

    Limitations Period Does Not Apply to Commonwealth:

    The limitation period of § 65.1-87 (now § 65.2-601 ) does not apply to the Commonwealth. Therefore, the Uninsured Employer’s Fund, as part of its subrogation and recoupment authority, may file a workers’ compensation claim against the direct employer or statutory employer more than two years after the date of the accident. McClanahan v. Liberty Coal Corporation, 70 O.I.C. 31 (1991).

    Computing Time:

    Code § 1-13.3:1 [see now § 1-210 ] provides that where the last day for any paper to be served, delivered or filed, falls on a Saturday, Sunday, or legal holiday, the act may be done on the next day that is not a Saturday, Sunday, or legal holiday. Burrus v. Hofheimer’s, Inc., 47 O.I.C. 53 (1965).

    Under § 1-13.3 [see now § 1-210 ] computation of time “within” which a certain action shall be taken, that time shall be allowed in addition to the day on which the event occurred. Where death occurred July 9, 1961, claim filed on July 9, 1962 was timely. Cooley v. Hundley, 45 O.I.C. 45 (1963).

    Date of award excluded in computing time. Bedwell v. Cetlin Wilson Shows, 34 O.I.C. 246 (1952).

    Work Incapacity Must Occur Within Two Years:

    Where there has been no prior award of compensation for any type of disability, an employee seeking permanent partial disability benefits must file a claim and establish some degree of permanent partial disability within two years from the date of the accident. It is unnecessary that the employee demonstrate the degree of permanency or that he has reached maximum medical improvement within the two year period. Hood v. CPP Security Services, 69 O.I.C. 30 (1990).

    An employee must file a claim and establish disability within two years from the date of the accident in order for there to be an award entered for disability. The Commission will not allow an anticipatory application to extend the time limitations indefinitely. Mayberry v. Alcoa Building Products, 18 Va. App. 18, 441 S.E.2d 349 (1994); 71 O.W.C. 67 (1992).

    A claim for initial disability benefits must be filed within two years of the work accident for compensable disability beginning within two years of that accident. The limitation period is not tolled where only medical benefits were initially awarded because disability did not exceed seven days. The change in condition claim for disability had to be filed within two years of the accident. Ashby v. West Point School Board, 74 O.W.C. 90 (1995).

    Where an employee files a claim within two years from the date of the accident but establishes entitlement only to a medical award, subsequent disability must occur within two years from the date of the accident rather than the limitations period for a change of condition. Therefore, the tolling provision of § 65.2-708 (C) is inapplicable. Mayberry v. Alcoa Building Products, 18 Va. App. 18, 441 S.E.2d 349 (1994); 71 O.W.C. 67 (1992).

    Where a medical award has already been entered for the work injury, a change in condition application is the appropriate procedural remedy for the claimant. Given that he already has an award for the subject accident, his claim simply alleges a change from an injury without compensable disability (as opposed to medical expense) to one with compensable disability. Pullen v. Stackhouse, Inc., 78 O.W.C. 59 (1999).

    The claimant was injured in an accident on September 8, 1995, resulting in disability through December 8, 1995, for which he filed a timely claim on September 26, 1995. The claimant filed an additional claim on September 29, 1998, seeking additional benefits beginning September 21, 1998. The initial hearing was held on April 30, 1999, at which time the claimant was awarded benefits for his initial period of disability. The Commission found that the subsequent disability beginning September 21, 1998 was barred by Code § 65.2-708 , because that period of disability began more than two years after the termination of the initial award. Ma v. Seal & Company, Inc., 78 O.W.C. 213 (1999).

    Where there has been an award for medical benefits only, § 65.2-708 is inapplicable because there has been no prior award of compensation. Therefore, disability must occur within two years from the date of the accident. James v. Morton G. Thalhimer Services Corporation, 71 O.W.C. 71 (1992).

    Tolling Limitations Period:

    An executed Agreement to Pay Benefits form that was filed with the Commission within two years of the accident constituted a timely claim for benefits because it contained all the information typically expected of a claim even though an Award could not be entered because of the need to clarify the seven-day waiting period. Belmonte-Arwood v. Net2000 Group, Inc., VWC File No. 206-54-65 (July 26, 2005).

    A claimant’s voluntary nonsuit does not toll the statute of limitations of § 65.2-601 . Morneault v. Tidewater Temps Inc., VWC File No. 202-31-60 (July 26, 2004).

    Section 8.01-229 E which provides for the tolling of the statute of limitations in civil actions pending an appeal, does not apply to workers’ compensation claims. Therefore, the employee’s application was barred because it was not filed within two years after the accident. Hammond v. Madison Decorating Corporation, Record No. 0884-85 (Ct. of Appeals, March 19, 1986).

    The right to compensation under the Act is barred unless a claim is filed with the Commission within two years after the accident. However, in any case where an employer has failed to file a report of accident with the Virginia Workers’ Compensation Commission, and such conduct of the employer has operated to prejudice the rights of the employee with respect to the filing of a claim prior to the expiration of a statute of limitations, the statute is tolled until the employer files the First Report of Accident. Tang v. Progressive Engineering Co., 77 O.W.C. 276 (1998).

    The burden to prove incompetency so as to toll the statute of limitations is on the claimant. He must prove insufficient mind or reasoning powers to comprehend the ordinary affairs of life, or that loss of mental power deprived him of sane and normal action. Thomas v. Southwestern Virginia Mental Health Institute, 74 O.W.C. 219 (1995).

    Copy of letter from claimant’s attorney to employer sent to the Commission constitutes filing of claim with Commission. Constantini v. Western Exterminating Co., 53 O.I.C. 47 (1971).

    Letters from counsel advising Commission of possible claim were sufficient to toll statute of limitations. Dean v. Jefferson Mills, 58 O.I.C. 84 (1978).

    Payment of salary in lieu of compensation does not toll the two-year statute of limitations under this section nor estop employer and carrier from availing themselves of the benefit of the statute. Roark v. City of South Boston, 61 O.I.C. 346 (1982).

    Voluntary payment of medical bills by a carrier does not toll the statute of limitations or estop the employer from asserting a statute of limitations defense. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    Filing claim in Maryland does not toll Virginia statute of limitations; proper procedure is to timely file in both jurisdictions. Burton v. Natkin & Co., 59 O.I.C. 45 (1982).

    The filing of an Employer’s First Report with the Commission is not the filing of a claim by the employee. Cheski v. Arlington County Public Schools, 16 Va. App. 936, 434 S.E.2d 353 (1993); 71 O.W.C. 59 (1992).

    Providing a panel of physicians or vocational rehabilitation efforts does not estop the carrier from asserting the statute of limitations. Cheski v. Arlington County Public Schools, 16 Va. App. 936, 434 S.E.2d 353 (1993); 71 O.W.C. 59 (1992).

    Where an employee is originally paid under the LHWCA without an award in Virginia and subsequently files for compensation benefits, it is an original claim and is not subject to the limitation period of § 65.2-501 or § 65.2-708 . Moore v. Virginia International Terminals, Inc., 73 O.W.C. 46 (1994).

    Voluntary payment of benefits under the LHWCA does not give rise to a de facto award under the Virginia Workers’ Compensation Act. The employee suffered a work-related injury, thereafter receiving voluntary payment of benefits under the federal LHWCA. The employee failed to file a claim for benefits under the Virginia Act within two years of the accident, but argued that his claim was timely because the employer made voluntary payments under the LHWCA. The Commission held that payment under the LHWCA does not toll the statute of limitations of § 65.2-601 , nor does the voluntary payment of benefits necessarily estop the employer from raising the statute of limitations as a bar to the action. Myrick v. Newport News Shipbuilding and Dry Dock Co., VWC File No. 181-60-08 (April 30, 2002).

    Estoppel:

    A majority held that where the initial award was for a left leg injury, a claim for a back injury filed almost nine years after the accident date is barred by the statute of limitations. The payment of medical expense for the back is not sufficient to establish estoppel, imposition, or a basis for a de facto award. Brickley v. Pardee Coal Company, Inc., VWC File No. 186-35-42 (April 4, 1997), aff’d, No. 116-07-3 (Ct. App. of Va., Sept. 11, 2007) (unpublished opinion).

    Untimely claim not barred where insurer coordinated claimant’s medical care and sent letter confirming compensability of accident while claimant was incarcerated. Robertson v. Harrington Corp., VWC File No. 208-25-49 (March 25, 2005).

    An employer is not estopped from asserting a statute of limitations defense because of its responses to the Commission’s “20-day Orders.” Such responses are intended to promote identification and resolution of workers’ compensation disputes and are not binding at hearing under Rule 1.5(B)(2). Moore v. Ross Store, Inc., VWC File No. 205-86-06 (Sept. 30, 2004).

    In order to prevail under a theory of equitable estoppel, the claimant must show by clear, precise, and unequivocal evidence that he relied to his detriment upon an act or statement by the employer or carrier to refrain from filing a claim within the statutory period. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    To prove equitable estoppel, the employee must show by clear and convincing evidence that he relied upon an act or statement of the employer or its agent in not filing a claim within the statutory period. The employee may show an affirmative, deliberate effort to prejudice his right to file a claim with the Commission within the limitations period, or he may prove that the conduct did, in fact, induce him to forego filing a timely claim. Adkins v. Nabisco, Inc., 75 O.W.C. 285 (1996).

    Where employer leads employee to believe that his claim for compensation has been filed with the Commission, he will be estopped to rely upon this section. American Mut. Liab. Ins. Co. v. Hamilton, 145 Va. 391 , 135 S.E. 21 , 1926 Va. LEXIS 399 (1926).

    Voluntary payment of compensation benefits with cost of living adjustments, standing alone, does not establish equitable estoppel and toll the statute of limitations. Such actions are no more than those expected from an employer complying with the Act. Adkins v. Nabisco, Inc., 75 O.W.C. 285 (1996).

    The voluntary payment of benefits, absent a finding of prejudice, does not create a de facto award. Adkins v. Nabisco, Inc., 75 O.W.C. 285 (1996).

    Where there was evidence that the employee did not receive either a “Blue Letter” or “Guide to the Employees” and that he was advised by his employer’s safety manager that his bills would be paid and the claim had been turned into the Commission, there has been sufficient proof of a representation, reliance, change of position, and detriment sufficient to establish equitable estoppel. Proof that the representation was false or that the employer intended to induce reliance is not required. The fact that the representation induced the employee to not file is sufficient. Cibula v. Allied Fibers & Plastics, 14 Va. App. 319, 416 S.E.2d 708, 8 Va. Law Rep. 2649, 1992 Va. App. LEXIS 125 (1992), aff'd, 245 Va. 337 , 245 Va. App. 337, 428 S.E.2d 905, 9 Va. Law Rep. 1166, 1993 Va. LEXIS 58 (1993).

    Where the employee admitted receiving the “blue letter” and that she was never advised by any carrier or employer representative that she should not file a claim with the Commission, there is no basis for estopping the employer from asserting the statute of limitations. Cheski v. Arlington County Public Schools, 16 Va. App. 936, 434 S.E.2d 353 (1993); 71 O.W.C. 59 (1992).

    The employer’s sole actions pertaining to the claim was to request that the claimant complete an incident report form, after which it offered a panel of physicians and completed its investigation, then informing the claimant that the claim was denied. Held, there was no evidence of an affirmative or deliberate effort by the employer to prejudice the claimant’s right to file a timely claim. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    Where the employer provides necessary insurance forms and advises the employee that it would process the paperwork for the work injury; and thereafter issues paychecks coded “WC” for lost time periods that were not charged against sick or annual leave; and the employer never disputed the claim; such evidence is sufficient to show the employer’s conduct induced the employee to refrain from filing a claim, and the employer is estopped from relying on a limitations defense. Hendrick v. Town of Ashland, 75 O.W.C. 125 (1996).

    Where employer and his physician belittle employee’s complaint and advise him to continue work, the former will be estopped. Kiser v. Clinchfield Carbocoal Corp., 5 O.I.C. 203; 5 O.I.C. 339 (1923).

    Employer’s failure to file required reports with Commission, coupled with conduct of employer inducted claimant’s inaction. Jewell v. Steel Erectors, Inc., 46 O.I.C. 123 (1964); Turner v. Hampton, etc., Co., 57 O.I.C. 354 (1976).

    The doctrine of estoppel does not apply to extend the statute of limitations where the employee was uninformed as to the limitation period. There was no evidence that the employer, who sent the claimant two Memorandums of Agreement before the statute expired, misled the claimant or in any way influenced her not to file a claim. Lane v. Anesthesia Services of Fairfax, Inc., 70 O.I.C. 35 (1991).

    There has been no material false representation or inducement not to file a workers’ compensation claim when representatives of the employer, who do not possess knowledge of the Workers’ Compensation Act, merely advise an employee that there is nothing else that needs to be done other than reporting the accident to the employer. Craig v. Hotel Roanoke, 70 O.I.C. 39 (1991).

    While the Commission found that neither the employer nor carrier intended to prevent the employee from filing an application within two years from the date of the accident, their consistent misrepresentations, relied upon by the employee, were a sufficient basis for invoking the doctrine of estoppel to prevent the running of the statute of limitations. Vandervreken v. Entre Computer Centers, Inc., 70 O.I.C. 47 (1991).

    Where the employer files Supplemental Memorandum of Agreements and Agreed Statement of Facts but fails to file an executed memorandum of agreement, imposition was established and the award was in effect notwithstanding that the memorandum of agreement was not provided. It was also noted that the employee dealt directly with the employer in signing and returning the papers and was assured that all necessary papers were filed with the Commission. Therefore, the claim was not barred by the statute of limitations. Avon Prods., Inc. v. Ross, 14 Va. App. 1, 415 S.E.2d 225, 8 Va. Law Rep. 2299, 1992 Va. App. LEXIS 73 (1992).

    An employer is not precluded from raising a statute of limitation’s defense where no claim was filed within two years, voluntary payments were made and the employee refused to sign the Memorandum of Agreement because of a disagreement with the termination date. Yarbrough v. Virginia Health Services, Inc., 69 O.I.C. 34 (1990).

    In failing to apply the doctrine of estoppel the Court found that the employer by its actions of paying medical bills and disability benefits pursuant to a health and accident policy was not guilty of misconduct which misled or induced the employee not to timely file a workers’ compensation claim. Hervey v. Newport News Shipbuilding & Dry Dock Co., 12 Va. App. 88, 402 S.E.2d 688, 7 Va. Law Rep. 1916, 1991 Va. App. LEXIS 43 (1991).

    Imposition:

    A majority held that where the initial award was for a left leg injury, a claim for a back injury filed almost nine years after the accident date is barred by the statute of limitations. The payment of medical expense for the back is not sufficient to establish estoppel, imposition, or a basis for a de facto award. Brickley v. Pardee Coal Company, Inc., VWC File No. 186-35-42 (April 4, 1997), aff’d, No. 116-07-3 (Ct. App. of Va., Sept. 11, 2007) (unpublished opinion).

    Imposition established where claimant repeatedly sought advice from employer’s representative, who helped her complete her original claim for benefits, told claimant her claim had been filed, discussed claimant’s medical care with her, and instructed claimant not to request compensation benefits. Hatch v. Sussex I State Prison/Commonwealth of Virginia, VWC File No. 202-80-13 (Dec. 17, 2004).

    Commission found that imposition precluded rejection of claim based on statute of limitations; employee filed timely claim for neck injury, but Commission’s Claims Department rejected claim based on incorrect conclusion that identical claim already filed, when other claim was for shoulder injury; employee later filed untimely claim for neck injury; Commission found that Commission’s error worked prejudice to claimant. Lewis v. Virginia Tree Harvesters, VWC File No. 201-60-06 (Mar. 5, 2004).

    The doctrine of imposition empowers the Commission to render decisions based on justice shown by the totality of the circumstances, even in the absence of fraud, mistake or concealment. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    The doctrine of imposition is not applicable where the employer’s or carrier’s acts are consistent with an endeavor to comply with the Act. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    The Commission has jurisdiction to do full and complete justice in each case. From that principle has developed the concept of imposition, which empowers the Commission in appropriate cases to render decisions based on justice shown by the totality of the circumstances, even in the absence of fraud, mistake, or concealment. The doctrine of imposition does not apply where the acts of a carrier or employer are consistent with an endeavor to comply with the Act. Where there were no acts by the carrier or the Commission upon which the employee naturally and reasonably relied, the doctrine of imposition are inapplicable. Adkins v. Nabisco, Inc., 75 O.W.C. 285 (1996).

    The claimant alleged an accident on February 1, 1995, but did not notify the employer until April 1995. The employer filed a First Report on August 24, 1995, offered a panel of physicians, investigated the claim, paid some of the claimant’s medical expenses, and then advised that the claim was denied. None of these actions were inconsistent with the intent or letter of the Act, nor was there evidence that the employer took any action in derogation of its statutory responsibilities. Held, the doctrine of imposition was inapplicable in this case. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    Award in Another Jurisdiction Does Not Preclude Award in Virginia:

    Filing claim in Maryland does not toll Virginia statute of limitations; proper procedure is timely to file in both jurisdictions. Burton v. Natkin & Co., 59 O.I.C. 45 (1980).

    An employer is entitled to file a claim in order to adjudicate its rights and obligations under the Virginia Workers’ Compensation Act. The employee’s receipt of benefits under the Longshoremen and Harbor Workers’ Act does not preclude the entry of an award under the Virginia Act. The employer will be granted credit for identical benefits paid under the Federal law. McKnight v. Virginia International Terminals, Inc., 69 O.I.C 19 (1990).

    An award in Virginia is not precluded merely because compensation has been awarded in another State. If a claim is compensable under Virginia law and the law of another State, concurrent jurisdiction exists. The employer will be granted a credit in Virginia for identical benefits paid under the law of another State. Whetzel v. Safeway Stores, Inc., 69 O.I.C. 22 (1990).

    § 65.2-601.1. Effect of filing claim; stay of debt collection activities by health care providers.

    1. Whenever an employee makes a claim pursuant to § 65.2-601 , all health care providers, as defined in § 8.01-581.1 , shall refrain from all debt collection activities relating to medical treatment received by the employee in connection with such claim until an award is made on the employee’s claim pursuant to § 65.2-704 . The statute of limitations for collection of such debt shall be tolled during the period in which the applicable health care provider is required to refrain from debt collection activities hereunder.
    2. For the purpose of this section, “debt collection activities” means repeatedly calling or writing to the employee and threatening either to turn the matter over to a debt collection agency or to an attorney for collection, enforcement or filing of other process. The term shall not include routine billing or inquiries about the status of the claim.

    History. 1994, c. 462.

    CASE NOTES

    Distribution of wrongful death benefit proceeds to hospital. —

    This section prohibits all debt collection activities other than routine billing and inquiries about the status of a claim instituted by a health care provider prior to the resolution of an employee’s workers’ compensation claim; thus, the trial court erred in entering an order directing the distribution of wrongful death benefit proceeds to the hospital that treated the decedent, as decedent’s workers’ compensation claim had not been resolved. Jeneary v. Commonwealth, 262 Va. 418 , 551 S.E.2d 321, 2001 Va. LEXIS 106 (2001).

    § 65.2-601.2. Notice to employee of employer’s intent.

    1. Whenever an employee makes a claim pursuant to § 65.2-601 , the Commission shall order the employer to advise the employee, within 30 days following the date of such order, whether the employer (i) intends to accept the claim, (ii) intends to deny the claim, or (iii) is unable to determine whether it intends to accept or deny the claim because the employer lacks sufficient information from the employee or a third party to make such determination. If the employer responds that it intends to deny the claim, the response shall provide reasons therefor. If the employer responds that it is unable to determine whether it intends to accept or deny the claim because it lacks sufficient information from the employee or a third party to make such determination, the response shall identify the additional information that the employer needs from the employee or a third party in order to make such determination.
    2. The employer’s response to the order shall be considered a required report for the purposes of § 65.2-902 .
    3. The employer’s response to the order shall not be considered part of the hearing record.
    4. An employer may, if the employee consents, send any response required by this section to the employee by email.

    History. 2020, c. 1086.

    § 65.2-602. Tolling of statute of limitations.

    In any case where an employer has received notice of an accident resulting in compensable injury to an employee as required by § 65.2-600 and, whether or not an award has been entered, the employer has paid compensation or wages to such employee during incapacity for work, as defined in § 65.2-500 or 65.2-502 , resulting from such injury or the employer has failed to file the report of said accident with the Virginia Workers’ Compensation Commission as required by § 65.2-900 , or otherwise has under a workers’ compensation plan or insurance policy furnished or caused to be furnished medical service to such employee as required by § 65.2-603 , the statute of limitations applicable to the filing of a claim shall be tolled until the last day for which such payment of compensation or wages or furnishment of medical services as described above is provided and that occurs more than six months after the date of accident. However, no such payment of wages or workers’ compensation benefits or furnishment of medical service as described above occurring after the expiration of the statute of limitations shall apply to this provision. In the case where the employer has failed to file a first report, the statute of limitations shall be tolled during the duration thereof until the employer filed the first report of accident as required by § 65.2-900 . In the event that more than one of the above tolling provisions applies, whichever of those causes the longer period of tolling shall apply.

    History. 1984, c. 608, § 65.1-87.1; 1989, c. 539; 1991, cc. 216, 355; 2019, c. 470.

    Editor’s note.

    Acts 2019, c. 470, cl. 2 provides: “That the provisions of this act shall apply with respect to any claim under the Virginia Workers’ Compensation Act (§ 65.2-100 et seq. of the Code of Virginia) that arises with respect to an injury as defined in § 65.2-101 of the Code of Virginia occurring on or after July 1, 2019.”

    The 2019 amendments.

    The 2019 amendment by c. 470 rewrote the section. For applicability clause, see Editor’s note.

    Law Review.

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 57, 58, 71.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-87.1.

    Construction with other law. —

    Existence of specific tolling provisions in § 65.2-528 and this section precluded Commission from applying subdivision A 1 of § 8.01-229 , a statute of general application, to toll limitation period in workers’ compensation proceeding. Whetzel v. Waste Management of Virginia, 1999 Va. App. LEXIS 496 (Va. Ct. App. Aug. 10, 1999).

    “Compensation.” —

    The phrase “and although no award has been entered” as used in former § 65.1-87.1 evinced a legislative intent that the word “compensation” applied to cases where payments were made in lieu of an award to which the employee would have been entitled under the Virginia Act. Bowden v. Newport News Shipbuilding & Dry Dock Co., 11 Va. App. 683, 401 S.E.2d 884, 7 Va. Law Rep. 1588, 1991 Va. App. LEXIS 27 (1991).

    There was nothing in former § 65.1-87.1 to indicate that the legislature intended the term “compensation” to apply to payments other than those mandated by Chapter 5, i.e., lost wages or a percentage thereof paid in lieu of an award by the Commission. The lack of an expressed contrary intent was evidence of the legislature’s intent not to broaden the statute to include payments made outside the requirements of the Virginia Act. Bowden v. Newport News Shipbuilding & Dry Dock Co., 11 Va. App. 683, 401 S.E.2d 884, 7 Va. Law Rep. 1588, 1991 Va. App. LEXIS 27 (1991).

    Error in retroactive application of 1991 amendment. —

    Because the statute created a new substantive right through the use of the 1991 amending language, the commission erred in applying this section as retroactively amended. B.E. & K. Constr. Co. v. Stanley, No. 1863-94-2 (Ct. of Appeals April 4, 1995).

    Payments from company’s health and accident policy were not compensation. —

    Payments which employee received from the company’s health and accident policy were payments outside the requirements of the Virginia Act and as such were not compensation under this section; accordingly, the provisions of this section were not applicable to this case for purposes of tolling the statute of limitations. Hervey v. Newport News Shipbuilding & Dry Dock Co., 12 Va. App. 88, 402 S.E.2d 688, 7 Va. Law Rep. 1916, 1991 Va. App. LEXIS 43 (1991) (decided prior to the 1989 amendment).

    The doctrine of imposition empowers the commission in appropriate cases to render decisions based on justice shown by the total circumstances even though no fraud, mistake or concealment has been shown; the doctrine prevents an employer’s use of its superior knowledge of, or experience with, the workers’ compensation act or its use of economic advantage to cause an unjust deprivation to the employee of benefits provided by the act. Strong v. Old Dominion Power Co., 35 Va. App. 119, 543 S.E.2d 598, 2001 Va. App. LEXIS 141 (2001).

    Under the doctrine of imposition, unlike estoppel, a claimant’s receipt of the standard “blue letter” from the commission does not create a de jure bar to a finding that claimant suffered prejudice. Rather, receipt of the “blue letter” is simply one circumstance among others to be considered. Odom v. Red Lobster #235, 20 Va. App. 228, 456 S.E.2d 140, 1995 Va. App. LEXIS 371 (1995).

    The fact that the employer voluntarily paid the benefits to the employee following injury does not as a matter of law operate to toll the statute of limitations or estop the employer from availing itself of the limitation provided by former § 65.1-87 (now § 65.2-601 ). Bowden v. Newport News Shipbuilding & Dry Dock Co., 11 Va. App. 683, 401 S.E.2d 884, 7 Va. Law Rep. 1588, 1991 Va. App. LEXIS 27 (1991).

    An employer is not estopped from asserting the statute of limitations defense merely because it voluntarily paid medical bills, wages or benefits; the employer’s payment of benefits and medical bills and its participation in the employee’s medical care for two years are not sufficient conduct upon which the employee can rely to excuse his failure to file a claim. Strong v. Old Dominion Power Co., 35 Va. App. 119, 543 S.E.2d 598, 2001 Va. App. LEXIS 141 (2001).

    Voluntary payment of compensation. —

    An employer’s voluntary payment of compensation estops the employer from asserting the statute of limitations if the employer makes representations to the employee that induce the employee to refrain from filing a claim with the Workers’ Compensation Commission. Cheski v. Arlington County Pub. Schs., 16 Va. App. 936, 434 S.E.2d 353, 10 Va. Law Rep. 157, 1993 Va. App. LEXIS 373 (1993).

    Blue letter or guide sent for one injury does not trigger the statutory per se lack of prejudice for second injury. —

    Blue letter or workers’ compensation guide sent for one injury does not trigger the statutory per se lack of prejudice for a second injury, even if it is received after the incident that caused the second injury. Absence of prejudice as a matter of law is triggered only when a claimant receives a workers’ compensation guide or blue letter relating to the specific injury at issue after that injury occurs. To trigger a per se absence of prejudice, each injury requires its own timely blue letter. Falls Church Cabinetry v. Jewell, 60 Va. App. 134, 724 S.E.2d 236, 2012 Va. App. LEXIS 134 (2012).

    No prejudice from late filing of injury report. —

    Record was insufficient to warrant applying tolling provision of this section, where claimant failed to provide any evidence that he was prejudiced by employer’s two-month delay in filing report of injury. Page v. Lynchburg Foundry Co., 2000 Va. App. LEXIS 158 (Va. Ct. App. Mar. 7, 2000).

    Improper standard applied to determine prejudice. —

    Virginia Workers’ Compensation Commission used an incorrect standard to find that an employer’s delay in reporting an accident did not prejudice a claimant because the Commission found there was no prejudice when: (1) the claimant did not allege that the employer told the claimant not to file a claim; and (2) nothing showed the employer purposefully misled the claimant or acted inappropriately toward the claimant to persuade the claimant not to file a claim, but no authority required such an act to show prejudice that tolled the statute of limitations, under § 65.2-602 . Jones v. Gwaltney of Smithfield, Ltd., 53 Va. App. 760, 675 S.E.2d 220, 2009 Va. App. LEXIS 177 (2009).

    Employer not estopped from raising statute of limitations as defense. —

    Where the Employer’s First Report of Accident was filed before the limitations period expired, this section could not serve as a basis to estop the employer from raising the statute of limitations defense. Cumbie v. Dining & Wall Sys., No. 0550-92-2 (Ct. of Appeals Dec. 1, 1992).

    Record supported finding that statute was tolled. —

    Statute of limitations for filing claim was tolled by this section, where employer’s first report of accident was not timely and employer paid either wage loss benefits or wages in lieu of compensation for time claimant was unable to work; moreover, claimant’s receipt of guide did not retrospectively eliminate tolling of statute of limitations, which had already occurred. Fairfax Hosp. v. Post, 2000 Va. App. LEXIS 39 (Va. Ct. App. Jan. 27, 2000).

    Because an employer failed to file an accident report with the Workers’ Compensation Commission, and because the employer had been paying benefits to the employee for over two years, the employee was actually prejudiced; therefore, pursuant to § 65.2-602 , the two-year statute of limitations period was tolled. Metl-Span 1, Ltd. v. Carter, 49 Va. App. 685, 644 S.E.2d 101, 2007 Va. App. LEXIS 183 (2007).

    This section does not toll the statute of limitations where employer failed to file a Memorandum of Agreement or filed late the First Report of Accident. Haider v. Fairfax Hosp. Ass’n, No. 0561-93-4 (Ct. of Appeals Jan. 11, 1994).

    There was no equitable basis to toll the statute of limitations where: (1) about six months before the expiration of the statute of limitations, the Workers’ Compensation Commission mailed to the claimant a pamphlet outlining her rights and responsibilities under the Workers’ Compensation Act, (2) the claimant admitted that she consulted an attorney who informed her by letter of the limitations period and the importance of filing a timely claim, and (3) the claimant initially filed a timely claim which was dismissed without prejudice. Shuron v. ARA Food Serv., 1998 Va. App. LEXIS 546 (Va. Ct. App. Oct. 27, 1998).

    Employee prejudiced by employer’s failure to file first notice of accident. —

    The commission properly rejected an employer’s statute of limitations defense where the record showed that the employee had given timely notice of the accident and that the employer had not filed its first report of injury with the commission until more than two and one-half years after it occurred. The employee’s rights were prejudiced by the employer as she relied on the employer to notify the commission of her claim and it did not do so. Pentran v. Cherry, 2001 Va. App. LEXIS 84 (Va. Ct. App. Feb. 27, 2001).

    Although a workers’ compensation claim was filed more than two years after the date of injury, the statute of limitations was tolled under § 65.2-602 because the employer failed to file an accident report under § 65.2-900 , and the claimant was unaware of the statute of limitations because no blue letter was sent under subsection D of § 65.2-201 . Falls Church Cabinetry v. Jewell, 60 Va. App. 134, 724 S.E.2d 236, 2012 Va. App. LEXIS 134 (2012).

    Failure to file first report of accident did not toll statute of limitations. —

    Company was not estopped from relying on the statute of limitations even though it failed to properly file a first report of accident in accordance with former § 65.1-124 (now § 65.2-900 ); this section provided for the tolling of the statute of limitations under certain circumstances; it also specified instances where the statute of limitations would not be tolled because of a per se absence of prejudice to the claimant; one of those instances was where an employer had filed a first report of accident as required by former § 65.1-124; therefore, a proper reading of this section prevented tolling of the statute of limitations when former § 65.1-124 had been satisfied but did not mandate the tolling of the statute of limitations where a first report of accident had not been filed. Hervey v. Newport News Shipbuilding & Dry Dock Co., 12 Va. App. 88, 402 S.E.2d 688, 7 Va. Law Rep. 1916, 1991 Va. App. LEXIS 43 (1991).

    Tolling appropriate where employer received employee notice, etc. —

    Pursuant to this section, the two-year statute of limitations is tolled where employer received notice of an accident, employer failed to file an employer’s first report of accident, and employer’s conduct prejudiced the employee’s right with respect to filing a timely claim; thus, where employer did not dispute that it received notice of claimant’s accident when it occurred, and that it did not file an employer’s first report of accident until after the expiration of the two-year statute of limitations, and employer presented no evidence to show that claimant received notice from the commission concerning his right to file a claim prior to the expiration of the limitations period, claimant was properly awarded compensation. Roanoke County v. Ferris, 1996 Va. App. LEXIS 14 (Va. Ct. App. Jan. 11, 1996).

    To estop the employer from pleading the statute of limitations, the employee must present clear, precise, and unequivocal evidence that he refrained from filing a claim because he relied to his detriment upon the acts or statements of the employer. If the employer’s representation induced the employee to refrain from filing a claim, it does not matter whether the employer harbored such intent. Strong v. Old Dominion Power Co., 35 Va. App. 119, 543 S.E.2d 598, 2001 Va. App. LEXIS 141 (2001).

    Workers’ Compensation Commission erred in applying a per se prejudice standard to find that the employer’s filing of an accident report involving the claim of the claimant, which was made more than two years after the claimant’s accident and outside the statute of limitations, tolled the statute of limitations which otherwise would have barred the claimant’s application for benefits. Rather, it should have applied an actual prejudice standard because the evidence showed that it fulfilled its duty of notifying the claimant in an earlier case that she only had a certain amount of time to file a claim, and, thus, in the present case the claimant may have been aware that she only had a certain amount of time to file a claim, which would undercut her argument that she did not know that she had to file a workers’ compensation claim within two years. Hall v. Winn-Dixie Stores, Inc., 41 Va. App. 835, 589 S.E.2d 484, 2003 Va. App. LEXIS 642 (2003).

    Employer was equitably estopped from invoking statute of limitations against employee where the person who had the responsibility for monitoring workers’ compensation claims told employee that employer’s workers’ compensation insurer “would take care of his bills,” that he needed only to submit his medical bills, mileage and prescriptions for reimbursement, and represented to employee “that his claim had been turned in to the Industrial Commission.” This affirmative assurance concerning employee’s “claim” was a representation that induced employee to believe that he was in compliance with all workers’ compensation requirements. Employee relied on this assurances and, to his detriment, failed to file a claim. Therefore, equitable estoppel applied to prevent employer from invoking statute of limitations against employee. Cibula v. Allied Fibers & Plastics, 14 Va. App. 319, 416 S.E.2d 708, 8 Va. Law Rep. 2649, 1992 Va. App. LEXIS 125 (1992), aff'd, 245 Va. 337 , 245 Va. App. 337, 428 S.E.2d 905, 9 Va. Law Rep. 1166, 1993 Va. LEXIS 58 (1993).

    Claimant must establish three requirements. —

    Notice, specified conduct and prejudice are the “three criteria” that must be established by a claimant seeking relief pursuant to either this section or repealed § 65.1-87.1. Bristol Newspapers, Inc. v. Shaffer, 16 Va. App. 703, 432 S.E.2d 23, 10 Va. Law Rep. 6, 1993 Va. App. LEXIS 248 (1993).

    Where (1) an employer has received notice of an accident resulting in compensable injury to an employee, (2) had paid compensation or wages to such employee during incapacity for work, and (3) such conduct of the employer has operated to prejudice the rights of such employee with respect to the filing of a claim prior to expiration of a statute of limitations, the statute of limitations under the Workers’ Compensation Act is tolled for the duration of such payment. Commonwealth Medical Inst. v. Stop-Headstart Program, 18 Va. App. 461, 453 S.E.2d 566, 1994 Va. App. LEXIS 767 (1994).

    Where the employee receives notice from the commission about the filing of a claim, there is a presumption he was not prejudiced. Strong v. Old Dominion Power Co., 35 Va. App. 119, 543 S.E.2d 598, 2001 Va. App. LEXIS 141 (2001).

    The employee’s rights shall be deemed not prejudiced if he has received after the accident a workers’ compensation guide. Commonwealth Medical Inst. v. Stop-Headstart Program, 18 Va. App. 461, 453 S.E.2d 566, 1994 Va. App. LEXIS 767 (1994).

    Equitable estoppel shown. —

    Evidence supported a decision finding that an employer was estopped from asserting a statute of limitations defense in an untimely filed workers’ compensation claim under circumstances in which a representative of the employer told the worker that her medical bills would be paid and that the employer would “handle everything”; there was credible evidence to support a finding that in telling the worker it would “handle everything” the employer caused her to refrain from filing a claim herself and misrepresented that it would file the worker’s claim for her. The employer then did not, in fact, file the workers’ compensation claim. Tidewater Acad., Inc. v. Evans, 2007 Va. App. LEXIS 138 (Va. Ct. App. Apr. 3, 2007).

    Estoppel not applicable. —

    Although claimant’s belief that she was not required to take further action to secure her benefits was reasonable and compelling, the doctrine of estoppel require the aggrieved party to show an affirmative, deliberate effort to prejudice the claimant’s right to file a claim with the commission within the limitations period. Thus, because carrier’s acts and omissions in this instance were passive, and without clear evidence of a deliberate fraud, estoppel did not apply. Odom v. Red Lobster #235, 20 Va. App. 228, 456 S.E.2d 140, 1995 Va. App. LEXIS 371 (1995).

    Statute of limitations not tolled. —

    Workers’ compensation claimant’s claim for a large herniated cervical disk was barred by the statute of limitations as: (1) the claimant was not prejudiced by the late filing of the employer’s first report of accident, but even if the limitations period was tolled until the date of the claimant’s first claim for benefits, the claim was filed more than two years later, (2) the doctrine of equitable estoppel did not apply as the employer did not misrepresent or conceal material facts that caused the claimant to refrain from filing her claim, and (3) the doctrine of imposition did not apply because the employer did not mislead the claimant or use superior knowledge of or experience with the Virginia Workers’ Compensation Act to deprive the claimant of her compensation. Tuck v. Goodyear Tire & Rubber Co., 47 Va. App. 276, 623 S.E.2d 433, 2005 Va. App. LEXIS 527 (2005).

    Because an employee never testified that the employee was prejudiced by the employer’s failure to file the first report of accident, the Workers’ Compensation Commission did not err in finding that the employee’s claim for benefits was not tolled by § 65.2-602 , but was barred by the statute of limitations contained in § 65.2-601 . Ayala v. Hann & Hann, Inc., 2008 Va. App. LEXIS 87 (Va. Ct. App. Feb. 19, 2008).

    Virginia Workers’ Compensation Commission decision denying a claim for benefits was proper, as the statute of limitations was not tolled under § 65.2-602 ; because the claimant received a “blue letter” after the claimant’s accident and before the statute of limitations expired, the claimant’s rights with respect to filing a timely claim were not prejudiced. Williams-Davidson v. Inova Fairfax Hosp. & Inova Health Sys. Found., 2013 Va. App. LEXIS 60 (Va. Ct. App. Feb. 26, 2013).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Claimant college professor who suffered psychological injuries resulting from campus shooting proved actual prejudice as result of employer’s failure to file First Report of Injury (FROI). Faigle v. New River Community College, JCN VA02000024395 (Dec. 28, 2019).

    The doctrine of imposition applies where the claimant’s failure to have disability within two years of the date of his accident and his failure to timely file a claim was caused by the insurer’s actions in delaying approval of surgery and delaying communication with the claimant. The insurer’s failure to file the required Employer’s Accident Report until the last day of the limitations period resulted in the claimant not receiving information from the Commission about his rights and how to file a claim until after the limitation period expired. Carman Eugene Hayne v. Clarion Hotel Roanoke Airport/Shree Vinayak, L.L.C., VWC File No. 236-03-59 (July 7, 2009).

    A majority held that where the carrier filed a 45A one year and eight months after the accident and filed a 45 G when medical benefits exceeded $1000, the tolling provision of § 65.2-602 is not applicable. In addition, the claimant failed to show prejudice in the absence of evidence that the employer or insurer’s actions induced her not to file a claim since the employer indicated that “everything was taken care of” only in response to questions concerning payment of medical bills and internal paperwork. The non-receipt of mail does not in and of itself establish prejudice. While the claimant indicated she did not receive a pamphlet in 2001, she did receive one in 2004 and still failed to file a claim until 2006. Lewis v. QVC, VWC File No. 220-57-19 (June 19, 2007).

    A majority, citing the Court of Appeals’ determination that there is no per se prejudice if the employer fails to file a report of accident, held that the claimant failed to present evidence that he was prejudiced by the employer’s failure to file the report. Within two months of the accident the claimant obtained legal counsel who actively represented him for one and one-half years. Ayala v. Hann & Hann, Inc., VWC File No. 226-00-09 (May 25, 2007).

    The late filing of the Employer’s Accident Report, standing alone, does not establish prejudice. There must also be a convergence of notice, specific conduct, and prejudice to seek relief under the tolling statute. The claimant must prove that she detrimentally relied upon an act or statement made by the employer, or its representative, which induced her to refrain from filing a claim. Filoso v. Prince William (County of) School Bd., VWC File Nos. 208-26-19, 208-77-64, 211-37-67 (Oct. 5, 2004), aff’d, No. 2587-04-4 (Ct. App. Va., March 15, 2005).

    Where evidence establishes employee was not aware of the need to file a claim within two years after the accident, the employer’s failure to timely file an Employer’s Accident Report operates to prejudice the rights of employee because that conduct deprives the employee of notice that she must file a claim within two years. Hardy v. ADT Security Systems, Inc., VWC File No. 208-93-94 (Sept. 13, 2004).

    The right to compensation under the Act is barred unless a claim is filed with the Commission within two years after the accident. However, in any case where an employer has failed to file a report of accident with the Virginia Workers’ Compensation Commission, and such conduct of the employer has operated to prejudice the rights of the employee with respect to the filing of a claim prior to the expiration of a statute of limitations, the statute is tolled until the employer files the First Report of Accident. Tang v. Progressive Engineering Co., 77 O.W.C. 276 (1998).

    Section 65.2-601 requires a claimant to file a claim within two years from the date of accident. However, § 65.2-602 provides for tolling if certain conditions are met. First, an employee must show that the employer received notice of the accident as required by § 65.2-600 ; and that the employer either has paid wages or compensation to the employee during incapacity from work, with or without an award, or has failed to file an Employer’s First Report of Accident as required by § 65.2-900 . Second, an employee must prove that either the employer’s payment of wages or compensation or its failure to file the First Report of Accident has operated to prejudice the employee’s rights with respect to filing a claim prior to the expiration of the statute of limitations. If an employee proves the existence of these conditions, the statute of limitations shall be tolled for the duration of the employer’s payment of compensation or wages during an employee’s incapacity from work or until the employer files a First Report of Accident. Chisholm v. The Washington Post, 77 O.W.C. 85 (1998).

    The tolling provisions of § 65.1-87.1 (now § 65.2-602 ) do not apply when a First Report has been filed. However, an employee may still invoke the doctrine of estoppel to prevent the running of the statute of limitation. Vandervreken v. Entre Computer Centers, Inc., 70 O.I.C. 47 (1991).

    If the employer has filed a First Report of Accident, or the employee has received a workers’ compensation guide or equivalent notice after the accident, the statute provides for a per se absence of prejudice with respect to the employee’s right to file a timely claim. Without a showing of prejudice, the tolling provisions of Code § 65.2-602 are not triggered. Chisholm v. The Washington Post, 77 O.W.C. 85 (1998).

    The mere fact that the claimant had other compensable accidents does not, without more, overcome the prejudice caused by the employer’s failure to file a First Report within two years from the date of accident. Chisholm v. The Washington Post, 77 O.W.C. 85 (1998).

    Since the payment of medical bills is not the payment of compensation, § 65.1-87.1 (now § 65.2-602 ) may not be invoked to toll the limitation period for filing a claim if such are the only sums paid. Flynn v. Sun & Shade Nursery and Gift, 66 O.I.C. 15 (1987).

    In order to seek relief under the tolling provisions of § 65.2-602 , there must be a convergence of notice, specific conduct, and prejudice. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    The tolling provision of § 65.2-602 applies where the payment of wages or compensation or the untimely filing of the Employer’s First Report operates to prejudice the rights of the employee. The rights of the employee are deemed not prejudiced if the Employer’s First Report is filed in a timely manner or the employee received a copy of the Workers’ Compensation Guide. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    Where the employee received compensation guides and a claim form for two prior work injuries, and received a compensation guide and claim form for a subsequent injury within 15 months of the work accident sub judice, he did not prove he was prejudiced if he failed to receive a compensation guide for this accident. Adkins v. Nabisco, Inc., 75 O.W.C. 285 (1996).

    Section 65.2-900 grants the Commission discretion to promulgate regulations governing the means by which employers report accidental injuries. Pursuant to 16 VAC 30-90-20, an employer must file an Employer’s Accident Report if the injury meets any of seven criteria. If the injury does not meet any of the criteria set out in the regulation, the injury is deemed minor and the employer may file the abbreviated Form 45-A (Report of Minor Injuries). If the employer files either form, whether or not the employer filed the correct form, the statute of limitations is not tolled. Filing either form triggers the Commission to send the claimant an information brochure, informing the claimant about the statute of limitations and the need to file a claim within two years of the accident. Komrowski v. Stafford (County of) School Board, VWC File No. 204-36-96 (April 5, 2002).

    Absent evidence of fraud, concealment or false representation, an employer’s filing of Commission Form 45A (Report of Minor Injuries) satisfies the requirements of § 65.2-900 , and the two-year statute of limitations for filing an original claim for benefits is not tolled under § 65.2-602 . Selfridge v. Hampton Inn/Holiday Inns, VWC File No. 203-54-72 (January 23, 2002).

    § 65.2-603. (Effective until July 1, 2022) Duty to furnish medical attention, etc., and vocational rehabilitation; effect of refusal of employee to accept.

    1. Pursuant to this section:
      1. As long as necessary after an accident, the employer shall furnish or cause to be furnished, free of charge to the injured employee, a physician chosen by the injured employee from a panel of at least three physicians selected by the employer and such other necessary medical attention. Where such accident results in the amputation or loss of use of an arm, hand, leg, or foot or the enucleation of an eye or the loss of any natural teeth or loss of hearing, the employer shall furnish prosthetic or orthotic appliances, as well as wheelchairs, walkers, canes, or crutches, proper fitting and maintenance thereof, and training in the use thereof, as the nature of the injury may require.In awards entered for incapacity for work, under this title, upon determination by the treating physician and the Commission that the same is medically necessary, the Commission may:
        1. Require that the employer either (i) furnish and maintain modifications to or equipment for the employee’s automobile or (ii) if there is a loss of function to either or both feet, legs, hands, or arms and if the Commission determines that modifications to or equipment for the employee’s automobile pursuant to clause (i) are not technically feasible, will not render the automobile operable by the employee, or will cost more than is available for such purpose after payment for any items provided under subdivision b, order that the balance of funds available under the aggregate cap of $42,000 be applied towards the purchase by the employee of a suitable automobile or to furnish or maintain modifications to such automobile; and
        2. Require that the employer furnish and maintain bedside lifts, adjustable beds, and modification of the employee’s principal home consisting of ramps, handrails, or any appliances prescribed by the treating physician and doorway alterations.The aggregate cost of all such items and modifications required to be furnished pursuant to subdivisions a and b on account of any one accident shall not exceed $42,000.The employee shall accept the attending physician, unless otherwise ordered by the Commission, and in addition, such surgical and hospital service and supplies as may be deemed necessary by the attending physician or the Commission.
      2. The employer shall repair, if repairable, or replace dentures, artificial limbs, or other prosthetic or orthotic devices damaged in an accident otherwise compensable under workers’ compensation, and furnish proper fitting thereof.
      3. The employer shall also furnish or cause to be furnished, at the direction of the Commission, reasonable and necessary vocational rehabilitation services; however, the employer shall not be required to furnish, or cause to be furnished, services under this subdivision to any injured employee not eligible for lawful employment.Vocational rehabilitation services may include vocational evaluation, counseling, job coaching, job development, job placement, on-the-job training, education, and retraining. Those vocational rehabilitation services that involve the exercise of professional judgment as defined in § 54.1-3510 shall be provided by a certified rehabilitation provider pursuant to Article 2 (§ 54.1-3510 et seq.) of Chapter 35 of Title 54.1 or by a person licensed by the Boards of Counseling; Medicine; Nursing; Optometry; Psychology; or Social Work or, in accordance with subsection B of § 54.1-3513 , by a person certified by the Commission on Rehabilitation Counselor Certification (CRCC) as a certified rehabilitation counselor (CRC) or a person certified by the Commission on Certification of Work Adjustment and Vocational Evaluation Specialists (CCWAVES) as a Certified Vocational Evaluation Specialist (CVE).In the event a dispute arises, any party may request a hearing and seek the approval of the Commission for the proposed services. Such services shall take into account the employee’s preinjury job and wage classifications; his age, aptitude, and level of education; the likelihood of success in the new vocation; and the relative costs and benefits to be derived from such services.
    2. The unjustified refusal of the employee to accept such medical service or vocational rehabilitation services when provided by the employer shall bar the employee from further compensation until such refusal ceases and no compensation shall at any time be paid for the period of suspension unless, in the opinion of the Commission, the circumstances justified the refusal. In any such case the Commission may order a change in the medical or hospital service or vocational rehabilitation services.
    3. If in an emergency or on account of the employer’s failure to provide the medical care during the period herein specified, or for other good reasons, a physician other than provided by the employer is called to treat the injured employee, during such period, the reasonable cost of such service shall be paid by the employer if ordered so to do by the Commission.
    4. As used in this section and in § 65.2-604 , the terms “medical attention,” “medical service,” “medical care,” and “medical report” shall be deemed to include chiropractic service or treatment and, where appropriate, a chiropractic treatment report.
    5. Whenever an employer furnishes an employee the names of three physicians pursuant to this section, and the employer also assumes all or part of the cost of providing health care coverage for the employee as a self-insured or under a group health insurance policy, health services plan or health care plan, upon the request of an employee, the employer shall also inform the employee whether each physician named is eligible to receive payment under the employee’s health care coverage provided by the employer.
    6. If the injured employee has an injury which may be treated within the scope of practice for a chiropractor, then the employer or insurer may include chiropractors on the panel provided the injured employee.

    History. Code 1950, § 65-85; 1952, c. 385; 1960, cc. 310, 444, 580; 1964, c. 366; 1966, c. 388; 1968, cc. 377, 660, § 65.1-88; 1970, c. 470; 1972, c. 229; 1973, c. 542; 1975, c. 280; 1980, c. 600; 1982, c. 585; 1983, c. 471; 1987, cc. 455, 475; 1989, c. 540; 1990, c. 789; 1991, cc. 275, 355, 376; 1994, c. 558; 1997, c. 839; 1998, c. 65; 1999, c. 780; 2000, cc. 473, 1018; 2004, c. 271; 2011, c. 656; 2017, c. 491.

    Cross references.

    As to disability retirement allowance, see §§ 51.1-157 , 51.1-308 . As to adjustments in supplemental disability benefits, see § 51.1-1125 .

    The 1998 amendment, in subdivision A 1, in the second sentence, inserted “or loss of use,” inserted “as well as wheelchairs, walkers, canes, or crutches,” and inserted “and maintenance,” and in the third sentence, deleted “wheelchairs” preceding “bedside lifts.”

    The 1999 amendment added subsection F.

    The 2000 amendments.

    The 2000 amendment by c. 473 inserted “Counseling” following “Boards of” and deleted “Licensed Professional Counselors, Marriage and Family Therapists and Substance Abuse Treatment Professionals” following “Optometry” in subdivision A 3.

    The 2000 amendment by c. 1018, effective April 19, 2000, inserted the language beginning “however, the employer” and ending “for lawful employment” at the end of the first sentence of subdivision A 3.

    The 2004 amendments.

    The 2004 amendment by c. 271 added the introductory paragraph in subsection A; and in subdivision A 3, substituted “pursuant to” for “as provided in” and added the language beginning “or in accordance with subsection B” at the end of the last sentence of the second paragraph.

    The 2011 amendments.

    The 2011 amendment by c. 656, in the third sentence in subdivision A 1, added clause (i) and the clause (ii) designation, inserted “pursuant to clauses (i) and (ii),” and substituted “$42,000” for “$25,000.”

    The 2017 amendments.

    The 2017 amendment by c. 491 rewrote subdivision A 1 by adding paragraph breaks and rewriting the former third sentence, which read: “In awards entered for incapacity for work, under this title, upon determination by the treating physician and the Commission that the same is medically necessary, the Commission may require that the employer furnish and maintain (i) modifications to or equipment for the employee’s automobile or (ii) bedside lifts, adjustable beds, and modification of the employee’s principal home consisting of ramps, handrails, or any appliances prescribed by the treating physician and doorway alterations, provided that the aggregate cost of all such items and modifications required to be furnished pursuant to clauses (i) and (ii) on account of any one accident shall not exceed $42,000.”

    The 2022 amendments.

    The 2022 amendment by c. 213, in subdivision A 1a and in the second paragraph of subdivision A 1 b, substituted “$55,000” for “$42,000”; in the first paragraph of subdivision A 1 b, deleted “or any appliances prescribed by the treating physician and” preceding “doorway alterations” and added “or any appliances prescribed by the treating physician, except for appliances or medical equipment required to be furnished by the employer pursuant to subdivision A 1”; added the second sentence in the second paragraph of subdivision A 1 b; and made a stylistic change.

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    For note, “Partially Disabled and Religious: Virginia Workers’ Compensation and the Free Exercise Clause,” see 28 U. Rich. L. Rev. 763 (1994).

    For 1995 survey of workers’ compensation, see 29 U. Rich. L. Rev. 1199 (1995).

    For an article relating to the most significant developments in the law of workers’ compensation since September 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 38, 39, 39.1, 40.

    CASE NOTES

  • Analysis
  • I.General Consideration.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-88 or prior law.

    Constitutionality. —

    This section and former § 65.1-102 (now § 65.2-714 ) did not impair hospital’s contract with employee in violation of federal and state Constitutions, since statutes challenged were not intended to impair existing contract of hospital. Fairfax Hosp. Ass'n v. Sines, 1995 Va. App. LEXIS 183 (Va. Ct. App. Feb. 21, 1995).

    Purpose. —

    This section does not direct or authorize an employer to require an employee involved in an accident to seek medical attention. Rather, it prescribes the duties and responsibilities of an employer when an employee is injured in an industrial accident. Fairfax Hosp. Ass'n v. Sines, 1995 Va. App. LEXIS 183 (Va. Ct. App. Feb. 21, 1995).

    Purpose of this section is twofold: To place the cost of medical care on the employer and to restore the employee’s good health so that he may return to useful employment as soon as possible. Richmond Mem. Hosp. v. Allen, 3 Va. App. 314, 349 S.E.2d 419, 3 Va. Law Rep. 1023, 1986 Va. App. LEXIS 366 (1986).

    Medical necessity mixed question. —

    The question of whether disputed medical treatment was necessary within the meaning of this section is a mixed question of law and fact. Gutierrez v. Espina Stone Co., 2000 Va. App. LEXIS 349 (Va. Ct. App. May 9, 2000).

    The question of whether disputed medical treatment was necessary within the meaning of this section is a mixed question of law and fact and, accordingly, the commission’s conclusions as to the necessity of disputed medical treatment are not binding upon the court. Uninsured Employer's Fund v. Childress, 2000 Va. App. LEXIS 742 (Va. Ct. App. Nov. 21, 2000).

    Necessary medical attention. —

    “Necessary medical attention” as that phrase is used in subdivision A 1 of § 65.2-603 includes palliative treatment; when a claimant changes physicians without authorization and realizes appreciable benefit and relief from said change, that treatment is considered necessary. H.J. Holz & Son, Inc. v. Dumas-Thayer, 37 Va. App. 645, 561 S.E.2d 6, 2002 Va. App. LEXIS 161 (2002).

    Treatment for palliative care qualifies as “necessary medical treatment” under § 65.2-603 where the workers’ compensation commission finds credible a claimant’s complaints of continuing pain. H.J. Holz & Son, Inc. v. Dumas-Thayer, 37 Va. App. 645, 561 S.E.2d 6, 2002 Va. App. LEXIS 161 (2002).

    Absent medical evidence that surgery was reasonable and necessary at the time an employee filed a workers’ compensation claim or at the time of a hearing on the claim, the employee did not prove the entitlement to benefits. Milette v. Haymes Bros., 2006 Va. App. LEXIS 252 (Va. Ct. App. June 6, 2006).

    Excessive medical bills. —

    Employer that alleged a medical provider’s bill was excessive presented insufficient evidence of the prevailing rate in the community, as the government-mandated reimbursement rate for injured longshoremen or Medicare patients, standing alone, did not establish that rate. The test was what a surgeon and his assistant with the skill and experience of those that operated on the worker’s compensation claimant typically charged for the surgery at the time and in the community that the surgery was performed. Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 722 S.E.2d 301, 2012 Va. App. LEXIS 59 (2012).

    Virginia Workers’ Compensation Commission’s award to a medical provider for a claimant’s surgery was proper, as it was reasonable for the Commission to consider a medical bill as prima facie evidence that the charges were consistent with requirements of the Virginia Workers’ Compensation Act and to place the burden on the employer to prove that the medical fee was excessive. Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 722 S.E.2d 301, 2012 Va. App. LEXIS 59 (2012).

    Future medical benefits. —

    Nothing stated that the award of medical benefits was final in the sense that the employee could not recover costs for future necessary medical treatment, and the Workers’ Compensation Commission’s opinion allowing for future medical benefits was consistent with the Workers’ Compensation Act. Target Corp. v. Hussein, 2014 Va. App. LEXIS 279 (Va. Ct. App. Aug. 12, 2014).

    Jurisdiction to order payment. —

    Deputy commissioner’s order directing the employer and/or the guaranty fund to pay the employee’s treating physician was within the deputy commissioner’s subject matter jurisdiction since the employee’s claim involved treatment for a work accident. Furthermore, the workers’ compensation commission could not rule on the merits of that order because the guaranty fund did not timely appeal the order once it was entered. Miller v. Potomac Hosp. Found., 50 Va. App. 674, 653 S.E.2d 592, 2007 Va. App. LEXIS 437 (2007).

    Commission must consider criteria found in Virginia Code. —

    Where the workers’ compensation commission made no findings as to the necessity or reasonableness of a claimant’s medical treatment for that time period, and the appellate court cannot determine from the record that it considered the criteria set forth in § 65.2-603 before making its award, the commission’s award was erroneous. Fairfax County Sch. Bd. v. Manola, 2003 Va. App. LEXIS 27 (Va. Ct. App. Jan. 28, 2003).

    The mere fact that the unauthorized treatment is an acceptable method of treating the condition does not mean that the treatment should be paid for by the employer. Haramis v. G.T. Painting & Constr. Co., No. 2489-94-1 (Ct. of Appeals May 16, 1995).

    Requirements of section read into employment contract. —

    The requirement of this section that the employer furnish and the employee accept medical attention is read into the employment contract between them. Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254, 1967 Va. LEXIS 128 (1967) (citing Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843 (1953) and commented on in 53 Va. L. Rev. 1763 (1967)).

    Medical attention is part of compensation. —

    The medical attention and hospitalization which the employee is entitled to receive and the employer is required to furnish by this section is incidental to and a part of the compensation to which the employee is entitled under the Act; and the employer is only liable for medical and hospital charges where the employee is entitled to compensation. Merrimac Anthracite Coal Corp. v. Showalter, 158 Va. 227 , 163 S.E. 73 , 1932 Va. LEXIS 250 (1932).

    Only medical treatment resulting from an accident is compensable. McGregor v. Crystal Food Corp., 1 Va. App. 507, 339 S.E.2d 917, 1986 Va. App. LEXIS 232 (1986).

    Finding of the deputy commissioner that the drug Clonidine was used for the treatment of claimant’s hypertension and high blood pressure, and that it was not necessary for the treatment of his compensable injury, which was affirmed by the Commission, could be upheld. Woody's Auto Parts v. Rock, 4 Va. App. 8, 353 S.E.2d 792, 3 Va. Law Rep. 1822, 1987 Va. App. LEXIS 160 (1987).

    Workers’ Compensation Commission properly found that a claimant sustained a compensable injury to his neck when he fell and injured his wrist because the claimant complained of neck pain after a wrist cast was removed, and a doctor found that the fall aggravated a preexisting neck condition. Outreach Constr. & S. Ins. Co. v. Peterson, 2010 Va. App. LEXIS 10 (Va. Ct. App. Jan. 12, 2010).

    Virginia Workers’ Compensation Commission did not err in relying upon the opinions of two doctors who treated the claimant to conclude that the claimant’s shoulder injury was caused by the claimant’s fall at work because the evidence did not show that the claimant failed to reveal the claimant’s past shoulder problems to the doctors. In addition, there was credible evidence to support the Commission’s finding that the claimant’s shoulder injury was caused by the fall and was not related to the preexisting condition. Hyatt Regency Crystal City & Hyatt Corp. v. Spencer, 2011 Va. App. LEXIS 23 (Va. Ct. App. Jan. 25, 2011).

    Causal connection between injury and treatment established. —

    Virginia Workers’ Compensation Commission did not err in holding an employer responsible under § 65.2-603 for the continuing medical treatment of a workers’ compensation benefits claimant because the medical evidence and the testimony of claimant’s treating physician established the causal connection between claimant’s compensable injury and her treatment for lumbar facet joint syndrome; the commission relied on the physician’s testimony to establish causation and reconciled any internal conflicts in favor of claimant, and the physician’s testimony accounted for any discrepancies between his diagnosis and the medical evidence. CVS Va. Distrib. v. Thompson, 2011 Va. App. LEXIS 175 (Va. Ct. App. May 17, 2011).

    Award of medical benefits in a workers’ compensation action was proper under subdivision A 1 of § 65.2-603 because the employee’s medical records were further corroborated by a doctor’s letter stating that the progression and nature of his complaints to his health care providers, as well as the lack of MRI findings, were consistent with a severe lumbosacral strain. The employer pointed to nothing in the record indicating that the doctor was unaware of the employee’s preexisting right ankle problem or that the employee told the doctor that his fall resulted from slippery winter conditions rather than his back “giving out.” Miller & Long, Inc. v. Knight, 2011 Va. App. LEXIS 385 (Va. Ct. App. Dec. 6, 2011).

    Order for the employer to pay for a left side denervation procedure to the employee’s lower back was proper because the Virginia Workers’ Compensation Commission was entitled to accept the portion of a doctor’s report indicating a probable relationship between the employee’s back pain and the workplace accident and to give that opinion appropriate weight in determining that the disputed left-side denervation procedure had a causal relationship to his compensable injury for purposes of subdivision A 1 of § 65.2-603 . Lantz Constr. Co. v. Adams, 2013 Va. App. LEXIS 175 (Va. Ct. App. June 11, 2013).

    Workers’ Compensation Commission properly found that a doctor’s treatment of a workers’ compensation benefits claims was reasonable, necessary, and causally related to claimant’s work injury because some medical records specifically stated that claimant’s complaints were the result of the work injury and that her other symptoms were exacerbated by the work injury. Cont'l Telecom Corp. v. Streets-Nash, 2017 Va. App. LEXIS 122 (Va. Ct. App. May 2, 2017).

    Workers’ Compensation Commission did not err in upholding the denial of a claimant’s request for authorization of further medical treatment because credible evidence supported its conclusion that the claimant’s evidence that his recurring foot pain was causally connected to his original injury was insufficient; the Commission evaluated all the medical evidence regarding the condition of the claimant’s foot, giving particular weight to the opinion of his primary treating physician. Wells v. Auto. Serv. Garage, 2018 Va. App. LEXIS 43 (Va. Ct. App. Feb. 20, 2018).

    Virginia Workers’ Compensation Commission did not err in concluding that an employer was obligated to pay for a claimant’s surgery and related treatment with her treating physician because the claimant offered sufficient medical evidence to establish that the surgery was reasonable, necessary, and causally related to the work accident. Hyatt Place-Chantilly Dulles v. Alvarenga, 2019 Va. App. LEXIS 234 (Va. Ct. App. Oct. 22, 2019).

    Compensable consequence injury. —

    Workers’ Compensation Commission properly awarded medical benefits to an employee for a compensable consequence injury because after the first doctor performed arthroscopic surgery on the employee’s left knee, he found a fracture in that area of the knee that was subsequently determined to be directly related to the surgical reshaping of the knee during the surgery, which fracture was compensable, and nothing in the record indicated that employer instructed the employee to return to the first doctor. Vital Link, Inc. v. Hope, 69 Va. App. 43, 814 S.E.2d 537, 2018 Va. App. LEXIS 164 (2018).

    Condition not a compensable consequence of injury. —

    Where a worker conceded that his heart condition had no causal connection to his compensable hernia injury and the worker’s heart condition was neither a compensable consequence of his hernia injury, nor was it a condition which would fall under the two causes rule, an employer had no responsibility for the medical treatment the worker received for the heart condition prior to undergoing the hernia surgery. Haftsavar v. All Am. Carpet & Rugs, Inc., 59 Va. App. 593, 721 S.E.2d 804, 2012 Va. App. LEXIS 44 (2012).

    Subdivision B of Industrial (now Workers’ Compensation) Commission Rule 13 facilitates the purpose of the Workers’ Compensation Act, encouraging a claimant to obtain compensation as it becomes due. It affords the opportunity for the employer to provide light work or rehabilitation in order to reduce liability, as the employer has the right to do under this section. If the employee may wait the full 24-month period without notifying the employer of the claimed change in condition, the employer’s rights under this section would be lost. Whitten v. Mead Paperboard Prods., 4 Va. App. 182, 355 S.E.2d 349, 3 Va. Law Rep. 2224, 1987 Va. App. LEXIS 178 (1987).

    Employer was not required to furnish employee medical service if she was not injured in course of employment, nor was it required to offer her a panel of physicians as required by this section when it denied her claim. Bradley v. Southland Corp., 3 Va. App. 627, 352 S.E.2d 718, 3 Va. Law Rep. 1757, 1987 Va. App. LEXIS 148 (1987).

    In the face of employer’s denial of liability, employee had no authority to obtain medical care at employer’s expense. Without authorization, the expense of medical care may not be compensable. Bradley v. Southland Corp., 3 Va. App. 627, 352 S.E.2d 718, 3 Va. Law Rep. 1757, 1987 Va. App. LEXIS 148 (1987).

    Employer’s payment of medical bills pursuant to settlement. —

    Pursuant to a settlement order, an employer was bound by its own agreement to accept the financial responsibility for an employee’s medical bills for a health care provider’s treatments of the employee prior to the entry of the settlement order. Northrop Grumman Shipbuilding, Inc. v. Wardell Orthopaedics, P.C., 67 Va. App. 420, 796 S.E.2d 469, 2017 Va. App. LEXIS 51 (2017).

    Health care provider was entitled to payments form an employer, pursuant to the terms of a settlement agreement between the employer and an employee and the plain language of a settlement order, because, although the employer claimed that the provider was not authorized to provide medical treatment, the settlement agreement did not include any limitation or exclusion regarding what physicians could provide the medical treatment for which the employer had agreed to pay until the date of the settlement order. Northrop Grumman Shipbuilding, Inc. v. Wardell Orthopaedics, P.C., 67 Va. App. 420, 796 S.E.2d 469, 2017 Va. App. LEXIS 51 (2017).

    The claimant has the burden to prove that the medical attention was causally related to the industrial accident. Watkins v. Halco Eng'g, Inc., 225 Va. 97 , 300 S.E.2d 761, 1983 Va. LEXIS 196 (1983).

    Where the Commission properly could conclude, based on inferences legitimately drawn from the facts, that claimant’s present problem of adjustment was not caused by the accident, but rather, that it was brought on by factors unrelated to the accident, similar to those experienced by a large segment of the general population when an individual is called upon to adapt to a new situation or routine, the Commission correctly denied the claim for payment of psychiatric services. Watkins v. Halco Eng'g, Inc., 225 Va. 97 , 300 S.E.2d 761, 1983 Va. LEXIS 196 (1983).

    Employer’s responsibility for medical expenses under § 65.2-603 depends upon: (1) whether the medical service was causally related to the industrial injury; (2) whether such other medical attention was necessary; and (3) whether the treating physician made a referral of the patient; claimant bears the burden of proof on these issues by a preponderance of the evidence. Fairfax County Sch. Bd. v. Manola, 2003 Va. App. LEXIS 27 (Va. Ct. App. Jan. 28, 2003).

    Failure to list injury in agreement to pay benefits. —

    As the parties’ agreement to pay benefits did not mention the employee’s hand injury, which prevented his cooperation with vocational rehabilitation, it was not the subject of an enforceable award. Therefore, the employer, which applied for a hearing to terminate benefits under subsection B of § 65.2-603 , did not have the burden to show that the hand injury was not work-related. UPS v. Ilg, 54 Va. App. 366, 679 S.E.2d 545, 2009 Va. App. LEXIS 329 (2009).

    Statute of limitations bar. —

    Although the workers’ compensation commission awarded medical benefits “for as long as necessary after the accident” to the employee regarding the employee’s work-related right knee injury pursuant to subdivision A 1 of § 65.2-603 , the employee was still required to file a change-in-condition application within two years of the time the employee last received disability benefits, pursuant to subsection A of § 65.2-708 , to have a viable change-in-condition claim regarding the pain in the employee’s left knee. Since the employee did not file his § 65.2-101 change-in-condition application within the required two-year time period, the employee’s claim for change-in-condition benefits was time barred by subsection A of § 65.2-708 . Tricord Homes, Inc. v. Smith, 2008 Va. App. LEXIS 573 (Va. Ct. App. Dec. 30, 2008).

    Res judicata did not bar application. —

    Workers’ compensation claimant’s application to resume medical benefits for treatment by her physician was not barred by res judicata principles where her change-in-condition application for temporary total disability benefits was denied by the Virginia Workers’ Compensation Commission one month earlier as: (1) disability benefit claims were a distinct and separate remedy from medical benefits and there was no identity of remedies between the two claims, and (2) the two applications involved two separate time periods. Sprint Corp. v. Brooks, 2006 Va. App. LEXIS 129 (Va. Ct. App. Apr. 4, 2006).

    Since the employee’s claim remained open for further evidence, res judicata did not apply to bar her claim. Target Corp. v. Hussein, 2014 Va. App. LEXIS 279 (Va. Ct. App. Aug. 12, 2014).

    Application for resumption of medical treatment properly granted. —

    Virginia Workers’ Compensation Commission’s decision to grant a workers’ compensation claimant’s application for the resumption of treatment by her physician was affirmed as: (1) the Commission was at liberty to consider the physician’s earlier report as to whether continued medical treatment was causally related to the compensable accident, (2) the Commission also had the physician’s second report clarifying his earlier report, which although not based upon a further examination, more directly addressed the causal relationship issue and was credible evidence to support the Commission’s finding that the claimant’s symptoms were causally related to the compensable accident. Sprint Corp. v. Brooks, 2006 Va. App. LEXIS 129 (Va. Ct. App. Apr. 4, 2006).

    Burden of proof. —

    A claimant has the burden to show by the preponderance of the evidence that the compensable accident is the actual cause of an injury. The employer is entitled to such a showing before it accepts responsibility for payment. Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 336 S.E.2d 903, 1985 Va. App. LEXIS 84 (1985).

    Burden of proof as to employer’s acceptance of financial responsibility. —

    Health care provider which provided medical care to an injured employee was not required to prove the existence of a compensable injury by accident to receive payment for services rendered because a decision regarding the compensability of the employee’s accident was rendered unnecessary by the employer’s acceptance of financial responsibility for the costs associated with the medical treatment by a settlement order. Northrop Grumman Shipbuilding, Inc. v. Wardell Orthopaedics, P.C., 67 Va. App. 420, 796 S.E.2d 469, 2017 Va. App. LEXIS 51 (2017).

    Employer cannot delay medical treatment until the time limitation for treatment under the settlement agreement has expired and then contend that the time for such treatment has passed. Although there was no bad faith on the part of employer in contesting the need for surgery, the fact remained that such contest prevented the resolution of the issue until after the limitation date. Dunrite Transmission v. Sheetz, 18 Va. App. 647, 446 S.E.2d 473, 11 Va. Law Rep. 39, 1994 Va. App. LEXIS 466 (1994).

    Finality of award. —

    Appellants claimed the findings were binding on the Workers’ Compensation Commission, but appellants proceeded as if the deputy commissioner found that medical benefits beyond 2008 were barred and no longer necessary, but he did not express such a finding; a finding of very good resolution to the employee’s problems did not provide finality of the award, and the interpretation that the award was not final and did not preclude further claims was reasonable in light of the statute. Target Corp. v. Hussein, 2014 Va. App. LEXIS 279 (Va. Ct. App. Aug. 12, 2014).

    II.Choice of Physician.

    Employer must advise employee of identity of panel physicians. —

    Panel of three physicians was not properly offered to employee; employer must advise the employee of the identity of the panel physicians from which he can make his choice of treating physician, and referring employee to a clinic was not a physician as envisioned by this section. Goodyear Tire & Rubber Co. v. Pierce, 9 Va. App. 120, 384 S.E.2d 333, 6 Va. Law Rep. 318, 1989 Va. App. LEXIS 124 (1989).

    Under § 65.2-603 , an employer is required to provide an injured employee with a panel of at least three physicians from which to select a treating physician; workers’ compensation commission properly required an employer to provide an employee with another panel once the employee was no longer being treated by the doctor the panel doctor referred the employee to, as she no longer had a treating physician. Fairfax County Sch. Bd. v. Manola, 2003 Va. App. LEXIS 27 (Va. Ct. App. Jan. 28, 2003).

    Treatment authorized where panel not offered but doctor referred employee. —

    Orthopedist’s treatment of the employee for carpal tunnel syndrome was authorized, where the employee was never offered a panel of physicians as required by this section and had been referred to the orthopedist by the company doctor. Lea Indus. & Ladd Furn., Inc. v. Brown, No. 0537-89-2 (Ct. of Appeals May 1, 1990).

    Discretion of attending physician. —

    The requirement of this section that necessary surgical and hospital services and supplies be furnished does not give the patient’s attending physician unbridled authority or discretion. The services which an employer has to furnish under the Workers’ Compensation Act are necessary services incident to the treatment of an injury sustained in a compensable accident. Daniels v. Insurance Management Corporation of Tidewater, 222 Va. 434 , 281 S.E.2d 847, 1981 Va. LEXIS 326 (1981).

    Virginia Workers’ Compensation Commission implicitly found that the claimant’s ongoing treatments for her fibromyalgia, including trigger point injections and physical therapy, were “necessary” treatments within the meaning of subdivision A 1 of § 65.2-603 ; the Commission was permitted to rely on the claimant’s treating physicians’ testimony, despite the employer’s experts’ opinions to the contrary. Fairfax County Sch. Bd. v. Fish, 2002 Va. App. LEXIS 684 (Va. Ct. App. Nov. 19, 2002).

    Necessity of other medical attention determined by physician or Commission. —

    Whether “such other medical attention” is deemed necessary is for the attending physician or Commission to determine, not the employer. Press v. Ale, 1 Va. App. 153, 336 S.E.2d 522, 1985 Va. App. LEXIS 77 (1985); Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 336 S.E.2d 903, 1985 Va. App. LEXIS 84 (1985).

    Discharge or release of patient by treating physician. —

    Whether a treating physician has released or abandoned his patient most often is determined by the express intent of the physician. Some situations may require analysis of the total circumstances to determine whether discharge, release or abandonment of a patient was intended. In either instance, it is a factual determination which must be proven by clear and convincing evidence in light of the high professional responsibility which a medical doctor owes to provide patient care and treatment. Press v. Ale, 1 Va. App. 153, 336 S.E.2d 522, 1985 Va. App. LEXIS 77 (1985).

    Workers’ Compensation Commission’s findings that the treating physician did not discharge the claimant from his care or refer her to her primary care physician to treat her injury were supported by credible evidence in the record because the physician’s records did not indicate any type of referral to another physician for treatment of the claimant’s back injury or show that he discharged her from his care. The records showed that he continued to recommend injections as the only remaining treatment option and did not schedule further follow up appointments with her due to her refusal to consider them. Yahner v. Fire-X Corp., 70 Va. App. 265, 826 S.E.2d 888, 2019 Va. App. LEXIS 101 (2019).

    Employee need not seek care from panel unless so authorized by employer. —

    An employee who asserts an employment-related injury is not required to seek medical care from an employer’s panel of physicians unless the employer authorizes the employee to do so at the employer’s expense. Bradley v. Southland Corp., 3 Va. App. 627, 352 S.E.2d 718, 3 Va. Law Rep. 1757, 1987 Va. App. LEXIS 148 (1987).

    Claimant was under no duty to see employer’s doctor for treatment for which employer disclaimed responsibility. Dan River, Inc. v. Turner, 3 Va. App. 592, 352 S.E.2d 18, 3 Va. Law Rep. 1599, 1987 Va. App. LEXIS 144 (1987).

    An award of medical benefits was proper where the record proved and the commission found that the employee turned to his wife’s insurance plan, which required him to use her primary care physician, because the employer had declined to accept the claim. The employee had good reason to treat with his wife’s primary care physician and the other doctors to whom that doctor referred him because his employer had declined to accept the claim and payment for these physicians would be covered by his wife’s health insurance. Marriott Int'l, Inc. v. Carter, 34 Va. App. 209, 539 S.E.2d 738, 2001 Va. App. LEXIS 1 (2001).

    Employee’s choice of physician who was not a panel member. —

    Employer failed to establish that an injured employee waived the right to treatment, by choosing a physician that was not included in the employer’s physician panel, because the Virginia Workers’ Compensation Commission rejected the proffered testimony of the employer’s representative. Furthermore, the Commission did not err in focusing on the signed written agreement between the representative and the employee and in finding that the agreement included ambiguous language that failed to properly inform the employee of the employee’s rights. Newport News Shipbuilding & Dry Dock Co. v. Wardell Orthopaedics, P.C., 67 Va. App. 404, 796 S.E.2d 461, 2017 Va. App. LEXIS 52 (2017).

    Employee’s treating physician was entitled to recovery of the difference between the prevailing rate in the community and the amount paid under the federal Department of Labor fee schedule because the employee, in light of the information that was available to the employee, did not refuse care and the statutory penalty did not apply. Newport News Shipbuilding & Dry Dock Co. v. Wardell Orthopaedics, P.C., 67 Va. App. 404, 796 S.E.2d 461, 2017 Va. App. LEXIS 52 (2017).

    An employer’s act of designating a medical facility and requiring an employee to obtain treatment from a doctor who works at that facility did not comply with the requirements of § 65.2-603 , and appellate court held that there was credible evidence to support the Virginia Workers’ Compensation Commission’s finding that the doctor an employee saw when the employee went to the medical facility designated by the employer did not become the employee’s treating physician. Dump Furniture Store/Haynes Furniture Co. v. Holloway, 2002 Va. App. LEXIS 586 (Va. Ct. App. Oct. 1, 2002).

    Attending physician selected by employee becomes the treating physician if employer fails or refuses to provide a panel of physicians. Davis v. Brown & Williamson Tobacco Co., 3 Va. App. 123, 348 S.E.2d 420, 3 Va. Law Rep. 676, 1986 Va. App. LEXIS 344 (1986).

    Employer not required to provide additional selection from original panel. —

    The employer was not required to provide claimant with an additional selection from the panel originally offered to her. Similarly, she was not required to accept the employer’s gratuitous offer to provide one. Richmond Mem. Hosp. v. Allen, 3 Va. App. 314, 349 S.E.2d 419, 3 Va. Law Rep. 1023, 1986 Va. App. LEXIS 366 (1986).

    Panel provided by employer defective. —

    Credible evidence supported the decision of the Virginia Workers’ Compensation Commission to award a workers’ compensation claimant medical benefits and temporary total disability benefits because the panel provided by the employer pursuant to § 65.2-603 was defective, and thus, claimant had the right to select the physician of his own choosing; because a neurologist and chiropractors were claimant’s treating physicians, the Commission was entitled to give their opinions great weight, and in the opinion of those physicians, claimant made progress over the course of the treatments, but he was unable to return to work until March 4, 2010, and then only for light-duty work. Gilbane v. Guzman, 59 Va. App. 128, 717 S.E.2d 433, 2011 Va. App. LEXIS 355 (2011).

    Although employer could have authorized employee’s treatment by a doctor referred to by the employer, the employer could not have required defendant to accept the treatment merely because it authorized it. Biafore v. Kitchin Equip. Co., 18 Va. App. 474, 445 S.E.2d 496, 10 Va. Law Rep. 1586, 1994 Va. App. LEXIS 387 (1994).

    Authority of Commission to order employer to pay for chiropractor. —

    In a workers’ compensation case in which an attorney, the insurer, and the Virginia Uninsured Employers’ Fund contested the fact that a chiropractor was an authorized treating physician, the parties stipulated that the employer refused to supply medical care for neck pain, and a doctor at a medical center declined to provide such treatment, the claimant was free to select his own treating physician for neck pain, and under subsection C of § 65.2-603 , the Workers’ Compensation Commission was authorized to order the employer to pay the reasonable cost of such service. Chester v. Redifer, 2009 Va. App. LEXIS 519 (Va. Ct. App. Nov. 24, 2009).

    Who may require employee to see another physician. —

    An employer can require an employee to select an attending physician from its panel of three, but only an attending physician or the Commission may require an employee to see another physician. Richmond Mem. Hosp. v. Allen, 3 Va. App. 314, 349 S.E.2d 419, 3 Va. Law Rep. 1023, 1986 Va. App. LEXIS 366 (1986).

    Under former § 65.1-88, now codified at § 65.2-603 , medical management of the workers’ compensation claimant is to be directed by the treating physician; a treating physician has the authority to refer the claimant to specialists and to determine whether medical attention was authorized, reasonable, and necessary. Fairfax County Sch. Bd. v. Manola, 2003 Va. App. LEXIS 27 (Va. Ct. App. Jan. 28, 2003).

    Virginia Workers’ Compensation Commission did not err in finding that a claimant failed to prove a basis for a second opinion from a pain management specialist at the employer’s expense because credible evidence supported the Commission’s factual finding that the claimant’s treating physician did not refer the claimant for a second opinion. Harvey v. Old Dominion Univ., 2015 Va. App. LEXIS 272 (Va. Ct. App. Sept. 22, 2015).

    Grounds for change in treating physician at employer’s request. —

    There are several grounds upon which the commission will order a change in an employee’s treating physician at the employer’s request: inadequate treatment is being rendered; it appears that treatment is needed by a specialist in a particular field and is not being provided; no progress being made in improvement of the employee’s health condition without any adequate explanation; conventional modalities of treatment are not being used; no plan of treatment of long-term disability cases and failure to cooperate with discovery proceedings ordered by the commission. Allen & Rocks, Inc. v. Briggs, 28 Va. App. 662, 508 S.E.2d 335, 1998 Va. App. LEXIS 661 (1998).

    Employer’s burden when seeking change of physician. —

    When an employer seeks to change a claimant’s treating physician because the claimant has made little progress and no treatment plan has been derived, the employer must identify the alternative care that would be substituted and must demonstrate that the suggested care would be more appropriate and productive. Allen & Rocks, Inc. v. Briggs, 28 Va. App. 662, 508 S.E.2d 335, 1998 Va. App. LEXIS 661 (1998).

    Insufficient grounds for change in treating physician. —

    Where none of the recognized reasons for ordering a change in treating physicians was found in the record, the employer’s grounds for requesting a change was that the treating physician had intervened as an advocate for the claimant in seeking to obtain compensation for his medical expenses and the employer only suggested another physician as a viable alternative, the commission did not abuse its discretion in refusing to order a change in treating physicians. Allen & Rocks, Inc. v. Briggs, 28 Va. App. 662, 508 S.E.2d 335, 1998 Va. App. LEXIS 661 (1998).

    Workers’ Compensation Commission’s finding that the claimant had failed to carry his burden of proof that a change in physician was necessary was supported by credible evidence because the claimant’s compensable foot injury had resolved completely through his treating physician’s care; the claimant could not prove that he was receiving inadequate treatment, or needed a different specialist, or that his treatment was not progressing. Wells v. Auto. Serv. Garage, 2018 Va. App. LEXIS 43 (Va. Ct. App. Feb. 20, 2018).

    Workers’ Compensation Commission did not err by determining that the claimant failed to show that circumstances warranted a change in her treating physician because the treating physician was a specialist in the field, his recommended physical therapy and prescribed medication regimens significantly improved the claimant’s recovery from the injury, after the improvement reached a plateau he continued to recommend injections that the claimant declined, and the claimant’s dislike of needles was not a circumstance that required the conclusion that she was entitled to change her treating physician. Yahner v. Fire-X Corp., 70 Va. App. 265, 826 S.E.2d 888, 2019 Va. App. LEXIS 101 (2019).

    Although the commission does have statutory authority to order a change in physicians, it must also give the claimant notice of such consideration for a change and a chance to be heard on the issue. Johnson v. Cracker Barrel Old Country Store, 1995 Va. App. LEXIS 894 (Va. Ct. App. Dec. 12, 1995).

    Neither employer nor insurer may limit referrals by treating physician. —

    A long-held principle of the Compensation Commission, founded on this section, is that medical management of the claimant is to be directed by the treating physician, not by an employer’s representative. Neither the employer nor its insurance carrier may limit the treating physician in the medical specialist, or treating facilities to which the claimant may be referred for treatment. Press v. Ale, 1 Va. App. 153, 336 S.E.2d 522, 1985 Va. App. LEXIS 77 (1985).

    When employer responsible for expense of referral. —

    So long as a causal relationship between the industrial accident and the complaints which are the subject of the referral is shown, the employer is financially responsible for the medical attention that the attending physician deems necessary, subject to review by the Commission. Press v. Ale, 1 Va. App. 153, 336 S.E.2d 522, 1985 Va. App. LEXIS 77 (1985); Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 336 S.E.2d 903, 1985 Va. App. LEXIS 84 (1985).

    Whether the employer is responsible for medical expenses pursuant to this section depends upon: (1) Whether the medical service was causally related to the industrial injury; (2) whether such other medical attention was necessary; and (3) whether the treating physician made a referral of the patient. The determination of proximate cause between an injury and the industrial accident is a factual finding conclusively binding on appeal if supported by credible evidence. Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 336 S.E.2d 903, 1985 Va. App. LEXIS 84 (1985).

    Unauthorized treatment not compensable where referral insisted upon by claimant. —

    An employer was not responsible for the cost of certain unauthorized medical treatment provided claimant incidental to a compensable injury because the treating physician made the referral at the claimant’s insistence rather than for medical necessity. Wytiaz v. Edison Bros. Stores, 1996 Va. App. LEXIS 223 (Va. Ct. App. Apr. 2, 1996).

    Knee surgery undertaken by claimant to remove tissue from the area surrounding her knee prosthesis was unauthorized and, therefore not the employer’s responsibility as the surgery was not a repair to the prosthesis, claimant provided no evidence that the treatment provided by the employer was inadequate, no emergency was shown, nor that it fell within the good faith exception, because claimant failed to request a physicians’ panel before scheduling and having the surgery performed. Locksmith v. Chippenham Hosp., 2004 Va. App. LEXIS 217 (Va. Ct. App. May 11, 2004).

    Referral from a former authorized treating physician, after subsequent physician assumed the position of authorized treating physician, did not constitute a referral from an authorized treating physician. Shenandoah Products, Inc. v. Whitlock, 15 Va. App. 207, 421 S.E.2d 483, 9 Va. Law Rep. 396, 1992 Va. App. LEXIS 253 (1992).

    Treatment a doctor provided was authorized within the proper chain of referral because the record supported the conclusion that the workers’ compensation benefits claimant’s treating physician referred the doctor; claimant testified the treating physician referred her to the doctor, she filled out a questionnaire naming the treating physician as the referring physician, and the doctor’s medical notes indicated the treating physician was the referring physician. Cont'l Telecom Corp. v. Streets-Nash, 2017 Va. App. LEXIS 122 (Va. Ct. App. May 2, 2017).

    Workers’ Compensation Commission properly found that a claimant’s primary doctor authorized each of the referrals to a neck and wrist specialists such that the employer was liable for the claimant’s medical expenses for these doctors’ treatments. Outreach Constr. & S. Ins. Co. v. Peterson, 2010 Va. App. LEXIS 10 (Va. Ct. App. Jan. 12, 2010).

    Virginia Workers’ Compensation Commission did not err in finding a county was responsible for a doctor’s treatment of an employee because the medical evidence supported the Commission’s finding that the doctor’s treatment of the employee was authorized based on the treating physician’s referral of the employee to the doctor for medical treatment that was causally related to the accident. County of Henrico v. Henry, 2012 Va. App. LEXIS 31 (Va. Ct. App. Feb. 7, 2012).

    Employer not liable for cost of treatment where physician changed without authority. —

    The employer was not responsible for the cost of treatment by the second physician where the claimant changed physicians without authority and without justification. Jackson v. Loveland Distrib. Co., 1 Va. App. 57, 334 S.E.2d 148, 1985 Va. App. LEXIS 60 (1985).

    Replacement of treating physician. —

    Commission’s rule mandating employer participation in the replacement of a claimant’s treating physician applies to situations in which the treating physician is no longer available and the claimant is left without any authorized medical care. In such instances, the rule requires an employer and claimant to “start from scratch” and to select a replacement treating physician in the same manner that a treating physician is initially selected under this section. This rule did not apply in the instant case because claimant had two authorized treating physicians. Thus, upon the one doctor’s retirement, the other physician was still available to direct claimant’s medical treatment. Dominion Coal Corp. v. Horne, 1997 Va. App. LEXIS 264 (Va. Ct. App. Apr. 22, 1997).

    Because an employer’s claims adjuster agreed in advance to accept a change of physician if the employee or his mother became dissatisfied with the treating physician’s care, and because the adjuster placed no time limitation on the open-ended offer, the commission did not err in requiring the employer to stand by the agreement. Food Lion, LLC v. Wright, 53 Va. App. 23, 668 S.E.2d 814, 2008 Va. App. LEXIS 522 (2008).

    Because an 85.62-mile commute to a doctor’s office was detrimental to a workers’ compensation claimant’s condition and treatment, and because nothing indicated that the treating physician provided any specialized treatment or treated a complicated condition, an order requiring the claimant to find a treating physician closer to the claimant’s home was not an abuse of discretion. Allen v. Wright's Buick, Inc., 2009 Va. App. LEXIS 110 (Va. Ct. App. Mar. 17, 2009).

    Workers’ compensation claimant had a reasonable justification for changing to another doctor because she had no other option if she wanted to receive medical treatment when the unrebutted evidence proved that claimant’s employer was not paying her first doctor so he refused to continue treating claimant; a claimant should be allowed to see a different doctor where her original treating physician refuses to treat her, her employer will not pay her medical bills, and employer does not have workers’ compensation insurance. Uninsured Employer's Fund v. Wiredu, 2009 Va. App. LEXIS 393 (Va. Ct. App. Sept. 8, 2009).

    Where a workers’ compensation claimant testified that the claimant spoke with a supervisor before seeking medical treatment from two new physicians, an award authorizing payment of medical expenses was justified pursuant to § 65.2-603 because the commissioner implicitly found the claimant’s testimony credible and determined that the claimant acted in good faith in seeking treatment from the new physicians. Va. Elec. & Power Co. v. Earley, 2010 Va. App. LEXIS 110 (Va. Ct. App. Mar. 23, 2010).

    Virginia Workers’ Compensation Commission did not err when it authorized, under § 65.2-603 , a new physician to treat a claimant’s continuing pain related to a compensable posterior tibial tendon injury, given that the employer had denied coverage for any further treatment under the claimant’s previous treating physician. Hayes v. Perrel Mgmt. Co., 2011 Va. App. LEXIS 83 (Va. Ct. App. Mar. 8, 2011).

    Workers’ Compensation Commission properly authorized an injured employee to change her treating physician because, while there was a difference of opinion among the doctors, the employee’s evidence that she continued to suffer pain was credible and there was credible evidence to support the Commission’s findings that inadequate treatment was being rendered, treatment was needed by a specialist in a particular field and was not being provided, and there was an unexplained lack of progress in the improvement of the employee’s condition. Miller Oil Co. v. Freeman, 2016 Va. App. LEXIS 215 (Va. Ct. App. Aug. 2, 2016).

    Where claimant testified that her employer authorized a change of physicians and neither the employer nor the insurance carrier called witnesses to refute this testimony, which stood uncontradicted on the record, the Commission’s finding that such change was unauthorized by the employer was unsupported by the evidence. Breckenridge v. Marval Poultry Co., 228 Va. 191 , 319 S.E.2d 769, 1984 Va. LEXIS 188 (1984).

    Where claimant made an independent decision to seek a second medical opinion, and did so without authorization from the employer or the Commission and without a referral from his treating physician, the employer had no duty to pay for this treatment under this section. McDaniel v. Triple B. Mechanical Contractors, No. 0319-85 (Ct. of Appeals Jan. 8, 1986).

    In cases of conflicting medical evidence, the general rule is that when an attending physician is positive in his diagnosis, great weight will be given by the courts to his opinion. Bill Branch Coal Corp. v. Cantrell, 1993 Va. App. LEXIS 611 (Va. Ct. App. Dec. 21, 1993).

    Opinion on non-attending physician may be adopted. —

    Although the opinion of the treating physician is entitled to great weight, the commission is not required to accept the treating physician’s opinion over the opinions of others. Where the treating physician’s diagnosis is shaded by doubt and there is expert medical opinion contrary to the treating physician’s opinion, the trier of the fact is left free to adopt that view which is most consistent with reason and justice. Baum v. Sports Auth., 1993 Va. App. LEXIS 636 (Va. Ct. App. Dec. 14, 1993).

    Designation of physician to whom claimant referred as treating physician. —

    Whether a physician to whom the claimant was referred by the previously designated treating physician should have been designated as the claimant’s treating physician was a matter within the discretion of the Commission. Daniel Constr. Co. v. Baker, 229 Va. 453 , 331 S.E.2d 396, 1985 Va. LEXIS 222 (1985).

    Commission’s action in requiring employer to designate a panel of three psychiatrists, one of whom the claimant would select to decide whether he was suffering from a psychological disability caused by his industrial accident was error, where the claimant utterly failed to establish even a prima facie case of psychological disability or causal relationship. The burden was upon the claimant to satisfy the Commission by a preponderance of the evidence both that he suffered from a psychological disability and that the disability was causally related to his industrial accident. Daniel Constr. Co. v. Baker, 229 Va. 453 , 331 S.E.2d 396, 1985 Va. LEXIS 222 (1985).

    Referral from treating physician after retirement. —

    Where a worker’s authorized treating physician referred the worker to another doctor when he retired, the employer was liable for all medical treatment provided by the second doctor, even though his name was not on the employer’s panel of treating physicians. Clinchfield Coal Co. v. Souleyrette, 2004 Va. App. LEXIS 250 (Va. Ct. App. June 1, 2004).

    When panel of physicians must be offered to employee. —

    There is no requirement in this section concerning the time after an accident within which an employer must offer an employee the panel of physicians prescribed by this section; therefore, the appropriate time must be determined by resort to a rule of reasonableness, with the time varying from case to case depending upon the different circumstances involved. Peninsula Transp. Dist. Comm'n v. Gibbs, 228 Va. 614 , 324 S.E.2d 662, 1985 Va. LEXIS 155 (1985).

    III.Other Necessary Medical Attention.

    This section does not require employer to pay for medical expenses incurred without permission of insurer absent emergency or other good cause. Rucker v. Thrift Transf., Inc., 1 Va. App. 417, 339 S.E.2d 561, 1986 Va. App. LEXIS 217 (1986).

    Factors to consider in determining whether employer is responsible for unauthorized medical treatment expense. —

    An employer’s responsibility for medical expenses related to unauthorized medical treatment depends upon whether the medical service was causally related to the industrial injury, whether such other medical attention was necessary, and whether the treating physician made a referral to the patient. Locksmith v. Chippenham Hosp., 2004 Va. App. LEXIS 217 (Va. Ct. App. May 11, 2004).

    Responsibility of claimant to prove “other necessary medical attention.” —

    Where claimant sought compensation for hospitalization and surgery for the removal of fatty tissue from her upper body more than two years after suffering a sprained back in the course of her employment, it was the claimant’s responsibility to prove that, considering her industrial injury, her claim qualified as “other necessary medical attention” under the meaning of this section. Daniels v. Insurance Management Corporation of Tidewater, 222 Va. 434 , 281 S.E.2d 847, 1981 Va. LEXIS 326 (1981).

    An employee has the burden of proving that “other necessary medical care,” including emergency medical care by other than an authorized physician, should be paid by the employer. McGregor v. Crystal Food Corp., 1 Va. App. 507, 339 S.E.2d 917, 1986 Va. App. LEXIS 232 (1986).

    Although claimant’s friend assisted him with ambulating, bathing, dressing, feeding and transportation, as well as general lifting and carrying, there was no evidence that she performed “medical attention” under direction and control of a physician, and thus commission did not err in ruling that these services were not compensable. Anselmo v. Cherrydale Motors, 1999 Va. App. LEXIS 260 (Va. Ct. App. May 4, 1999).

    Higher level of care covered where lower level not available. —

    Although the parties stipulated that the claimant did not require an acute inpatient level of care after a certain date and that, from a medical standpoint, he could thereafter have been treated at a lower level of medical service, this did not render the provision of acute inpatient care unnecessary in light of the testimony of a discharge planner for the acute care facility regarding the difficulties she encountered in her efforts to obtain funding and an appropriate placement for the claimant at a lower level of care and the lack of evidence of any reasonable alternative to continuing to provide acute care. The fact that the claimant could have, from a medical standpoint, been treated at a lower level of medical service after the specified date did not compel the conclusion that his treatment at the acute care facility was not “necessary medical treatment” under this section. Uninsured Employer's Fund v. Childress, 2000 Va. App. LEXIS 742 (Va. Ct. App. Nov. 21, 2000).

    Surgery necessary to treat symptoms of compensable injury. —

    Commission properly found that contested cervical disc surgery was necessary in order to successfully treat symptoms causally related to claimant’s compensable shoulder injury. Quality Inn Executive v. Umana, 1999 Va. App. LEXIS 344 (Va. Ct. App. June 15, 1999).

    Phrase “such medical service” refers only to the single physician if chosen by another appropriate method, and other necessary medical attention which an employer is required to provide its employees. Richmond Mem. Hosp. v. Allen, 3 Va. App. 314, 349 S.E.2d 419, 3 Va. Law Rep. 1023, 1986 Va. App. LEXIS 366 (1986).

    When employer must pay for care by spouse. —

    The employer must pay for care when it is performed by a spouse, if: (1) the employer knows of the employee’s need for medical attention at home as a result of the industrial accident; (2) the medical attention is performed under the direction and control of a physician, that is, a physician must state home nursing care is necessary as the result of the accident and must describe with a reasonable degree of particularity the nature and extent of duties to be performed by the spouse; (3) the care rendered by the spouse must be of the type usually rendered only by trained attendants and beyond the scope of normal household duties; and (4) there is a means to determine with proper certainty the reasonable value of the services performed by the spouse. Chandler v. Warren Trucking Co., 221 Va. 1108 , 277 S.E.2d 488, 1981 Va. LEXIS 255 (1981).

    A spouse may receive reimbursement for necessary medical attention only if there is a means to determine with proper certainty the reasonable value of the services performed by the spouse. Judge v. R & T Constr. Co., 1995 Va. App. LEXIS 402 (Va. Ct. App. May 2, 1995).

    Although the Workers’ Compensation Commission found that a home health attendant was necessary medical attention, it erred when it awarded compensation under the statute for care provided by an employee’s spouse because it did not first determining that the employee had met all four requirements established by the supreme court; to determine if care rendered by the spouse was necessary medical attention, the Commission had to analyze the four requirements. Cumberland Hosp. & Ace Am. Ins. Co. v. Ross, 70 Va. App. 761, 833 S.E.2d 479, 2019 Va. App. LEXIS 231 (2019).

    Insufficient description of aide’s duties. —

    Where claimant testified in general terms that the aide’s duties were to assist him in bathing, going to the bathroom, cooking, cleaning, taking his medication, and occasionally changing his bandages, there was nothing in the medical record to support the necessity of these services, and doctor — who made after-the-fact determination of necessity — did not describe or set forth in any medical record with particularity the nature and extent of duties to be performed by the aide, the commission did not err in finding that claimant’s evidence failed to prove that a physician described with particularity the nature and extent of the duties to be performed by the aide. Pollack v. Lake Taylor Hosp., 1995 Va. App. LEXIS 377 (Va. Ct. App. Apr. 18, 1995).

    Nursing care at home given a disabled employee by the spouse is allowable under this section, provided the care is “medical attention” and provided it is “necessary.” Chandler v. Warren Trucking Co., 221 Va. 1108 , 277 S.E.2d 488, 1981 Va. LEXIS 255 (1981).

    Wife as 24-hour caregiver. —

    Claimant’s wife was entitled to 24-hour caregiver costs at the rate of $1,512 per week where the parties had already agreed to permit the claimant to have anyone he chose as his caregiver and the wife left her job as a systems analyst and took medical training to become a certified nursing assistant. Va. Polytechnic Inst. v. Posada, 47 Va. App. 150, 622 S.E.2d 762, 2005 Va. App. LEXIS 508 (2005).

    For case holding that structural alternations were not covered under this section, prior to the 1983 amendment, see Low Splint Coal Co. v. Bolling, 224 Va. 400 , 297 S.E.2d 665, 1982 Va. LEXIS 309 (1982).

    Medically necessary home exercise equipment. —

    This section does not limit appliances prescribed by treating physicians to those that constitute structural modifications of a claimant’s home and may include medically necessary exercise equipment; because credible evidence in the record showed that the home exercise station was “medically necessary” for treatment of claimant’s work-related injury, reimbursement by employer was properly required. ARA Servs. v. Swift, 22 Va. App. 202, 468 S.E.2d 682, 1996 Va. App. LEXIS 219 (1996).

    Running blade prosthetic device not medically necessary. —

    In a case in which the claimant was injured in a work-related accident, which resulted in a below-the-knee amputation of his left foot, and in which he was awarded lifetime medical benefits and temporary partial disability benefits, and given a prosthesis to replace his left foot, the Workers’ Compensation Commission did not err in finding that the running blade prosthetic device the claimant requested was not medically necessary because, although it might improve his quality of life, neither his treating physician nor his prosthetist said a running blade was medically necessary; thus, because the claimant did not prove the running blade he requested was medically necessary, his employer was not financially obligated to provide the blade. Pacheco v. J.P. Masonry, Inc., 2017 Va. App. LEXIS 294 (Va. Ct. App. Nov. 28, 2017).

    The employer was responsible, etc.

    for the care provided by a physician who specialized in back injuries where the Workers’ Compensation Commission ordered the claimant to see a physician who, in turn, referred the claimant to the specialist as a more suitable physician. Childress, Jr. v. Appalachian Power Co., 1998 Va. App. LEXIS 673 (Va. Ct. App. Dec. 22, 1998).

    Commission’s finding that employer was responsible for medical treatment rendered to employee would be affirmed, where the employee’s referral to doctor was causally related to employee’s compensable injury, because the employee was referred by his treating physician, and the referral was designed to determine whether the employee’s memory loss and work-related back surgery were related. Charter Integrated Servs. & Home Indem. Co. v. Skoff, 2002 Va. App. LEXIS 258 (Va. Ct. App. Apr. 30, 2002).

    Virginia Workers’ Compensation Commission’s award of pain medication and shoulder arthroscopy under subdivision A 1 of § 65.2-603 to a workers’ compensation claimant was proper as the Commission’s finding that the claimant’s right shoulder injury was caused by the claimants’ workers’ compensation injury was supported by the office notes of the claimant’s treating physicians; a treating physician recommended the right shoulder arthroscopy, and an employer was responsible for its cost. Herbert Clements & Sons, Inc. v. Harris, 52 Va. App. 447, 663 S.E.2d 564, 2008 Va. App. LEXIS 362 (2008).

    Appellants remained responsible for medical treatment for the employee’s injuries so long as she could establish that the treatment was necessary and related to the work injury. Target Corp. v. Hussein, 2014 Va. App. LEXIS 279 (Va. Ct. App. Aug. 12, 2014).

    Virginia Workers’ Compensation Commission did not err in finding that a claimant’s arthritis medications were prescribed for injuries causally related to an accident and awarding the claim for continuing prescription medication benefits where it weighed the opinion of seven different doctors and was not convinced by the employer’s evidence. Pittsylvania Cty. Bd. of Supervisors v. Hall, 2018 Va. App. LEXIS 161 (Va. Ct. App. June 12, 2018).

    Virginia Workers’ Compensation Commission did not err in ordering an employer to pay for a claimant’s medical treatment because the record supported its finding that the employer was responsible for paying for prescription medications and care a doctor provided to the claimant; the doctor’s evidence established that the physical therapy and massage treatment he provided to the claimant to manage his pain was reasonable, necessary, and causally related to his work injury. Can. Dry Potomac Corp. v. Anderson, 2018 Va. App. LEXIS 264 (Va. Ct. App. Oct. 9, 2018).

    Medical treatment by other than authorized medical providers. —

    While the commission is not required to have the employer pay the expense for other than authorized medical care, this section empowers the commission under certain circumstances to require the employer to pay for medical treatment by other than authorized medical providers. Master Roofing & Siding, Inc. v. Edge, No. 0750-89-4 (Ct. of Appeals May 22, 1990).

    Recovery authorized “for other good reasons.” Shenandoah Products, Inc. v. Whitlock, 15 Va. App. 207, 421 S.E.2d 483, 9 Va. Law Rep. 396, 1992 Va. App. LEXIS 253 (1992).

    To require an employer to pay for the cost of an unauthorized physician’s treatment under the “other good reasons” exception, it must be shown that the employee obtained unauthorized medical treatment in good faith, the treatment provided by the employer was inadequate treatment for the employee’s condition, and the unauthorized treatment was medically reasonable. Johnson v. City of Hampton Gen. Servs., 1995 Va. App. LEXIS 205 (Va. Ct. App. Feb. 28, 1995).

    If a claimant in good faith obtains medical treatment different from that provided by the employer, 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 “other good reasons” exception is applicable, and the employer should be responsible. Wellmore Coal Corp. v. Williamson, 1998 Va. App. LEXIS 10 (Va. Ct. App. Jan. 13, 1998).

    Payment of unauthorized medical care expense. —

    In evaluating whether unauthorized medical care expense should be paid by an employer, the Commission must carefully evaluate whether the health care provider who is justifying his services has provided credible justification for the course of treatment. Shenandoah Products, Inc. v. Whitlock, 15 Va. App. 207, 421 S.E.2d 483, 9 Va. Law Rep. 396, 1992 Va. App. LEXIS 253 (1992).

    Employer was liable to pay for the surgery and treatment of the employee’s work-related injuries performed by an unauthorized treating physician as the employee sought medical treatment from that physician in good faith because the treatment rendered by the approved physician was inadequate to treat the employee’s condition as the medications he prescribed gave little or no relief, he stated twice that the employee’s pain was a mystery to him, and, even after multiple diagnostic tests, he could not find an answer; and the unauthorized treatment was reasonable and necessary as no other treatment options were effective in reducing the employee’s pain, and a third doctor confirmed that no other options were available aside from surgery. City of Norfolk v. Gray, 2017 Va. App. LEXIS 36 (Va. Ct. App. Feb. 14, 2017).

    Workers’ Compensation Commission did not err by determining that the claimant failed to show that she was justified in seeking unauthorized medical treatment because the difference in medical opinion as to whether the claimant should utilize injections or a different type of physical therapy did not render the treating physician’s care inadequate. Yahner v. Fire-X Corp., 70 Va. App. 265, 826 S.E.2d 888, 2019 Va. App. LEXIS 101 (2019).

    Fact that unauthorized medical treatment is an acceptable method of treating condition does not mean that the treatment should be paid for by the employer. Only where the course of treatment provided by the employer is inadequate for the condition should the employer have to pay for a different course of treatment. Shenandoah Products, Inc. v. Whitlock, 15 Va. App. 207, 421 S.E.2d 483, 9 Va. Law Rep. 396, 1992 Va. App. LEXIS 253 (1992).

    Employer responsible for expense despite lack of prior approval. —

    If 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. Shenandoah Products, Inc. v. Whitlock, 15 Va. App. 207, 421 S.E.2d 483, 9 Va. Law Rep. 396, 1992 Va. App. LEXIS 253 (1992).

    Therapeutic whirlpool tub. —

    An employee’s pain doctor’s records and opinions, coupled with the employee’s testimony, constitute credible evidence to support the Commission’s findings that the doctor prescribed a home therapeutic whirlpool tub and that it constituted reasonable and necessary medical treatment of the employee’s work-related injury. Reynolds Metals Co. v. Chowning, 2000 Va. App. LEXIS 614 (Va. Ct. App. Aug. 22, 2000).

    Home spa pool. —

    Employer was not responsible, pursuant to subdivision A 1 of § 65.2-603 , for paying for a home spa pool that was purchased by a claimant because the record was devoid of any evidence to support the claimant’s purchase of a six-person home spa pool as medically necessary, even though the claimant’s doctor wrote a letter indicating that the claimant, who sustained a compensable injury to the claimant’s left shoulder that led to ongoing swelling, stiffness, and soreness in the claimant’s back, would benefit from a spa pool. Portsmouth (City of) Sch. Bd. v. Harris, 58 Va. App. 556, 712 S.E.2d 23, 2011 Va. App. LEXIS 240 (2011).

    Pool therapy. —

    Virginia Workers’ Compensation Commission did not err in requiring an employer and its insurer to pay for a workers’ compensation claimant’s YMCA membership and mileage for his unsupervised physician-directed independent pool therapy following a compensable workplace injury because claimant met his burden of proving that the therapy was necessary medical attention under § 65.2-603 ; both of claimant’s treating physicians indicated that his independent pool therapy was part of a continuing course of treatment, which began with his compensable work-related injury, and claimant demonstrated that his pool therapy was recommended by an authorized treating physician. Am. Armoured Found., Inc. v. Lettery, 2012 Va. App. LEXIS 138 (Va. Ct. App. May 1, 2012).

    Expenses of treatment at pain clinic. —

    Whether the employer is responsible pursuant to this section for past and future expenses of physicians and specialists at a pain clinic depends upon: (1) Whether the treating physician made a medical referral of the patient; and (2) whether such other medical attention was necessary. Press v. Ale, 1 Va. App. 153, 336 S.E.2d 522, 1985 Va. App. LEXIS 77 (1985).

    Home health care. —

    Workers’ Compensation Commission did not err in denying a claimant’s request for compensation covering home health care for twenty-four hours a day, seven days a week because the record supported its conclusion that his treating physician’s recommendation, on which he relied, did not establish that home health care twenty-four hours a day, seven days a week, was necessary medical attention. Dawson v. Cty. of Henrico, 2019 Va. App. LEXIS 232 (Va. Ct. App. Oct. 22, 2019).

    Employee was properly awarded medical benefits pursuant to this statute, including around-the-clock home health care to be provided by her husband, as her employer provided inadequate treatment to the employee because the physician-assistant’s letter stated that the employee’s experience with the home health agency was detrimental to her health and recovery in that it increased her anxiety and depression. Cumberland Hosp. v. Ross, 2020 Va. App. LEXIS 300 (Va. Ct. App. Dec. 8, 2020).

    Care administered by the employee’s husband was compensable as “other necessary medical attention” because the employee’s post-traumatic brain injury symptoms grew worse under the home health agency’s care; being serviced by a home health care aide who was not her spouse risked adverse effects on the employee’s health; the husband was a registered nurse with experience treating patients suffering from mental and physical disorders similar to those of his wife; and, given the extent of the employee’s disabilities, the type of care he administered to the employee could not fairly be characterized as merely normal household duties. Cumberland Hosp. v. Ross, 2020 Va. App. LEXIS 300 (Va. Ct. App. Dec. 8, 2020).

    Expense of home care by nursing service. —

    Although having a nursing service change claimant’s dressing at home may not have been necessary, changing the dressing itself was medically necessary, thereby requiring payment by the employer. Lynchburg Foundry Co. v. Goad, 15 Va. App. 710, 427 S.E.2d 215, 9 Va. Law Rep. 875, 1993 Va. App. LEXIS 31 (1993).

    Home health aide. —

    Worker’s doctor clearly indicated that the worker’s injuries necessitated the need for a home health aide, and the requested services, which had previously been provided by the worker’s wife and daughter and included medical attention to prevent bed sores and administration of medications, sometimes through the worker’s PICC line, were beyond the scope of normal household duties; there was credible evidence to support the finding that the worker’s request for a home health aide fell within the scope of necessary medical attention. Howard Bros. v. Howard, 2014 Va. App. LEXIS 99 (Va. Ct. App. Mar. 18, 2014).

    Counseling services held not covered. —

    Employer was not required to pay for services rendered by a professional counselor, who counseled the claimant after she was robbed while working as a clerk, since such counseling was not provided by a physician or under the supervision of, or in conjunction with treatment rendered by, a physician. Markwell v. American Convenience, Inc., 1998 Va. App. LEXIS 246 (Va. Ct. App. Apr. 28, 1998).

    Professional counselor’s report held not “medical report.” —

    Absent some showing that a licensed professional counselor was competent to give opinions with regard to disability, the Commission did not err in finding that the counselor’s testimony and records did not constitute a “medical report” for purposes of this section. Markwell v. American Convenience, Inc., 1998 Va. App. LEXIS 246 (Va. Ct. App. Apr. 28, 1998).

    Consultation with family physician. —

    It may not be unreasonable for a person to want to discuss his treatment with a trusted family physician, but nothing in the Act makes an employer liable for such advice after the employer provides a treating physician. Rucker v. Thrift Transf., Inc., 1 Va. App. 417, 339 S.E.2d 561, 1986 Va. App. LEXIS 217 (1986).

    Transportation to medical treatment. —

    Worker could not drive himself to his medical treatment, and a doctor indicated that the worker, who was wheelchair dependent, required assistance with transportation to treatment, and thus there was credible evidence to support the requirement that the employer provide for payment of transportation in this regard. Howard Bros. v. Howard, 2014 Va. App. LEXIS 99 (Va. Ct. App. Mar. 18, 2014).

    Section applies to hernia cases. —

    The limitation provided in this section is applicable in hernia cases. Maryland Cas. Co. v. Robinson, 149 Va. 307 , 141 S.E. 225 , 1928 Va. LEXIS 367 (1928); Commonwealth v. Granger, 188 Va. 502 , 50 S.E.2d 390, 1948 Va. LEXIS 184 (1948).

    Former § 65.1-85 (now § 65.2-600 ) and this section relate to accidental injuries for which an employee is entitled to compensation, and injuries resulting in hernia are not excepted therefrom. Commonwealth v. Granger, 188 Va. 502 , 50 S.E.2d 390, 1948 Va. LEXIS 184 (1948).

    Surgical attention in hernia cases. —

    See Maryland Cas. Co. v. Robinson, 149 Va. 307 , 141 S.E. 225 , 1928 Va. LEXIS 367 (1928).

    Surgery found reasonable and necessary. —

    Treating physician’s initial attempts to avoid surgical intervention, and his ultimate conclusion that claimant’s back and neck pain could improve with surgery, supported conclusion that claimant’s lumbar and cervical fusions were reasonable and necessary. City of Martinsville Water & Sewer v. Turner, 1999 Va. App. LEXIS 458 (Va. Ct. App. July 27, 1999).

    Additional injury received while seeking medical attention for work-connected injury. —

    When the employer directs or authorizes the employee to seek medical attention for a work-connected injury and the employee follows such direction or authorization, they are but fulfilling the reciprocal obligations of the Act and their contract. To say that an additional injury, suffered by an employee while fulfilling such an obligation, is not also work-connected has little support in modern legal authority and even less in logic. Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254, 1967 Va. LEXIS 128 (1967) (citing Glassco v. Glassco, 195 Va. 239 , 77 S.E.2d 843 (1953) and commented on in 53 Va. L. Rev. 1763 (1967)).

    Commission did not abuse discretion in ordering employer to pay medical expense. —

    Failure of the employer to have treating doctor examine employee’s back after employer became aware of employee’s complaints and after company knew he was seeking independent medical attention justified the commission’s ordering that the employer pay for the medical expense; the commission did not abuse its discretion in ordering the payment based upon a finding of good cause. Master Roofing & Siding, Inc. v. Edge, No. 0750-89-4 (Ct. of Appeals May 22, 1990).

    “Other good reason” for seeking unauthorized treatment found. —

    Where in early 1988, treating physician permitted claimant to return to light-duty work and by rating his permanent injury declared that claimant had reached his maximum improvement, and in his June 8, 1992 letter, treating physician admitted that a related condition existed but had not been discovered at the time of his treatment, and where unauthorized physician diagnosed the cause of claimant’s continued complaints which had been left untreated in an April 22, 1992 report, doctor’s opinions sufficiently supported the commission’s finding of “other good reasons” to seek medical treatment that had not been specifically authorized. Weston Truck Lines v. Pepper, 1993 Va. App. LEXIS 627 (Va. Ct. App. Dec. 21, 1993).

    Claimant’s testimony and the medical records provided ample credible evidence to support the commission’s factual findings of good reason for seeking unauthorized medical care. Where despite claimant’s continuing cervical pain, none of her authorized physicians determined the cause of her condition or offered her the option of undergoing imaging studies. Lynchburg City Schs. v. Dalton, 1996 Va. App. LEXIS 279 (Va. Ct. App. Apr. 23, 1996).

    Claimant’s uncontradicted testimony that she was subjected to an unnecessarily painful examination and treatment on March 29, 1996 by Dr. A, which worsened her condition, supported the commission’s finding that claimant was justified in seeking alternative treatment from Dr. B. Dr. B’s treatment proved productive and provided claimant with pain relief. Furthermore, claimant’s failure to attend the May 3, 1996 appointment with Dr. A was of no moment. As the commission correctly noted, the treating physician, not the employer or its representative, directs the medical management of the employee. Given the circumstances in this case, the commission did not err in holding that claimant did not refuse medical treatment without justification. Williamsburg Soap & Candle Co. v. Eames, 1997 Va. App. LEXIS 533 (Va. Ct. App. Aug. 5, 1997).

    “Other good reason” exception inapplicable. —

    Claimant’s unauthorized medical treatment was not compensable by the employer because the other good reasons exception was not applicable in that the record did not support that the treatment provided to the claimant by the employer was inadequate, as the claimant did not follow the authorized medical provider’s recommended course of treatment, or that the unauthorized treatment received by the claimant was medically reasonable and necessary, as the claimant’s pain and other symptoms did not permanently resolve after the unauthorized treatment. Phillips v. Loudoun Cty., 2017 Va. App. LEXIS 200 (Va. Ct. App. Aug. 8, 2017).

    Employer was not estopped from denying payment of medical treatment rendered by doctor after June 1988. No evidence was presented that employer represented to employee that it would pay for doctor’s treatments. The fact that employer requested doctor’s independent opinion six months after treating physician released employee to sedentary work did not constitute a representation by employer that it would authorize doctor to treat employee. Furthermore, no evidence was presented that employer knowingly acquiesced in doctors’ treatment of employee after the June 1988, examination. Georgia Pac. Corp. v. Dancy, 17 Va. App. 128, 435 S.E.2d 898, 1993 Va. App. LEXIS 460 (1993).

    Immunoglobulin shots and testing for Hepatitis B and HIV constituted reasonable and necessary medical treatment for which the employer is responsible where the employee, an advance life support responder pricked his finger with a needle performing a blood sugar test on a patient. County of Fauquier Emergency Servs. v. Clayton, 1993 Va. App. LEXIS 585 (Va. Ct. App. Nov. 23, 1993).

    Treatment of idiopathic thrombocytopenia (ITP) was medically necessary adjunct. —

    Credible medical evidence established that claimant’s idiopathic thrombocytopenia (ITP) was diagnosed during medically necessary treatment of his compensable back injury. To continue treatment of claimant’s back with further surgeries in July and September, 1994, claimant’s physicians required limited treatment of the ITP to normalize his platelet count. Thus, treatment of the ITP was a medically necessary adjunct to the successful completion of that care required by claimant’s work-related back injury. Papco Oil Co. v. Farr, 26 Va. App. 66, 492 S.E.2d 858, 1997 Va. App. LEXIS 700 (1997).

    Because the deep venous thrombophlebitis (DVT) and pulmonary emboli followed as natural consequences of the compensable back injury, the commission did not err in holding employer responsible for medical expenses related to treatment of those problems. Even if claimant’s prednisone therapy also contributed to cause his DVT and pulmonary embolism, employer was still responsible for the cost of medical treatment related to those conditions. Papco Oil Co. v. Farr, 26 Va. App. 66, 492 S.E.2d 858, 1997 Va. App. LEXIS 700 (1997).

    Aggravation of pre-existing condition of knee. —

    Evidence supported workers’ compensation benefits award where doctors were clear that employee’s later injury aggravated a pre-existing compensable condition, pigmented villonodular synovitis, necessitating a total left knee replacement. UPS of Am. v. Wheeler, 2002 Va. App. LEXIS 309 (Va. Ct. App. May 14, 2002).

    Employer responsible for cost of coumadin therapy. —

    The medical records established that doctor prescribed the coumadin therapy to prevent pulmonary emboli, which could have been caused by claimant’s left lower extremity deep venous thrombophlebitis (DVT). Because the DVT flowed as a natural consequence of the compensable back injury, employer was responsible for any necessary medical treatment related to the DVT. Accordingly, the commission did not err in holding employer responsible for the cost of the coumadin therapy. Papco Oil Co. v. Farr, 26 Va. App. 66, 492 S.E.2d 858, 1997 Va. App. LEXIS 700 (1997).

    Release. —

    Whether a treating physician has released or abandoned his patient generally is determined by the express intent of the physician. In some cases, the total circumstances must be analyzed in order to determine whether discharge, release, or abandonment of a patient was intended. This is a factual determination which must be proved by clear and convincing evidence. Locklear v. Equifax Servs., 1995 Va. App. LEXIS 179 (Va. Ct. App. Feb. 21, 1995).

    When a treating physician determines that a workers’ compensation claimant’s medical attention is no longer “necessary and reasonable,” an employer is no longer required to cover claimant’s medical expenses. Fairfax County Sch. Bd. v. Manola, 2003 Va. App. LEXIS 27 (Va. Ct. App. Jan. 28, 2003).

    Sufficient evidence supporting non-payment for home exercise equipment. —

    While doctor stated that he had no objection to claimant having home exercise equipment and that he would defer to the reasonable recommendation of the physical therapist, and when the therapist recommended some equipment, doctor stated that it would be reasonable and beneficial, doctor never stated that the equipment was medically necessary to supplement claimant’s physical therapy program. Thus, credible evidence supported the commission’s finding that employer was not responsible to provide such equipment. Sterling v. Tyson's Westpark Hotel, 1995 Va. App. LEXIS 372 (Va. Ct. App. Apr. 18, 1995).

    Panel eligibility. —

    A chiropractor is not a physician for purposes of designation to a panel of physicians pursuant to this section. Gray v. Graves Mt. Lodge, Inc., 26 Va. App. 350, 494 S.E.2d 866, 1998 Va. App. LEXIS 29 (1998).

    IV.Emergency Treatment.

    An emergency exists where an employee reasonably believes under the circumstances that a physical condition requires emergency treatment. Henrico County Sch. Bd. & Consol. Risk Mgt. Servs., Inc. v. Englehart, No. 1641-91-2 (Ct. of Appeals May 26, 1992) (decided under former § 65.1-88(c)).

    Compensability of emergency treatment. —

    Emergency treatment is compensable if the claimant’s subjective symptoms were related to the accidental injury. Even if the claimant’s emergency situation was a product of his anxiety, it is still compensable if his anxiety was created by the injury. Payne v. Master Roofing & Siding, Inc., 1 Va. App. 413, 339 S.E.2d 559, 1986 Va. App. LEXIS 216 (1986).

    A claimant has the burden of proving that an actual emergency exists. This burden is implicit from reading this section and has been the Commission’s longstanding interpretation. Payne v. Master Roofing & Siding, Inc., 1 Va. App. 413, 339 S.E.2d 559, 1986 Va. App. LEXIS 216 (1986).

    Reimbursement required. —

    Although the claimant received treatment from an unauthorized physician and the employer would ordinarily not be required to reimburse the claimant under that circumstance, the employer was required to reimburse the claimant since the claimant’s severe pain and inability to receive treatment from her treating physician because he was unavailable involved an emergency, and, thus, meant a recognized, narrow exception existed to the general rule that the employer was not required to pay for unauthorized treatment. Loudoun County Sch. Bd. v. Kostecka, 2003 Va. App. LEXIS 348 (Va. Ct. App. June 17, 2003).

    Since claimant’s severe pain was found to have been related to a slip-and-fall injury from a few years earlier, the orthopedic surgeon determined that a new test gave better insight into what was causing the pain, and the surgery the orthopedic surgeon performed was necessary to relieve the severe pain, the claimant was entitled to reimbursement for the services provided by the orthopedic surgeon, as a narrow exception applied to the general rule that an employer was not required to reimburse unauthorized treatment, such as that provided by the orthopedic surgeon, since the claimant sought treatment as the result of an emergency created by the fact that she was in severe pain and her regular treating physician was unavailable to see her. Loudoun County Sch. Bd. v. Kostecka, 2003 Va. App. LEXIS 348 (Va. Ct. App. June 17, 2003).

    Claimant, following receipt of emergency treatment from orthopedic surgeon, who was not authorized by the employer to treat the claimant, was authorized to receive continued treatment from him based on the “other good reasons” exception of subsection C of § 65.2-603 , as credible evidence in the record showed that the claimant acted in good faith in seeing the unauthorized healthcare provider, that the claimant’s previous treatment with other healthcare providers was inadequate, and that the orthopedic surgeon’s treatment was medically reasonable and necessary, as the orthopedic surgeon’s treatment was the only treatment that relieved her from persistent pain; thus, the employer was responsible for reimbursing her for the treatment services the orthopedic surgeon provided. Loudoun County Sch. Bd. v. Kostecka, 2003 Va. App. LEXIS 348 (Va. Ct. App. June 17, 2003).

    It was reasonable for claimant to go to emergency room where he fell from a roof on April 1, 1984, and was treated by his physician; on June 6, 1984, he was again examined by his physician; he continued to be in pain for two days after his last visit to his physician and his pain increased; and on the day of his admission to the emergency room, claimant’s wife called his physician’s office repeatedly, just as she had done for several days preceding the admission, but could not reach his physician and he did not return her calls. Payne v. Master Roofing & Siding, Inc., 1 Va. App. 413, 339 S.E.2d 559, 1986 Va. App. LEXIS 216 (1986).

    As soon as the crisis requiring emergency treatment ends, the claimant is under a duty to contact his physician, the employer, or the compensation insurance carrier with whom he has been dealing. He is not authorized to continue treatment with a physician other than the treating physician. Payne v. Master Roofing & Siding, Inc., 1 Va. App. 413, 339 S.E.2d 559, 1986 Va. App. LEXIS 216 (1986).

    The duty of the employee, once he obtains an attending physician, is to accept such necessary medical attention as the nature of the accident may require. Davis v. Brown & Williamson Tobacco Co., 3 Va. App. 123, 348 S.E.2d 420, 3 Va. Law Rep. 676, 1986 Va. App. LEXIS 344 (1986).

    V.Refusal of Medical Treatment.

    Benefits conditioned on employee undergoing treatment. —

    Workers’ compensation benefits are conditioned upon the employee undergoing necessary medical treatment, placing the cost of treatment on the employer, and restoring the employee’s health enabling him to return to work. Dan River, Inc. v. Owen, 2001 Va. App. LEXIS 220 (Va. Ct. App. Apr. 24, 2001).

    Intent of this section is to penalize employees who unjustifiably refuse reasonable and necessary medical treatment. The sanction can be avoided only where the refusal is justified. Chesapeake Masonry Corp. v. Wiggington, 229 Va. 227 , 327 S.E.2d 121, 1985 Va. LEXIS 197 (1985).

    The intent of this section is to penalize employees who unjustifiably refuse reasonable and necessary medical treatment, from their attending physician, whether selected from a panel or chosen independently by the employee. Davis v. Brown & Williamson Tobacco Co., 3 Va. App. 123, 348 S.E.2d 420, 3 Va. Law Rep. 676, 1986 Va. App. LEXIS 344 (1986).

    This section requires an injured employee to accept reasonable and necessary care occasioned by an occupational injury. VEPCO v. Bobbitt, 1997 Va. App. LEXIS 145 (Va. Ct. App. Mar. 11, 1997).

    Failure to limit employer’s liability. —

    Where an employee refuses prescribed treatment and such refusal results in an aggravation or impediment to the cure of the disability, the employee has not taken reasonable steps to limit the employer’s liability. Dan River, Inc. v. Owen, 2001 Va. App. LEXIS 220 (Va. Ct. App. Apr. 24, 2001).

    The question is not whether the recommended procedure was justified, but whether the employee’s refusal to submit to it was justified. Biafore v. Kitchin Equip. Co., 18 Va. App. 474, 445 S.E.2d 496, 10 Va. Law Rep. 1586, 1994 Va. App. LEXIS 387 (1994).

    The matter of justification of employee’s refusal to accept medical treatment must be considered from the viewpoint of the patient and in the light of the information which was available to him. Holland v. Virginia Bridge and Structures, Inc., 10 Va. App. 660, 394 S.E.2d 867, 7 Va. Law Rep. 187, 1990 Va. App. LEXIS 145 (1990).

    Justification must be considered from viewpoint of patient and information. —

    The question is not whether the recommended procedure is justified, but whether the patient’s refusal to submit to it is justified. The matter of justification must be considered from the viewpoint of the patient and in light of the information which was available to him. The patient’s viewpoint, however, is not the sole means by which to judge the reasonableness of a refusal. The justification for refusal must be objectively reasonable and not the product of an individual quirk or paranoia. Wisniewski v. Fairfax County Sch. Bd., No. 1019-92-4 (Ct. of Appeals Sept. 23, 1992).

    Treatment must first be recommended for there to be refusal. —

    In order to constitute a refusal of medical services, there must be some evidence that the claimant has “refused to undergo medical treatment or to participate in the plan of treatment recommended by the treating physician”; in this case, there was no course of treatment recommended by any physician, thus there was no evidence in the record that the claimant failed to follow the advice of her doctors. Philip Morris USA v. Marshall, 1997 Va. App. LEXIS 22 (Va. Ct. App. Jan. 21, 1997).

    Diverging medical opinion. —

    The court of appeals did not read Cho v. Northern Virginia Builders, 62 O.I.C. 123 (1983) to establish the principle that whenever medical opinions diverge the employee can refuse treatment. Rather, each case must be evaluated on its own facts. In Cho, the commission made no finding as to which procedure was more credible. In this case, the commission made a factual finding that the more credible medical evidence favored surgery. Wisniewski v. Fairfax County Sch. Bd., No. 1019-92-4 (Ct. of Appeals Sept. 23, 1992).

    Where the Commission has made a finding of unjustified refusal to accept medical treatment, the sanctions called for in this section must be imposed. This is so whether the physician whose services were refused was selected from a three-physician panel or chosen by another appropriate method, so long as the physician became the attending physician within the meaning of this section. Chesapeake Masonry Corp. v. Wiggington, 229 Va. 227 , 327 S.E.2d 121, 1985 Va. LEXIS 197 (1985).

    Issue of refusal of treatment not appealable if not raised before Commission. —

    Where the issue of unjustifiable refusal of medical treatment, for whatever reasons, was not raised before the Commission, and in the absence of a ruling by the Commission on this issue, there was no foundation for appellate review. Catalytic, Inc. v. Mitchell, No. 0421-85 (Ct. of Appeals Dec. 13, 1985).

    Seeking more aggressive treatment does not constitute refusal. —

    The claimant’s cancellation of his appointment, while continuing to follow the prescribed treatment, and his immediate action in seeking more aggressive medical treatment, did not constitute a “refusal” under this section. Davis v. Brown & Williamson Tobacco Co., 3 Va. App. 123, 348 S.E.2d 420, 3 Va. Law Rep. 676, 1986 Va. App. LEXIS 344 (1986).

    Employee may not be penalized for seeking more aggressive care. —

    While an employee cannot refuse the medical services offered by a treating physician without forfeiting his compensation and medical benefits, it is contrary to the purpose of the Act to penalize an employee for seeking additional, more aggressive and perhaps better medical care to correct injuries received in an industrial accident. Dan River, Inc. v. Turner, 3 Va. App. 592, 352 S.E.2d 18, 3 Va. Law Rep. 1599, 1987 Va. App. LEXIS 144 (1987).

    Where claimant wanted additional medical advice and sought it on her own, the medical service she received may have been unauthorized, but her seeking it and refusing the employer’s offer to arrange an appointment with another physician was not an unjustified refusal of medical care within the meaning of this section. Richmond Mem. Hosp. v. Allen, 3 Va. App. 314, 349 S.E.2d 419, 3 Va. Law Rep. 1023, 1986 Va. App. LEXIS 366 (1986).

    An unauthorized change in physicians is not necessarily equivalent to a refusal of medical services under this section. In order to invoke the suspension of benefits provision of this section, there must be evidence of a refusal of the employee to accept medical service when provided by the employer. Davis v. Brown & Williamson Tobacco Co., 3 Va. App. 123, 348 S.E.2d 420, 3 Va. Law Rep. 676, 1986 Va. App. LEXIS 344 (1986).

    Use of unauthorized medical service is not necessarily refusal of medical service. If medical care required under this section is refused, further compensation is suspended unless the refusal is justified or until the refusal is cured. Richmond Mem. Hosp. v. Allen, 3 Va. App. 314, 349 S.E.2d 419, 3 Va. Law Rep. 1023, 1986 Va. App. LEXIS 366 (1986).

    Credible evidence supported the Commission’s finding that the claimant did not unjustifiably refuse authorized medical treatment where deputy sheriff sought care from his family physician who, although not himself on a specified list of “panel physicians,” practiced in the same medical group as a listed physician. Stafford County Sheriff's Office v. DeBord, 22 Va. App. 312, 469 S.E.2d 88, 1996 Va. App. LEXIS 284 (1996).

    An employee who had obtained treatment for a work-related injury from a physician not authorized by the employer was not entitled to medical benefits covering the cost of that treatment but was entitled to wage-loss benefits since she had promptly obtained treatment from a physician and had followed the treatment regimen that was prescribed for her and since the employer had not initially objected to her choice of doctors and there was no evidence that the treatment had adversely affected her recovery. Southland Corp. v. Welch, 33 Va. App. 633, 536 S.E.2d 443, 2000 Va. App. LEXIS 699 (2000).

    Unjustifiable refusal of initial physician’s treatment. —

    Where the claimant refused to follow the initial treating physician’s course of treatment and without justification changed to another physician, the Commission correctly found that the claimant unjustifiably refused the initial treating physician’s treatment. Ware v. Dow Indus., Inc., No. 1045-86-2 (Ct. of Appeals Aug. 31, 1987).

    Treatment sought after initial refusal. —

    Where claimant repeatedly declined medical treatment and related transportation offered by employer immediately after the accident and failed to advise employer of any change in this respect until the chiropractic care in dispute was substantially completed, the employer had no notice that claimant was an “injured employee” contemplated by this section and, therefore, no duty to act under the statute. Fairfax Hosp. Ass'n v. Sines, 1995 Va. App. LEXIS 183 (Va. Ct. App. Feb. 21, 1995).

    Refusal was unjustified. —

    Where commission made a finding that the more credible medical evidence favored surgery as the best hope to return employee to productivity, and where employee knew that a neurosurgeon predicted that surgery would give him an 80 percent chance of returning to work, that a neurologist also favored surgery, and that his chiropractor could offer no better option than to attempt to maintain his current painful and unproductive condition, under these circumstances, the commission was correct in finding that the refusal was unjustified. Wisniewski v. Fairfax County Sch. Bd., No. 1019-92-4 (Ct. of Appeals Sept. 23, 1992).

    The commission did not err in finding that the plaintiff’s claim of fear constituted an unreasonable refusal of medical treatment. Michael v. Masonry, No. 1533-96-2 (Ct. of Appeals Jan. 7, 1997).

    Claimant unjustifiably refused reasonable and necessary treatment, consisting of a cervical myelogram, notwithstanding his allegation of “nerves” and a discomfort with the treating physician, as such allegations appeared to be a pretext. Combs v. Valley Hauling, Inc., 1998 Va. App. LEXIS 485 (Va. Ct. App. Sept. 15, 1998).

    Virginia Workers’ Compensation Commission erred in determining that the treatment the claimant sought reimbursement for was unauthorized and that the claimant lacked “good reasons” to seek such treatment, where the employer’s letter denying medical benefits to the claimant amounted to a failure to provide medical care under subsection C of § 65.2-603 . McIntyre v. DMHMRSAS E. State Hospital, 2011 Va. App. LEXIS 213 (Va. Ct. App. June 28, 2011).

    “Elective” surgery. —

    In arguing that the surgery was not necessary, employee noted that doctor stated that the surgery was “elective”; the court of appeals did not read report as being inconsistent with doctor’s recommendation for surgery; the court read it as nothing more than a recognition that the decision whether to proceed with the surgery rests with the patient. Employee was free to decline surgery and “take it easy.” However, he could not expect the employer to pay for this inactivity when a reasonable alternative exists that would, in all likelihood, return him to work. Wisniewski v. Fairfax County Sch. Bd., No. 1019-92-4 (Ct. of Appeals Sept. 23, 1992).

    Employee could not expect employer to pay for him to “take it easy.” —

    Where in his testimony, employee agreed with the notion that he was content to take it easy and minimize his activity, live with this level of pain and physical incapacity and just forget about the possibility of returning to work, although employee could certainly exercise this option, he could not expect the employer to pay for him to “take it easy” when there existed, according to the medical opinion accepted by the commission, an 80 percent chance that surgery could return him to work. Wisniewski v. Fairfax County Sch. Bd., No. 1019-92-4 (Ct. of Appeals Sept. 23, 1992).

    Worker’s refusal to submit to bone scan was reasonable. —

    Worker’s refusal to submit to a bone scan without further medical consultation and adequate explanation of benefits and/or risks was reasonable in light of manufacturer’s printed warnings and disclaimers as to the possible long-term effects of radioactive isotope to be injected into the worker. Holland v. Virginia Bridge and Structures, Inc., 10 Va. App. 660, 394 S.E.2d 867, 7 Va. Law Rep. 187, 1990 Va. App. LEXIS 145 (1990).

    Smoking was refusal of medical care. —

    Refusal of claimant to stop smoking after being advised to do so by doctor in order to have corrective surgery precluded her from receiving benefits. Shawnee Mgt. Corp. v. Hamilton, 24 Va. App. 151, 480 S.E.2d 773, 1997 Va. App. LEXIS 41 (1997).

    Smoking was not refusal of medical care. —

    In light of claimant’s long history with cigarettes, the sizable reduction in her smoking, and her testimony that she had not abandoned her current effort to quit, credible evidence supported the commission’s finding that claimant had not “refused” to comply with her physicians’ directives to stop smoking. Shawnee Mgt. Corp. v. Hamilton, 25 Va. App. 672, 492 S.E.2d 456, 1997 Va. App. LEXIS 733 (1997).

    Employee did not unjustifiably refuse medical attention when he chose a chiropractor as his treating physician even though employer contended it offered a panel of physicians since employer’s insurance carrier denied liability and refused to provide employee with medical services, employee was entitled to choose his own physician. Goodyear Tire & Rubber Co. v. Pierce, 9 Va. App. 120, 384 S.E.2d 333, 6 Va. Law Rep. 318, 1989 Va. App. LEXIS 124 (1989).

    The mere filing of a petition to have another doctor become the treating physician, and claimant’s corresponding refusal to select a new panel physician during the pendency of that petition, were not per se a refusal of medical treatment justifying the suspension of benefits under subsection B. Macica v. ARA Services Tidewater Vending, 26 Va. App. 36, 492 S.E.2d 843, 1997 Va. App. LEXIS 686 (1997).

    Workers’ Compensation Commission did not err in finding that claimant was justified in refusing to undergo surgery recommended by treating neurosurgeon. The facts supported the commission’s finding that claimant was justified in refusing to undergo back surgery because of the unsuccessful outcome of his first surgery, and because the second surgery was presented as an option that carried with it certain risks. ABF Freight Sys. v. Johnson, 1997 Va. App. LEXIS 527 (Va. Ct. App. Aug. 5, 1997).

    Workers’ Compensation Commission erred by not addressing whether statement to a doctor about test expense was a valid basis to refuse the treatment and erred in ruling a decision not to pursue pain treatment was an unjustified refusal of treatment. Owen v. Dan River, Inc., 2002 Va. App. LEXIS 790 (Va. Ct. App. Dec. 31, 2002).

    Virginia Worker’s Compensation Commission’s reinstatement of disability benefits to a claimant was supported by the evidence as the claimant’s genuine fear of undergoing an osteotomy was justifiable for § 65.2-603 purposes where the claimant suffered extreme pain after a first surgery that left her debilitated for a week, and her doctor asked her to undergo second, even more painful surgery that her doctor described as brutal, for which he could not guarantee same probability of success. 7-Eleven v. Fore, 2013 Va. App. LEXIS 93 (Va. Ct. App. Mar. 26, 2013).

    VI.Vocational Rehabilitation.

    Whether college education reasonable and necessary as question of law and fact. —

    The question whether “reasonable and necessary vocational rehabilitation training services” authorized by this section, as applied to a particular claimant’s case, include a college education, is a mixed question of law and fact. The Compensation Commission’s determination of such questions is not binding upon the Supreme Court. City of Salem v. Colegrove, 228 Va. 290 , 321 S.E.2d 654, 1984 Va. LEXIS 201 (1984).

    College education program not aimed at retraining for specific skill is outside scope of section. —

    A four-year program of college education which, rather than retraining the claimant for a specific skill or trade, undertakes to expand the claimant’s occupational horizons to embrace a wide range of business, industrial and professional callings, is outside the range of benefits provided by the General Assembly. It fails to meet the “reasonable and necessary” standard of this section when any fair consideration is given to the relative costs and benefits to be derived from the program. City of Salem v. Colegrove, 228 Va. 290 , 321 S.E.2d 654, 1984 Va. LEXIS 201 (1984).

    Commission correctly held that employee’s educational program did not qualify as a reasonable and necessary vocational rehabilitation training service; employee’s degree program in applied studies consisted of courses that were normally considered part of a general liberal arts education, and rather than retraining her for a specific skill or trade, the program which employee proposed undertook to expand the claimant’s occupational horizons to embrace a wide range of business, industrial, and professional callings. Yeargain v. Daniel Int'l, 9 Va. App. 82, 384 S.E.2d 114, 6 Va. Law Rep. 274, 1989 Va. App. LEXIS 123 (1989).

    Learning program and recording studio equipment not compensable rehabilitation costs. —

    Appellate court held the record supported the Virginia Workers’ Compensation Commission’s findings denying claimant’s request for reimbursement of the cost of a learning program and home recording studio equipment as vocational rehabilitation services in light of the lack of any medical documentation establishing claimant’s disability or inability to work and the high cost of the services requested. Stroupe v. Radio Shack/Tandy Corp., 2002 Va. App. LEXIS 77 (Va. Ct. App. Feb. 5, 2002).

    An employer and carrier are not estopped from denying future payments merely because they have paid them in the past. Rucker v. Thrift Transf., Inc., 1 Va. App. 417, 339 S.E.2d 561, 1986 Va. App. LEXIS 217 (1986).

    Initial burden of employer regarding job placement and rehabilitation. —

    An employer who contends that a claimant has failed to cooperate with job placement services bears the initial burden of proving that the job leads provided were appropriate to the claimant’s residual capacity. Thus, where prior medical approval is not secured for a prospective job, the employer must demonstrate that the job obviously fits within the limitations provided by the claimant’s physician. Fairfax County Sch. Bd. v. Wright, 1997 Va. App. LEXIS 225 (Va. Ct. App. Apr. 15, 1997).

    An employer contending that a claimant unjustifiably refused job placement efforts must prove that the job leads were bona fide. Bona fide jobs leads consist of available employment positions reasonably compatible with the claimant’s capacities. Fairfax County Sch. Bd. v. Wright, 1997 Va. App. LEXIS 225 (Va. Ct. App. Apr. 15, 1997).

    Necessity of cooperation. —

    This section rests upon a bedrock of cooperation, and a claimant must cooperate with reasonable and necessary efforts designed to achieve reemployment. Fairfax County Sch. Bd. v. Wright, 1997 Va. App. LEXIS 225 (Va. Ct. App. Apr. 15, 1997).

    Claimant did not unjustifiably fail to cooperate with vocational rehabilitation efforts because the initial meeting with the claimant’s counselor was voluntarily rescheduled, so that the claimant could travel to Iraq as a result of the death of the claimant’s parent, and the claimant attended the rescheduled meeting. Furthermore, although the claimant’s total disability obviated the need to comply with vocational rehabilitation, the claimant still met with the counselor for a period of time. Food/Bev Serv-Crystal City & Hyatt Corp. v. Al-Boarab, 2017 Va. App. LEXIS 194 (Va. Ct. App. Aug. 8, 2017).

    Authority to order vocational evaluation. —

    Commission’s authority to direct employer to perform a vocational evaluation did not require a request from either employer or claimant. Irwin v. Contemporary Woodcrafts, Inc., 1999 Va. App. LEXIS 661 (Va. Ct. App. Dec. 7, 1999).

    Role of vocational consultant. —

    Prior medical approval, detailed job descriptions specifying the mental and physical requirements of a position, and direct contact with prospective employers to confirm the availability of jobs and their suitability to the individual claimant constitute acceptable methods by which a vocational consultant may purge inappropriate job leads. This enables the claimant to avoid futile pursuit of unsuitable employment and prevents lengthening of the period in which the employer remains liable to the claimant for benefits. Fairfax County Sch. Bd. v. Wright, 1997 Va. App. LEXIS 225 (Va. Ct. App. Apr. 15, 1997).

    Jobs not “obviously” compatible. —

    Where vocational consultant neither obtained medical approval for the job leads, nor contacted the prospective employers to determine their expectations of an employee; and did not furnish claimant with descriptions of the job performance requirements, the lack of meaningful information regarding the physical and mental requirements for the positions renders the appellate court unable to conclude that the jobs were obviously compatible with claimants severe physical restrictions. Fairfax County Sch. Bd. v. Wright, 1997 Va. App. LEXIS 225 (Va. Ct. App. Apr. 15, 1997).

    Unjustified refusal of rehabilitation efforts found. —

    Cooperation suggests working with another for a common purpose. Conversely, a failure to cooperate necessarily implies a refusal to work with another toward achieving the established goal. Thus, where record established without question that claimant refused to make even a minimal effort toward investigating his suitability for remedial education and, through education, vocational rehabilitation; the commission erred in finding that employer had failed to prove that claimant unjustifiably refused reasonable vocational rehabilitation efforts. Fairfax County Sch. Bd. v. Wright, 1997 Va. App. LEXIS 225 (Va. Ct. App. Apr. 15, 1997).

    When an employee cannot cooperate with vocational rehabilitation because of a medical condition not causally related to the work-related accidental injury for which benefits were originally awarded, the employee’s refusal to cooperate is “unjustified” for purposes of § 65.2-603 , and the employer is absolved of liability for compensation for the duration of the refusal. UPS v. Ilg, 54 Va. App. 366, 679 S.E.2d 545, 2009 Va. App. LEXIS 329 (2009).

    Evidence supported the decision that a claimant unjustifiably refused vocational rehabilitation services because (1) the claimant’s doctor contemplated that the claimant could perform work other than the claimant’s pre-injury work; (2) the claimant refused to attend job interviews for positions within the claimant’s medical restrictions that the employer procured for the claimant; and (3) the claimant instructed the employer’s vocational rehabilitation specialist not to schedule further interviews for the claimant. Anderson v. Anderson, 65 Va. App. 354, 778 S.E.2d 132, 2015 Va. App. LEXIS 316 (2015).

    No claim of refusal to cooperate with rehabilitation efforts. —

    Fact that a temporary total disability claimant was enrolled in college did not require termination of her benefits as she was required only to cooperate with reasonable vocational rehabilitation efforts offered by the employer under § 65.2-603 , and there was no claim that she had not done so. Starbucks Coffee Co. v. Shy, 61 Va. App. 229, 734 S.E.2d 683, 2012 Va. App. LEXIS 396 (2012).

    Commission did not err in denying claimant’s request for vocational rehabilitation; the evidence presented did not provide the Commission with a means of considering the relative costs and benefits to be derived from a vocational rehabilitation program in order to determine if the program met the “reasonable and necessary” standard of subdivision A 3 of § 65.2-603 . Aguilar v. VEGA Indus., Inc., No. 0743-92-4 (Ct. of Appeals Nov. 3, 1992).

    Commission did not err in refusing to require employer to pay for vocational retraining in the form of a two-year associate’s degree in computer technology, based on absence of evidence of claimant’s aptitude for computer programming and his likelihood of success in the new vocation; moreover, benefits to claimant and employer from such education were speculative at best. Irwin v. Contemporary Woodcrafts, Inc., 1999 Va. App. LEXIS 661 (Va. Ct. App. Dec. 7, 1999).

    Vocational rehabilitation. —

    Claimant was justified in refusing offered employment, where it served no legitimate rehabilitative purpose and was not appropriate vocational rehabilitation pursuant to this section. City of Buena Vista Pub. Works v. Southers, 1999 Va. App. LEXIS 531 (Va. Ct. App. Sept. 14, 1999).

    Because an employee attended the majority of his appointments with a vocational rehabilitation coordinator and registered for educational programs suggested by the coordinator, the employer failed to prove the employee unjustifiably refused to cooperate with vocational rehabilitation services, as required by subsection B of § 65.2-603 . Homescapes, Ltd. v. Anderson, 2011 Va. App. LEXIS 265 (Va. Ct. App. Aug. 9, 2011).

    When an employer offers selective employment to an injured employee suitable to his residual capacity, the burden of persuasion shifts to the employee to show justification for refusing the offer; this principle is equally applicable to cases involving the refusal to participate in vocational rehabilitation offered under § 65.2-603 . Ilg v. UPS, Inc., 284 Va. 294 , 726 S.E.2d 21, 2012 Va. LEXIS 128 (2012).

    Employee was not precluded from asserting that his refusal of vocational rehabilitation was justified because he remained fully disabled by his hand injury related to the industrial accident for which he was receiving benefits for his compensable knee injury. Ilg v. UPS, Inc., 284 Va. 294 , 726 S.E.2d 21, 2012 Va. LEXIS 128 (2012).

    Employer and carrier were not estopped from denying compensability of claimant’s educational program because of the carrier’s voluntary payment of part of his expenses in the past. City of Salem v. Colegrove, 228 Va. 290 , 321 S.E.2d 654, 1984 Va. LEXIS 201 (1984).

    “Appropriate” vocational rehabilitation. —

    The testimony of claimant, the vocational rehabilitation counselor, and rehabilitation specialist, as well as claimant’s medical records, amply supported the commission’s finding that claimant’s placement at the sheltered workshop was not appropriate vocational rehabilitation pursuant to subdivision A 3. B.W.B. Constr. Corp. v. Taylor, 1997 Va. App. LEXIS 13 (Va. Ct. App. Jan. 28, 1997).

    Vocational rehabilitation services shall take into account the employee’s pre-injury job and wage classifications, his age, aptitude, and level of education. Fluor Corp. v. Beasley, 2001 Va. App. LEXIS 660 (Va. Ct. App. Dec. 4, 2001).

    Issue of vocational rehabilitation not appealable if not raised before Commission. —

    As a claimant did not seek the assistance of the Virginia Workers’ Compensation Commission to direct his employer to provide vocational rehabilitative services, nor did he request a hearing to argue why it should be compelled to do so when the employer refused, the employer was not obligated to provide vocational rehabilitative services solely on the claimant’s request and its failure to do so did not absolve the claimant of the obligation to market his residual work capacity. Melton v. Atl. Group, Inc., 2004 Va. App. LEXIS 604 (Va. Ct. App. Dec. 7, 2004).

    Resumption of compensation not required where employment unjustifiably refused. —

    Neither former § 65.1-63 (now § 65.2-510 ) nor this section, dealing with the employer’s duty to furnish medical attention and vocational rehabilitation, authorize the Commission to require the employer or its insurer to resume payment of compensation in the event selective employment cannot be procured, in the face of positive evidence that the employee has unjustifiably refused previous offers of selective employment or otherwise has failed to cooperate with the employer’s rehabilitative efforts. Transfer v. Dicks, 229 Va. 548 , 331 S.E.2d 449, 1985 Va. LEXIS 230 (1985).

    Refusal to cooperate in vocational rehabilitation justified. —

    A claimant is not required to cooperate with an employer’s vocational rehabilitation provider if the claimant’s refusal to cooperate is justified; such a refusal was justified where the claimant was actively participating with the Virginia Employment Commission’s vocational rehabilitation and seeking appropriate employment. Metro Mach. Corp. v. Sowers, 33 Va. App. 197, 532 S.E.2d 341, 2000 Va. App. LEXIS 591 (2000), overruled in part, King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016) (applying an economic loss test as opposed to loss of earning capacity analysis).

    Decision of the Workers’ Compensation Commission denying a request for a hearing seeking to suspend benefits to an injured employee for refusal to accept offered vocational rehabilitation training was affirmed where the employee was a 60 year-old former crane operator with an injured back who was offered training as a telemarketer, the training was over one hour from employee’s home, and both the training and the job would have required sitting all day long. Fluor Corp. v. Beasley, 2001 Va. App. LEXIS 660 (Va. Ct. App. Dec. 4, 2001).

    Argument not preserved for appeal. —

    Court of appeals could not consider an employer’s argument that a workers’ compensation claimant’s decision to move to a small town was proof that she failed to cooperate with its rehabilitation services pursuant to § 65.2-603 because when the case was before the Virginia Workers’ Compensation Commission, the employer did not raise that argument, and the Commission did not address the argument in its opinion. Big Lots Stores, Inc. v. Browning, 2010 Va. App. LEXIS 431 (Va. Ct. App. Nov. 9, 2010).

    Virginia Workers’ Compensation Commission did not err in denying an employer’s motion to terminate a workers’ compensation claimant’s disability benefits pursuant to Va. § 65.2-603 because the record supported the Commission’s finding that the vocational rehabilitation services the employer provided were inadequate and that the employer did not meet its burden of proving that the claimant refused to cooperate with those services; the claimant provided information to a rehabilitation service company, but the company failed to use that information to adequately screen the job openings that were sent to the claimant, and the Commission could conclude that the company did not screen job openings before sending them to the claimant. Big Lots Stores, Inc. v. Browning, 2010 Va. App. LEXIS 431 (Va. Ct. App. Nov. 9, 2010).

    CIRCUIT COURT OPINIONS

    Exacerbated injury during vocational evaluation. —

    Where an employee filed a workers’ compensation claim and allegedly exacerbated an injury during a second functional capacity evaluation, a settlement agreement barred the employee’s negligence claim against the workers’ compensation insurer because: (1) the injuries were properly treated as an extension of the employee’s original workers’ compensation claim; and (2) the insurer and its agents enjoyed the same immunity from liability that the employer did under the Workers’ Compensation Act, since Virginia did not recognize the “dual capacity doctrine.” Mathes v. Davis, 74 Va. Cir. 411, 2007 Va. Cir. LEXIS 298 (Norfolk Dec. 3, 2007).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    GENERAL.

    Amendments to the per accident aggregate limits for home modifications and prescribed appliances set forth in 65.2-603 (A)(1) are not retroactive; statutory limit in effect on the date of accident applies. Harris v. Princeton Homes, JCN 2023038, 2069573 (June 24, 2015).

    More formal referral for pain management not required where nurse case manager sought doctor’s approval to which doctor replied, “That would be fine. If she is still requiring/demanding pain medication, a pain management referral is reasonable.” Palmer v. Tidewater Community College, JCN VA00000604832 (Sept. 18, 2014).

    While the Commission does not issue advisory decisions, it does have the authority to determine the necessity of ongoing medical treatment and attention where the employer has summarily denied all access to treatment. Pugh v. Mountain Chrysler Plymouth Dodge, JCN 1459729 (Aug. 14, 2013).

    The Commission has no jurisdiction to order the carrier to reimburse the employer for medical bills paid while the issue of whether there was workers’ compensation insurance coverage was adjudicated. Pavon v. Yankee Concrete Construction, Inc., VWC File No. 223-00-87 (Feb. 21, 2007).

    Injuries sustained in a motor vehicle accident while going to a medical appointment for the work injury are a compensable consequence of the industrial accident. Jones v. Checkered Flag Toyota, VWC File No. 220-84-93 (Jan. 26, 2007).

    The Commission has jurisdiction to determine whether medical expenses are causally related to, and reasonable and necessary for the work injury even though Medicare has paid the bill. Dubilewski v. Old Dominion University, VWC File No. 173-77-39 (Aug. 4, 2005).

    When seeking wage-loss benefits for work missed because of a medical appointment, the claimant has the burden to show why his appointment could not be scheduled on a non-work day. Robbins v. County of Lee School Bd., VWC File No. 209-20-79 (Dec. 8, 2004).

    Where the claimant generally scheduled medical appointments at the end of the work day but requested the first available appointment because he “was hurting” which was corroborated by medical evidence, the claimant acted reasonably and there was sufficient reason for him to miss all day from work. Robbins v. Lee County School Bd., VWC File No. 209-20-79 (Sept. 26, 2005).

    Wage loss benefits may be received for required medical appointments during work time only if it is shown that the medical condition required the appointment during work hours, if the scheduling at a non-work time would interfere with obtaining favorable work assignments, or if scheduling at a non-work time would cause substantial hardship. Aubuchon v. Domino’s Pizza, VWC File No. 211-80-86 & 217-98-00 (Oct. 3, 2005).

    The Commission has no jurisdiction to order the reimbursement of a private health insurance company by a medical provider. Parham v. J.P. Distributing Co., VWC File No. 195-39-78 (Aug. 20, 2004).

    Commission may extend medical treatment under settlement agreement due to employer/carrier’s delay in authorizing the treatment. Fraysier v. Clinch River Health Services, Inc., VWC File No. 193-86-15 (May 28, 2004).

    Code § 65.2-607 (A) waives the physician/patient privilege as to all physicians and in all proceedings under the Act. It is not limited to facts learned or communicated during an independent medical examination. Wiggins v. Fairfax Park Ltd. Partnership, 22 Va. App. 432, 470 S.E.2d 591, 1996 Va. App. LEXIS 355 (1996).

    A contract between a hospital and an employee for medical services covered under the Virginia Workers’ Compensation Act is not a contract which the hospital may enforce against an employee once a claim is found to be compensable. The responsibility for hospital services is the obligation of the employer to the hospital. Sines v. Better Homes Realty, Inc., 66 O.I.C. 158 (1987).

    Where surgery is delayed while the carrier obtains other opinions to determine whether it is reasonable and necessary treatment of the work injury, the agreed period during which medical care is to be provided by the employer pursuant to a compromise settlement may be extended to the extent of such delay. Fox v. W. G. Enterprises, 75 O.W.C. 243 (1996).

    Although similar conditions existed, the same facts and circumstances were not involved in the present application and the previous hearing. The doctrine of res judicata does not therefore preclude consideration of whether there is a current medical need and causal connection for a previously prescribed medication. St. Clair v. Virginia Pocahontas, 69 O.I.C. 141 (1990).

    For the purpose of evaluating work capacity, the employer and insurance representative are entitled to have the benefit of a physical capacities evaluation form executed by the attending physician. Written communication or depositions are the appropriate means for obtaining the physician’s opinion. Carter v. City of Falls Church Public Utilities, 69 O.I.C. 151 (1990).

    Injuries received in travel in connection with medical treatment for prior industrial injury are compensable. Brosnahan v. Immer & Co., 207 Va. 720 , 152 S.E.2d 254, 1967 Va. LEXIS 128 (1967).

    The Act does not provide for the assessment of interest on an award for previously contested medical cost. Martin v. Saunders B. Moon Community, 71 O.W.C. 198 (1992).

    In holding that it is not permissible to apply adjudicated credit to subsequent medical costs, the Commission noted that to do so would equate medical benefits with compensation. Compensation does not include voluntary medical payments and the twenty percent penalty may not be assessed against such payments. In addition, cost-of-living adjustments are not considered compensation. Mabe v. Happy Stores #494, 73 O.W.C. 175 (1994).

    The employer is responsible for the medical care given to the claimant for her work injury, and it is also liable for the results of ineffective and inappropriate care that it provides. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997), aff’d, Nos. 1238-97-3 & 1290-97-3 (Va. Ct. App., Dec. 23, 1997).

    The duty of the employer/insurer to provide medical treatment does not extend to treatment necessary to control all chronic conditions from which a person may be suffering and which, if left untreated, would cause a deterioration of health. Rucker v. Carico, 76 O.W.C. 251 (1997).

    Where the claimed expenses were related to visits with unauthorized physicians, including the claimant’s independent consultation to determine the extent of his permanent partial impairment, the Commission held that the costs associated with the visits were properly denied on either ground. Harris v. Goodyear Tire & Rubber Co., 79 O.W.C. 198 (2000).

    PROCEDURE.

    Evidence:

    Even where orthopedic surgeons made no definitive statements linking claimant’s knee condition to work accident, Commission may rely on claimant’s testimony coupled with doctor’s impression of “an acute component” to the injury, to find causal relationship. Rivera-King v. Loudon Sheet Metal, JCN VA00000799621 (Oct. 6, 2014).

    Even though the claimant may testify that he is able to return to work, if the treating physician opines that the claimant is not able to return to work, greater weight will be given to that medical opinion, since it is based upon medical knowledge. This is simply the converse of the principle upon which the Commission relies in giving greater weight to a physician’s opinion that a claimant is able to return to work over the opinion of the claimant that he cannot. Moore v. Auto Truck Transport, VWC File No. 241-63-54 (February 18, 2011).

    A nurse practitioner’s unchallenged opinion concerning causation and disability will be considered. However a contradictory opinion from a physician will be given greater weight than a nurse practitioner. Counts v. Virginia Dept. of Transportation/Commonwealth of Va., VWC File No. 220-85-21 (March 9, 2006) see also Shine v. Teco Energy, Inc., VWC File No. 223-46-12 (April 5, 2006) (nurse practitioner’s notes are admissible) and Patterson-Parker v. Lowe’s Home Centers, Inc., VWC File No. 212-86-74 (Sept. 29, 2006) (release to work by nurse practitioner is sufficient where notes reflect discussed with doctor).

    A physician assistant’s opinion as to diagnosis and disability is admissible but unless a medical doctor has endorsed the conclusion, it will not be given the same weight as a physician’s determination. Austin v. Allstate Insurance Co., VWC File No. 224-68-41 (Aug. 1, 2006).

    A chiropractor’s opinion concerning a thumb and hand condition is beyond the scope of the “practice of chiropractic” as defined by § 54.1-2900 and therefore will not be considered. Fedorko v. Prince William Hospital, VWC File No. 208-77-08 (Feb. 7, 2006) see also Torres v. Maid Brigade, #153, VWC File No. 203-57-08 (April 1, 2004) (chiropractor’s rating to an arm not considered).

    Opinions contained in physical therapy reports are not admissible hearsay except to the extent such opinions may be ratified and incorporated in the medical reports of licensed physicians as their own opinions. Physical therapists are not competent to offer expert medical opinions regarding diagnosis and causal relationships. Here the report was not “ratified or incorporated” in the doctor’s medical reports because he had not examined the claimant since August 1999 and did not refer the claimant to the physical therapist. Sutherland v. Craft Machine Works, Inc., VWC File No. 194-35-92 (Nov. 1, 2005).

    A nurse practitioner’s unrebutted opinion may establish a claimant’s disability. Gordon v. Roger L. DeHaven Well Drilling, Inc., VWC File No. 212-05-69 (Feb. 23, 2005).

    A doctor’s office note stating that the claimant failed to attend a medical appointment was admissible as a record of the physician’s care of the patient. Griffith v. Commonwealth Steel Erectors, Inc., 68 O.I.C. 218 (1989).

    The notes, reports and opinions of a licensed clinical psychologist who does not have a Ph.D. are not, by themselves, competent evidence under the Act. Medical reports and opinions rendered by physicians and clinical psychologists holding a Ph.D. degree are accepted into evidence as exceptions to the hearsay rule. The opinions of licensed clinical psychologists without a Ph.D. may become competent evidence only to the extent that such opinions have been expressly ratified, and incorporated in the medical reports of licensed physicians as their own opinions. Price v. Sodexho Marriott Services, Inc., VWC File No. 197-76-40 (May 14, 2002) see also Landy v. Eastern State Hospital, 69 O.I.C. 212 (1989) (clinical psychologist report admissible).

    Mental health records are not admissible without testimony of the counselor unless the care has been rendered by or at the direction of a practitioner of the healing arts licensed under § 54.1-2929 , Code of Virginia. Potter v. Island Creek Coal Co., 69 O.I.C. 67 (1990).

    While the parties may stipulate that reports from a counselor with a master’s degree in education and a licensed clinical social worker are submitted as evidence, the Commission is not bound by medical opinions expressed in such records. In the absence of a diagnosis by a psychiatrist or a clinical psychologist with a Ph.D, the diagnosis of the counselors cannot be considered as medical evidence. Stiltner v. Southwest Ambulance Service, Inc., 73 O.W.C. 60 (1994) (see also Markwell v. American Convenience, Inc., 1998 Va. App. LEXIS 246 (Va. Ct. App. Apr. 28, 1998).

    In evaluating varying medical opinions, the deputy commissioner considers the expertise of each physician, the extent of involvement in the treatment of the claimant’s condition, the reasoning applied by each physician, and the criteria relied upon by each physician. Jackson v. Haynes Furniture Co., Inc., 77 O.W.C. 92 (1998).

    The general rule is that when an attending physician is positive in his diagnosis of a disease, great weight will be given by the courts to his opinion. Where there is a conflict in the medical evidence, the Commission typically affords greater weight to the opinion of the treating physician than to the assessment of another doctor of the same medical specialty who has only recently been consulted. Taylor v. Northern VA Regional Park Authority, 77 O.W.C. 63 (1998).

    Normally the Commission places great weight on a treating physician’s opinion. However, in this case, the treating physician’s records showed that his opinion was based upon a faulty premise. Although the claimant complained of back pain, the physician never examined or inquired about her back condition. Still later, he declined to treat her promptly for that problem, effectively abandoning her treatment. On this evidence, the Commission held that the physician’s opinion regarding the etiology of that back condition was of limited value. Redford v. Stafford County School Board, 79 O.W.C. 85 (2000).

    Medical reports from an unauthorized physician may be considered in determining work incapacity. Clark v. R & E Electronics, 71 O.W.C. 200 (1992).

    Medical reports are tantamount to direct testimony and create a right of cross-examination. Pasley v. Arlington County, 58 O.I.C. 267 (1978).

    Communication of a medical release to return to regular work is not necessary if there is proof that the employee is able to do the work. Williams v. Virginia Electric & Power Company, 18 Va. App. 569, 445 S.E.2d 693 (1994); 71 O.W.C. 101 (1992).

    Credible testimony of the claimant may be sufficient to establish an injury by accident unimpeached by the medical records, even if the medical histories refer only to general repetitive tasks the claimant performed when the accident occurred. Mullins v. Dickenson County Medical Center, 74 O.W.C. 176 (1995).

    The claimant has the burden to prove by a preponderance of the evidence that her back condition is causally related to her work accident. Causation between an incident and an injury is essentially a medical issue that is usually resolved by reference to medical reports. Redford v. Stafford County School Board, 79 O.W.C. 85 (2000).

    A physician’s release to return to work on a trial basis is not sufficient to suspend compensation benefits. The physician must state unconditionally that the claimant is able to perform all aspects of his pre-injury employment. Byrd v. Island Creek Coal Company, 74 O.W.C. 45 (1995).

    Once an accident has been established without consideration of the medical history, medical histories may be considered to determine whether the treatment was for injury related to that accident. Sandra R. Hall v. Spartan Industries/Barnes and Company, Inc., 74 O.W.C. 56 (1995).

    Where chiropractic treatment has resulted in substantial improvement of the employee’s condition, and the appropriateness of care is confirmed by a neurologist and another chiropractor, the report of an orthopaedic surgeon who merely reviewed the medical records and was unaware of the employee’s response to treatment is given little weight. Flanegin v. Hechingers Corp., 75 O.W.C. 275 (1996).

    Hearing Application:

    A claimant may amend her claim at the hearing to include a claim for lifetime medical benefits. Such a claim is implicit in an initial claim that alleges disability from work. Woodson v. County of Nelson School Bd., VWC File No. 216-72-04 (Oct. 26, 2004), aff’d, 45 Va. App. 674, 613 S.E.2d 480 (2005).

    Party with the burden of proof (employer) must allege this ground (refusal of medical treatment) for suspending compensation in his application for hearing or be barred from raising the issue for the first time at the hearing. Johnson v. Williams Co., 42 O.I.C. 85 (1960).

    Applications for hearing on the basis of refusal of employment under § 65.1-63 (now § 65.2-510 ) or of medical attention or vocational rehabilitation training services under § 65.1-88 (now § 65.2-603 ) should be specifically labeled as to the issue presented. Rule 13 (now Rules 1.2 and 1.4) requires employers and employees to specify grounds for an application. Myers v. Grand Union Company, 63 O.I.C. 241 (1984).

    When an employer files an application seeking to suspend compensation benefits on the basis that the claimant has refused vocational rehabilitation or medical treatment, the application must specify the dates and the nature of such refusal. Phelps v. J. B. Eurell Company, 67 O.I.C. 28 (1988).

    While an allegation of refusal of employment, medical attention or examination requires that compensation be paid through the date of the refusal or fourteen days prior to the filing, whichever is later, an assertion of failure to cooperate with vocational rehabilitation efforts requires payment to be made to the date on which the application is received in the Commission’s offices or posted by certified mail. Hajducsek v. Ames Department Stores, Inc., 71 O.W.C. 256 (1992).

    Until the issue of a change in treating physicians has been determined in an opinion no longer subject to review or appeal, the claimant is not required to select from a panel of physicians. Until there has been a final decision on the issue of a change in physicians, an employer may not demand that a claimant select from a panel and terminate benefits for a failure to do so. Such a rule would require the claimant to disrupt her medical treatment for a period when she may ultimately be able to return to her treating physician. Cubbage v. Wrangler, 78 O.W.C. 166 (1999).

    MEDICAL TREATMENT.

    Duty to Provide Medical Treatment:

    Taking claimant to a doctor does not relieve defendants of obligation to offer claimant a valid panel of physicians and claimant was free to choose his own physician. Matthews v. Frito-Lay, JCN VA000000985667 (Sept. 8, 2015).

    Section 65.2-603 requires an employer to furnish to an injured employee a panel of at least three physicians, from which the employee may select an authorized treating physician. Once a selection of the treating physician is made by picking from such a panel, or by entering into a continuing course of treatment with a physician selected in some other manner, the employee is not at liberty to change therefrom unless referred by said physician, confronted with an emergency, or given permission by the employer and/or its insurer or the Commission. Dell’Orco v. Electronic Data Systems Corporation, 78 O.W.C. 221 (1999).

    An employer must provide a claimant with medical treatment under Code § 65.2-603 . The purpose of Code § 65.2-603 is twofold: to place the costs of medical care and treatment on the employer and to restore the employee’s good health so that he may return to useful employment. Campbell v. Ken Bridge Corporation, 78 O.W.C. 97 (1999).

    Code § 65.2-603 requires that the employer/insurer provide reasonable and necessary medical attention to an injured worker. However, the claimant has the burden to prove that the medical attention is causally related to the industrial accident. Rucker v. Carico, 76 O.W.C. 251 (1997).

    Section 65.2-603 obligates the employer and its carrier to pay for reasonable and necessary medical treatment needed to treat a job injury. Whether an employer is responsible for medical expenses for care provided by another physician depends on whether (1) the medical service was causally related to the industrial injury; (2) such other medical attention was necessary; and (3) the treating physician made a referral of the patient. Harris v. Goodyear Tire & Rubber Co., 79 O.W.C. 198 (2000).

    The employer’s liability for the cost of treatment deemed necessary by an authorized treating physician is established so long as a causal relationship between the industrial accident and the complaints which are the subject of the treatment is shown, and preauthorization by the carrier for the recommended treatment is not required. Cook v. Augusta Correctional Center, 78 O.W.C. 162 (1999).

    A determination of medical causation at one particular time is not binding when claims are made concerning later medical treatment. Wimer v. S.T. Wooten Const. Co., 76 O.W.C. 122 (1997).

    Medical attention must be provided only where claimant is injured in industrial accident. Where employer is liable for compensation, it is also liable for medical treatment and its expenses related to compensable injury. DeLaFleur v. Fairfax Hospital, 59 O.I.C. 69 (1980).

    Where employer or insurer agrees to pay medical expenses as a volunteer for treatment not related to industrial accident, Commission has no jurisdiction. Merrimac Anthracite Coal Corp. v. Showalter, 158 Va. 227 , 163 S.E. 73 , 1932 Va. LEXIS 250 (1932).

    Employer’s liability for medical attention does not cease with termination of claimant’s employment. Grant v. Georgia-Pacific, 51 O.I.C. 115 (1969).

    Where an employer denies a claim and fails to provide medical benefits the employee may select a physician of his own choice. If the claim is subsequently found to be compensable the employer will be financially responsible for the cost of such treatment. Trammel Crow Company, Inc. v. Redmond, 12 Va. App. 610, 405 S.E.2d 632, 7 Va. Law Rep. 2750, 1991 Va. App. LEXIS 118 (1991).

    Where the employer defended the claim on the alternative ground that the medical treatment rendered was not causally related to the compensable accident, because the chain of causation was broken by an alleged intervening event, the employer cannot compel the claimant to seek treatment from its panel physician. To hold otherwise would place the claimant in the untenable position of having to accept the treatment from the employer’s physician, and then become personally responsible for that treatment should the Commission find that the treatment was not causally related to the accident. A claimant, faced with the prospect of paying for medical care due to the employer’s disclaimer of responsibility, is free to choose his own treating physician. It is of no moment that the employer’s disclaimer comes after the treatment is rendered. The claimant still faces personal responsibility for the charges, and the employer will not be allowed to select the doctor. Dell’Orco v. Electronic Data Systems Corporation, 78 O.W.C. 221 (1999).

    Where the employer unilaterally and arbitrarily denies responsibility for certain medical treatment prescribed by the treating physician without reasonable grounds, the employer shall be liable for the claimant’s attorney’s fees as to that issue, even though it prevails on other issues raised in the proceedings. Leon v. Lewis-Gale Clinic, 76 O.W.C. 350 (1997).

    The claimant suffered head injuries in a work accident, for which he was treated at Roanoke Memorial Hospital for five months. The parties stipulated that the claimant could have received a lower level of care during the last six weeks of his hospitalization, and the Uninsured Employer’s Fund denied liability during that period. The Commission held that, where the reduced level of care was not available at the hospital, where the hospital could not simply discharge the claimant before a suitable treatment facility was located, and where the hospital took all reasonable steps to locate such a suitable facility that could provide that care, the care provided by the hospital during those six weeks was reasonable and necessary treatment. Childress v. Perdue/Blacksburg Seamless Guttering, 79 O.W.C. 108 (2000).

    Duty to Provide Panel/When Has a Treat- ing Physician Been Selected:

    Where agreed-upon treating physician declined to provide treatment and insurer did not offer a new panel, claimant was free to seek medical treatment on his own, and insurer is responsible for cost of that treatment. Hayden v. Labor Ready, No. 1257, VWC File No. 204-09-82 (March 25, 2005).

    Employee required to notify carrier that treating physician no longer available; treating physician left practice and claimant continued to treat with other physicians, but not satisfied and sought treatment at emergency room, who referred to new physician; new physician not authorized because employee did not seek new panel or receive referral from original physician for treatment with new treating physician. Gill v. McQuay Int’l, VWC File No. 179-35-06 (May 30, 2003).

    As soon as possible after the injury an employee must be provided with a panel of physicians, otherwise he may seek treatment from the doctor of his choice. Posting a notice or advising employees of the company panel during safety meetings is not sufficient. Lambert v. Clinchfield Coal Co., 68 O.I.C. 194 (1989).

    The employer must provide the panel of physicians within a reasonable time after a work accident. The appropriate time in which a panel may be furnished will vary from case to case depending upon the different circumstances involved. An employer’s delay in providing a panel of physicians would be reasonable where 1) the employer did not know of the need for medical treatment, and where 2) the employee had not commenced a course of treatment with his own physician. Flanegin v. Hechingers Corp., 75 O.W.C. 275 (1996) (see also Roberts v. Quest Enterprises, Inc., 76 O.W.C. 410 (1997) (time to furnish panel will vary)).

    The claimant notified her employer immediately after the accident and sought treatment the following day from her family physician, who three days later referred her to an orthopedist. The carrier spoke with the claimant eight days after the accident and sent a letter offering a panel the same day, which was received by the claimant before the appointment she had scheduled with the orthopedic specialist. The Commission held that the panel was offered within a reasonable time, that treatment rendered by the orthopedic specialist recommended by the family physician was unauthorized, and that compensation benefits and medical expenses after the panel offer were properly denied by the deputy commissioner because of her refusal to select a panel physician. Roberts v. Quest Enterprises, Inc., 76 O.W.C. 410 (1997). See also “Choi v. Shoppers Food Warehouse” (failure to authorize care for 2 months employee justified in seeking care from doctor of her choice) Locke v. Kline Tysons Toyota, 71 O.W.C. 207 (1992), (panel offered 2 weeks after accident and employee engaged in treatment was too late).

    Where the employee reported the accident on the day following the event, and the employee was limited to light duty by his physician, who treated him on approximately eight occasions beginning the day after the accident, the proffer of a panel three weeks later was untimely. Flanegin v. Hechingers Corp., 75 O.W.C. 275 (1996).

    Once a selection of the treating physician is made by picking one from a panel provided by the employer, or by entering into a continuing course of treatment with a physician selected in some other manner, the employee is not at liberty to change therefrom unless referred by the treating physician, confronted with an emergency, or given permission by the employer and/or its insurer or the Commission. Riddick v. Whole Foods Market, Inc., 76 O.W.C. 28 (1997).

    Once employee selects initial treating physician the employer may not thereafter offer panel. Crickenberger v. Tacco, 57 O.I.C. 86 (1976) (see also Walls v. Zayre Corp., 54 O.I.C. 385 (1972)).

    After an accident, an employer is allowed a reasonable time to investigate a claim, during which time a claimant is required to accept medical care from a panel physician. If the claim is accepted, then the doctor selected from the panel is the claimant’s treating physician. However, if the claim is denied and the employer does not provide the claimant with medical services, then the employer is responsible for the treatment received by the claimant before and after the claim was denied if it is held compensable by the Commission. Fondahn v. Manpower, Inc., 77 O.W.C. 123 (1998).

    It is well-established that when an employer denies a claim, the employee is free to select his own treating physician. Clark v. Goodyear Tire & Rubber Co., 76 O.W.C. 145 (1997) (see also Smith v. Food Lion, Inc., 75 O.W.C. 136 (1996)).

    When a carrier denies liability for a claim, the claimant may choose her own physician, and the carrier may not thereafter impose a panel upon the claimant when the claim is found to be compensable. Fleshman v. Checkers Check Cashing, 74 O.W.C. 148 (1995).

    Panel must be provided by employer to employee at time of injury. Otherwise, employee is free to select the initial treating physician. Dooley v. McCormick Foods, 56 O.I.C. 97 (1975); Spence v. Arlington Public Schools, 53 O.I.C. 353 (1971); Woolfolk v. H.K. Porter Co., Inc., 57 O.I.C. 399 (1977); Embrey v. Barber & Ross Co., 59 O.I.C. 78 (1980); Large v. Fairfax County Public Schools, 59 O.I.C. 167 (1980).

    Where the employer did not initially accept the alleged injury as compensable and did not offer a panel of physicians, the claimant was free to select her own treating physician. However, once she selected a treating physician and established a course of treatment, she was no longer entitled to change treating physicians or seek out evaluations by other physicians until the claim was formally denied. Dyer v. Vann-Atlantic Orthopaedic Specialists, 76 O.W.C. 457 (1997).

    Where the employer denies the claim on the grounds that treatment rendered by chiropractors is not causally related to the compensable accident, thus disclaiming the causal relationship of the injury to the accident and responsibility for medical care, the employer cannot compel the claimant to seek treatment from its physician and the employee is free to choose his own treating physician. Harvey v. Dean Steel Erectors Co., 76 O.W.C. 24 (1997).

    Once a claimant has made a choice of treating physicians from a panel or established a course of treatment with a physician when no panel is offered, a claimant cannot unilaterally change physicians without agreement of the employer or approval of the Commission. However, a claimant may select a physician of his own choice when an employer or carrier has denied a claim. The employer cannot refuse to provide the employee with full medical service and also insist that he seek medical care only from physicians it selects. Such a policy would require an employee to seek treatment from a physician chosen by the employer but would not require the employer to pay the physician’s charges. Felise v. Delta Airlines, 76 O.W.C. 315 (1997) (see also Fondahn v. Manpower, Inc., 77 O.W.C. 123 (1998)).

    Where compensability of a claim is disputed, and the employee is denied further medical care by the physician treating the work injury under the employer’s health care benefits plan after his termination from that employment, the claimant is entitled to seek care from a physician of his choice. Sharp v. Stratford and Monticello Square Apts., Ltd., 76 O.W.C. 65 (1997).

    Where the claimant is justified in seeking care from a physician of her own choice, a single visit to a physician does not constitute such a selection. Choi v. Shoppers Food Warehouse, 76 O.W.C. 183 (1997).

    Where the employer fails to provide a panel of physicians to the injured employee, but directs him to a physician who provides care for one week, acceptance of treatment for that short period of time does not constitute a meaningful choice of a treating physician and the employee is free to choose his own doctor. Harvey v. Dean Steel Erectors Co., 76 O.W.C. 24 (1997).

    Posting names of panel physicians at various locations at work is not an offer of a panel. Smith v. Food Lion, Inc., 75 O.W.C. 136 (1996).

    The selection of a treating physician is made when treatment actually commences, and not when an appointment for treatment is made, but deemed unnecessary at the time. Thus, the selection of a physician from a panel provided by the employer is effective at the time such treatment becomes necessary. Kilhefner v. Virginian Nursing Home, 75 O.W.C. 28 (1996). Robinson v. Alexandria Hospital Association, 62 O.I.C. 376 (1983)(choice made at time appointment made).

    One visit to a family practice physician with whom the appointment was not originally made does not constitute the selection of a treating physician. Page v. Copy Systems, Inc., 71 O.W.C. 204 (1992).

    An employee who sees a physician upon referral by an emergency room has not selected a “treating physician”, or been provided a panel. Custer v. City of Newport News, 70 O.I.C. 199 (1991).

    An employee seeking emergency treatment from an emergency care center does not constitute a meaningful choice of a treating physician and, consequently, is not bound by referrals from that facility. Locke v. Kline Tysons Toyota, 71 O.W.C. 207 (1992), (panel offered 2 weeks after accident and employee engaged in treatment was too late).

    The mere fact that a primary care physician refers an employee to a specialist does not automatically remove the primary care provider from any involvement in the case. Where the employee experiences problems outside the area of expertise of the specialist to whom she was referred for another problem, it is reasonable for her to return to her original treating doctor for a referral for the other condition. Strickler v. Augusta Correctional Center, 75 O.W.C. 156 (1996).

    Where treatment is denied by or is otherwise no longer available from the authorized physician, the claimant is again in a situation similar to that as existed immediately after her injury, and her rights and responsibilities as to medical care are comparable. First, she must provide notice to the employer or carrier that she needs medical care and that it is not being provided, so the employer has an opportunity to provide it pursuant to the Act. If treatment is not provided within a reasonable period, the claimant only then may seek care from any physician she chooses. Riddick v. Whole Foods Market, Inc., 76 O.W.C. 28 (1997).

    Where the claimant’s treating physician prescribed swimming therapy and deemed it reasonable and necessary to the claimant’s rehabilitation needs, and the employer offered no medical evidence to the contrary, but argued only about the distance the claimant has to travel and its doubts as to whether or not such treatment is useful, the Commission found the employer was attempting to medically manage treatment of the claimant. Prince v. E. E. Lyons Const. Co., Inc., 76 O.W.C. 35 (1997).

    What Constitutes a Proper Panel:

    The commission established criteria for assessing the reasonableness of travel distance in determining an appropriate panel offer: the injured worker’s limitations, the physician’s specialty, the availability of physicians in the area. The commission will review distances on a case-by-case basis without micro-managing the selection of every panel. An appropriate panel must include at least three qualified physicians each located within a reasonable distance from the claimant’s residence. Smith v. Dale Stanley Trucking, Inc., VWC File No. 227-98-45 (Jan. 17, 2007), aff’d, No. 0252-07-3 (Ct. App. of Va., June 5, 2007).

    A meaningful choice of physicians must not only consist of a list personally brought to the attention of the employee but must also contain the names of three physicians who do not share a community of interest in a joint practice. Burns v. Badische Corporation, 61 O.I.C. 87 (1982) (see also Washington v. Petersburg General Hospital, 61 O.I.C. 398 (1986) (defective panel where all physicians member of defendant’s hospital staff); Lohr v. Lohr Electric, 74 O.W.C. 165 (1995) (defective panel where includes doctor who is unwilling to see claimant)).

    It would not be feasible for the Commission to delineate the precise distance to travel for medical treatment for all situations. Each case differs depending upon the specifics involved, such as the employee’s limitations, the physician’s specialty, and the availability of physicians in the area. However, the Commission will review distances that appear to be unreasonable. Moomaw v. Pemdor Virginia, 79 O.W.C. 97 (2000) (see also Alsop v. Marriott Corp., 60 O.I.C. 12 (1981) (panel defective where distance too far); Coleman v. Haynes Furniture Co., Inc., 75 O.W.C. 131 (1996) (50 miles each way was too far)).

    The panel of physicians offered by the employer must contain at least three qualified physicians who are located within a reasonable distance from the claimant’s residence. In this case, the panel offered by the employer included physicians located approximately 66 miles, 56 miles, and 35 miles from the claimant’s home. The claimant testified, and the medical records confirmed, that she has difficulty sitting for long periods of time. She also has difficulty driving long distances and often has to stop and get out of the car to stretch. The driving causes increased pain and decreased productivity for several days after the trip. Furthermore, the claimant’s back injury required an orthopedic surgeon, of which there appeared to be many available in the claimant’s area. On these facts, the Commission concluded that the panel of physicians offered to the claimant was defective in that it included only one physician located within a reasonable distance from the claimant’s residence. Moomaw v. Premdor Virginia, 79 O.W.C. 97 (2000).

    Treatment by a physician is authorized if he is a member of an authorized medical group. Virginia Beach General Hospital v. Watson, Record No. 0432-85 (Ct. of Appeals, December 10, 1985).

    Carrier/Rehabilitation Counselor Cannot Dictate Medical Treatment:

    Nurse case managers are entitled to monitor the claimant’s medical treatment and progress but cannot direct medical care. There was no evidence the case manager engaged in prohibited conduct in this case. Gilbert v. Department of Motor Vehicles/Commonwealth of Virginia, VWC File Nos. 158-77-90 & 211-09-23 (March 28, 2005).

    Whether medical attention is necessary is a matter for the attending physician or the Commission to determine, not the employer. So long as a causal relationship between the industrial accident and the complaints which are the subject of the referral is shown, the employer is financially responsible for the medical attention which the attending physician deems necessary, subject to review by the Commission. Leon v. Lewis-Gale Clinic, 76 O.W.C. 350 (1997).

    Where the employer unilaterally and arbitrarily discontinues treatment recommended by the authorized physician without medical opinion to support the denial of such care, it will not be heard to deny the efficacy of the treatment that was recommended and will be liable for that care. Leon v. Lewis-Gale Clinic, 76 O.W.C. 350 (1997).

    Agreements between health care providers and medical care administrators may not limit the care to be authorized by the treating physician for treatment of industrial accidents. In re Cohen, 75 O.W.C. 63 (1996).

    Medical management of a claimant is to be directed by the treating physician, not by an employer’s representative. Neither the employer nor its insurance carrier may limit the treating physician in the medical specialist or treating facilities to which the claimant may be referred for treatment. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    An insurance carrier cannot limit the treating doctor’s medical management of a case or dictate the referral of a patient to a medical specialist or facility by its approval or disapproval of medical expenses. Robinson v. Omni Construction, Inc., 69 O.I.C. 137 (1990); Prince v. E. E. Lyons Const. Co., Inc., 76 O.W.C. 35 (1997).

    In finding that the claimant’s treating physician shall determine whether future treatment, including additional injections, is appropriate, the Commission noted that the Act does not proscribe palliative treatment, so long as such treatment is determined to be reasonable and necessary. Comer v. Newton Construction Company, 73 O.W.C. 147 (1994).

    It is within the purview of the treating physician’s expertise to determine the type of specialized treatment the claimant requires. The referral by the treating physician to a doctor who is not on the employer’s panel of physicians does not entitle the employer to require the employee to select from a new panel. Carter v. County of Arlington Fire Department, 73 O.W.C. 149 (1994); Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    If a claimant’s treating physician determines that a particular type of treatment is reasonable and necessary, the claimant is entitled to such treatment, even if such treatment is palliative in nature. Prince v. E. E. Lyons Const. Co., Inc., 76 O.W.C. 35 (1997).

    It is not within expertise of rehabilitation counselor to initiate referrals to a pain clinic. Taylor v. Capitol Milk Producers Coop., 60 O.I.C. 439 (1981).

    Claimant’s refusal to sign consent form for rehabilitation nurse not a refusal of medical attention where rehabilitation had not yet been recommended. Darden v. Franklin Concrete Products Corp. (appeal denied), 58 O.I.C. 78 (1978).

    Where the treating physician has prescribed specific medical treatment for the claimant’s work injury, the employer or its workers’ compensation carrier, not the employee, has the burden to proceed with evidence which would relieve it from the mandate of the act. Leon v. Lewis-Gale Clinic, 76 O.W.C. 350 (1997).

    It is well-settled that an employer cannot engage in medical management. It is the responsibility of the authorized treating physician to pursue and direct such medical treatment as may be deemed necessary for the benefit and improvement of the injured employee. However, where the authorized treating physician has requested the claimant return for examination and the claimant has not, it is not medical management for the employer to facilitate that examination by scheduling and advising the claimant of an appointment. Colindres v. Jay Swigart Construction, 76 O.W.C. 503 (1997).

    Effect of Physician’s Failure to Notify Employer or Provide Reports:

    Where a physician fails to provide medical reports to an employer/insurer within a reasonable time they are released from the responsibility to pay the doctor’s charge and may seek a change of physicians to continue the claimant’s treatment. Parks v. Systems Engineering Associates Corporation, 66 O.I.C. 104 (1987).

    Physicians rendering treatment to injured worker for which a claim will be made against his employer have a responsibility to notify the employer of such treatment within a reasonable period of time and failure to do so will bar their claim against such employer for costs of treatment rendered. Jackson v. Newport News Shipbuilding, 57 O.I.C. 189 (1977).

    The Commission may require reports not requested by other federal and state agencies and medical codes are not sufficient to report medical diagnosis and medical services. A properly executed Attending Physician’s Report meets this obligation. Martin v. Saunders B. Moon Community, 71 O.W.C. 198 (1992).

    General:

    No refusal of medical treatment where surgery is scheduled on same date as already scheduled elective surgery. Thomas v. Ford Motor Co., VWC File No. 216-63-99 (Feb. 15, 2005).

    Denial of employer’s Application to terminate benefits, based on refusal of medical treatment, affirmed; Application filed November 2003 and was supported by alleged refusal in April and August 2002 and March 2003; evidence showed compliance with treating physician’s treatment as of November 2003, and thus, at time employer’s Application was filed, there was no evidence of refusal. Gray v. Wal Mart Associates, Inc., VWC File No. 208-04-10 (Apr. 9, 2004).

    Employee did not refuse medical treatment by seeking treatment from unauthorized medical provider; although employer not responsible for payment for unauthorized treatment, evidence did not show that the treatment adversely affected employee’s recovery. Wright v. Newport News Sch. Bd., VWC File No. 210-53-06 (July 11, 2003).

    Employee not required to disclose telephone number to carrier, although it was necessary for carrier to coordinate transportation for employee to medical treatment; notice to employee’s counsel, however, considered notice to employee. Jones v. US Senate Fed’l Credit Union, VWC File No. 185-73-44 (May 16, 2003).

    The term “refusal” connotes a volitional act, some conscious and willful denial to accept or cooperate with medical services provided by or through the employer for treatment or rehabilitation. Campbell v. Ken Bridge Corporation, 78 O.W.C. 97 (1999).

    There is a clear distinction between “unauthorized medical treatment” and “refusal of medical treatment.” If medical treatment is unauthorized, this means only that the employer or its insurer cannot be required to pay for the cost of such treatment. One refuses medical care when one declines to see one of the treating physicians. Brown v. Miller & Long Company, 64 O.I.C. 68 (1985).

    Where, after choosing Patient-First from the panel of physicians, the claimant elected to seek subsequent treatment from a physician of her own choice, there has been no refusal of medical treatment. A claimant is entitled to seek treatment by a non-panel physician at her own expense. Alexander v. City of Richmond School Board, 73 O.W.C. 162 (1994).

    Unjustified refusal to accept medical treatment or to appear for medical appointments is grounds for suspension of compensation for period of such unjustified refusal. Stump v. Norfolk Shipbuilding Corp., 187 Va. 932 , 48 S.E.2d 209 (1948); Horn v. Centennial Constructors, Inc., 57 O.I.C. 171 (1976); Johnson v. TWA, Inc., 59 O.I.C. 157 (1980). Unless refusal later shown to be justified. Biggs v. Norfolk Dredging Co., 44 O.I.C. 20 (1962); Pettus v. American Airlines, Inc., 587 F.2d 627, 1978 U.S. App. LEXIS 8789 (4th Cir. 1978).

    The employer is responsible for providing transportation to physical therapy appointments for an injured employee, and the employee has not refused such medical treatment when the employer is aware of his transportation problems and declines to provide that transportation. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    Suspension of compensation cannot be based upon mere representation by counsel that claimant failed to report for medical examination. Chapman v. Centennial Contractors, 58 O.I.C. 59 (1979).

    Compensation will be reinstated after claimant’s unjustified refusal to accept medical treatment has ceased. Garris v. Hopewell City School Bd., 59 O.I.C. 88 (1980).

    The evidence failed to establish that the claimant’s failure to remain off his feet as directed interfered with the healing process. Lopez v. CLC Construction, 73 O.W.C. 13 (1994).

    Where the claimant just prior to the compensable injury underwent hernia surgery which was initially believed to be the cause of his problem, an eight-month delay before the claimant received treatment for a back injury was not unreasonable. Falls v. O’Baugh Ford Chrysler Plymouth, 73 O.W.C. 91 (1994).

    A refusal to accept medical care may be excused if the claimant is actually seeking a “higher level of care,” where the conduct is not actually a refusal of medical care but only a dispute as who should provide it. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    The claimant may seek medical care from an unauthorized physician of her own choosing, so long as it is not detrimental to her condition and does not prolong her injury or disability, but the employer is not necessarily responsible for that treatment. Dell’Orco v. Electronic Data Systems Corporation, 78 O.W.C. 221 (1999) (see also Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997); Riddick v. Whole Foods Market, Inc., 76 O.W.C. 28 (1997)).

    Employer not liable for increased disability resulting from refusal of medical treatment. Gayle v. Coleman Excelsior Co., 47 O.I.C. 141 (1965).

    Failure to Accept Treatment:

    Code § 65.2-603 (B) allows an employer to suspend compensation benefits to any employee who unjustifiably refuses reasonable and necessary medical services. The employee must prove that his refusal is justified. Justification for an employee’s refusal to accept medical treatment must be considered from the viewpoint of the patient and in light of the information that was available to him. Campbell v. Ken Bridge Corporation, 78 O.W.C. 97 (1999).

    Claimant’s refusal to continue with medical treatment by physician she had selected from proper panel offered by employer constitutes unjustified refusal of medical treatment under this section and bars her from further compensation. Koch v. The Southland Corporation, 61 O.I.C. 273 (1982).

    An employee’s unjustified refusal to select a treating physician from a panel presented by the employer constitutes refusal of medical services, and therefore bars the employee from further compensation until such refusal ceases. Bennett v. The Southland Corporation, 62 O.I.C. 53 (1983).

    The claimant may seek medical care from an unauthorized physician of her own choosing, so long as it is not detrimental to her condition and does not prolong her injury or disability, but the employer is not necessarily responsible for that treatment. Riddick v. Whole Foods Market, Inc., 76 O.W.C. 28 (1997).

    Refusal to be examined by internist justified where claimant was already being treated by two other physicians. Raines v. Stone & Webster Engineering Corp., (appeal denied), 58 O.I.C. 297 (1979).

    Failure to Attend Examination:

    Claimant’s failure to attend an FCE that was not ordered by the authorized treating physician did not constitute a refusal of medical treatment. Manion v. Northwestern Regional Adult Detention, JCN VA00000322305 (Aug. 5, 2019).

    Refusal of medical treatment justified where claimant incarcerated pending trial. Ellis v. Coastal Building Systems, Inc., VWC File No. 210-95-21 (June 7, 2004).

    Employee did not unjustifiably refuse medical treatment by failing to attend FCE, when treating physician had not advised employee of need for FCE, but had restricted employee from work; employee also provided advance notice to carrier of confusion over scheduling of FCE; Commission found that, from employee’s perspective, he was justified in not attending FCE. McClenahan v. American Med’l Labs., Inc., VWC File No. 202-86-46 (Feb. 23, 2004).

    An employer seeking to suspend compensation for the claimant’s refusal to submit to a medical examination must prove the claimant received notice of the examination. Devault v. Virginia Imports, Ltd., 74 O.W.C. 174 (1995) (see also Hall v. Highlander, 57 O.I.C. 153 (1976) (not properly notified of appointment)).

    A claimant’s failure to attend a scheduled appointment for treatment or in some cases for an independent medical examination may constitute a refusal to accept medical services and be a basis for the suspension of compensation. Griffith v. Commonwealth Steel Erectors, Inc., 68 O.I.C. 218 (1989).

    Medical management of a claimant is to be directed by the treating physician, not by an employer’s representative, and a carrier may not independently schedule treatment appointments for a claimant. A refusal to attend a treatment session scheduled by the carrier is not a refusal that is actionable under Va. Code Ann. § 65.2-603 . Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    In finding that an employee was justified in missing a medical appointment, the Commission held that the carrier made a unilateral attempt to change the treating physician and that the employee continued to accept medical attention from the treating physician. Haggin v. American Academy of Otolaryngology, 70 O.I.C. 293 (1991).

    Claimant’s conduct in scheduling a medical examination for a time when he was reasonably aware that he would be in jail, and not immediately rescheduling it upon his release, was tantamount to an unjustified refusal to accept medical treatment. Donigan v. American Steel Placing Company, 60 O.I.C. 144 (1981).

    An incarcerated claimant who was unable to attend a medical examination arranged outside the prison neither precluded nor refused an independent medical examination and remained entitled to benefits. Escobar v. L. M. Sandler & Sons, Inc., 68 O.I.C. 206 (1989) (see also Blankenship v. Giles, 46 O.I.C. 23 (1964) (no refusal where court refused to allow release for treatment)).

    Independent Medical Examinations:

    An independent medical examiner cannot admit an employee to a hospital for diagnostic and work-up procedures unless the employee, or his counsel, agree and the treating physician approves. Rice v. Misty Bec Coal Corp., 70 O.I.C. 302 (1991).

    In requiring an employee to submit to an MRI and thermographic examination, the Commission held that reasonable noninvasive medical tests and procedures are properly allowed as the part of an independent medical examination under § 65.1-91 (now § 65.2-607 ). Willis v. William Bohannon, 70 O.I.C. 300 (1991).

    While an employer has a right to an independent medical examination it does not have the authority to require an employee to attend an institution’s program without the concurrence of the treating physician or the Commission. Hasler v. Rockingham Memorial Hospital, 70 O.I.C. 298 (1991).

    It is not a refusal of medical care for the employee to decline to be seen for follow-up examinations by a physician she chose to see for an independent second opinion. Coleman v. Haynes Furniture Co., Inc., 75 O.W.C. 131 (1996).

    The bare assertion from an employer’s medical examiner, after treatment has already been rendered to the injured employee, is not sufficient evidence to establish that medical care provided by the treating health care providers was excessive or unnecessary. Choi v. Shoppers Food Warehouse, 76 O.W.C. 183 (1997).

    Refusal of Specific Medical Procedure:

    Refusal justified where treatment dangerous to the life of the claimant. Hunsucker v. Coal Processing Corp., 29 O.I.C. 15 (1947).

    Where claimant’s physician advised against myelogram refusal was justified. Shimett v. Schewel Furniture Co., 40 O.I.C. 141 (1958).

    Refusal of myelogram justified where claimant’s fear of needles and related myelographic procedure verified by psychiatrist. Hayes v. Family & Children Services of Richmond, 60 O.I.C. 199 (1981).

    Refusal justified where medical opinion divided as to necessity of myelogram or necessity of exploratory operation. Barnette v. Rasnic, 46 O.I.C. 17 (1964); Biggs v. Norfolk Dredging Co., 44 O.I.C. 20 (1962).

    A claimant’s continued refusal of recommended surgery because of fear of the procedure and its possible effects may be an unjustified refusal of medical attention for which compensation benefits may be terminated. Wallen v. Prime Time Restaurant, 65 O.I.C. 251 (1986).

    The Commission will not order an employee to undergo surgery nor will it require an employer or carrier to continue payments for disability during the period the claimant elects not to accept the only mode of treatment which will allow him to return to productive employment. The medical evidence does not have to establish that the surgery will allow the employee to return to his regular employment. Wisniewski v. Fairfax County School Board, 71 O.W.C. 225 (1992).

    Where the outcome of an operation is problematical, or attended with real dangers to life or limb or may not, even if successful, reduce the amount of disability or compensation payable, refusal of the procedure is justified. Nance v. Fuqua, 34 O.I.C. 562 (1952).

    The claimant experienced chest pains and other symptoms after undergoing a nerve block prescribed by his treating physicians. The claimant thereafter was treated by other physicians who suggested nerve block treatment, but who also acknowledged the claimant’s hesitation and instead continued conservative treatment. The Commission noted that the treating physician had reported that the claimant’s “disinclination” to undergo nerve blocks was “entirely logical,” that the nerve block was only one of several treatment regimens recommended, and it held that the facts of this case did not show a refusal of medical care that would justify denial of benefits. Wood v. D. S. Nash Construction Co., 79 O.W.C. 178 (2000).

    Where the employee’s treating physician offers no assurances that surgery would be effective, but only that she might either gain or lose motion, the Commission will not compel the claimant to accept surgery under those conditions and the claimant is justified in refusing such surgery. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997), aff’d, Nos. 1238-97-3 & 1290-97-3 (Va. Ct. App., Dec. 23, 1997).

    An employee was justified in refusing to take a stress test during an independent medical examination because of a genuine fear of the testing and the potential for injury. In addition, the physical requirements of the test were contrary to the treatment prescribed by her treating physician. Justification for refusal must be determined based on an objective view of all circumstances as they reasonably appeared to the employee. R. G. Moore Building Corp. v. Mullins, 10 Va. App. 211, 390 S.E.2d 609 (1990).

    Where an employee refused to undergo a bone scan until he had an opportunity to consult with the treating doctor concerning the risk inherent in the procedure, there was no unjustified refusal of medical treatment. The matter of justification must be considered from the viewpoint of the patient and in light of the information which is available to him. Holland v. Virginia Bridge and Structures, Inc., 10 Va. App. 660, 394 S.E.2d 867, 7 Va. Law Rep. 187, 1990 Va. App. LEXIS 145 (1990).

    The Commission held that the claimant was justified in refusing surgery where on the morning of the surgery she was surprised to learn that “a piece” ( i.e. bone graft) would be placed in her neck. Chatman v. Mary Immaculate Hospital, 73 O.W.C. 159 (1994).

    Failure to Obtain Prescription/Treatment:

    In deciding whether the claimant has refused medical treatment, we consider whether the claimant’s refusal to submit to the treatment was justified from the claimant’s viewpoint and in light of the information available to the claimant at the time. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    An employee’s failure to obtain prescribed medication is not a refusal of medical services if the employer has denied the claim. Stephens v. WARROCO, Inc., 69 O.I.C. 92 (1990).

    Where an employer denies the compensability of a claim and its responsibility for medical treatment, it cannot assert the employee’s failure to follow medical instructions as a defense. Hall v. C. R. Hudgins Plating Company, 70 O.I.C. 237 (1991).

    Failure to Lose Weight or Stop Smoking:

    When a claimant demonstrates a continuing attempt to lose weight as recommended by his physician and was not placed in a specific weight loss program, compensation benefits may not be terminated for refusal of medical attention. Collins v. TLI, Inc., 67 O.I.C. 177 (1988).

    In order to suspend benefits, there must be some evidence that the employee failed to follow the prescribed treatment or behaved in such a manner as to sabotage or obstruct his weight loss or stop smoking program. Campbell v. Ken Bridge Corporation, 78 O.W.C. 97 (1999).

    The mere fact that an employee does not lose weight while enrolled in a weight reduction program does not by itself establish the employee has failed to cooperate with medical attention. Sprague v. Arlington County Public Schools, 71 O.W.C. 236 (1992).

    The fact that doctors suggested to the claimant that he lose weight and stop smoking, and that the claimant did not do so, does not in itself constitute refusal of medical treatment, where there is no evidence that the claimant was ever put on an actual weight loss or stop smoking program. Campbell v. Ken Bridge Corporation, 78 O.W.C. 97 (1999).

    Where there is no evidence of a specific weight reduction diet program, employer’s application denied. Willis v. Clark Transfer, Inc., 57 O.I.C. 389 (1977).

    Compensation suspended for failure to follow a prescribed weight reduction program. Wine v. Hearty-Virginia, Inc., 45 O.I.C. 255 (1963); Ward v. Roses Stores, Inc., 51 O.I.C. 288 (1969); Pence v. The Macke Co., 57 O.I.C. 290 (1977).

    An employee, who was advised by her treating physician that the vasospasm that developed after treatment for a finger cut would be exacerbated by smoking, complied with medical treatment by reducing her cigarette consumption to one pack per day. Harris v. Petland, Inc., 70 O.I.C. 291 (1991).

    The treating physician directed the employee to quit smoking, explaining that necessary spinal fusion could not be performed until he did so. The Deputy Commissioner found that his failure to cease smoking constituted an unjustified refusal of medical treatment under Code § 65.2-603 (B). The employee argued that he “cured” his refusal, asserting that he had reduced the amount of his cigarette smoking. While acknowledging that the mere fact that smoking cessation efforts have not been completely successful does not establish a per se failure to cooperate with medical treatment, the Commission held that the employee “must show behavior that demonstrates a substantial personal effort to stop smoking.” Because the employee did not prove that he was in the midst of an ongoing, good faith effort to end the smoking habit, the Commission found that he had failed to cure his earlier refusal medical treatment. Lind v. United Parcel Service, VWC File No. 152-82-72 (January 5, 2001).

    Curing Refusal:

    To cure unjustified refusal of FCE claimant must do more than verbally state she is now willing to undergo the evaluation. In order to show good faith there must be an affirmative action demonstrating willingness to attend the evaluation. Devaughn v. Fairfax County Public Schools, JCN VA00000940928 (Mar. 5, 2018), aff’d. No. 0539-18-4 (Ct. App. of Va., Oct. 30, 2018) (unpublished opinion).

    The Workers’ Compensation Act was amended October 1, 1991 to include within the definition of “change in condition” an award that had been earlier “suspended.” This statutory change effectively vitiated the distinction between suspended and terminated. Employees thereafter were obliged to prove the extent of continuing disability through marketing efforts, in order to have compensation benefits reinstated. Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    In the absence of other mitigating factors, suspension of benefits for refusal of medical or rehabilitation services will continue until the claimant actually meets with a physician or counselor and cures a refusal. Lester v. Northern Mineral Corporation, 64 O.I.C. 203 (1985).

    An award suspended for failure to attend an independent medical examination, may be reinstated upon evidence that the employee has cured his earlier refusal. Campbell v. Thomas J. Fannon & Son, Inc., 69 O.I.C. 147 (1990).

    Where there has been a refusal of medical treatment, a cure may be effected by meeting with the treating doctor. The cure for unreasonably refusing surgery is not limited to undergoing the surgery. Kibler v. Alger Brothers Construction Co., 73 O.W.C. 157 (1994).

    The claimant’s unjustified refusal to attend examinations with his treating physician can be cured only by his attending examinations by that doctor. It is not cured by attending an employer’s medical examination. Colindres v. Jay Swigart Construction, 76 O.W.C. 503 (1997).

    The employee cured her refusal to submit to an employer’s medical examination by agreeing to attend an independent medical examination by a physician to be chosen by the Commission. Coleman v. Haynes Furniture Co., Inc., 75 O.W.C. 131 (1996).

    While acknowledging that the mere fact that smoking cessation efforts have not been completely successful does not establish a per se failure to cooperate with medical treatment, the Commission held that to cure such refusal, the employee “must show behavior that demonstrates a substantial personal effort to stop smoking.” While the employee may have reduced his smoking because he did not prove that he was in the midst of an ongoing, good faith effort to end the smoking habit, the Commission found that he had failed to cure his earlier refusal medical treatment. Lind v. United Parcel Service, VWC File No. 152-82-72 (January 5, 2001).

    CHANGE IN PHYSICIAN OR HOSPITAL.

    A change in treating physicians is warranted where a doctor’s care is no longer helpful, the claimant’s condition is not improving, the doctor has no long-term plan for the claimant’s care, and the employer’s doctors have recommended aggressive physical therapy or work hardening because the claimant’s condition has deteriorated due to lack of physical activity. Johnson v. Service Solutions Corp., VWC File No. 201-04-09 (May 24, 2004).

    Employer estopped from denying employee’s treatment with family physician; employee requested that carrier approve changing physicians from panel physician to family physician, and carrier did not object; thereafter family physician referred employee to another specialist, and employee’s condition improved; employer responsible for treatment with family physician and subsequent referrals. Darden v. Greensville Corr. Ctr., VWC File No. 206-54-96 (Nov. 12, 2003).

    Physician who retired and referred employee, along with other patients, to another physician did not deny or refuse treatment, which would require employee to seek another panel from employer, but made valid referral for authorized medical treatment. Souleyrette v. Clinchfield Coal Co., VWC File No. 199-21-61 (Oct. 9, 2003), aff’d, No. 2877-03-3 (Ct. App. Va., June 1, 2004).

    Change of treating physician not appropriate when based on speculation of outcome of treatment, when employee did not fully comply with recommended treatment; claimant’s objection to treatment not supported by medical opinion; thus treatment not shown to be improper or incomplete. Handy v. Lester Group, Inc., VWC File No. 208-87-03 (May 20, 2003).

    Claimant who changes physicians or hospitals without (1) prior authorization of employer, insurance carrier, or Commission, or (2) subsequently established justification for such change must pay the medical treatment rendered by second physician or hospital. Martin v. Miller & Rhoads, Inc., 34 O.I.C. 19 (1952); Mitchell v. Anchor Warehouses, 49 O.I.C. 223 (1967).

    The Commission has the authority to change a treating physician. The employee shall accept the attending physician, unless otherwise ordered by the Commission. Directing a change in physician is within the Commission’s discretion. Livingston v. Dart Drug Stores, Inc., 77 O.W.C. 77 (1998).

    The Commission will order a change in physicians if it finds inadequate treatment is being rendered; a specialist in a particular field is required and not being provided; the absence of improvement in an employee’s health condition is without adequate explanation; conventional modalities of treatment are not being used; there is no treatment plan for long-term disability cases; or a physician fails to cooperate with discovery proceedings. Powers v. J. B. Construction, 68 O.I.C. 208 (1989); Livingston v. Dart Drug Stores, Inc., 77 O.W.C. 77 (1998); Cubbage v. Wrangler, 78 O.W.C. 166 (1999).

    Reimbursement for unauthorized medical treatment should be the rare exception. When an employee seeks treatment other than that provided by the employer or ordered by the commission, he or she does so at his or her own peril and risks not being reimbursed. Only where the course of treatment provided by the employer is inadequate for the condition should the employer have to pay for a different course of treatment. Reasonable and necessary treatment does not mean merely an alternative form of treatment. Dell’Orco v. Electronic Data Systems Corporation, 78 O.W.C. 221 (1999).

    The carrier refused two requests by the claimant to provide her with a new panel of physicians. The claimant then arranged to see another physician through the employer’s health insurance plan. Thus, the employer was aware that the claimant had sought alternative treatment, and the Commission found that the claimant acted in good faith. Also, none of the authorized physicians ever ordered a discogram, even though her condition was diagnosed as a lumbar disc problem with a “pinched nerve” and radiculopathy. The discography ordered by the new physician showed an operable condition, where the claimant’s condition before had managed with strong narcotic pain medication. The claimant improved after surgery was performed by the new physician. The Commission held that the treatment provided by the authorized physicians was inadequate, since they failed to prescribe tests necessary to diagnose the surgically correctable lesion, and the claimant’s change in physician was approved. Dell’Orco v. Electronic Data Systems Corporation, 78 O.W.C. 221 (1999).

    The employer failed to justify its request for a change in approved treating physician. Where the employer alleges only that there is a lack of progress and no plan of continuing treatment, it must identify alternative care that should be substituted and present persuasive evidence that such alternative care is more appropriate and would be more productive. Lentz v. The Stanley Works, VWC File No. 191-04-68 (January 23, 2001) see also Bennett v. Fairfax County School Board, 74 O.W.C. 1 (1995).

    When the treating physician fails to discover the essential medical problem, there is a sound basis for the designation of another treating physician. Owen v. McLean Trucking Company, 63 O.I.C. 260 (1984).

    Improvement in the claimant’s medical condition alone is not a basis for changing physicians. There must be evidence that the authorized treatment was inappropriate or inadequate. Nevitt v. Wilmik, Inc., 73 O.W.C. 151 (1994).

    If 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. Dell’Orco v. Electronic Data Systems Corporation, 78 O.W.C. 221 (1999).

    The claimant began treating with her family physicians and an allergist/immunologist after her exposure to fumes precipitated an asthma attack. The Commission found that the treatment she was receiving from those physicians was appropriate and adequate, and her evaluation by another medical facility for a second opinion, without a referral from the treating physicians and before the claim was denied, was unauthorized and not the responsibility of the employer. Dyer v. Vann-Atlantic Orthopaedic Specialists, 76 O.W.C. 457 (1997).

    Where the treating physician made appropriate referrals for neurological, orthopaedic, chiropractic, and physical therapy evaluations, and none of the referrals resulted in treatment plans to improve the claimant’s condition; and where the treating physician candidly admitted that he is unable to determine the basis of the claimant’s problem and that he mainly treats her with pain management techniques, but the claimant testified that such treatment is the only thing that has provided her any relief; the Commission concluded that it could not find that the doctor’s treatment had been inadequate, or that he had failed to refer the claimant to appropriate specialists, or that conventional modalities of treatment had not been used. The Commission held that a mere absence of improvement in the claimant’s condition, where there is no evidence that any other type of treatment is warranted or would improve the claimant’s condition, is an insufficient basis to direct a change in the claimant’s treating physician, when no other potentially beneficial modality of treatment has been offered. Cubbage v. Wrangler, 78 O.W.C. 166 (1999).

    When a claimant who was never initially offered a panel of three physicians subsequently changes physicians without authorization but realizes appreciable benefit and relief from said change, the treatment is considered necessary and shall be paid by the insurer. Wiggins v. Planters Peanuts/Division of Nabisco Brands, Inc., 62 O.I.C. 510 (1983).

    An employee may be justified in changing treating physicians where the evidence establishes difficulties in contacting and scheduling appointments with the current physician. Palmer v. City of Roanoke Emergency Services, 7 O.I.C. 147 (1991).

    That claimant is unable to communicate with treating physician because of language barrier and selects physician with whom he can communicate in his native tongue was basis for a change in physician. Kassaz v. Gay Plumbing & Heating, 56 O.I.C. 193 (1975) (aff’d on review).

    Where the treating physician advised the claimant that he had nothing further to offer in the way of medical treatment, the burden passed to the employer to either accept the physician subsequently chosen by the claimant or offer the claimant a panel of physicians. Peck v. Buckley Lages, Inc., 68 O.I.C. 203 (1989).

    Treatment and assessment of work disability by a physician’s assistant without any attention from a physician is inadequate treatment and a basis for finding that the physician abandoned treatment. The claimant had good reason to seek alternative treatment when he realized he was being treated by a physician’s assistant. Galvan v. Checkered Flag Mitsubishi Parts, 73 O.W.C. 153 (1994).

    The Commission has considered in some cases other circumstances for justification to change a treating physician, including the distance an employee must drive to visit his treating physician. Livingston v. Dart Drug Stores, Inc., 77 O.W.C. 77 (1998).

    Where employer’s failure to comply with lawful award of Commission operated as an injustice upon claimant and resulted in unnecessary economic hardship and inability to obtain medical care, claimant was justified in changing psychiatrists and securing treatment closer to home. Alsop v. Marriott Corp., 60 O.I.C. 12 (1981).

    The Commission is unwilling to micro-manage the selection of every panel of physicians by comparing the distance the employee must travel. Neither would it be feasible for the Commission to delineate the precise distance which would be reasonable for all situations. Each case differs depending upon the specifics involved, such as the employee’s limitations, the physician’s specialty, and the availability of physicians in the area. However, the Commission will review distances which appear to be unreasonable. Livingston v. Dart Drug Stores, Inc., 77 O.W.C. 77 (1998).

    The claimant visited Dr. Gisolfi at hospitals in Alexandria and Woodbridge. Her condition did not hinder her from driving and she drove herself to appointments. She did not provide any evidence of the precise mileage of the trip from Falmouth to Woodbridge, but the Commission estimated from a map of the Commonwealth that the distance from her former residence in Dale City to Dr. Gisolfi’s office in Alexandria was approximately 20 miles, and that the distance from Falmouth to Woodbridge was less than 40 miles. The Commission held that the distance from the claimant’s residence in Falmouth to her treating physician’s office in Woodbridge was reasonable. Livingston v. Dart Drug Stores, Inc., 77 O.W.C. 77 (1998).

    The Commission ordered a change in the approved treating physician due to the physician’s consistent failure to cooperate with the insurer’s reasonable efforts to collect information regarding the claimant’s medical status. While Code § 65.2-603 grants the approved treating physician the exclusive right to manage the injured worker’s medical treatment, the Act provides a concomitant obligation on the part of the physician to reasonably cooperate with the insurer’s requests for information regarding the claimant’s condition and ongoing treatment. Code § 65.2-604 and Commission Rule 4.2 require that physicians attending injured workers provide medical reports upon request. In this case, the treating physician’s consistent refusal to cooperate prejudiced the insurer’s ability to evaluate the employee’s ongoing condition and treatment, thereby justifying his removal. Newton v. Hunt Country Nursing Service, VWC File No. 196-43-73 (June 12, 2002).

    Generally, where the treating physician states that he has nothing further to offer the claimant, and will not continue to see her, the employer must offer the claimant a new panel of treating physicians. If the employer fails to provide a new panel, the claimant is free to select a treating physician on her own. In this case, the claimant chose her own doctor, and began treatment, after her requests for a new panel were met with denials. Under these circumstances, the Commission found that the Deputy Commissioner erred when he ordered the employer to provide a new panel of physicians, instead of recognizing the treating physician selected by the claimant. Simmons v. Stafford (County of) School Board, VWC File No. 203-42-59 (March 25, 2002).

    MEDICAL COSTS.

    General:

    The entry of an order concerning injured employee’s settlement of unadjudicated claim is not the equivalent of a viable award of medical benefits and medical provider’s claim for payment filed after approval of settlement is denied. Riddick v. Newport News Shipbuilding and Dry Dock Co., JCN 2307754 (Feb. 8, 2016).

    Carrier denied payment of medical bills submitted by the claimant on the ground that they were not obligated to pay expenses without receiving CPT codes to determine whether the bills were related to the work injury. The Commission ruled that the defendants possessed sufficient evidence and information to pay, and that the defendants defended the claim for payment of the bills without reasonable grounds. The Act does not allow the defendants to deny payment because they have not received the bills on a particular form or because they have not received CPT codes for those charges. Lucas v. Dan Lepore & Sons Company, JCN VA01002425789 (Aug. 12, 2011).

    Where a non-English speaking claimant requires an interpreter at medical appointments, the services of the interpreter, like medical transportation, facilitate the claimant’s access to and receipt of medical treatment, and must be provided by the employer. Garcia v. Headway Corporate Resources, Inc., VWC File No. 227-88-25 (Nov. 12, 2009).

    In denying the medical provider’s claim that the employer/carrier was responsible for the remaining balance of the medical charges for treatment of the claimant, the Commission found that a preferred provider organization contract (PPO) controlled and the charges were properly reduced in accordance with the contract. Byies and Orthopedic Specialty Clinic v. Tri State Plumbing and Heating, Inc., VWC File No. 220-72-61 (Sept. 19, 2007).

    Employee failed to show that installation of hand controls on personal vehicle was necessary medical treatment; evidence did not show that ankle injury resulted in inability to drive; evidence also did not show that inability to drive prevented employee from returning to selective employment. Quinn v. Dressler,, VWC File No. 176-71-96 (Feb. 24, 2004).

    Deputy Commissioner properly rejected medical provider’s application for hearing concerning payment of outstanding medical bills; application was not filed personally by the physician or by a bona fide member of the physician’s office staff, but by a non-attorney third-party collections agency. Howe v. Shenandoah Nursing Home, VWC File No. 207-50-00 (Aug. 4, 2003).

    Medical bills received by a claimant are prima facie evidence that they are both reasonable and necessary. An employer or carrier alleging excessive medical charges must prove that such costs exceed the prevailing rate of the community for the same services. A mere statement by a carrier that their administrator recommended a different community rate payment does not satisfy the insurer’s burden to show that the charges in question are higher than the prevailing community rate. Moorefield v. Cooperative Supply Inc., 79 O.W.C. 29 (2000).

    The threshold issue in determining whether an employer is responsible for payment of medical expenses or supplying medical appliances under § 65.2-603 is whether the costs are reasonable and necessary. Flanegin v. Hechingers Corp., 75 O.W.C. 275 (1996).

    Where the treating physician has prescribed specific medical treatment, the carrier, not the employee, has the burden to proceed with evidence to show that medical treatment is unreasonable, unnecessary, and inappropriate. Flanegin v. Hechingers Corp., 75 O.W.C. 275 (1996).

    Although the treating physician stated that medication prescribed for hypertension and hypercholesterolemia is beneficial to the claimant’s general health, and will likely negatively affect any or most other health conditions from which the claimant may be suffering, the evidence does not show it is necessary treatment of the compensable injury. Rucker v. Carico, 76 O.W.C. 251 (1997).

    Code § 65.2-600 , Sections C - E, provides that an employee shall not be entitled to physicians’ fees prior to giving notice of the accident, as well as the nature and cause of the accident and the injury, unless it is shown that the employer had knowledge of the accident or that the party required to give notice had been prevented from giving notice by reason of physical or mental incapacity. Further, no medical benefits shall be payable unless reasonable excuse is made for not giving notice and the Commission is satisfied that the employer has not been prejudiced. This section requires that the employer prove the extent of any prejudice due to the failure of the claimant to give notice. Hall v. A. Bertozzi, Inc., 76 O.W.C. 415 (1997).

    Where the employer was not told that the claimant suffered an injury that required medical care until after an operation to re-attach a retina had been performed, the Commission found that the employer was prejudiced because it was denied the opportunity to offer a panel of physicians to evaluate and treat the injury, and that the employer was not liable for medical treatment prior to the date it received notice of the injury. Hall v. A. Bertozzi, Inc., 76 O.W.C. 415 (1997).

    The Commission denied a physician’s demand for fees related to medical “case management.” The physician demanded a fee for telephone communications he had with defense counsel and the insurer’s representatives. In denying the claim, the Commission noted that approved physicians are entitled to reasonable reimbursement for services that provide the claimant with necessary care. An approved physician may be entitled to a reasonable fee for the preparation of any special reports required by the parties, and the costs associated with the time the physician may have to spend offering testimony, whether at a hearing or by deposition. However, the physician may not necessarily be reimbursed for all the time spent related to the employee’s treatment. By statute, certain types of reports must be provided by the physician, the preparation of which constitutes medical “case management.” The costs associated with preparing these reports are subsumed within the totality of the fee paid to the physician and the medical care he is expected to provide. Fox v. Waffle House, VWC File No. 194-57-70 (April 30, 2001).

    Absent evidence of reasonable cause, the employer/insurer are not responsible for a “no show” fee charged by a physician when the injured employee fails to attend a scheduled medical appointment. This charge does not result from treatment by a physician or other “necessary medical attention.” There is no provision in the Act that requires employers to be responsible for the claimant’s failure, without reasonable cause, to attend scheduled appointments. The medical provider’s request for payment of the “no show” fee was denied. Hargrave v. Williamsburg/James City County School Board, VWC File No. 195-12-65 (March 20, 2002).

    Reasonableness of Charge:

    See Commission Rule 14. Definition of Community.

    The employer was not responsible for the full payment of the bill because the pharmacy charges exceeded the prevailing community rate and it included charges for ancillary services that are not included under the Act, such as advocacy services in achieving reimbursement and the shifting of risk of non-payment away from the patient. Riggleman, Jr. v. Donald L. Riggleman, VWC File No. 138-66-10 (Aug. 30, 2005).

    Medical bills received by the claimant are prima facie evidence that they are both reasonable and necessary. Blevins v. Williamsburg Pottery, 75 O.W.C. 103 (1996).

    An employer alleging excessive doctors’ fees must prove that such costs exceed the prevailing rate of the community for the same or comparable services. Korsh v. Builders Hardware & Architectural Prods., Inc., 76 O.W.C. 76 (1997).

    Actual charges rather than the rate billed must be used in submitting fee data. Hopkins v. Fairfax County School Board, 73 O.W.C. 168 (1994).

    The employer has the burden of showing that the physician’s charges did not fall within the prevailing community rate as set forth in § 65.2-605 , and that the carrier’s reimbursement did meet that standard. The employer retains this burden whether the claim is brought by the employer or the medical care provider. Korsh v. Builders Hardware & Architectural Prods., Inc., 76 O.W.C. 76 (1997).

    An employer and/or medical care provider may file an action under § 65.2-605 . However, the employer has the burden of establishing that the medical fee billed did not meet the community standard and the reimbursement rate was appropriate. Hopkins v. Fairfax County School Board, 73 O.W.C. 168 (1994).

    The fact that MedCheck procedures have been found to be appropriate in prior cases does not mean its procedures in a subsequent proceeding may not be challenged where different factual evidence is available. Where the evidence reveals that the cost data base is incomplete and is not shown to be truly representative of the costs of similar services charged by health care providers in the community, but is collected only from payer clients and thereafter “augmented” with other data, the evidence does not show that charges for x-rays exceeded those prevailing in the community for similar treatment that would be charged to and paid by an individual injured person. The employer’s decision to fully pay only at the 70th percentile fails to show any correlation with the standard for determining appropriate costs as set out in Va. Code Ann. § 65.2-605 , i.e., the “charges as prevail in the same community for similar treatment when such treatment is paid for by the injured person.” Louise Obici Hosp. v. Dept. of Trans., 75 O.W.C. 235 (1996).

    The Commission held that an acceptable method for determining what constitutes the prevailing rate in the same community may include employing a reasonable procedure in calculating the usual and customary charges for the services rendered, assigning codes for the services, then comparing them to a data base of fees in the geographic area. Griffin v. Suffolk City Public Schools, 71 O.W.C. 217 (1992).

    There is no requirement that an application from a health care provider be filed by a licensed attorney. Blevins v. Williamsburg Pottery, 75 O.W.C. 103 (1996).

    The Commission found that there was a compensable accident, and that the claimant’s medical treatment was related to the accident. The claim of the health care provider to recover the cost of its services was denied, because the treatment was not reasonable and necessary. Since the health care provider availed himself of the Commission’s jurisdiction and is bound by that decision denying a recovery, he no longer has a cause of action for the subject charges against either the claimant or the employer/insurer. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    Transportation/Travel Costs:

    Note: Effective July 1, 2011, the reimbursement is 55.5 cents per mile.

    A motorcycle is a motor vehicle but not an “automobile” for the purposes of Code § 65.2-603 ; claim for modification of motorcycle denied.

    Claimant required by treating physician and state law to present to office in person to pick up prescriptions for narcotics refills between regularly scheduled physical appointments was entitled to transportation reimbursement. Williams v. Food Lion, LLC, JCN 2364717 (May 15, 2014).

    The Act does not require the purchase of a modified van or modifications to an existing vehicle as a reasonable and necessary medical expense. The defendants are allowed to choose the method for meeting their obligation to provide transportation to medical appointments. An employer is not estopped from relying on provisions of the Act merely because it made voluntary payments or provided voluntary benefits. Davis v. Lupton Logging & Pulpwood, Inc., VWC File No. 168-83-90 (Aug. 14, 2006).

    In view of the employer’s refusal to arrange for a transfer of prescription to a pharmacy near the claimant’s home, the employer is responsible for mileage to the pharmacy. Snyder v. Found and Sons, Inc., VWC File No. 204-55-02 (Sept. 8, 2004).

    Employer responsible for employee’s taxicab expenses for travel to medical appointments; employee lacked personal transportation and sought transportation from carrier, but carrier denied; taxicab expenses considered transportation expenses under Act, requiring reimbursement by employer. Hamil v. Lowe’s of N. Manassas VA, VWC File No. 208-73-39 (May 30, 2003).

    The carrier is responsible for reasonable and necessary transportation costs in connection with medical treatment. However, in the absence of evidence that an injured employee cannot have a prescription filled in connection with medical appointments or other errands, a carrier is not responsible for the cost of mileage to and from a pharmacy. Mabe v. Great Barrier Insulation Co., 70 O.I.C. 288 (1991).

    Failure to attend medical examination excused where carrier failed to advance travel expenses or arrange for transportation. Diggins v. Grace and Co., 46 O.I.C. 66 (1964); Gilbert v. Hyman Construction Co., 58 O.I.C. 149 (1978).

    Employer will be liable for necessary mode of transportation: ambulance, airplane. Penley v. Handcraft One Hour Cleaners, 49 O.I.C. 257 (1967); Montgomery v. Hausman Corp., 52 O.I.C. 183 (1970).

    Employer is obligated to pay the cost of transportation for the claimant to and from vocational training courses. Garland v. Williams Enterprises, Inc., 60 O.I.C. 167 (1981).

    An employee was justified in missing work hardening appointments since the carrier was aware of his transportation problems and failed to make alternative travel arrangements. Osterle v. Interior Specialty Construction, Inc., 70 O.I.C. 310 (1991).

    Although long established principles in interpreting the Virginia Workers’ Compensation Act instruct that it is to be liberally construed for the benefit of employees, such liberal construction may not be used to amend a statute by changing the meaning of the statutory language. The Commission found that Va. Code Ann. § 65.2-603 (A) does not provide for modification or purchase of an automotive vehicle as a reasonable and necessary medical expense. Falls v. W E L, Inc., 77 O.W.C. 197 (1998).

    Even if modification or purchase of an automotive vehicle was authorized by the Act, it would not be allowed in this case, where the claimant purchased the vehicle without authorization and without giving the insurer an opportunity to arrange alternative transportation, and where the purchase was made before the claimant received authorization from his treating physician that it was medically necessary. Falls v. W E L, Inc., 77 O.W.C. 197 (1998).

    Where the claimant had car repair problems and knew that other patients were provided transportation by the carrier, but represented that the car problems were short term and did not request transportation from the carrier, the carrier was under no obligation to affirmatively offer such transportation, and the failure of the claimant to attend a back rehabilitation program for lack of transportation was not justified. Mason v. Baker Roofing Co., 75 O.W.C. 18 (1996).

    Where the claimant fails to keep receipts for the cost of meals during travel to medical appointments, he may be reimbursed pursuant to the perquisites schedule of the Commission, with the costs of three meals paid on days on which he traveled and attended two appointments, and the costs of two meals paid on days on which the claimant attended only one appointment. Spaulding v. Kroger Company, 77 O.W.C. 135 (1998).

    Specially modified van is not a form of necessary medical attention. Judge v. Robert Whitmar & C. Kirk Reilly & Associates & R. T. Construction Corporation, 62 O.I.C. 257 (1983).

    Acupuncture:

    When a licensed physician renders acupuncture treatment, the employer is responsible for the cost. Jones v. Commonwealth of Virginia Department of Correction, 62 O.I.C. 254 (1983).

    Air-Conditioning:

    A prescription indicating it would be “extremely helpful” for the claimant to have air-conditioning in his car “optimally” to control his asthma does not establish medical necessity. Carter v. Arlington County Fire Department, 73 O.W.C. 164 (1994).

    Chiropractic Care:

    Chiropractic services and treatment are included within the ambit of medical care available to the injured employee. Taliaferro v. Monroe Transfer & Storage Company of Hampton, 62 O.I.C. 443 (1983) (see also Yates v. Royal Machine Works, Inc., 61 O.I.C. 444 (1982) (medical treatment so long as authorized)).

    Section 54.1-2900 defines the “practice of chiropractic” to be “the adjustment of the twenty-four movable vertebrae of the spinal column, and assisting nature for the purpose of normalizing the transmission of nerve energy. . . .” The treating physician, a chiropractor, assigned impairment ratings to the claimant’s arms and legs, based on an alleged torn rotator cuff and bilateral hip conditions, parts of the body clearly not included within the statutory definition of the “practice of chiropractic”. The Commission held that the chiropractor’s opinions on the impairments exceeded the statutory definition of chiropractic practice and were not probative. Marshall v. Old Dominion University, 78 O.W.C. 238 (1999). For other cases where treatment outside scope of chiropractic care see also Donato v. Owens Illinois, Inc., VWC File No 210-84-57 (June 9, 2004) (opinion concerning left wrist not considered) Brookes v. Fauquier Springs Country Club, VWC File No. 210-35-35 (Aug. 26, 2003) (not required to pay for treatment to ankle).

    The evidence established that chiropractic treatment was reasonable and necessary and there was no basis for ordering a change in treating physicians. Dotti v. Sonco Wholesale Fence Company, Inc., 70 O.I.C. 307 (1991).

    Annual concierge fee charged by treating pain management physician was not a reasonable and necessary cost of medical treatment and thus not responsibility of employer. Cooper v. Quik Case 211, JCN 2159285 (May 10, 2018).

    Dental:

    Dental problems that result from medication prescribed for the industrial accident are a compensable consequence and the responsibility of the employer. Martin v. Still Water, Inc., VWC File No. 152-51-72 (May 17, 2007).

    Carrier responsible for replacement of damaged teeth. McKeaver v. Southern Oil & Feed Mills, Inc., 7 O.I.C. 659 (1925); Fields v. Nello L. Teer Co., 52 O.I.C. 102 (1970); Fox v. Vass Constr. Co., 55 O.I.C. 135 (1973).

    Cost of repairing partial plate was under the Act. Driscoll v. Caudle-Hyatt, 52 O.I.C. 83 (1970).

    Diagnostic Procedures:

    The medical reports must show a possible causal connection to the work accident before diagnostic studies are ordered at the defendant’s expense. Lawson v. Lawson Water Conditioning, Inc., VWC File No. 226-47-69 (May 8, 2007).

    Cost of diagnostic studies including a thermogram ordered by the treating physician are the financial responsibility of the employer. Wortman v. Delancey Printing and Publishing, 67 O.I.C. 170 (1988) (see also Benham v. Leaseway Personnel, 67 O.I.C. 171 (1988)).

    Employer responsible for the cost of all diagnostic produres and in addition for the cost of treatment for any condition revealed by the diagnostic procedure to be causally related to the industrial accident. Harris v. Hylton Bldg. Corp, 50 O.I.C. 179 (1968); Williams v. Casey Chevrolet Co., 51 O.I.C. 297 (1969); Owen v. Associated Builders, 55 O.I.C. 260 (1973).

    The employer is responsible for the cost of diagnostic studies to determine the extent of an industrial injury and its causal relation to symptoms which may or may not be related to the compensable injury. However, once it is established that particular malady is not causally related to the industrial accident, the employer is not responsible for the cost of further treatment of that condition. Garcia-Arana v. Mary Washington College, 70 O.I.C. 282 (1991) (see also Burkhart v. William Chisholm Oil Co., 65 O.I.C. 266 (1986); Hatch v. J M D Stone Co., Inc., 77 O.W.C. 131 (1998) (diagnostic procedure must be authorized by the treating physician)).

    Emergency Treatment:

    The burden is on the employee to establish that treatment was truly an emergency and that there was no opportunity to obtain treatment from the authorized treating physician. Duty v. Skeens Fork Coal Company, Inc., 73 O.W.C. 156 (1994).

    Where an employee had a reasonable belief that emergency treatment was necessary and in his mind an emergency existed, treatment by his family physician who was not on the employer’s panel was appropriate. Barnhart v. Crown, Cork & Seal Co., Inc., 68 O.I.C. 198 (1989).

    An employer may be required to pay for treatment by an unauthorized physician in an emergency or for other good reason. The Court found that the requirements of the “other good reason” test were satisfied and required the employer to pay the cost of surgery. Shenandoah Products, Inc. v. Whitlock, 15 Va. App. 207, 421 S.E.2d 483, 9 Va. Law Rep. 396, 1992 Va. App. LEXIS 253 (1992).

    An employee seeking emergency treatment from an emergency care center does not constitute a meaningful choice of a treating physician and, consequently, is not bound by referrals from that facility. Locke v. Kline Tysons Toyota, 71 O.W.C. 207 (1992), (panel offered 2 weeks after accident and employee engaged in treatment was too late).

    Ergonomic Chair:

    Where the claimant’s treating physician stated that an ergonomic chair was necessary and that the claimant’s condition worsened without it, the chair was palliative care which is contemplated by the Act, and thus the responsibility of the carrier. Lolita R. Jones v. Staff Builders Home Health Care, Inc., VWC File No. 191-43-51 (July 7, 2008).

    Exercise Equipment:

    Where a physician prescribes exercise equipment such as a treadmill machine, it is the choice of the carrier to determine whether the equipment will be provided in the home or through a less expensive membership in a local health club. Emmett v. Food Lion, Inc., 73 O.W.C. 166 (1994).(see also).Sturgill v. Westmoreland Coal Co., 75 O.W.C. 39 (1996), (claimant’s purchase of treadmill not reasonable and necessary where employer offered to pay for physical therapy at a facility within a reasonable distance from his home).

    Experimental Treatment:

    The treating physician reported that the claimant suffered internal disc disruption of the lumbar spine, as well as epidural scarring and fibrosis, as a result of her work accident, which had not been relieved by conventional measures. The physician advised that the claimant had recently undergone epidural neurolysis [“RACZ”], which he had recommended as medically reasonable and necessary for her ongoing symptomatology. The employer challenged the procedure as uncommon, ineffective, and experimental. The Commission found that the procedure was recommended by the authorized treating physician, who believed it was appropriate treatment under the circumstances, and concluded that the Deputy Commissioner had appropriately resolved the competing medical opinions in favor of the claimant. Cook v. Augusta Correctional Center, 78 O.W.C. 162 (1999).

    Footwear and Orthopedic Shoes:

    The carrier will not be held responsible for the purchase of ordinary footwear recommended by the employee’s approved treating physician. The claimant’s physician recommended that the claimant purchase “good quality,” “well fitting and well tolerated” boots, causally relating this need to the compensable accident. The Commission found that the boots at issue did not constitute “other necessary medical attention,” a medically necessary appliance, prosthesis or an orthotic appliance. The Commission will find the employer responsible for specific recommended orthotic devices, corrective shoes for arch support or orthopedic shoes, if they are prescribed by a physician and the reasonableness and medical necessity of such devices is supported by medical reports. Harpine v. Wampler Longacre Turkey, VWC File No. 164-63-07 (September 17, 2002).

    HIV Testing/Hepatitis:

    Defendants responsible for functional capacity evaluation ordered by claimant’s treating physician where FCE had dual purpose of both assessing the claimant’s permanent impairment and determining claimant’s physical restrictions, which is part of claimant’s medical treatment and recovery. Hall v. Kroger Ltd. Partnership I, JCN VA00001034555 (Nov. 14, 2016).

    The employer is responsible for the cost of an HIV test routinely performed in pre-surgical preparation necessitated by an industrial accident. However, the employer is not responsible for any of the costs associated with the employee’s HIV positive status where the evidence indicates that this condition was neither caused nor exacerbated by the industrial accident. Loar v. Figgie Systems Support, 70 O.I.C. 283 (1991).

    While there is no provision in the Act requiring an employer to provide preventive health measures to curb the contraction of a contagious disease, the employer may be required to pay for the cost of hepatitis and HIV tests when an employee has already sustained a puncture injury from a hypodermic needle. The fact that the employee requested the test does not prevent it from being the responsibility of the employer. Clevinger v. Town of Grundy, 71 O.W.C. 220 (1992).

    The employer is responsible for the cost of an HIV test required by the treating physician prior to performing a myelogram. Allen v. County of Stafford School Board, 71 O.W.C. 222 (1992).

    Where the medical evidence fails to corroborate testimony that HIV tests were ordered by treating physicians, and where the medical reports show evidence of a history of illicit drug abuse by the employee, the employer is not responsible for HIV testing. Thomas v. Eastern State Hospital, 75 O.W.C. 191 (1996).

    Home Modification:

    Commission awarded cost of prescribed home modifications to employee who developed foot drop from left-knee injury; evidence showed modifications to make employee’s home handicap accessible were recommended by treating physician and were medically necessary. Quinteros v. Absolute Nursing Care of Va., Inc., VWC File No. 188-55-24 (Oct. 6, 2003).

    Home Nursing Care:

    If prescribed by physician, employer is responsible. Lusby v. Va. Shipbuilding Corp., 1 O.I.C. 146 (1919).

    The employer is responsible for home nursing care when the treating physician makes arrangements for a nurse to change the patient’s bandages at home even if the employee is not homebound. Goad v. Lynchburg Foundry Company, 15 Va. App. 215, 427 S.E.2d 215 (1993); 71 O.W.C. 234 (1992).

    Nursing care at home given a disabled employee by his spouse is the responsibility of the carrier provided the care is “medical attention” and is “necessary.” Chandler v. Warren Trucking Co., 221 Va. 1108 , 277 S.E.2d 488, 1981 Va. LEXIS 255 (1981) (see also Watson v. Allied Chemical Corp., 62 O.I.C. 500 (1983) (care provided by wife not necessary medical attention)).

    If equally appropriate medical care can be provided at the employee’s home or in a nursing home facility, the Commission may consider the monetary benefit realized by the employer by providing such services in a nursing home. Jackson v. Clemons Agency, Inc., 70 O.I.C. 268 (1991).

    Certain home care rendered by the wife of quadriplegic constitutes “necessary medical attention.” Rule 13 (now Rule 1.2 B) does not apply to medical expenses, therefore, payment for wife’s care was awarded retroactively. Sensabaugh v. Vulcan Material Company, 62 O.I.C. 398 (1983).

    Payment must be made to family member if that person has to leave other employment to provide nursing care authorized by attending physician. Womble v. E.C. Womack, 49 O.I.C. 339 (1967); Sugg v. Commercial Trading Corp., 53 O.I.C. 358 (1971); Hullihen v. J.A. Lap Inc., 46 O.I.C. 114 (1964); Porter v. Harris Heating Plumbing Co., Inc., 59 O.I.C. 245 (1980).

    Employer not liable to family member who attends claimant in ordinary course of their household duties without discontinuing their regular employment. Foster v. Lumber & Mfg. Co., 2 O.I.C. 79 (1920).

    Wife’s remuneration for home care of husband was reasonably set at a rate lower than that paid nurses. The scheduling of shifts should be the responsibility of the agency furnishing nursing care and not the employee’s wife. Judge v. Robert Whitmer & C. Kirk Reilly & Associates & R. T. Construction Corporation, 62 O.I.C. 257 (1983).

    Where a claimant requires nursing care the selection of nurses is within the discretion of the employer and its carrier so long as the requirements established by the treating physician are met. Neither the claimant nor his wife have the authority to demand that she be retained for such purpose or that they be given discretion to select the appropriate nurses. Judge v. Robert Whitmer & C. Kirk Reilly & Associates & R. T. Construction Corporation, 6 Va. App. 152, 336 S.E.2d 713 (1988), 66 O.I.C. 97 (1987).

    Hospital Charges:

    Hospital charges for T.V. rental, phone charges, visitor meals, etc. not are the responsibility of the employer. Banks v. Murphy, 56 O.I.C. 19 (1975).

    Interest:

    The employer is not responsible for interest on late charges. Horne v. Superior Life Ins. Co., 44 O.I.C. 142 (1962).

    Mattress/Waterbed:

    An orthopedic mattress does not meet the definition of “necessary medical attention.” Hutcherson v. Washington Metropolitan Area Transit Authority, 65 O.I.C. 268 (1986).

    A waterbed does not fit the definition of “medical attention.” Williams v. Hercules, Inc., 64 O.I.C. 357 (1985).

    Military Hospital:

    Employer may be responsible for the expense of treatment rendered claimant in military hospital, depending upon circumstances. Peck v. Mr. Softee, 55 O.I.C. 271 (1973); Tyrrell v. City Bank & Trust Co. of Alexandria, 51 O.I.C. 277 (1969).

    Palliative Treatment:

    In finding that the claimant’s treating physician shall determine whether future treatment, including additional injections, is appropriate, the Commission noted that the Act does not proscribe palliative treatment, so long as such treatment is determined to be reasonable and necessary. Comer v. Newton Construction Company, 73 O.W.C. 147 (1994).

    The Deputy Commissioner erred in holding that palliative treatment is only an option “where such treatment allows the injured employee to continue working.” If a claimant’s physician determines that a particular treatment is reasonable and necessary, the claimant is entitled to such care even if it is only palliative. Davis v. Old Oak Mining, 76 O.W.C. 113 (1997).

    The claimant is entitled to medical care to alleviate painful symptoms, even if the treatment is not curative. Campbell v. NVT Technologies, Inc., 74 O.W.C. 191 (1995); Greene v. Capital Masonry Corp., 76 O.W.C. 508 (1997); Prince v. E. E. Lyons Const. Co., Inc., 76 O.W.C. 35 (1997); Davis v. Old Oak Mining, 76 O.W.C. 113 (1997).

    The employer is responsible for the costs of surgery recommended by the treating physician, which is aimed only at the alleviation of symptoms, and which would not lead to greater work capacity. Greene v. Capital Masonry Corp., 76 O.W.C. 508 (1997).

    An injured employee is entitled to necessary medical care for the consequences of his work injury to alleviate painful symptomatology for his lifetime, even if the care is only palliative and brings only temporary relief. Davis v. Old Oak Mining, 76 O.W.C. 113 (1997).

    The Commission denied authorization for long-term opiate therapy, that reportedly would have negative cognitive and sedative effects, where three physicians recommended alternative forms of treatment that had not been fully explored, including formal pain management and rehabilitation. The Commission held that it was medically reasonable to attempt these treatment options prior to consideration of opiate therapy. Cronk v. Fairfax County Fire Dept., 76 O.W.C. 209 (1997).

    As a result of the claimant’s compensable injury she underwent a laminectomy with a multi-level fusion, leaving her unable to bend to reach her feet. The authorized treating physician referred her podiatrist and then a pedicurist for pedicures. The Commission found that the pedicures were a necessary medical service prescribed by the treating physician to prevent ingrown toenails because of the claimant’s inability to cut her nails due to her work injuries, and thus the responsibility of the employer. Young v. Richmond Newspaper, Inc., VWC File No. 167-90-51 (Oct. 28, 2009).

    Preventative Treatment:

    Where a nurse sticks her finger with a needle used to draw blood from a hepatitis patient, the cost of the resulting treatment to prevent the employee from contracting the disease is the responsibility of the employer. Cross v. Neurology Specialists, Ltd., 67 O.I.C. 45 (1988).

    An employer will be responsible for preventive medical treatment if the claimant suffered a specific industrial accident giving rise to the need for such treatment. Blanks v. Battlefield Veterinary Clinic, 76 O.W.C. 41 (1997).

    In the absence of a precipitating injury by accident or contraction of the disease, prophylactic vaccine for rabies after exposure to a calf was found to be preventive medicine for which benefits were not payable under the Act. Fleming v. Daniel M. Fleming, 71 O.W.C. 129 (1992).

    Where the claimant is unable to establish the occurrence of an injury by accident, and where there has been no diagnosis of an occupational disease, the employer is not responsible for the cost of prophylactic treatment, even for a work-related condition. Blanks v. Battlefield Veterinary Clinic, 76 O.W.C. 41 (1997).

    While there is no provision in the Act requiring an employer to provide preventive health measures to curb the contraction of a contagious disease, the employer may be required to pay for the cost of hepatitis and HIV tests when an employee has already sustained a puncture injury from a hypodermic needle. The fact that the employee requested the test does not prevent it from being the responsibility of the employer. Clevinger v. Town of Grundy, 71 O.W.C. 220 (1992).

    Psychiatric Care:

    Act does not provide for marriage counseling or psychological treatment for non-injured spouse, friends, or family; employer not responsible for claimant’s joint counseling with wife. Lynch v. Coleman Homes, Inc., VWC File No. 165-92-78 (Dec. 3, 2004).

    When a traumatic neurosis was found to be causally related to an industrial accident, the employer was responsible for the cost of psychiatric treatment. Gentry v. City of Richmond, 62 O.I.C. 188 (1983).

    Diagnosis and treatment are part of medical expenses if causally related to industrial accident. Womack v. Ellis, 209 Va. 588 , 166 S.E.2d 265 (1969); Ford v. Bowen, 54 O.I.C. 126 (1972).

    The employer was found responsible for treatment rendered by a licensed clinical social worker upon referral by the treating physician. Settle v. Rubins Contractors, Inc., 71 O.I.C. 211 (1992).

    Where a compensable injury is a contributing cause of a subsequent injury or disability, the subsequent injury is a compensable consequence of the original injury. The employer is responsible for psychiatric treatment necessitated by a compensable industrial accident. Palmer v. City of Roanoke Emergency Services, 70 O.I.C. 147 (1991).

    Prosthesis:

    Defendants were not responsible for damage to claimant’s pre-existing spinal cord stimulator in compensable accident. Commission rejected claimant’s characterization of spinal cord stimulator as a prosthesis. Quiroz v. Prince William Cnty. Schs., JCN VA00000647619 (Oct. 27, 2014).

    Employer is required to provide and repair any prosthesis necessary as result of industrial accident including special orthopedic shoes. Babgalupo v. Excavation Contractors, 56 O.I.C. 12 (1974) (see also Jenkins v. J.P. Walters & Sons, 54 O.I.C. 188 (1972) (tailor-made stocking under Act); Lamb v. Southland Industries, Inc., 62 O.I.C. 282 (1983) (artificial finger is qualifying prosthesis)).

    Where the claimant’s eyeglasses were lost or damaged in an accident arising out of and in the course of his employment, his employer is responsible for the replacement of this prosthetic device. Crawford v. County of Henrico Division of Parks & Recreation, 60 O.I.C. 116 (1981).

    Referrals:

    Physician who retired and referred employee, along with other patients, to another physician did not deny or refuse treatment, which would require employee to seek another panel from employer, but made valid referral for authorized medical treatment. Souleyrette v. Clinchfield Coal Co., VWC File No. 199-21-61 (Oct. 9, 2003), aff’d, Ct. App. Record No. 2877-03-3 (June 1, 2004).

    Employee required to notify carrier that treating physician no longer available; treating physician left practice and claimant continued to treat with other physicians, but not satisfied and sought treatment at emergency room, who referred to new physician; new physician not authorized because employee did not seek new panel or receive referral from original physician for treatment with new treating physician. Gill v. McQuay Int’l, VWC File No. 179-35-06 (May 30, 2003).

    Employee’s desired evaluation at ‘major medical center‘ not considered necessary medical treatment; employee’s failure to improve considered to be motivational rather than physiological; evidence did not support referral to major medical center as necessary medical treatment. Tolliver v. Carilion Roanoke Mem’l, VWC File No. 196-83-52 (Feb. 7, 2003).

    The employer is responsible for medical attention rendered by physicians or institutions as a result of a referral by the principal treating physician earlier designated by the Commission. Boettger v. Commonwealth of Virginia/Division of Motor Vehicle, 64 O.I.C. 51 (1985).

    Referrals for evaluation or treatment of a claimant by an authorized treating physician are deemed to be an extension of the reasonable and necessary authorized treatment being provided by that treating physician, and the employer is responsible for referrals made by an authorized physician for treatment that he deems medically necessary. Stevens v. United Electrical Radio & Machine, 78 O.W.C. 241 (1999).

    It is within the purview of the treating physician’s expertise to determine the type of specialized treatment the claimant requires. The referral by the treating physician to a doctor who is not on the employer’s panel of physicians does not entitle the employer to require the employee to select from a new panel. Carter v. County of Arlington Fire Department, 73 O.W.C. 149 (1994).

    While the treating physician did not initially refer the claimant to a specific neurologist, she had few contacts in the community and she was aware of the claimant’s desire to treat in Richmond due to transportation problems. The treating physician approved of the claimant’s choice to treat with the neurologist he selected, and the Commission held that such treatment was authorized. Eccard v. Southside Community Hospital, 77 O.W.C. 54 (1998).

    The mere fact that a primary care physician refers an employee to a specialist does not automatically remove the primary care provider from any involvement in the case. Where the employee experiences problems outside the area of expertise of the specialist to whom she was referred for another problem, it is reasonable for her to return to her original treating doctor for a referral for the other condition. Strickler v. Augusta Correctional Center, 75 O.W.C. 156 (1996).

    Where a consulting physician suggests that an MRI might be necessary, after which the claimant obtains the MRI from a physician selected by the claimant without a referral from his authorized physician, the connection between the consulting physician and physician performing the test is too tenuous a thread to hold the employer responsible for payment for the diagnostic test. Hatch v. J M D Stone Co., Inc., 77 O.W.C. 131 (1998).

    The claimant’s authorized physician referred the claimant to the UVA Medical Center for evaluation by Dr. Chan. The claimant and the carrier subsequently agreed that the claimant could select a new primary physician from a panel. The claimant thereafter advised the new primary physician [Dr. Witmer] that he was also receiving care from Dr. Chan, who was recommending fusion surgery, and Dr. Witmer encouraged that he continue with the other contemporaneous treatment. The claimant ultimately elected to have hip replacement surgery recommended by Dr. Witmer. The employer denied it was liable for the treatment by Dr. Chan, but the Commission found that Dr. Chan was an authorized treating physician, since he had been referred by an authorized physician, and had been acknowledged afterwards by the new treating physician, who encouraged that the treatment continue and even deferred to Dr. Chan’s expertise. Stevens v. United Electrical Radio & Machine, 78 O.W.C. 241 (1999).

    Reports:

    Medical reports are not part of medical treatment and employer is not responsible. Evans v. Edwin F. Thompson, Inc., 56 O.I.C. 106 (1975); Sears v. Wilkins Brothers, Inc., 49 O.I.C. 298 (1967).

    Scooter:

    A motorized scooter is an appliance not a wheelchair. Harris v. Princeton Homes, JCN 2023038, 2069573 (June 24, 2015).

    A motorized scooter is a reasonable and medically necessary “appliance” that the employer is responsible for providing when a preponderance of the evidence established that the claimant’s psychological and physiological condition would benefit from its use. Henry v. Socran Financial Corp., VWC File No. 133-78-91 (March 22, 2007).

    Sexual Dysfunction:

    Employee’s claim for prescription expenses caused by compensable consequence not barred by statute of limitations; employee suffered 1994 back injury and was awarded benefits; he developed symptoms of erectile dysfunction shortly after accident, but it became “major problem” in 2001 and he was prescribed corrective medication in 2002; Commission found problem not immediate result of accident but eventual compensable consequence thereof and thus not barred by statute of limitations. Landrum v. Berglund Chevrolet, VWC File No. 171-85-74 (Oct. 15, 2003), (appeal pending).

    Employer responsible for payment of medication for treatment of employee’s sexual dysfunction, when evidence showed that employee, who suffered back, rib, arm, and hand, injuries, developed the dysfunction as a result of depression because of the injuries. Sandres v. GRC Roofing, Inc., File No. 206-15-32 (VWC July 29, 2003).

    Spousal Expenses:

    Expenses incurred by spouse incident to providing “emotional support” are not compensable. Semones v. The New Jersey Zinc Company, 62 O.I.C. 394 (1983).

    Topical Prescription Analgesic:

    Need for topical prescription analgesic causally related to compensable accident. Employer failed to prove recommended topical analgesic cream was not reasonable and necessary medical treatment. Ashworth v. VCU Health System Auth., JCN 2287719 (Aug. 28, 2014).

    Treatment Secondary to Injury:

    The claimant sustained an injury to his back for which pins and rods had been inserted. His treating surgeon suggested that the claimant’s dentist prescribe antibiotics prior to any dental treatment in order to prevent potential infection by blood borne bacterial seeding the back instrumentation. Such prophylactic antibiotic therapy is directly related to the treatment of the claimant’s back injury and is “other such necessary medical attention” ordered by treating physicians. Slaughter v. Abercrombie Oil Company, Inc., JCN 213-26-70 (Oct. 4, 2011).

    Employer responsible for payment of medication to treat gastric acid reflux disease caused by emotional and physical stress from claimant’s spinal cord injury. Marshall v. Farmington Country Club, Inc., VWC File No. 203-05-04 (March 14, 2005).

    Where a steroid injection given the claimant for a compensable back injury triggered a latent case of diabetes, the employer is responsible for such medical expenses until the diabetic condition had stabilized and was under control. Shelton v. National Distillers, Inc., 62 O.I.C. 411 (1983).

    The employer is responsible for treatment of a pre-existing inactive lymph node condition that became activated as a result of surgery for a compensable hernia. Wadowick v. Hospital Building and Equipment Co., 70 O.I.C. 280 (1991).

    The employer was responsible for the medical cost of the surgical repair of a pre-existing vascular insufficiency because this condition needed to be corrected in order to treat the foot that was injured in the industrial accident. Patron v. Joy Garden Restaurant, Inc., 67 O.I.C. 173 (1988).

    Carrier responsible for extra expenses incurred for treatment of pulmonary condition which developed during anesthesia induction while claimant was undergoing radical surgery for compensable hernia. Nash v. Montague-Betts Company, Inc., 60 O.I.C. 323 (1981).

    Cyst removal in connection with hernia repair was compensable medical expense. Guseman v. Noland Co., 54 O.I.C. 150 (1972).

    Tumor condition aggravated by injury was employer’s responsibility. Sykes v. Moran, 31 O.I.C. 224 (1949).

    Costs for medical treatment denied where evidence proves that claimant’s back problems and treatment were not causally related to his earlier industrial accident. Mason v. Fairfax County Fire & Rescue Services, 60 O.I.C. 298 (1981).

    Sterilization not related to accident, not part of medical expense. Smith v. Imperial Woven Label Co., 51 O.I.C. 255 (1969).

    Carcinoma not related. Hewitt v. Woodward Iron Co., 54 O.I.C. 176 (1972).

    Cost may be apportioned between related and non-related treatment. Shumaker v. Southland Wine Co., 51 O.I.C. 247 (1969).

    Treatment for two industrial accidents with different employers, cost pro-rated by physician between employers. Brunk v. Anning Johnson Co., Inc., 48 O.I.C. 21 (1966).

    VOCATIONAL REHABILITATION.

    General:

    Claimant who worked in dissimilar pre-injury job with second employer and returned to full time work only with that employer still was required to market residual work capacity and cooperate with vocational rehabilitation. Crumpton v. City of Danville, JCN VA00001159204 (Apr. 26, 2018).

    While an employer may not prevent a claimant from relocating, the claimant must provide sufficient information to allow the employer to attempt to continue to provide vocational rehabilitation services. Failure to do so constitutes an unjustified refusal of vocational rehabilitation services. Wilson v. United Parcel Service, JCN 2376910 (Oct. 4, 2013).

    A vocational rehabilitation specialist providing services to an injured worker living outside of Virginia is not required to be licensed in Virginia. It is reasonable that a local vocational rehabilitation counselor who is knowledgeable of the vocational operation in the state and area where the claimant resides provides the services. Cook v. Tidewater Staffing, Inc., VWC File No. 216-72-03 (Nov. 1, 2006), aff’d, No. 2292-06-1 (Ct. of App., March 27, 2007) (unpublished opinion).

    “The mere fact that an employer has secured light duty employment for an employee consistent with the injured employee’s residual capacity does not automatically relieve the employer of its obligation to provide continuing vocational rehabilitation — particularly when, as here, the light duty work being performed by the employee provides minimal opportunities for future career growth.” Recommendation for specific rehabilitation that would be consistent with the claimant’s age, education and skills are appropriate. Holland v. Crown Cork & Seal Co., Inc., VWC File No. 204-08-10 (June 17, 2005).

    Evidence established claimant’s intention to sabotage his job search where he placed restrictions on hours he was willing to work, asserted he was unable to perform certain physical functions during interviews, failed to obtain transportation to interview, failed to complete applications or submit employment information in a timely manner, and expressed overall desire not to be hired. Davis v. J.D. Littlejohn, Inc., VWC File No. 206-23-54 (March 29, 2005).

    The limitation provisions of Code § 65.2-708 do not apply to claims for vocational rehabilitation brought pursuant to Code § 65.2-603 (A)(3) because vocational rehabilitation services do not constitute “compensation” as contemplated in the time limitation provisions of § 65.2-708 . Lingenfelter v. Busch Gardens, VWC File No. 186-51-24 (Aug. 18, 2004).

    Employer’s application based on claimant’s alleged refusal to cooperate with vocational rehabilitation properly dismissed where the rehabilitation services were not provided by a certified rehabilitation provider. It is not sufficient that the provider’s supervisor was a certified rehabilitation consultant. Copeland v. Stone Container Corp., VWC File No. 206-01-65 (July 19, 2004).

    Employer did not have standing to assert a refusal of vocational rehabilitation because college retraining that was allegedly refused by employee was not being financed by employer; evidence showed that employee received federal grant to attend program and employer was not paying for books and expenses. Ashburn v. Pillowtex Corp., VWC File No. 201-98-03 (Nov. 24, 2003).

    Employee found to unjustifiably refuse vocational rehabilitation by six-month visit to India; although employee not required to refrain from all travel or risk suspension of benefits, six-month out-of-country visit unreasonable interference with employer’s efforts at vocational rehabilitation. Mendes v. Phillip Chan t/a Yuan Ho Carry Out, VWC File No. 191-42-35 (Oct. 15, 2003).

    Vocational rehabilitation benefits are separate and distinct from medical benefits under the Act, and an employer’s obligation under an approved agreement to provide medical care for an extended period does not obligate it to provide vocational rehabilitation. Johnson v. Seasons Greetings, Inc., 75 O.W.C. 73 (1996).

    The Supreme Court has defined the term “vocational” as training related to a specific skill or trade. “Rehabilitation” is defined as the process of restoring an individual to a useful and constructive place in society through some form of vocational or therapeutic retraining. Dew v. Alleghany Regional Hospital, 77 O.W.C. 190 (1998).

    An employer must find employment suitable for the employee or provide retraining to achieve rehabilitation. Dew v. Alleghany Regional Hospital, 77 O.W.C. 190 (1998).

    An employee is entitled by statute to reasonable and necessary vocational rehabilitation that serves the twofold purpose to restore the employee to gainful employment and to relieve the employer’s burden of future compensation. Bryant v. F. A. Bartlett Tree Expert Co., 76 O.W.C. 81 (1997); Dew v. Alleghany Regional Hospital, 77 O.W.C. 190 (1998).

    Code § 65.2-603 (A)(3) states that the employer shall furnish reasonable vocational rehabilitation services “at the direction of the Commission.” The Commission has held in numerous cases that retraining will not be ordered until the employer has been given a reasonable opportunity to find the employee suitable alternative employment. Dyer v. Vann-Atlantic Orthopaedic Specialists, 76 O.W.C. 457 (1997).

    The employer is entitled to a reasonable period within which it may find alternative employment for a claimant before incurring retraining expenses, and such retraining should be considered only after a determination that appropriate job placement efforts would not be successful and that the employee’s transferable skills cannot readily be marketed. Bryant v. F. A. Bartlett Tree Expert Co., 76 O.W.C. 81 (1997).

    Where the employer fails to offer suitable rehabilitation services as provided under the Act and requested by the claimant, the Commission may order that such services be provided that would approximate her pre-injury work and income. Markham v. Revco, 75 O.W.C. 180 (1996).

    The Act requires that vocational rehabilitation services provided by the employer must take into account the claimant’s pre-jury job and wage classifications; her age, aptitude, and level of education; the likelihood of success in the new vocation; and the relative costs and benefits of vocational services. Markham v. Revco, 75 O.W.C. 180 (1996); Dew v. Alleghany Regional Hospital, 77 O.W.C. 190 (1998).

    Where the claimant is not without job skills, her disability is not severe and her work restrictions not highly restrictive, and she has made no effort to find work within her restrictions utilizing her current skills, the Commission held that the request for vocational rehabilitation was premature, that partial disability in and of itself does not justify vocational rehabilitation. Dyer v. Vann-Atlantic Orthopaedic Specialists, 76 O.W.C. 457 (1997).

    The Commission held that the employer was not liable for costs of retraining in this case, where pay in the selective employment offered by the employer was comparable to the anticipated earnings of the claimant, at least initially, after retraining. Meade v. Clinchfield Coal Company, 76 O.W.C. 420 (1997).

    The obligation of the employer to provide vocational rehabilitation does not include the responsibility to expand the claimant’s occupational horizons to embrace a wide range of business, industrial, and professional callings. Bryant v. F. A. Bartlett Tree Expert Co., 76 O.W.C. 81 (1997).

    Where an examining physician has specified work capacity limitations that are not inconsistent with the findings of treating physicians, and it is obvious that the proffered work satisfies those limitations, it is unnecessary for the employer to submit job descriptions to the physician for “rubber stamp” preapproval before the job interviews. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    The Commission held that the employer was not liable for the costs of retraining in this case, where the claimant began such retraining as alternative employment before his work accident because of an impending layoff. Meade v. Clinchfield Coal Company, 76 O.W.C. 420 (1997).

    Telemarketing and telephone solicitation positions are not legitimate job opportunities in the absence of evidence to demonstrate that, in addition to physical ability, the employee possesses a special capacity as a salesperson. Cain v. Warrior Xpress, 76 O.W.C. 3 (1997).

    The vocational consultant located several positions with a company that manufactures and sells wedding favors, such as birdseed wrapped in small decorative bags. This company frequently employs individuals with disabilities, at wages less than the amount it would receive from the claimant’s employer for providing the employment. The Commission held that such employment did not provide meaningful benefits to either the claimant or the employer. The proposed employment offered no prospect for advancement, no teaching of necessary work skills, and no restoration to a productive place in the workforce, and the Commission held that the refusal of such work was justified. Dew v. Alleghany Regional Hospital, 77 O.W.C. 190 (1998).

    Virginia Code § 65.2-603 (A)(3) requires that vocational rehabilitation services be provided by a professional, certified or licensed in the Commonwealth of Virginia. However, the purpose of the statute is to regulate rehabilitative services in Virginia, and is not applicable to rehabilitative services provided to employees who have relocated outside Virginia. Employees who have relocated outside Virginia should be provided with a local rehabilitative counselor or specialist who is knowledgeable with respect to the vocational rehabilitation opportunities where the employee then resides. Paolicelli v. Magna Corporation, VWC File No. 196-09-56 (August 29, 2001).

    Effect of Refusal:

    Compensation benefits may be suspended for failure to cooperate with reasonable rehabilitation efforts where a claimant failed to attend meetings, refused certified letters, advised he was retired and stated an unwillingness to participate in a job search. James v. Capitol Steel Construction Co., 8 Va. App. 512, 382 S.E.2d 487, 6 Va. Law Rep. 121, 1989 Va. App. LEXIS 99 (1989) (see also James v. Auto Services, Inc., 78 O.W.C. 209 (1989)).

    Compensation suspended for period when claimant refused to cooperate by not attending arranged interviews or completing employment applications mailed to him. Flowers v. Clinebell, 57 O.I.C. 124 (1976).

    Where an employee acts in a manner to prevent an offer of employment, he may be deemed to have unjustifiably refused employment by sabotaging the interview process. James v. Auto Services, Inc., 78 O.W.C. 209 (1989).

    Claimant’s failure to cooperate with vocational rehabilitation efforts is not a bar to further compensation where offer of rehabilitation services did not come from employer. Lassiter v. Montgomery Ward, Inc., 61 O.I.C. 283 (1982).

    The failure of an employee and his/her attorney to provide the employer, through its placement counselor, access to the employee for the pursuit of placement activities, is tantamount to refusal of employment under § 65.1-63, (now § 65.2-510 ) Code of Virginia. Barton v. Mullins Coal Co., 69 O.I.C. 159 (1990).

    The language of Code § 65.2-510 (C) specifically limits its application to the failure to cure a refusal pursuant to “subsection A,” which refers to employment “procured” for the employee. It does not encompass an unjustified refusal involving vocational rehabilitation or a combination of job placement and vocational rehabilitation. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    A refusal of rehabilitation efforts sufficient to terminate compensation benefits was found where the rehabilitation specialist was advised by claimant’s counsel not to contact his client. Morrison v. Mount Vernon Medical Group, 65 O.I.C. 286 (1986).

    The treating physician released the claimant to light duty with left wrist restrictions. The Commission found that the claimant’s subsequent self-limiting conduct of placing limitations on the hours he would work; reporting unreliable transportation and lack of education; alleging continued pain and inability to perform physical duties; failing to complete employment applications; and, most significantly, voicing a desire not to be hired, clearly projected the attitude that he did not want to be hired sufficient to show efforts that were intended to sabotage the job search. James v. Auto Services, Inc., 78 O.W.C. 209 (1989).

    Compensation benefits may be terminated for refusal of vocational rehabilitation on the basis that while the rehabilitation coordinator did not seek to place the claimant in jobs that would reduce the employer’s immediate compensation liability, there was potential for a future reduction in that payment for partial incapacity is limited to 500 weeks from the date of the accident, and cost-of-living benefits do not accrue during such payment. Dehart v. Safeway Stores, Inc., 67 O.I.C. 202 (1988).

    Referral to a Goodwill Industries assessment program paying $36.80 per week, compared to the employee’s pre-injury weekly wage of $975.94, was not a bona fide job offer, and the employee was justified in refusing to continue with the program. Markham v. Revco, 75 O.W.C. 180 (1996).

    Where a claimant voluntarily terminates selective employment within her capacity, the employer has no statutory responsibility to provide further job placement services until so directed by the Commission. Ater v. Fairfax County Fire & Rescue Service, 67 O.I.C. 199 (1988).

    Where a claimant cooperated with rehabilitation counselors but essentially on her own initiative engaged in a babysitting business at a wage less than her pre-injury employment the employer may continue to seek a selective employment position that would clearly outweigh the economic benefits and physical demands of the claimant’s use of her capacities as a babysitter. Zimmer v. Capital Milk Producers Cooperative, Inc., 66 O.I.C. 123 (1987) (see also Gates v. David Knowlton Artist, Inc., 66 O.I.C. 126 (1987)).

    Absent some showing that an employee has a particular aptitude for telemarketing or telephone soliciting, a refusal to accept such employment does not constitute a refusal of rehabilitation or selective work. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996) (see also Cain v. Warrior Xpress, 76 O.W.C. 3 (1997)).

    Implementation of a reasonable vocational rehabilitation plan formulated by state rehabilitation agency may not be delayed to allow the carrier to select a private rehabilitation agency when the need for such services has been apparent for an extended period of time. Burnette v. Consolidated Foods Corporation, 60 O.I.C. 69 (1981).

    Compensation may not be suspended for claimant’s failure to cooperate with a vocational rehabilitation plan until such a plan has actually been formulated. Richardson v. Commonwealth of Virginia Department of Conservation, 60 O.I.C. 363 (1981).

    Rehabilitation Efforts Must Be Reasonable:

    There has been no reasonable vocational effort where the counselor fails to pre-screen jobs. Thus there can be no refusal to co-operate with vocational rehabilitation even though the claimant missed appointments and failed to follow up job leads. McCargo v. Toombs Logging and Trucking, VWC File No. 211-87-16 (July 18, 2005).

    An injured employee cannot be required to engage in job search or vocational rehabilitation efforts until he is medically released for work. However, the claimant may be required to meet with a vocational consultant so that the employer might assess the claimant’s potential for returning to work. Gardner v. Legum Home Health/Home I.V. Care and Nutritional Service, 74 O.W.C. 97 (1995).

    The employee must cooperate with reasonable demands which are likely to return her to gainful employment. However, the employer must also make some reasonable accommodation for the claimant’s personal life and provide adequate notice of the dates and times of interviews to the employee. A partially impaired employee must accommodate reasonable requests of the vocational consultant to meet and discuss vocational rehabilitation, in order that the consultant may learn more from the claimant regarding her vocational interests, aptitudes, and transferrable skills. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    While an employee has an obligation to cooperate with reasonable rehabilitation efforts, an employer cannot demand an appearance at a particular time and place. Consideration must be given to the employee’s circumstances, the availability of transportation and the travel distance required to meet a rehabilitation counselor. Holmes v. Continental Airlines, Inc., 69 O.I.C. 155 (1990) (see also Fauls v. Willard Lillard Co., 60 O.I.C. 156 (1981) (half an hour notice of interview not sufficient)).

    A vocational consultant must assess potential employment opportunities by direct contact with the potential employer to confirm that a job within medical restrictions is presently available and to purge inappropriate leads, so that the claimant is not directed to futile and meaningless interviews that would not offer actual and suitable employment opportunities. Beverly v. Zeh Plumbing & Heating, 75 O.W.C. 175 (1996).

    The Act requires that vocational rehabilitation services provided by the employer must take into account the claimant’s pre-injury job and wage classifications; her age, aptitude, and level of education; the likelihood of success in the new vocation; and the relative costs and benefits of vocational services. Markham v. Revco, 75 O.W.C. 180 (1996).

    It is the responsibility of the vocational rehabilitation counselor to locate potential employers and confirm that a position within the claimant’s capacity is available prior to requesting that the injured worker contact the employer. Requiring the claimant to locate and contact a certain number of potential employers per week on his own initiative is not appropriate vocational rehabilitation. Meyland v. Dittmar Company, 74 O.W.C. 5 (1995).

    Where an examining physician has specified work capacity limitations that are not inconsistent with the findings of treating physicians, and it is obvious that the proffered work satisfies those limitations, it is unnecessary for the employer to submit job descriptions to the physician for “rubber stamp” preapproval before the job interviews. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    An employee’s failure to comply with a vocational rehabilitation agreement that he will contact at least ten potential employers per week on his own initiative and provide the counselor with the list is not appropriate vocational rehabilitation nor a basis for the suspension of compensation benefits. However, a failure to keep appointments with the rehabilitation counselor and to follow up on job leads is a basis for suspension. Pettiford v. S & K Famous Brands, Inc., 71 O.W.C. 239 (1992).

    A claimant is not required to move back to her pre-injury residence to accept vocational rehabilitation. A document signed by the claimant stating that she declined to participate in vocational rehabilitation efforts, because she intended “to continue as a full-time student at Concord College, and am therefore not available for work activities,” was interpreted by the Commission as meaning she would not participate in such efforts only in the area where she no longer resided. Payne v. Buchanan General Hospital, 76 O.W.C. 131 (1997).

    Where a carrier has failed to exhaust job search possibilities in the locality where the employee currently lives, there has been no unjustified refusal of selective employment or job search efforts when the employee is furnished a bus ticket without arrangements for food and lodging and directed to return to the location where the injury occurred to interview with prospective employers. Gibson v. Painters Roofing & Heating, Inc., 71 O.W.C. 248 (1992).

    Driving restrictions that present transportation difficulties will not justify failure to attend job interviews, where the employee’s home and the potential work locations were close to stops along a major bus route. An employee will not be heard to complain for the first time at a much later date that transportation difficulties prevented her appearance at job interviews, where the purported difficulty was not revealed when the interviews were scheduled and thus deprived the employer of a timely opportunity to provide transportation. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    Where the claimant had car repair problems and knew that other patients were provided transportation by the carrier, but represented that the car problems were short term and did not request transportation from the carrier, the carrier was under no obligation to affirmatively offer such transportation, and the failure of the claimant to attend a back rehabilitation program for lack of transportation was not justified. Mason v. Baker Roofing Co., 75 O.W.C. 18 (1996).

    In the absence of evidence that the injured worker traveled some distance to work prior to the injury, the Commission will view skeptically potential job opportunities located a great distance from his home. Meyland v. Dittmar Company, 74 O.W.C. 5 (1995).

    A claimant will not be required to move back to the Virginia job site and place of injury to accept selective employment without evidence that job placement efforts have been exhausted where the claimant currently resides. Cox v. Hensel Phelps Construction Company, 74 O.W.C. 112 (1995) (see also Payne v. Buchanan General Hospital, 76 O.W.C. 131 (1997) (claimant not required to move back for selective employment or vocational rehabilitation services until exhausted at current location)).

    While being unavailable for vocational rehabilitation efforts for a brief period of time because of a family emergency may be justified, failure to cooperate for an extended time because of the illness of a relative is not a sufficient basis for continuing compensation benefits. Troitino v. Dekor National Granite and Marble, Inc., 71 O.W.C. 242 (1992) (see also Marrow v. Addington Beaman Lumber Co., Inc., 69 O.I.C. 195 (1990) (no refusal where advised of inability to attend a meeting because of family illness)).

    A claimant whose physician continues to certify him as totally disabled has not unjustifiably refused vocational rehabilitation services when he fails to participate in a volunteer program. Martin v. F & W Management, 70 O.I.C. 324 (1991).

    The Commission found there was no refusal to participate in a job search where the claimant asked the rehabilitation counselor to have the treating physician approve the job before she applied for the position. Gronski v. Ice Follies & Holiday on Ice, Inc., 73 O.W.C. 182 (1994).

    An employee who refuses to make available to his employer his personal vehicle regardless of the promise of reimbursement, has not refused selective employment nor refused to cooperate with vocational rehabilitation. Rouleau v. Gateway Distributors, Inc., 70 O.I.C. 231 (1991).

    Application forms submitted by an employee did not prove noncooperation with vocational rehabilitation, where the employee was shown to have serious cognitive and psychological deficits and where the forms were submitted under the supervision of the vocational counselor. Beverly v. Zeh Plumbing & Heating, 75 O.W.C. 175 (1996).

    Curing Refusal:

    A claimant may cure an unjustified refusal of vocational rehabilitation and be entitled to temporary partial disability benefits by obtaining selective employment on his own initiative. However, the employer is not precluded from seeking a better-paying position for the claimant who has a continuing obligation to cooperate with those efforts. Vernon v. Hampton Roads Sanitation District, 68 O.I.C. 190 (1989).

    In order to cure a refusal of vocational rehabilitation efforts there must be something more than a mere statement of willingness to cooperate. There must be an affirmative action such as contacting the rehabilitation counselor, seeking light work, registering with the V.E.C. and, in effect, demonstrating a willingness to cooperate. McLaughlin v. Manville Sales Corporation, 73 O.W.C. 185 (1994); Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998) (see also Foltz v. B. Leslie Constr., Inc., VWC File No 203-72-36 (Jan. 31, 2005) (letter alone not enough); Garner v. St. Coletta of Greater Washington, Inc., VWC File No. 211-74-41 (Mar. 15, 2004) (refusal cured by marketing and counsel’s letter stating willingness to accept light-duty work)).

    A verbal statement of willingness to cooperate with vocational rehabilitation must be made in good faith in order to cure an earlier refusal of services. James v. Capitol Steel Construction Co., 8 Va. App. 512, 382 S.E.2d 487, 6 Va. Law Rep. 121, 1989 Va. App. LEXIS 99 (1989).

    Retraining:

    For an overview of employer responsibility for retraining expenses, see Jones v. INOVA Fairfax Hospital, JCN 237-06-67 (Feb. 13, 2013).

    Employer responsible for educational program in respiratory therapy at community college where evidence established a high likelihood of success in the new vocation, a favorable employment market for respiratory therapists, and that carrier would financially benefit from claimant’s pursuit of this vocation. Warren v. D&P Painting, Inc., VWC File No. 207-01-01 (Oct. 26, 2004).

    Claimant’s request for reimbursement for courses taken in pursuit of her associate’s degree denied where curriculum qualifies claimant to obtain employment in wide range of occupations and disciplines and course work is not directed toward training in a specific skill or trade. Brown v. CSC, VWC File No. 210-24-60 (June 30, 2004).

    Home-based GED course considered reasonable and necessary vocational retraining; employer offered county-sponsored program; employee’s physician recommended home-study course; deputy commissioner correctly exercised discretion in awarding home-based program. Coleman v. Super Suds Mgmt., VWC File No. 202-02-45 (Feb. 20, 2003).

    Where a claimant has been released to his pre-injury work, vocational rehabilitation and education are not mandated by the Act. Rogers v. Universal Life Insurance Company, 73 O.W.C. 178 (1994).

    An employer must find employment for the employee that was comparable to his pre-injury employment or to provide retraining to achieve rehabilitation consistent with the provisions of § 65.2-603 . United Parcel Service of America, Inc. v. Godwin, 14 Va. App. 764, 418 S.E.2d 910, 8 Va. Law Rep. 3600, 1992 Va. App. LEXIS 177 (1992).

    If no attempt at placement is made by the employer within a reasonable time, or if an attempt is completely unsuccessful, retraining would be in order. Burton v. Giant Food, Inc., 62 O.I.C. 94 (1983).

    Before directing the employer to assume the substantial financial burden of retraining, the Commission expects that some effort be made to place the claimant in an existing position utilizing the claimant’s existing skills. Kelly v. Appalachian Learning Center, 62 O.I.C. 262 (1983).

    Vocational retraining will not be ordered after the claimant’s release to light duty until the employer has been given a reasonable time to find suitable alternative employment. Ramey v. Dickenson County Medical Center, 74 O.W.C. 102 (1995).

    The claimant did not present a specific retraining program for which he requested payment by the carrier. The Commission noted that he was well educated and had varied job skills that were transferable in the employment market, and held that he did not establish a basis for the Commission to direct retraining. Meyland v. Dittmar Company, 74 O.W.C. 5 (1995).

    In finding the employer responsible for student’s loans resulting from retraining as an electronic repairman, the Commission held this to be appropriate vocational rehabilitation in view of the carrier’s failure to locate employment with long term earning potential similar to his pre-injury wage. Potter v. Russell A. Potter, 71 O.W.C. 244 (1992).

    In determining whether the employer is responsible for the cost of a two year college computer programmer course, the test is whether the employee is being trained for specific skill or trade which will lead to re-employment. Collier v. Elliott, Inc., 64 O.I.C. 87 (1985).

    Cosmetology training was within the definition of vocational rehabilitation under the Act. The carrier was, therefore, responsible for the cost of such training. Hatten v. Westvaco/Liquid Packaging Division, 70 O.I.C. 314 (1991).

    A carrier’s agreement to continue compensation payments while a claimant pursued higher education does not obligate it to pay for the cost of the education. Higgins v. C. W. Wright Construction Co., 68 O.I.C. 192 (1989).

    Sixty year old farm laborer with an eighth grade education permanently disabled from his pre-injury work and unable to find alternative employment is entitled to vocational rehabilitation services. Messer v. Grub Hill Farm, Inc., 74 O.W.C. 159 (1995).

    The requirement that an employer provide vocational rehabilitation training services applies to all injured employees including those who are permanently and totally disabled. Meredith v. Independent Services, LTD., 70 O.I.C. 320 (1991).

    A claimant who is permanently and totally disabled may not be denied vocational rehabilitation services solely on the grounds that his re-entry into the work force would not reduce the employer’s liability for compensation benefits. However, the relative cost in benefit to be derived from the program must be considered in determining whether vocational rehabilitation is justified. Judge v. Robert Whitmer & C. Kirk Reilly & Associates, 67 O.I.C. 205 (1988).

    In requiring the insurance carrier to pay the cost and fees for a quadriplegic to obtain a college degree, the Commission noted evidence of his ability to live independently, do volunteer work in the chosen field of study, and a specialist’s recommendation of further educational developments. The carrier’s liability for the cost of attending a program out of state could not exceed the cost of attending a comparable program at an in-state university. Meredith v. Independent Services, LTD., 70 O.I.C. 320 (1991).

    Where it did not appear that claimant sought or received recommendation from Virginia Department of Rehabilitative Services or other rehabilitative agency, his enrollment in an Ohio Technical School was not reasonable or necessary. Jackson v. Dart Drug Corp., 60 O.I.C. 226 (1981).

    Employer held responsible for cost of retraining an occupationally disabled police officer as a gunsmith based on claimant’s age, aptitude and likelihood of success in new vocation. Skaggs v. City of Portsmouth Department, 60 O.I.C. 398 (1981).

    Rehabilitation Transportation, Student Loan and Other Expenses:

    Employer is obligated to pay the cost of transportation for the claimant to and from vocational training courses. Garland v. Williams Enterprises, Inc., 60 O.I.C. 167 (1981).

    Where vocational rehabilitation is being provided by the carrier, it bears the responsibility to provide upon request mileage money in advance or run the risk that the claimant may not be able to attend the interview or application process. In such cases, the carrier cannot expect that compensation benefits will be suspended for failing to cooperate with vocational rehabilitation absent evidence that transportation was provided to the claimant. Meyland v. Dittmar Company, 74 O.W.C. 5 (1995).

    In requiring the carrier to reimburse the claimant for the cost of transportation and materials for attendance at a GED program, the Commission noted that equivalency instruction was a reasonable and appropriate vocational service. Newcomb v. United Consolidated Industries, Inc., 73 O.W.C. 179 (1994).

    An employer is financially responsible for mileage expenses incurred by an employee’s job seeking efforts. This includes the mileage cost incurred for trips to the Virginia Employment Commission, the Department of Motor Vehicles, rehabilitation services, job training services and job interviews. In addition, the employer is responsible for expenses incurred through telephone calls, photocopying, postage, prescriptions and D.M.V. records incurred through vocational placement efforts. Harris v. Little Creek Construction Co., 70 O.I.C. 328 (1991).

    In finding the employer responsible for student’s loans resulting from retraining as an electronic repairman, the Commission held this to be appropriate vocational rehabilitation in view of the carrier’s failure to locate employment with long term earning potential similar to his pre-injury wage. Potter v. Russell A. Potter, 71 O.W.C. 244 (1992) (see also Holt v. Commonwealth of Virginia/Virginia Correctional Center for Women, 65 O.I.C. 276 (1986) (where claimant enrolled without approval of the employer or Commission, employer is not obligated to pay educational expenses including student loans)).

    Effect of Third Party Settlement:

    In determining a carrier’s lien in a third-party settlement the cost of job searches, medical management, coordination and appointment arrangement between prospective employers and injured workers by a private rehabilitation group may not be included or reimbursed to the carrier. Washington v. Miller & Rhoads, 68 O.I.C. 250 (1989).

    § 65.2-603. (Effective July 1, 2022) Duty to furnish medical attention, etc., and vocational rehabilitation; effect of refusal of employee to accept.

    1. Pursuant to this section:
      1. As long as necessary after an accident, the employer shall furnish or cause to be furnished, free of charge to the injured employee, a physician chosen by the injured employee from a panel of at least three physicians selected by the employer and such other necessary medical attention. Where such accident results in the amputation or loss of use of an arm, hand, leg, or foot or the enucleation of an eye or the loss of any natural teeth or loss of hearing, the employer shall furnish prosthetic or orthotic appliances, as well as wheelchairs, scooters, walkers, canes, or crutches, proper fitting and maintenance thereof, and training in the use thereof, as the nature of the injury may require. In awards entered for incapacity for work, under this title, upon determination by the treating physician and the Commission that the same is medically necessary, the Commission may:
        1. Require that the employer either (i) furnish and maintain modifications to or equipment for the employee’s automobile or (ii) if there is a loss of function to either or both feet, legs, hands, or arms and if the Commission determines that modifications to or equipment for the employee’s automobile pursuant to clause (i) are not technically feasible, will not render the automobile operable by the employee, or will cost more than is available for such purpose after payment for any items provided under subdivision b, order that the balance of funds available under the aggregate cap of $55,000 be applied towards the purchase by the employee of a suitable automobile or to furnish or maintain modifications to such automobile; and
        2. Require that the employer furnish and maintain bedside lifts, adjustable beds, and modification of the employee’s principal home consisting of ramps, handrails, doorway alterations, or any appliances prescribed by the treating physician, except for appliances or medical equipment required to be furnished by the employer pursuant to subdivision A 1. The aggregate cost of all such items and modifications required to be furnished pursuant to subdivisions a and b on account of any one accident shall not exceed $55,000. This limit shall be increased on an annual basis at the same rate as provided in subsection C of § 65.2-709 . The employee shall accept the attending physician, unless otherwise ordered by the Commission, and in addition, such surgical and hospital service and supplies as may be deemed necessary by the attending physician or the Commission.
      2. The employer shall repair, if repairable, or replace dentures, artificial limbs, or other prosthetic or orthotic devices damaged in an accident otherwise compensable under workers’ compensation, and furnish proper fitting thereof.
      3. The employer shall also furnish or cause to be furnished, at the direction of the Commission, reasonable and necessary vocational rehabilitation services; however, the employer shall not be required to furnish, or cause to be furnished, services under this subdivision to any injured employee not eligible for lawful employment. Vocational rehabilitation services may include vocational evaluation, counseling, job coaching, job development, job placement, on-the-job training, education, and retraining. Those vocational rehabilitation services that involve the exercise of professional judgment as defined in § 54.1-3510 shall be provided by a certified rehabilitation provider pursuant to Article 2 (§ 54.1-3510 et seq.) of Chapter 35 of Title 54.1 or by a person licensed by the Boards of Counseling; Medicine; Nursing; Optometry; Psychology; or Social Work or, in accordance with subsection B of § 54.1-3513 , by a person certified by the Commission on Rehabilitation Counselor Certification (CRCC) as a certified rehabilitation counselor (CRC) or a person certified by the Commission on Certification of Work Adjustment and Vocational Evaluation Specialists (CCWAVES) as a Certified Vocational Evaluation Specialist (CVE). In the event a dispute arises, any party may request a hearing and seek the approval of the Commission for the proposed services. Such services shall take into account the employee’s preinjury job and wage classifications; his age, aptitude, and level of education; the likelihood of success in the new vocation; and the relative costs and benefits to be derived from such services.
    2. The unjustified refusal of the employee to accept such medical service or vocational rehabilitation services when provided by the employer shall bar the employee from further compensation until such refusal ceases and no compensation shall at any time be paid for the period of suspension unless, in the opinion of the Commission, the circumstances justified the refusal. In any such case the Commission may order a change in the medical or hospital service or vocational rehabilitation services.
    3. If in an emergency or on account of the employer’s failure to provide the medical care during the period herein specified, or for other good reasons, a physician other than provided by the employer is called to treat the injured employee, during such period, the reasonable cost of such service shall be paid by the employer if ordered so to do by the Commission.
    4. As used in this section and in § 65.2-604 , the terms “medical attention,” “medical service,” “medical care,” and “medical report” shall be deemed to include chiropractic service or treatment and, where appropriate, a chiropractic treatment report.
    5. Whenever an employer furnishes an employee the names of three physicians pursuant to this section, and the employer also assumes all or part of the cost of providing health care coverage for the employee as a self-insured or under a group health insurance policy, health services plan or health care plan, upon the request of an employee, the employer shall also inform the employee whether each physician named is eligible to receive payment under the employee’s health care coverage provided by the employer.
    6. If the injured employee has an injury which may be treated within the scope of practice for a chiropractor, then the employer or insurer may include chiropractors on the panel provided the injured employee.

    History. Code 1950, § 65-85; 1952, c. 385; 1960, cc. 310, 444, 580; 1964, c. 366; 1966, c. 388; 1968, cc. 377, 660, § 65.1-88; 1970, c. 470; 1972, c. 229; 1973, c. 542; 1975, c. 280; 1980, c. 600; 1982, c. 585; 1983, c. 471; 1987, cc. 455, 475; 1989, c. 540; 1990, c. 789; 1991, cc. 275, 355, 376; 1994, c. 558; 1997, c. 839; 1998, c. 65; 1999, c. 780; 2000, cc. 473, 1018; 2004, c. 271; 2011, c. 656; 2017, c. 491; 2022, c. 213.

    § 65.2-603.1. Use of therapeutically equivalent drug products required.

    1. As used in this section, “therapeutically equivalent drug products” means drug products that (i) contain the same active ingredients, (ii) are identical in strength or concentration, dosage form, and route of administration, and (iii) are classified as being therapeutically equivalent by the U.S. Food and Drug Administration pursuant to the definition of “therapeutically equivalent drug products” set forth in the most recent edition of Approved Drug Products with Therapeutic Equivalence Evaluations, known as the Orange Book.
    2. Notwithstanding the provisions of § 54.1-3408.03 , and except as provided in subsection C, any pharmacist filling a prescription for medication for a workers’ compensation claimant shall dispense a therapeutically equivalent drug product for the prescribed name-brand drug product. If a therapeutically equivalent drug product does not exist or the usual and customary retail price charged by the pharmacist for the therapeutically equivalent drug product is higher than that of the prescribed name-brand drug product, the pharmacist shall dispense the prescribed name-brand drug product.
    3. A prescriber may specify on the prescription “brand medically necessary” if there is a medical reason why the claimant should not have the prescription filled with a therapeutically equivalent drug product. A request by the claimant that a name-brand drug product be prescribed shall not constitute a sufficient reason under this section for the prescriber to specify “brand medically necessary” on the prescription. If the prescriber specifies on the prescription “brand medically necessary,” the pharmacist shall fill the prescription with the name-brand drug product prescribed. If the prescriber calls the prescription in to the pharmacy by telephone and verbally tells the pharmacist “brand medically necessary,” the pharmacist shall note on the prescription that the prescriber stated “brand medically necessary” and then fill the prescription with the name-brand drug product prescribed. The cost of any medication prescribed by any authorized treating physician and covered pursuant to this section to treat injuries or diseases that result from a compensable claim shall not be the responsibility of the claimant unless the claimant obtained the prescription through fraud.
    4. An act in compliance with the provisions of this section shall not be deemed to be a prohibited act under § 54.1-3457 .

    History. 2009, cc. 333, 559.

    Law Review.

    For annual survey article, “Health Care Law,” see 44 U. Rich. L. Rev. 473 (2009).

    § 65.2-604. Furnishing copy of medical report.

    1. Any health care provider attending an injured employee shall, upon request of the injured employee, employer, insurer, or a certified rehabilitation provider as provided in Article 2 (§ 54.1-3510 et seq.) of Chapter 35 of Title 54.1 providing services to the injured employee, or of any representative thereof, furnish a copy of any medical report to the injured employee, employer, insurer, or a certified rehabilitation provider as provided in Article 2 (§ 54.1-3510 et seq.) of Chapter 35 of Title 54.1 providing services to the injured employee, or to any representative thereof, or to each of them upon request for such medical report.
    2. Whenever any health care provider attending an injured employee refers the employee or transfers responsibility for his care to another health care provider, the referring or transferring provider, upon receipt of a request therefor, shall promptly transfer or cause to be transferred to the new or succeeding provider, or to the employee or someone acting on behalf of the employee, copies of all diagnostic test results, x-ray photographs, and other medical records pertaining to the employee’s injury for which further treatment is to be sought from the succeeding provider.In the event of such referral or transfer, the succeeding provider, if given any such diagnostic test results, x-ray photographs and other medical records pertaining to the employee’s injury which were performed or recorded within the preceding 60 days by a referring or transferring provider, shall not repeat any such diagnostic tests or procedures previously conducted without making a good faith attempt to use them unless there is a medical necessity to do so as certified by a qualified physician on behalf of the succeeding provider. If the succeeding health care provider violates the requirements of this paragraph, such succeeding provider shall not be entitled to compensation or reimbursement from the injured employee’s employer or the employer’s insurer for any repeated test or procedure not so certified to be medically necessary, nor may the succeeding provider require the employee to bear any cost associated with the repeated test or procedure which would have been the responsibility of the employer or his insurer but for the provisions of this subsection.
    3. As used in this section, the term “health care provider” shall have the same meaning as set forth in § 8.01-581.1 , except that state-operated facilities shall also be considered health care providers for the purposes of this section.

    History. 1970, c. 470, § 65.1-88.1; 1982, c. 128; 1991, c. 355; 1994, c. 685; 1998, c. 431; 1999, c. 314; 2000, c. 542.

    Cross references.

    As to health records privacy, see § 32.1-127.1:03 .

    The 1998 amendment, in subsection A, inserted “or of any representative thereof” in two places.

    The 1999 amendment substituted “health care provider” for “physician” in subsection A, and added subsection C.

    The 2000 amendments.

    The 2000 amendment by c. 542 substituted “insurer, or a certified rehabilitation provider as provided in Article 2 (§ 54.1-3510 et seq.) of Chapter 35 of Title 54.1 providing services to the injured employee” for “or insurer” in subsection A in two places.

    Law Review.

    For an article relating to the most significant developments in the law of workers’ compensation since September 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    For a review of workers’ compensation law in Virginia for year 1999, see 33 U. Rich. L. Rev. 1101 (1999).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 9 Discovery. § 9.04 Privileges against discovery; § 9.08 Production of documents and things. Bryson.

    CASE NOTES

    Independent expert witness selected by the Commission pursuant to the provisions of this section together with his work product, such as X-rays or other tests and records, is subject to the same discoveries, examinations and views as any other witness in the cause being heard. Moreover, if X-rays are admitted into the record together with an expert’s report — regardless of whether such evidence results from the efforts of a party or the Commission — then the reports of other experts should be admitted and considered by the Commission together with the other evidence in the record. Lynchburg Foundry v. Goldies Tune, 1 Va. App. 295, 338 S.E.2d 645, 1986 Va. App. LEXIS 198 (1986) (decided under former § 65.1-88.1).

    Claimant bore the burden of proving that the physician’s medical treatment was reasonable, necessary, and causally related to his industrial injury. Neither the physician nor claimant produced any medical records related to the physician’s treatment of claimant from which it could be determined that such treatment was reasonable, necessary, and causally related to claimant’s industrial injury. Therefore, claimant’s evidence failed to sustain his burden of proof. Mika v. Sears, Roebuck & Co., 1997 Va. App. LEXIS 100 (Va. Ct. App. Feb. 18, 1997).

    Access by employer to X-rays relied on by independent expert. —

    The Commission should have allowed the employer access to X-rays on which the independent expert selected by the Commission relied, since it was necessary to effective cross-examination of this expert to have the benefit of employer’s expert advice prior to the examination. Lynchburg Foundry v. Goldies Tune, 1 Va. App. 295, 338 S.E.2d 645, 1986 Va. App. LEXIS 198 (1986) (decided under former § 65.1-88.1).

    Excuse for refusing medical attention. —

    The evidence was convincing that the claimant refused the medical attention offered him and urged upon him, without any excuse for doing so other than his notion that he could take care of himself. This was not a legal excuse. Stump v. Norfolk Shipbuilding & Dry Dock Corp., 187 Va. 932 , 48 S.E.2d 209, 1948 Va. LEXIS 280 (1948) (decided under prior law).

    Notice sufficient. —

    Finding that the employee was entitled to ongoing workers’ compensation benefits was appropriate because evidence of prejudice from the settlement as to injuries other than the compensable brain injury did not justify termination of the award for that injury. The evidence, viewed in the light most favorable to claimant, established that claimant suffered no exacerbation of his compensable 2004 brain injury in the 2006 auto accident and continued to be temporarily and totally disabled as a result of the 2004 brain injury after the 2006 auto accident. United Airlines, Inc. v. Hayes, 58 Va. App. 220, 708 S.E.2d 418, 2011 Va. App. LEXIS 163 (2011).

    Credible evidence showed that the treating physicians refused to produce claimant’s medical records to the employer and insurer pursuant to their statutory duty. Wiggins v. Fairfax Park Ltd. Partnership, 22 Va. App. 432, 470 S.E.2d 591, 1996 Va. App. LEXIS 355 (1996).

    CIRCUIT COURT OPINIONS

    Submission of diagnosis. —

    Plaintiff alleged that a doctor was mistaken in her diagnosis, but the diagnosis, however erroneous, it was an expression of opinion, it was necessary for the doctor to submit this form to the insurer, since the plaintiff was pursuing a workers’ compensation claim; it was appropriate for the third-party administrator to alert the chief of police to the diagnosis, and the communication of the diagnosis was not defamatory as a matter of law. Shumate v. City of Martinsville, 90 Va. Cir. 122, 2015 Va. Cir. LEXIS 25 (Martinsville Mar. 25, 2015), aff'd, No. 151285, 2016 Va. Unpub. LEXIS 21 (Va. Sept. 22, 2016).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The language of § 65.2-604 , and the § 32.1-127.1:03 C exclusion of information governed by the Workers’ Compensation Act, applies to all medical records, not just those records which are or may be related to a claimant’s injury by accident. The health care provider is not allowed to determine which of its records possibly relate to an employee’s workplace injury before responding to a subpoena duces tecum. Scarafino v. CVS Drugs, VWC File No. 206-30-17 (July 8, 2004), appeal rejected as interlocutory, No. 1844-04-2 (Ct. App. Va., Feb. 10, 2005).

    Subpoenas duces tecum are “requests” under § 65.2-604 . The requirements of § 32.1-172.1:03 H do not apply to subpoenas duces tecum served in the context of workers’ compensation proceedings. A claimant waives his or her medical privacy rights upon filing a workers’ compensation claim. Randall v. SHS, VWC File No. 214-26-37 (March 29, 2004).

    Deputy Commissioner correctly refused to quash subpoena for non-party’s medical records, which was resisted under the Health Insurance Portability and Accountability Act of 1996; HIPAA does not preclude issuance of a subpoena of non-party’s medical records and also does not apply to workers’ compensation provisions allowing production of such records. Goodwin v. Sentara Norfolk Gen’l Hosp., VWC File No. 208-72-40 (Aug. 6, 2003).

    Commission Rule 4.2 provides that a medical care provider attending an injured employee shall furnish a copy of required reports to the employer or employee. The physician-patient privilege as to all physicians is waived in all proceedings under the Act. Hassell v. Arlington County Human Services, 79 O.W.C. 141 (2000).

    The Commission may require reports not requested by other federal and state agencies and medical codes are not sufficient to report medical diagnosis and medical services. A properly executed Attending Physician’s Report meets this obligation. Martin v. Saunders B. Moon Community, 71 O.W.C. 198 (1992).

    The treating physician is required to provide the employer information regarding the treatment and status of the claimant, and the employer is entitled to have the attending physician complete a physical capacities form for the purpose of evaluating work capacity, even if he has not been released to work. Gardner v. Legum Home Health/Home I.V. Care and Nutritional Service, 74 O.W.C. 97 (1995).

    Where a physician fails to provide medical reports to an employer/insurer within a reasonable time they are released from the responsibility to pay the doctor’s charge and may seek a change of physicians to continue the claimant’s treatment. Parks v. Systems Engineering Associates Corporation, 66 O.I.C. 104 (1987) (see also In re: Dr. Hladys, 58 O.I.C. 194 (1978); Jenkins v. Lowes of Norfolk, Inc., 59 O.I.C. 149 (1960) (not have to pay if doctor fails to file reports)).

    Even if a claim is found to be compensable, the employer is not responsible for the cost of a physician’s treatment if the physician declines to produce the records of treatment. Hassell v. Arlington County Human Services, 79 O.W.C. 141 (2000).

    Medical reports are tantamount to direct testimony and create a right of cross-examination. Pasley v. Arlington County, 58 O.I.C. 267 (1978).

    The Commission ordered a change in the approved treating physician due to the physician’s consistent failure to cooperate with the insurer’s reasonable efforts to collect information regarding the claimant’s medical status. While § 65.2-603 grants the approved treating physician the exclusive right to manage the injured worker’s medical treatment, the Act provides a concomitant obligation on the part of the physician to reasonably cooperate with the insurer’s requests for information regarding the claimant’s condition and ongoing treatment. Section 65.2-604 and Commission Rule 4.2 require that physicians attending injured workers provide medical reports upon request. In this case, the treating physician’s consistent refusal to cooperate prejudiced the insurer’s ability to evaluate the employee’s ongoing condition and treatment, thereby justifying his removal. Newton v. Hunt Country Nursing Service, VWC File No. 196-43-73 (June 12, 2002).

    Medical reports from an unauthorized physician may be considered in determining work incapacity. Clark v. R & E Electronics, 71 O.W.C. 200 (1992).

    § 65.2-605. Liability of employer for medical services ordered by Commission; fee schedules for medical services; malpractice; assistants-at-surgery; coding.

    1. As used in this section, unless the context requires a different meaning:“Burn center” means a treatment facility designated as a burn center pursuant to the verification program jointly administered by the American Burn Association and the American College of Surgeons and verified by the Commonwealth.“Categories of providers of fee scheduled medical services” means:
      1. Physicians exclusive of surgeons;
      2. Surgeons;
      3. Type One teaching hospitals;
      4. Hospitals, exclusive of Type One teaching hospitals;
      5. Ambulatory surgical centers;
      6. Providers of outpatient medical services not covered by subdivision 1, 2, or 5; and
      7. Purveyors of miscellaneous items and any other providers not described in subdivisions 1 through 6, as established by the Commission in regulations adopted pursuant to subsection C.“Codes” means, as applicable, CPT codes, HCPCS codes, DRG classifications, or revenue codes.“CPT codes” means the medical and surgical identifying codes using the Physicians’ Current Procedural Terminology published by the American Medical Association.“Diagnosis related group” or “DRG” means the system of classifying in-patient hospital stays adopted for use with the Inpatient Prospective Payment System.“Fee scheduled medical service” means a medical service exclusive of a medical service provided in the treatment of a traumatic injury or serious burn.“Health Care Common Procedure Coding System codes” or “HCPCS codes” means the medical coding system, including all subsets of codes by alphabetical letter, used to report hospital outpatient and certain physician services as published by the National Uniform Billing Committee, including Temporary National Code (Non-Medicare) S0000-S-9999.“Level I or Level II trauma center” means a hospital in the Commonwealth designated by the Board of Health as a Level I trauma center or a Level II trauma center pursuant to the Statewide Emergency Medical Services Plan developed in accordance with § 32.1-111.3 .“Medical community” means one of the following six regions of the Commonwealth:
    2. The pecuniary liability of the employer for a:
      1. Medical, surgical, and hospital service herein required when ordered by the Commission that is provided to an injured person prior to the transition date, regardless of the date of injury, shall be limited absent a contract providing otherwise, to such charges as prevail in the same community for similar treatment when such treatment is paid for by the injured person. As used in this subdivision, “same community” for providers of medical services rendered outside of the Commonwealth shall be deemed to be the principal place of business of the employer if located in the Commonwealth or, if no such location exists, the location where the Commission hearing regarding the dispute is conducted;
      2. Fee scheduled medical service provided on or after the transition date, regardless of the date of injury, shall be limited to:
        1. The amount provided for the payment for the fee scheduled medical service as set forth in a contract under which the provider has agreed to accept a specified amount in payment for the service provided, which amount may be less than or exceed the maximum amount for the service as set forth in the applicable Virginia fee schedule;
        2. In the absence of a contract described in subdivision 2 a, the lesser of the billing amount or the amount for the fee scheduled medical service as set forth in the applicable Virginia fee schedule that is in effect on the date the service is provided, subject to an increase approved by the Commission pursuant to subsection H; or
        3. In the absence of (i) a contract described in subdivision 2 a and (ii) a provision in a Virginia fee schedule that sets forth a maximum amount for the medical service on the date it is provided, the maximum amount determined by the Commission as provided in subsection E; and
      3. Medical service provided on or after the transition date for the treatment of a traumatic injury or serious burn, regardless of the date of injury, shall be limited to:
        1. The amount provided for the payment for the medical service provided for the treatment of the traumatic injury or serious burn as set forth in a contract under which the provider has agreed to accept a specified amount in payment for the service provided, which amount may be less than or exceed the maximum amount for the service calculated pursuant to subdivision 3 b; or
        2. In the absence of a contract described in subdivision 3 a, an amount equal to 80 percent of the provider’s charge for the service based on the provider’s charge master or schedule of fees; however, if the compensability under this title of a claim for traumatic injury or serious burn is contested and after a hearing on the claim on its merits or after abandonment of a defense by the employer or insurance carrier, benefits for medical services are awarded and inure to the benefit of a third-party insurance carrier or health care provider and the Commission awards to the claimant’s attorney a fee pursuant to subsection B of § 65.2-714 , then the pecuniary liability of the employer for the service provided shall be limited to 100 percent of the provider’s charge for the service based on the provider’s charge master or schedule of fees.
    3. The Commission shall adopt regulations establishing initial Virginia fee schedules for fee scheduled medical services as follows:
      1. The Commission’s regulations that establish the initial Virginia fee schedules shall be effective on January 1, 2018.
      2. Separate initial Virginia fee schedules shall be established for fee scheduled medical services (i) provided by each category of providers of fee scheduled medical services and (ii) within each of the medical communities to reflect the variations among the medical communities as provided in subdivision 3, for each category of providers of fee scheduled medical services.
      3. The Virginia fee schedules for each medical community shall reflect variations among medical communities in (i) all reimbursements and other amounts paid to providers for fee scheduled medical services among the medical communities and (ii) the extent to which the number of providers within the various medical communities is adequate to meet the needs of injured workers.
      4. In establishing the initial Virginia fee schedules for fee scheduled medical services, the Commission shall establish the maximum fee for each fee scheduled medical service at a level that approximates the reimbursement objective for each category of providers of fee scheduled medical services among the medical communities. The Commission shall retain a firm with nationwide experience and actuarial expertise in the development of workers’ compensation fee schedules to assist the Commission in establishing the initial Virginia fee schedules. The Commission shall consult with the regulatory advisory panel established pursuant to subdivision F 2 prior to retaining such firm. Such firm shall be retained to assist the Commission in developing the Virginia fee schedules by recommending a methodology that will provide, at reasonable cost to the Commission, statistically valid estimates of the reimbursement objective for fee scheduled medical services within the medical communities, based on available data or, if the necessary data is not available, by recommending the optimal methodology for obtaining the necessary data. The Commission shall consult with the regulatory advisory panel prior to adopting any such methodology. Such methodology may, but is not required to, be based on applicable codes. The estimates of the reimbursement objective for fee scheduled medical services shall be derived from data on all reimbursements and other amounts paid to providers for fee scheduled medical services provided pursuant to this title during 2014 and 2015, to the extent available.
    4. The Commission shall review Virginia fee schedules during the year that follows the transition date and biennially thereafter and, if necessary, adjust the Virginia fee schedules in order to address (i) inflation or deflation as reflected in the medical care component of the Consumer Price Index for All Urban Consumers (CPI-U) for the South as published by the Bureau of Labor Statistics of the U.S. Department of Labor; (ii) access to fee scheduled medical services; (iii) errors in calculations made in preparing the Virginia fee schedules; and (iv) incentives for providers. The Commission shall not adjust a Virginia fee schedule in a manner that reduces fees on an existing schedule unless such a reduction is based on deflation or a finding by the Commission that advances in technology or errors in calculations made in preparing the Virginia fee schedules justify a reduction in fees.
    5. The maximum pecuniary liability of the employer for a fee scheduled medical service that is not included in a Virginia fee schedule when it is provided shall be determined by the Commission. The Commission’s determination of the employer’s maximum pecuniary liability for such fee scheduled medical service shall be effective until the Commission sets a maximum fee for the fee scheduled medical service and incorporates such maximum fee into an adjusted Virginia fee schedule adopted pursuant to subsection D. If the fee scheduled medical service is not included in a Virginia fee schedule because it is:
      1. A new type of technology, the employer’s maximum pecuniary liability shall not exceed 130 percent of the provider’s invoiced cost for such device, as evidenced by a copy of the invoice. If the new type of technology has not been cleared or approved by the FDA prior to such date, then the provider shall not be entitled to payment or reimbursement therefor unless the employer or its insurer agree; or
      2. A new type of procedure that has not been assigned a billing code, the employer’s maximum pecuniary liability shall not exceed 80 percent of the provider’s charge for the service based on the provider’s charge master or schedule of fees, provided the employer and the provider mutually agree to the provision of such procedure.
    6. The Commission shall:
      1. Provide public access to information regarding the Virginia fee schedules for medical services, by categories of providers of fee scheduled medical services and for each medical community, through the Commission’s website. No information provided on the website shall be provider-specific or disclose or release the identity of any provider; and
      2. Utilize a 10-member regulatory advisory panel to assist in the development of regulations adopting initial Virginia fee schedules pursuant to subsection C, in adjusting initial Virginia fee schedules pursuant to subsection D, and on all matters involving or related to the fee schedule as deemed necessary by the Commission. One member of the regulatory advisory panel shall be selected by the Commission from each of the following: (i) the American Insurance Association; (ii) the Property and Casualty Insurers Association of America; (iii) the Virginia Self-Insurers Association, Inc.; (iv) the Medical Society of Virginia; (v) the Virginia Hospital and Healthcare Association; (vi) a Type One teaching hospital; (vii) the Virginia Orthopaedic Society; (viii) the Virginia Trial Lawyers Association; (ix) a group self-insurance association representing employers; and (x) a local government group self-insurance pool formed under Chapter 27 (§ 15.2-2700 et seq.) of Title 15.2. The Commission shall meet with the regulatory advisory panel and consider the recommendations of its members in its development of the Virginia fee schedules pursuant to subsections C and D.
    7. The Commission’s retaining of a firm with nationwide experience and actuarial expertise in the development of workers’ compensation fee schedules to assist the Commission in developing the Virginia fee schedules pursuant to subsections C and D shall be exempt from the provisions of the Virginia Public Procurement Act (§ 2.2-4300 et seq.), provided the Commission shall issue a request for proposals that requires submission by a bidder of evidence that it satisfies the conditions for eligibility established in this subsection and in subdivision C 4. Records and information relating to payments or reimbursements to providers that is obtained by or furnished to the Commission by such firm or any other person shall (i) be for the exclusive use of the Commission in the course of the Commission’s development of fee schedules and related regulations and (ii) shall remain confidential and shall not be subject to the provisions of the Virginia Freedom of Information Act (§ 2.2-3700 et seq.).
    8. When the total charges of a hospital or Type One teaching hospital, based on such provider’s charge master, for inpatient hospital services covered by a DRG code exceed the charge outlier threshold, then the Commission shall establish the maximum fee for such scheduled inpatient hospital services at an amount equal to the total of (i) the maximum fee for the service as set forth in the applicable fee schedule and (ii) initially equal to 80 percent of the provider’s total charges for the service in excess of the charge outlier threshold. The charge outlier threshold for such services initially shall equal 300 percent of the maximum fee for the service set forth in the applicable fee schedule; however, the Commission, in consultation with the firm retained pursuant to subdivision C 4, is authorized on a biennial basis to adjust such percentage if it finds that the number of such claims for which the total charges of the hospital or Type One teaching hospital exceed the charge outlier threshold is less than five percent or to increase such percentage if such number is greater than 10 percent of all such claims.
    9. No provider shall use a different charge master or schedule of fees for any medical service provided under this title than the provider uses for health care services provided to patients who are not claimants under this title.
    10. The employer shall not be liable in damages for malpractice by a physician or surgeon furnished by him pursuant to the provisions of § 65.2-603 , but the consequences of any such malpractice shall be deemed part of the injury resulting from the accident and shall be compensated for as such.
    11. The Commission shall determine the number and geographic area of communities across the Commonwealth. In establishing the communities, the Commission shall consider the ability to obtain relevant data based on geographic area and such other criteria as are consistent with the purposes of this title. The Commission shall use the communities established pursuant to this subsection in determining charges that prevail in the same community for treatment provided prior to the transition date.
    12. The pecuniary liability of the employer for treatment of a medical service that is rendered on or after July 1, 2014, by:
      1. A nurse practitioner or physician assistant serving as an assistant-at-surgery shall be limited to no more than 20 percent of the reimbursement due to the physician performing the surgery; and
      2. An assistant surgeon in the same specialty as the primary surgeon shall be limited to no more than 50 percent of the reimbursement due to the primary physician performing the surgery.
    13. Multiple procedures completed on a single surgical site associated with a medical service rendered on or after July 1, 2014, shall be coded and billed with appropriate CPT codes and modifiers and paid according to the National Correct Coding Initiative rules and the CPT codes as in effect at the time the health care was provided to the claimant.
    14. The CPT code and National Correct Coding Initiative rules, as in effect at the time a medical service was provided to the claimant, shall serve as the basis for processing a health care provider’s billing form or itemization for such items as global and comprehensive billing and the unbundling of medical services. Hospital in-patient medical services shall be coded and billed through the International Statistical Classification of Diseases and Related Health Problems as in effect at the time the medical service was provided to the claimant.

    1. Northern region, consisting of the area for which three-digit ZIP code prefixes 201 and 220 through 223 have been assigned by the U.S. Postal Service.

    2. Northwest region, consisting of the area for which three-digit ZIP code prefixes 224 through 229 have been assigned by the U.S. Postal Service.

    3. Central region, consisting of the area for which three-digit ZIP code prefixes 230, 231, 232, 238, and 239 have been assigned by the U.S. Postal Service.

    4. Eastern region, consisting of the area for which three-digit ZIP code prefixes 233 through 237 have been assigned by the U.S. Postal Service.

    5. Near Southwest region, consisting of the area for which three-digit ZIP code prefixes 240, 241, 244, and 245 have been assigned by the U.S. Postal Service.

    6. Far Southwest region, consisting of the area for which three-digit ZIP code prefixes 242, 243, and 246 have been assigned by the U.S. Postal Service.The applicable community for providers of medical services rendered in the Commonwealth shall be determined by the zip code of the location where the services were rendered. The applicable community for providers of medical services rendered outside of the Commonwealth shall be determined by the zip code of the principal place of business of the employer if located in the Commonwealth or, if no such location exists, the zip code of the location where the Commission hearing regarding a dispute concerning the services would be conducted. “Medical service” means any medical, surgical, or hospital service required to be provided to an injured person pursuant to this title. “Medical service provided for the treatment of a serious burn” includes any professional service rendered during the dates of service of the admission or transfer to a burn center. “Medical service provided for the treatment of a traumatic injury” includes any professional service rendered during the dates of service of the admission or transfer to a Level I or Level II trauma center. “Miscellaneous items” means medical services provided under this title that are not included within subdivisions 1 through 6 of the definition of categories of providers of fee scheduled medical services. “Miscellaneous items” does not include (i) pharmaceuticals that are dispensed by providers, other than hospitals or Type One teaching hospitals as part of inpatient or outpatient medical services, or dispensed as part of fee scheduled medical services at an ambulatory surgical center or (ii) durable medical equipment dispensed at retail. “New type of technology” means an item resulting or derived from an advance in medical technology, including an implantable medical device or an item of medical equipment, that is supplied by a third party, provided that the item has been cleared or approved by the federal Food and Drug Administration (FDA) after the transition date and prior to the date of the provision of the medical service using the item. “Physician” means a person licensed to practice medicine or osteopathy in the Commonwealth pursuant to Chapter 29 (§ 54.1-2900 et seq.) of Title 54.1. “Professional service” means any medical or surgical service required to be provided to an injured person pursuant to this title that is provided by a physician or any health care practitioner licensed, accredited, or certified to perform the service consistent with state law. “Provider” means a person licensed by the Commonwealth to provide a medical service to a claimant under this title. “Reimbursement objective” means the average of all reimbursements and other amounts paid to providers in the same category of providers of fee scheduled medical services in the same medical community for providing a fee scheduled medical service to a claimant under this title during the most recent period preceding the transition date for which statistically reliable data is available as determined by the Commission. “Revenue codes” means a method of coding used by hospitals or health care systems to identify the department in which medical service was rendered to the patient or the type of item or equipment used in the delivery of medical services. “Serious burn” means a burn for which admission or transfer to a burn center is medically necessary. “Transition date” means the date the regulations of the Commission adopting initial Virginia fee schedules for medical services pursuant to subsection C become effective. “Traumatic injury” means an injury for which admission or transfer to a Level I or Level II trauma center is medically necessary and that is assigned a DRG number of 003, 004, 011, 012, 013, 025 through 029, 082, 085, 453, 454, 455, 459, 460, 463, 464, 465, 474, 475, 483, 500, 507, 510, 515, 516, 570, 856, 857, 862, 901, 904, 907, 908, 955 through 959, 963, 998, or 999. Claimants who die in an emergency room of trauma or burn before admission shall be deemed to be claimants who incurred a traumatic injury. “Type One teaching hospital” means a hospital that was a state-owned teaching hospital on January 1, 1996. “Virginia fee schedule” means a schedule of maximum fees for fee scheduled medical services for the medical community where the fee scheduled medical service is provided, as initially adopted by the Commission pursuant to subsection C and as adjusted as provided in subsection D.

    History. Code 1950, § 65-86; 1968, c. 660, § 65.1-89; 1991, c. 355; 2014, c. 670; 2015, c. 456; 2016, cc. 279, 290; 2017, c. 478; 2018, c. 261.

    Editor’s note.

    Acts 2015, c. 456, cl. 2 provides: “That the Workers’ Compensation Commission shall promulgate regulations to implement the provisions of this act to be effective within 280 days of its enactment and shall provide an opportunity for public comment on the regulations prior to adoption.”

    Acts 2015, c. 456, cl. 3 provides: “That the Workers’ Compensation Commission shall convene a work group of stakeholder representatives of employers, health care service providers, claimants, and insurers to advise and assist the Commission in (i) reviewing, analyzing, and comparing information contained within and reports on all possible databases containing workers’ compensation or health care data for medical services rendered in Virginia, (ii) reviewing, analyzing, and comparing information contained within and reports on how similar databases are used for the establishment of the pecuniary liability of the employer in other states, and (iii) making findings or recommendations as to how the databases reviewed and the contents thereof may serve to enhance or replace Virginia’s current mechanisms for establishing the pecuniary liability of the employer. The Workers’ Compensation Commission shall report its findings and recommendations to the Chairmen of the House and Senate Commerce and Labor Committees by December 15, 2015.”

    Acts 2016, cc. 279 and 290, cl. 2 provides: “That the Workers’ Compensation Commission’s adoption of regulations establishing initial Virginia fee schedules for medical services pursuant to subsection C, and its adoption of regulations adjusting Virginia fee schedules for medical services pursuant to subsection D, of § 65.2-605 of the Code of Virginia as amended and reenacted by this act shall be exempt from the provisions of Article 2 (§ 2.2-4006 et seq.) of the Administrative Process Act (§ 2.2-4000 et seq.) of the Code of Virginia, provided that the Workers’ Compensation Commission utilizes a regulatory advisory panel constituted as provided in subdivision F 2 of § 65.2-605 as added by this act to assist in the development of such regulations and provides an opportunity for public comment on the regulations prior to adoption.”

    Acts 2016, cc. 279 and 290, cl. 4, as amended by Acts 2017, c. 478, cl. 2, provides: “That the Workers’ Compensation Commission (Commission) shall select the members of the regulatory advisory panel created pursuant to subdivision F 2 of § 65.2-605 of the Code of Virginia as added by this act prior to August 1, 2016. The regulatory advisory panel shall meet, review, and make recommendations to the Commission prior to July 1, 2018, on workers’ compensation issues relating to (i) pharmaceutical costs not previously included in the Virginia fee schedules; (ii) durable medical equipment costs not previously included in the Virginia fee schedules; (iii) attorney fees awarded under § 65.2-714 ; (iv) how to resolve the issues that the peer review committees established under Chapter 13 (§§ 65.2-1300 through 65.2-1310) of Title 65.2 of the Code of Virginia as repealed by this act had been authorized to address; (v) prior authorization for medical services; and (vi) any other issues that the Commission assigns to the regulatory advisory panel.”

    The 2014 amendments.

    The 2014 amendment by c. 670 designated the existing provision as subsection A; and added subsections B and C.

    The 2015 amendments.

    The 2015 amendment by c. 456 added subsection B; redesignated former subsections B and C as subsections C and D, respectively.

    The 2016 amendments.

    The 2016 amendments by cc. 279 and 290, effective March 7, 2016, are identical, and rewrote section.

    The 2017 amendments.

    The 2017 amendment by c. 478, effective March 13, 2017, in subsection A, added the definitions for “Medical service provided for the treatment of a serious burn,” “Medical service provided for the treatment of a traumatic injury,” “New type of technology,” “Professional service,” “Revenue codes”; in the definition of “Codes,” inserted “or revenue codes”; in the definition for “Health Care Common Procedure Coding System codes,” inserted “including all subsets of codes by alphabetical letter”; in subdivision E 1, deleted “including an implantable medical device or item of medical equipment, that is supplied by a third party, provided that such technology has been cleared or approved by the federal Food and Drug Administration (FDA) prior to the date of the provision of the medical service” following “type of technology”; in the first sentence of subdivision F 2, inserted “and on all matters involving or related to the fee schedule as deemed necessary by the Commission”; in subsection H, inserted “initially equal to” in clause (ii), and in the second sentence, substituted “300 percent of the maximum” for “150 percent of the maximum” and “adjust such percentage” for “decrease such percentage”; and made minor stylistic changes.

    The 2018 amendments.

    The 2018 amendment by c. 261, in subsection A, added the last paragraph in the definition for “Medical community”; and in subdivision B 1, added the second sentence.

    Michie’s Jurisprudence.

    For related discussion, see 14B M.J. Physicians and Surgeons, § 3.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-89 or prior law.

    Applicability. —

    In a consolidated appeal from two decisions from the Workers’ Compensation Commission regarding a medical billing dispute between an insurance carrier and a medical provider, the appellate court concluded that the Commission erred by applying a certain subsection of a contract and § 65.2-605 to the bills at issue. As the carrier had already compensated the provider, the carrier owed no further payment to the provider, and the Commission reversibly erred to the extent it held otherwise. Goldkress Corp. v. Orthopaedic & Spine Ctr., 2016 Va. App. LEXIS 339 (Va. Ct. App. Dec. 13, 2016).

    This section merely affirms the common law with respect to liability for the consequences of an aggravation of an original injury. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)).

    Providers’ fee-reimbursement agreements not prohibited. —

    This section establishes a standard that is often called the prevailing community rate and provides a mechanism for resolving disputes over medical charges; it does not establish a minimum charge or schedule of fees nor does it prohibit medical care providers from entering into agreements for fee reimbursement in workers’ compensation cases. Leibovic v. Melchor, 35 Va. App. 51, 542 S.E.2d 795, 2001 Va. App. LEXIS 94 (2001).

    Under this section, the employer is relieved from liability in damages for malpractice by the physician or surgeon, but there is no provision for the benefit of a third-party wrongdoer, whether he be a negligent physician or other person. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)).

    But employer is liable to pay compensation for any aggravation of the original injury, even if such aggravation arises by reason of malpractice. Evans v. Newport News Shipbuilding & Dry Dock Co., 243 F. Supp. 1017, 1965 U.S. Dist. LEXIS 7419 (E.D. Va. 1965), aff'd, 361 F.2d 364, 1966 U.S. App. LEXIS 6204 (4th Cir. 1966).

    And third-party wrongdoer is not relieved from liability. —

    There is no provision for the benefit of a third-party wrongdoer, whether he be a negligent physician or other person. Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951) (commented on in 9 Wash. & Lee L. Rev. 316 (1952)).

    Prevailing rate in community. —

    Employer that alleged a medical provider’s bill was excessive presented insufficient evidence of the prevailing rate in the community, as the government-mandated reimbursement rate for injured longshoremen or Medicare patients, standing alone, did not establish that rate. The test was what a surgeon and his assistant with the skill and experience of those that operated on the worker’s compensation claimant typically charged for the surgery at the time and in the community that the surgery was performed. Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 722 S.E.2d 301, 2012 Va. App. LEXIS 59 (2012).

    Test for determining whether medical fee is excessive. —

    Virginia Workers’ Compensation Commission did not err by refusing an employer’s request to consider whether a medical bill exceeded the medical provider’s regular rate or some amorphous “reasonable” rate, apart from the prevailing rate in the community for similar medical treatment. Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 722 S.E.2d 301, 2012 Va. App. LEXIS 59 (2012).

    Burden is on employer to prove excessive medical fee. —

    Virginia Workers’ Compensation Commission’s award to a medical provider for a claimant’s surgery was proper, as it was reasonable for the Commission to consider a medical bill as prima facie evidence that the charges were consistent with requirements of the Virginia Workers’ Compensation Act and to place the burden on the employer to prove that the medical fee was excessive. Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 722 S.E.2d 301, 2012 Va. App. LEXIS 59 (2012).

    Fee not reasonable. —

    Virginia Workers’ Compensation Commission’s exercise of its authority and finding that a medical provider’s fees, which included a 40 percent surcharge because an employee was a workers’ compensation patient, were not reasonable and necessary under § 65.2-605 were proper since the provider did not show that the surcharge was reasonable in the employee’s case. Fredericksburg Orthopaedic Assocs. v. Fredericksburg Mach. & Steel, LLC, 62 Va. App. 83, 741 S.E.2d 813, 2013 Va. App. LEXIS 154 (2013).

    In a workers’ compensation case, an amount billed for a back surgery was not paid in its entirety because the employer’s evidence would have rebutted the provider’s billing presumption of reasonableness. It was up to the Virginia Workers’ Compensation Commission to determine the credibility of an insurance industry expert in medical reimbursement, who gave an opinion on the cost per day of such a surgery, the calculations made by the expert relied only upon what the facilities charged, and the Commission was allowed to consider surgery charges in other facilities as additional data. Surgcenter of Silver Spring, LLC v. Michael & Son Servs., 2017 Va. App. LEXIS 24 (Va. Ct. App. Jan. 31, 2017).

    Methodology used to determine fee. —

    Virginia Workers’ Compensation Commission’s application of a 50 percent reduction to billed charges by a health care provider for certain surgical procedures was inappropriate because the version of the statute in effect at the time did not provide for application of the Medicare Claims Manual or an automatic 50 percent payment reduction for multiple procedures. As a result, the Commission erred by determining the allowable charges for multiple procedures based on the methodology contained in the Medicare Claims Manual. Va. Hand Ctr. v. Adams Lumber Co., 2020 Va. App. LEXIS 272 (Va. Ct. App. Nov. 4, 2020).

    CIRCUIT COURT OPINIONS

    Malpractice action against employer is barred. —

    Because an employee’s injuries were compensable under the Virginia Workers’ Compensation Act, it provided the employee’s sole remedy against the employer and the dual capacity doctrine did not apply; therefore, §§ 65.2-307 and 65.2-605 barred a subsequent medical malpractice action against the employer for negligent treatment of the compensable injury. Budd v. Punyanitya, 69 Va. Cir. 148, 2005 Va. Cir. LEXIS 146 (Albemarle County Oct. 14, 2005).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Medical bills for services rendered prior to the effective date of the medical fee schedule were prima facie evidence of the prevailing community rate for those services when introduced by the claimant independently of the medical provider. Hansen v. TMA Trucking, JCN VA00001001203 (May 28, 2019).

    Medical fee schedule applied to limit medical provider’s charges. Cole v. Total Truck Transport, Inc., JCN VA00001420921 (March 29, 2019).

    The Tennessee fee schedule applies only to individuals seeking benefits under the Tennessee Workers’ Compensation Act, not those who seek benefits under the Virginia Act, even where the medical services are rendered in Tennessee; the prevailing community rate standard applies to such services of the Virginia Act. Mullins, Highlands Neurosurgery, P.C. v. Kyn Coal Corporation, VWC File No. 236-10-44 (Sept. 2, 2009).

    Where a carrier pays a medical bill and it is later found that the payment exceeded the prevailing community rate, pursuant to Rule 14, the carrier is entitled to repayment or a credit for the overpayment. Bush v. Sure Kick Battery Co., VWC File No. 156-69-22 (March 5, 2008).

    In denying the medical provider’s claim that the employer/carrier was responsible for the remaining balance of the medical charges for treatment of the claimant, the Commission found that a preferred provider organization contract (PPO) controlled and the charges were properly reduced in accordance with the contract. Byies and Orthopedic Specialty Clinic v. Tri State Plumbing and Heating, Inc., VWC File No. 220-72-61 (Sept. 19, 2007).

    Agreements between health care providers and medical care administrators for payment of medical costs will be enforced in the absence of fraud, mutual mistake, or a violation of law or public policy. In re Cohen, 75 O.W.C. 63 (1996).

    Medical bills received by the claimant are prima facie evidence that they are both reasonable and necessary. Blevins v. Williamsburg Pottery, 75 O.W.C. 103 (1996).

    Medical bills received by a claimant are prima facie evidence that they are both reasonable and necessary. An employer or carrier alleging excessive medical charges must prove that such costs exceed the prevailing rate of the community for the same services. A mere statement by a carrier that their administrator recommended a different community rate payment does not satisfy the insurer’s burden to show that the charges in question are higher than the prevailing community rate. Moorefield v. Cooperative Supply Inc., 79 O.W.C. 29 (2000).

    An employer and/or medical care provider may file an action under § 65.2-605 . However, the employer has the burden of establishing that the medical fee billed did not meet the community standard and the reimbursement rate was appropriate. Hopkins v. Fairfax County School Board, 73 O.W.C. 168 (1994).

    An employer alleging excessive doctors’ fees must prove that such costs exceed the prevailing rate of the community for the same or comparable services. Korsh v. Builders Hardware & Architectural Prods., Inc., 76 O.W.C. 76 (1997).

    The employer has the burden of showing that the physician’s charges did not fall within the prevailing community rate as set forth in § 65.2-605 , and that the carrier’s reimbursement did meet that standard. The employer retains this burden whether the claim is brought by the employer or the medical care provider. Korsh v. Builders Hardware & Architectural Prods., Inc., 76 O.W.C. 76 (1997).

    An acceptable method of determining what constitutes the prevailing rate in the same community involves collecting data from physicians, clinics, insurance carriers and other existing fee schedules; grouping them by geographic area and CPT; dividing the 50 states into 195 “fee similar” and geographic areas by zip code and making payment recommended at the eightieth percentile. While the physician provided statements concerning the extensiveness of his evaluation, his medical reports failed to substantiate that the stated services were performed. Davidson v. Smyth County Public Service Authority, 73 O.W.C. 171 (1994).

    The Commission held that an acceptable method for determining what constitutes the prevailing rate in the same community may include employing a reasonable procedure in calculating the usual and customary charges for the services rendered, assigning codes for the services, then comparing them to a data base of fees in the geographic area. Griffin v. Suffolk City Public Schools, 71 O.W.C. 217 (1992).

    The fact that MedCheck procedures have been found to be appropriate in prior cases does not mean its procedures in a subsequent proceeding may not be challenged where different factual evidence is available. Where the evidence reveals that the cost data base is incomplete and is not shown to be truly representative of the costs of similar services charged by health care providers in the community, but is collected only from payer clients and thereafter “augmented” with other data, the evidence does not show that charges for x-rays exceeded those prevailing in the community for similar treatment that would be charged to and paid by an individual injured person. The employer’s decision to fully pay only at the 70th percentile fails to show any correlation with the standard for determining appropriate costs as set out in Va. Code Ann. § 65.2-605 , i.e. , the “charges as prevail in the same community for similar treatment when such treatment is paid for by the injured person.” Louise Obici Hosp. v. Dept. of Trans., 75 O.W.C. 235 (1996).

    The employer is responsible for the medical care given to the claimant for her work injury, and it is also liable for the results of ineffective and inappropriate care that it provides. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997), aff’d, Nos. 1238-97-3 & 1290-97-3 (Va. Ct. App., Dec. 23, 1997).

    Absent evidence of reasonable cause, the employer/insurer are not responsible for a “no show” fee charged by a physician when the injured employee fails to attend a scheduled medical appointment. This charge does not result from treatment by a physician or other “necessary medical attention.” There is no provision in the Act that requires employers to be responsible for the claimant’s failure, without reasonable cause, to attend scheduled appointments. The medical provider’s request for payment of the “no show” fee was denied. Hargrave v. Williamsburg/James City County School Board, VWC File No. 195-12-65 (March 20, 2002).

    § 65.2-605.1. Prompt payment; limitation on claims.

    1. Payment for health care services that the employer does not contest, deny, or consider incomplete shall be made to the health care provider within 60 days after receipt of each separate itemization of the health care services provided.
    2. If the itemization or a portion thereof is contested, denied, or considered incomplete, the employer or the employer’s workers’ compensation insurance carrier shall notify the health care provider within 45 days after receipt of the itemization that the itemization is contested, denied, or considered incomplete. The notification shall include the following information:
      1. The reasons for contesting or denying the itemization, or the reasons the itemization is considered incomplete;
      2. If the itemization is considered incomplete, all additional information required to make a decision; and
      3. The remedies available to the health care provider if the health care provider disagrees.Payment or denial shall be made within 60 days after receipt from the health care provider of the information requested by the employer or employer’s workers’ compensation carrier for an incomplete claim under this subsection.
    3. Payment due for any properly documented health care services that are neither contested within the 45-day period nor paid within the 60-day period, as required by this section, shall be increased by interest at the judgment rate of interest as provided in § 6.2-302 retroactive to the date payment was due under this section.
    4. An employer’s liability to a health care provider under this section shall not affect its liability to an employee.
    5. No employer or workers’ compensation carrier may seek recovery of a payment made to a health care provider for health care services rendered after July 1, 2014, to a claimant, unless such recovery is sought less than one year from the date payment was made to the health care provider, except in cases of fraud. The Commission shall have jurisdiction over any disputes over recoveries.
    6. No health care provider shall submit a claim to the Commission contesting the sufficiency of payment for health care services rendered to a claimant after July 1, 2014, unless (i) such claim is filed within one year of the date the last payment is received by the health care provider pursuant to this section or (ii) if the employer denied or contested payment for any portion of the health care services, then, as to that service or portion thereof, such claim is filed within one year of the date the medical award covering such date of service for a specific item or treatment in question becomes final.
    7. No health care provider shall submit, nor shall the Commission adjudicate, any claim to the Commission seeking additional payment for medical services rendered to a claimant before July 1, 2014, if the health care provider has previously accepted payment for the same medical services pursuant to the Longshore and Harbor Workers’ Compensation Act, 33 U.S.C. § 901 et seq.
    8. The Commission, by January 1, 2016, shall establish a schedule pursuant to which employers, employers’ workers’ compensation insurance carriers, and providers of workers’ compensation medical services shall be required, by a date determined by the Commission that is no earlier than July 1, 2016, and no later than December 31, 2018, to adopt and implement infrastructure under which (i) providers of workers’ compensation medical services (providers) shall submit their billing, claims, case management, health records, and all supporting documentation electronically to employers or employers’ workers’ compensation insurance carriers, as applicable (payers) and (ii) payers shall return actual payment, claim status, and remittance information electronically to providers that submit their billing and required supporting documentation electronically. The Commission shall establish standards and methods for such electronic submissions and transactions that are consistent with International Association of Industrial Accident Boards and Commission Medical Billing and Payment guidelines. The Commission shall determine the date by which payers and providers shall be required to adopt and implement the infrastructure, which determinations shall be based on the volume and complexity of workers’ compensation cases in which the payer or provider is involved, the resources of the payer or provider, and such other criteria as the Commission determines to be appropriate.

    History. 2014, c. 670; 2015, c. 621; 2016, cc. 279, 290; 2018, c. 261; 2019, c. 760.

    The 2015 amendments.

    The 2015 amendment by c. 621 added subsection H.

    The 2016 amendments.

    The 2016 amendments by cc. 279 and 290, effective March 7, 2016, are identical, and inserted “subdivision B 1 of § 65.2-605 for treatment provided prior to the transition date as defined in” in subsection G.

    The 2018 amendments.

    The 2018 amendment by c. 261 deleted former subsection G, which read “Any health care provider located outside of the Commonwealth who provides health care services under the Act to a claimant shall be reimbursed as provided in this section, and the ‘same community,’ as used in subdivision B 1 of § 65.2-605 for treatment provided prior to the transition date as defined in subsection A of § 65.2-605 , shall be deemed to be the principal place of business of the employer if located in the Commonwealth or, if no such location exists, then the location where the Commission hearing regarding the dispute is conducted”; and redesignated former subsection H as subsection G.

    The 2019 amendments.

    The 2019 amendment by c. 760 added subsection G; and redesignated former subsection G as subsection H.

    CASE NOTES

    Applicability. —

    Clause (ii) of subsection F of § 65.2-605.1 applied to a health care provider’s claim contesting the sufficiency of payment for services rendered to a workers’ compensation claimant where the employer clearly contested payment of the bill for each of two surgeries, and the Workers’ Compensation Commission had issued an award. Roanoke Ambulatory Surgery Ctr. v. Bimbo Bakeries USA, Inc., 69 Va. App. 675, 822 S.E.2d 675, 2019 Va. App. LEXIS 21 (2019).

    Pharmacy failed to comply with the one-year statute of limitations of subsection F of § 65.2-605.1 because the pharmacy last received partial payment from the worker’s compensation claimant in January 2015 but the pharmacy failed to file with the Workers’ Compensation Commission claims until July 2019. Summit Pharm., Inc. v. Costco Wholesale, 73 Va. App. 96, 855 S.E.2d 866, 2021 Va. App. LEXIS 49 (2021).

    Interpretation. —

    Plain reading of subsection F of § 65.2-605.1 is that if the employer denied or contested payment for any portion of the health care services, the health care provider may file a claim with the Workers’ Compensation Commission within one year of the date on which the relevant medical award becomes final. Roanoke Ambulatory Surgery Ctr. v. Bimbo Bakeries USA, Inc., 69 Va. App. 675, 822 S.E.2d 675, 2019 Va. App. LEXIS 21 (2019).

    Workers’ Compensation Commission properly dismissed, for lack of jurisdiction, a provider’s claim for payment of medical services rendered to an employee because the provider did not request that the Commission hear its claims during the statutory time period, which manifested an intent to apply it retrospectively, and the provider had a reasonable window of opportunity to request that the Commission adjudicate the claim before the end of the time limitation. Wardell Orthopaedics, P.C. v. Colonna's Shipyard, Inc., 72 Va. App. 296, 844 S.E.2d 436, 2020 Va. App. LEXIS 194 (2020).

    Claim time barred. —

    While Workers’ Compensation Commission did not err in holding that the employer could raise a statute of limitations defense because subsections A and B of § 65.2-605.1 were not precondition to the statute of limitations, the medical provider’s claim was time barred because it failed to file the claim within one year after the award order became final. Atl. Orthopaedic Specialists v. City of Portsmouth, 73 Va. App. 157, 857 S.E.2d 155, 2021 Va. App. LEXIS 72 (2021).

    Pharmacy was a health care provider, and therefore it was required to comply with the statute of limitations, because a “health care provider” was a person, corporation, facility or institution licensed by the Commonwealth to provide health care or professional services as a pharmacist, and there was no indication that the General Assembly intended to exclude pharmacies from the term “health care provider.” Summit Pharm., Inc. v. Costco Wholesale, 73 Va. App. 96, 855 S.E.2d 866, 2021 Va. App. LEXIS 49 (2021).

    § 65.2-605.2. Biennial peer-reviewed studies.

    1. The Commission shall have a peer-reviewed study conducted every two years commencing in 2016 by a reputable independent, not-for-profit research organization to determine how Virginia’s workers’ compensation system and workers’ compensation medical costs compare with (i) those of other states’ systems and (ii) previous workers’ compensation medical benchmarks studies conducted in Virginia. Such studies shall also review the status of access to medical services under Virginia’s workers’ compensation system.
    2. The Commission shall pay for the studies conducted pursuant to subsection A through revenues generated pursuant to the administrative tax assessed pursuant to Chapter 10 (§ 65.2-1000 et seq.) and deposited in the fund established pursuant to § 65.2-1007 .

    History. 2016, cc. 279, 290.

    Editor’s note.

    Acts 2016, cc. 279 and 290, cl. 5 made this section effective March 7, 2016.

    § 65.2-606. Physicians for medical examination.

    The Commission or any member thereof may, upon the application of either party or upon its own motion, appoint a disinterested and duly qualified physician or surgeon to make any necessary medical examination and to testify in respect thereto; however, the provisions of this section shall not apply to determination of whether an employee died of pneumoconiosis or any chronic occupational lung disease, which shall be governed by the provisions of § 65.2-513 and the regulations promulgated thereunder. Such physician or surgeon shall be allowed travelling expenses and a reasonable fee to be fixed by the Commission.

    The fees and expenses of such physician or surgeon shall be paid by the Commonwealth.

    History. Code 1950, § 65-87; 1966, c. 417; 1968, c. 660, § 65.1-90; 1972, c. 619; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 9 Discovery. § 9.09 Medical examinations. Bryson.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 59, 62, 67.

    CASE NOTES

    Editor’s note.

    The cases annotated below were decided under former § 65.1-90 or prior law.

    There is nothing within the language of this section which limits the Industrial (now Workers’ Compensation) Commission’s fact finding authority. Island Creek Coal Co. v. Honaker, 9 Va. App. 336, 388 S.E.2d 271, 6 Va. Law Rep. 1218, 1990 Va. App. LEXIS 13 (1990).

    Rule authorizing appointment of physician applies to claimant who is not employee. —

    The statutory rule embodied in this section authorizing the Commission to appoint a “disinterested” physician to make a medical examination applies to the examination of a claimant who is not an employee. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940) (applying section to dependent claiming compensation).

    Request for an examination must be timely. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940).

    A motion for an examination made five days after the trial was denied. C.D. Kenny Co. v. Solomon, 158 Va. 25 , 163 S.E. 97 , 1932 Va. LEXIS 237 (1932) (see Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638 (1940)).

    Examination should be made by a physician selected by the Commission, and who is in that sense “disinterested” or impartial. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940).

    And appointment of physician is left to discretion of the hearing commissioner.

    Gale v. Zaban's Mattress & Box Spring Co., 191 Va. 610 , 62 S.E.2d 19, 1950 Va. LEXIS 244 (1950).

    Court of Appeals of Virginia sees no indication that the legislature intended the word may contained in § 65.2-606 to be interpreted as shall or must; therefore, the court gives the word may its ordinary meaning. Ordinarily, may is a permissive word. It follows that if the Virginia Workers’ Compensation Commission is permitted to take certain action, the commission is also permitted not to do so. Pittsylvania Cty. Bd. of Supervisors v. Hall, 2018 Va. App. LEXIS 161 (Va. Ct. App. June 12, 2018).

    Virginia Workers’ Compensation Commission did not err in denying the employer’s request for appointment of a disinterested physician for a medical examination under § 65.2-606 where nothing indicated that the legislature intended that the word “may” be interpreted as mandatory, and the commission exercised its discretion not to appoint. Pittsylvania Cty. Bd. of Supervisors v. Hall, 2018 Va. App. LEXIS 161 (Va. Ct. App. June 12, 2018).

    A physician selected, employed and paid by either party is not “disinterested” or impartial within the meaning of this section. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940).

    And his testimony should be excluded. —

    Since the Commission had no authority to require claimant, over her objection, to submit to an examination by physicians selected by the insurance carrier, the court erred in permitting these physicians to testify as to the result of their examinations. Basham v. Lowe, 176 Va. 485 , 11 S.E.2d 638, 1940 Va. LEXIS 268 (1940).

    Who may require employee to see another physician. —

    An employer can require an employee to select an attending physician from its panel of three, but only an attending physician or the Commission may require an employee to see another physician. Richmond Mem. Hosp. v. Allen, 3 Va. App. 314, 349 S.E.2d 419, 3 Va. Law Rep. 1023, 1986 Va. App. LEXIS 366 (1986).

    Section permits Commission to consider evidence not adduced before hearing commissioner. —

    The agreement of litigants to submit a case upon the evidence adduced before the hearing commissioner did not conclusively preclude the Commission from hearing and considering other evidence if that be deemed necessary to a correct determination of the issues before it. That procedure is permitted by this section. Pittston Co. v. Fulks, 201 Va. 128 , 109 S.E.2d 387, 1959 Va. LEXIS 202 (1959).

    Employer may examine expert on whose report Commission relies. —

    Where the Commission gave the employer no opportunity to examine the expert upon whose report it relied, the award was set aside and the case remanded. Pittston Co. v. Fulks, 201 Va. 128 , 109 S.E.2d 387, 1959 Va. LEXIS 202 (1959).

    Examination may be ordered after evidence taken by deputy. —

    Under this section the hearing commissioner could properly order claimant to appear for examination after evidence had been taken by a deputy, since the matter was still pending before him and there had been no adjudication thereon. Walsh Constr. Co. v. London, 195 Va. 810 , 80 S.E.2d 524, 1954 Va. LEXIS 160 (1954).

    The opinion of an independent medical expert, selected by the Commission pursuant to this section, is subject to the same examination and challenge as that of any other witness and to hold otherwise would result in a transfer to the independent medical examiner of the commission’s role as finder of fact and such a holding would contradict former § 65.1-96 A (now § 65.2-704 A), which assigns the commission responsibility to decide all issues presented before it. Island Creek Coal Co. v. Honaker, 9 Va. App. 336, 388 S.E.2d 271, 6 Va. Law Rep. 1218, 1990 Va. App. LEXIS 13 (1990).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Va. Code § 65.2-606 authorizes the Commission to appoint a disinterested physician or surgeon to make a necessary medical examination. This authority is exercised to help the Commission resolve a conflict in the medical opinions or to prevent the perpetration of a fraud on the Commission. Code § 65.2-606 is not intended to provide a means through which a claimant may use the Commission and its resources to develop evidence for her case where there is no conflict in the medical evidence, or where there is only such conflict as requires that the Commission make a reasonable choice as to which of the medical opinions are more persuasive. Pollard v. First General Services, 77 O.W.C. 259 (1998).

    The Commission’s appointment of a disinterested physician is unnecessary when the medical evidence is without conflict. Gale v. Zaban’s Mattress Co., 191 Va. 610 , 62 S.E.2d 19; Chafin v. Burton Ford Coal Co., 47 O.I.C. 68 (1965); Keene v. Jewell Ridge Coal Co., 61 O.I.C. 259 (1982).

    The findings of an independent medical expert selected by the Commission are subject to examination and challenge by the parties. Lynchburg Foundry v. Goldies Tune, 1 Va. App. 295, 338 S.E.2d 645, 1986 Va. App. LEXIS 198 (1986).

    The Commission is not bound by the opinion of an expert it obtained pursuant to Code § 65.1-90 (now § 65.2-606 ). Island Creek Coal Co. v. Honaker, 9 Va. App. 336, 388 S.E.2d 271, 6 Va. Law Rep. 1218, 1990 Va. App. LEXIS 13 (1990).

    § 65.2-607. Medical examination; physician-patient privilege inapplicable; autopsy.

    1. After an injury and so long as he claims compensation, the employee, if so requested by his employer or ordered by the Commission, shall submit himself to examination, at reasonable times and places, by a duly qualified physician or surgeon designated and paid by the employer or the Commission. However, no employer may obtain more than one examination per medical specialty without prior authorization from the Commission, based upon a showing of good cause or necessity. The employee shall have the right to have present at such examination any duly qualified physician or surgeon provided and paid by him. No fact communicated to, or otherwise learned by, any physician or surgeon who may have attended or examined the employee, or who may have been present at any examination, shall be privileged, either in hearings provided for by this title, or any action at law brought to recover damages against any employer subject to the provisions of this title.
    2. If the employee refuses to submit himself to or in any way obstructs such examination requested by and provided for by the employer, his right to compensation and his right to take or prosecute any proceedings under this title shall be suspended until such refusal or objection ceases and no compensation shall at any time be payable for the period of suspension unless in the opinion of the Commission the circumstances justify the refusal or obstruction.
    3. The employer or the Commission may in any case of death require an autopsy at the expense of the party requesting the same. Such autopsy shall be performed upon order of the Commission, and anyone obstructing or interfering with such autopsy shall be punished for contempt.

    History. Code 1950, § 65-88; 1968, c. 660, § 65.1-91; 1991, c. 355; 1993, c. 379.

    Cross references.

    As to protection of communications between physicians and patients, see § 8.01-399 . As to health records privacy, see § 32.1-127.1:03 .

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 9 Discovery. § 9.09 Medical examinations. Bryson.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 40 Rules of Evidence. § 40.02 Witnesses. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 5C M.J. Dead Bodies, § 5; 7B M.J. Evidence, §§ 84, 221; 9B M.J. Homicide, §§ 59, 76.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-91 or prior law.

    Justification for refusal must be from claimant’s viewpoint. —

    Justification for an employee’s refusal to submit to a medical examination must be determined from the viewpoint of the claimant. R. G. Moore Building Corp. v. Mullins, 10 Va. App. 211, 390 S.E.2d 788, 6 Va. Law Rep. 1997, 1990 Va. App. LEXIS 61 (1990).

    Refusal to be examined justified where notice inadequate. —

    Should an employee refuse to cooperate in an examination, his right to compensation is suspended until his refusal ceases. However, where employer did not inform claimant of the appointment with the ophthalmologist until 30 minutes before the time of the appointment, claimant had no time or opportunity to arrange to have his own physician present, and claimant’s counsel was never informed of the appointment, the Commission’s finding that claimant’s refusal to be examined was justified due to inadequate notice of the appointment was clearly supported by the evidence. Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 336 S.E.2d 903, 1985 Va. App. LEXIS 84 (1985).

    Claimant justified in refusing to submit to stress test. —

    Evidence supported the commission’s finding that the claimant was justified in refusing to submit to a stress test because “she was genuinely in fear of the testing.” R. G. Moore Building Corp. v. Mullins, 10 Va. App. 211, 390 S.E.2d 788, 6 Va. Law Rep. 1997, 1990 Va. App. LEXIS 61 (1990).

    Inability to cooperate with examination requests. —

    Employer did not establish that injured employee refused to cooperate with examining physician, where the physician reported that while the employee did not comply with certain examination requests the employee seemed unable to cooperate with the requests. Buchanan Gen. Hosp. v. Hunt, 2001 Va. App. LEXIS 602 (Va. Ct. App. Oct. 30, 2001).

    Claimant not justified in refusing independent psychiatric examination. —

    The Workers’ Compensation Commission did not err in suspending claimant’s compensation for his refusal to undergo an independent psychiatric examination, where claimant received appropriate notice of the examination, but refused to go through with the examination without his attorney being present. Elliott v. Neighbors, 1998 Va. App. LEXIS 286 (Va. Ct. App. May 12, 1998).

    Claimant must cure refusal in order to receive benefits. —

    In the absence of other mitigating factors, suspension of benefits for refusal of medical services will continue until a claimant actually meets with a physician and cures a refusal. Tageldin v. St. Paul Fire & Marine Ins. Co., 1995 Va. App. LEXIS 118 (Va. Ct. App. Feb. 14, 1995).

    Refusal to complete forms. —

    When a worker who appeared for an independent medical examination at a clinic refused to fill out the medical history portions of a form provided by the clinic, despite the fact that the form had been sent to his attorney to review, this was an obstruction of the examination, which did not proceed because of the worker’s refusal to complete the form. The fact that the worker was justified in not completing the portion of the form that obligated him to pay any balance due did not justify him in refusing to complete the medical history. Sherwin Williams Co. v. England, 2006 Va. App. LEXIS 157 (Va. Ct. App. Apr. 25, 2006).

    Right to have doctor present. —

    Although claimant had a right under subsection A to have her doctor present at the examination, this right may not be used to obstruct the employer’s right to have a medical examination take place. Tageldin v. St. Paul Fire & Marine Ins. Co., 1995 Va. App. LEXIS 118 (Va. Ct. App. Feb. 14, 1995).

    Release. —

    Whether a treating physician has released or abandoned his patient generally is determined by the express intent of the physician. In some cases, the total circumstances must be analyzed in order to determine whether discharge, release, or abandonment of a patient was intended. This is a factual determination which must be proved by clear and convincing evidence. Locklear v. Equifax Servs., 1995 Va. App. LEXIS 179 (Va. Ct. App. Feb. 21, 1995).

    This section waives the physician-patient privilege as to all physicians and in all proceedings under the Workers’ Compensation Act. Wiggins v. Fairfax Park Ltd. Partnership, 22 Va. App. 432, 470 S.E.2d 591, 1996 Va. App. LEXIS 355 (1996).

    CIRCUIT COURT OPINIONS

    Exacerbated injury during vocational evaluation. —

    Where an employee filed a workers’ compensation claim and allegedly exacerbated an injury during a second functional capacity evaluation, a settlement agreement barred the employee’s negligence claim against the workers’ compensation insurer because: (1) the injuries were properly treated as an extension of the employee’s original workers’ compensation claim; and (2) the insurer and its agents enjoyed the same immunity from liability that the employer did under the Workers’ Compensation Act, since Virginia did not recognize the “dual capacity doctrine.” Mathes v. Davis, 74 Va. Cir. 411, 2007 Va. Cir. LEXIS 298 (Norfolk Dec. 3, 2007).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Deputy Commissioner correctly refused to quash subpoena for non-party’s medical records, which was resisted under the Health Insurance Portability and Accountability Act of 1996; HIPAA does not preclude issuance of a subpoena of non-party’s medical records and also does not apply to workers’ compensation provisions allowing production of such records. Goodwin v. Sentara Norfolk Gen’l Hosp., VWC File No. 208-72-40 (Aug. 6, 2003).

    Employee not required to execute authorization for examination by employer-paid physician that contained hold-harmless provision; Act requires employees to submit to examination but does not require execution of hold- harmless releases. Wright v. Paramount Parks, Inc., VWC File No. 208-70-26 (Mar. 18, 2003).

    Although the common law recognizes no physician-patient privilege in either criminal or civil proceedings, Code § 8.01-399 provides a limit privilege in civil actions. However, Code § 65.2-607 grants no such privilege to a party in workers’ compensation proceedings. Morgan v. Eastern State Hospital, 78 O.W.C. 192 (1999).

    Commission Rule 4.2 provides that a medical care provider attending an injured employee shall furnish a copy of required reports to the employer or employee. The physician-patient privilege as to all physicians is waived in all proceedings under the Act. Hassell v. Arlington County Human Services, 79 O.W.C. 141 (2000).

    Even if a claim is found to be compensable, the employer is not responsible for the cost of a physician’s treatment if the physician declines to produce the records of treatment. Hassell v. Arlington County Human Services, 79 O.W.C. 141 (2000).

    Code § 65.2-607 (A) waives the physician/patient privilege as to all physicians and in all proceedings under the Act. It is not limited to facts learned or communicated during an independent medical examination. Wiggins v. Fairfax Park Ltd. Partnership, 22 Va. App. 432, 470 S.E.2d 591, 1996 Va. App. LEXIS 355 (1996).

    Code § 65.2-607 (A) waives the physician/patient privilege as to all physicians and in all proceedings under the Act. It is not limited to facts learned or communicated during an independent medical examination. Wiggins v. Fairfax Park Ltd. Partnership, 22 Va. App. 432, 470 S.E.2d 591, 1996 Va. App. LEXIS 355 (1996).

    The claimant alleged that certain patient records of the employer were necessary to establish the hazards to which she was exposed in the employment, because they would establish that the patient was prescribed medicine for aggressive tendencies. The Commission held that it was not vital that the specific records be produced, because evidence was already available that patients were prescribed medication and the Commission acknowledged that patients were hospitalized at the hospital for certain identifiable diagnoses, and that this case did not override the need to preserve the confidentiality of the medical records of the patient, who was not a party to the case. Morgan v. Eastern State Hospital, 78 O.W.C. 192 (1999).

    The effect of the amendment effective July 1, 1993 to Code § 65.2-607 was to allow the employer beginning July 1, 1993 only one examination per medical specialty without prior authorization from the Commission for good cause shown. Thus, the first medical examination after July 1, 1993 could be obtained without prior authorization, but a second medical examination required approval. Campbell v. NVT Technologies, Inc., 74 O.W.C. 191 (1995).

    Time For Filing Report:

    The time limit for filing additional medical evidence is within the discretion of the hearing Commissioner and certain limitations must be applied if the work of the Commission is to be accomplished with the dispatch the parties have a right to expect. Montgomery v. Beck’s Bakery, Inc., 45 O.I.C. 177 (1963).

    Case may be decided on the record when medical evidence was not submitted within time allowed. Davis v. Armstrong Cork, 48 O.I.C. 62 (1966).

    When Examination May Be Requested:

    An employer may request an independent medical examination prior to accepting a claim. Clark v. R & E Electronics, 71 O.W.C. 200 (1992).

    The claimant’s request that the Commission authorize surgery was denied by a deputy commissioner after an evidentiary hearing. The claimant thereafter obtained additional medical reports from his treating physician and renewed his request for the surgery. On these facts, the Commission held that the employer was entitled to compel an examination by a second orthopedist to ascertain the necessity for the surgery recommended by the treating physician. Pennock v. Rickman Central Vacuum Company, 78 O.W.C. 197 (1999).

    After an injury and as long as compensation is claimed, an employee shall submit to a qualified physician’s examination at reasonable times and places as requested by the employer or insurer. The insurer may not obtain more than one examination per medical specialty without the Commission’s authorization. If the employee refuses without justification to submit himself to or in any way obstructs such examination, his right of compensation, and his right to take or prosecute any proceedings under the Act, must be suspended until such refusal or objection ceases. Bunch v. Pennington Seed, Inc., 79 O.W.C. 174 (2000).

    Effect of Refusal:

    The provisions of this section relating to the effect upon employee’s right to compensation of his refusal to permit examination by physician designated and paid by either employer or the Commission are similar to those in § 65.1-88 (now § 65.2-603 ) relating to the effect of employee’s refusal to accept medical attention offered by his employer, and reference is made to authorities there collected. Parton v. Giant Food, Inc., 59 O.I.C. 242 (1980).

    Curing Refusal:

    An award suspended for failure to attend an independent medical examination may be reinstated upon evidence that the employee has cured his earlier refusal. Campbell v. Thomas J. Fannon & Son, Inc., 69 O.I.C. 147 (1990).

    Suspension of compensation on grounds of refusal of medical treatment is self-executing; compensation resumes when claimant cooperates. Thomas v. Grief and Brother, 58 O.I.C. 339 (1979).

    The Workers’ Compensation Act was amended October 1, 1991 to include within the definition of “change in condition” an award that had been earlier “suspended.” This statutory change effectively vitiated the distinction between suspended and terminated. Employees thereafter were obliged to prove the extent of continuing disability through marketing efforts, in order to have compensation benefits reinstated. Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    Requirements:

    When an employee is requested by his employer or the Commission to submit to a medical examination, he has the right to have present any duly qualified physician or surgeon at his expense. There is no statutory basis, with or without agreement by the parties, to require a medical examination in the presence of an attorney. Boone v. City of Norfolk-Police Department, 65 O.I.C. 257 (1986).

    The provisions of § 65.1-91 (now § 65.2-607 ) concerning the waiver of doctor/patient privilege do not apply unless there is sufficient evidence that the report or information sought from the doctor is relevant or at least possibly relevant to the compensable injury. Jenkins v. Honeycutt Fabric Inc., 65 O.I.C. 262 (1986).

    Section does not require that an independent medical examination be conducted in Virginia so long as an evaluation is scheduled at a reasonable time, place and distance with the expenses paid by the employer. Failure of the out-of-state physician to submit to cross-examination will result in the medical report being excluded from evidence. Tauro v. Fairfax County School Board, 69 O.I.C. 145 (1990).

    This section does not require that a doctor performing an independent medical examination for a party be disinterested. However, demonstrated bias will affect the weight given to medical reports from the doctor. Harris v. Jones Schiavone Construction Co., 68 O.I.C. 221 (1989).

    An employer seeking to suspend compensation for the claimant’s refusal to submit to a medical examination must prove the claimant received notice of the examination. Devault v. Virginia Imports, Ltd., 74 O.W.C. 174 (1995).

    Section 65.2-607 requires that the employee submit to the employer’s examination only at a reasonable place and a reasonable time. When the employer’s request for a medical examination requires the employee to travel a significant distance, the employer must explain why an examination cannot be scheduled closer to the employee’s home, or why the expertise of a particular physician is needed. Without such a showing, the Commission is without evidence upon which to judge the reasonableness of the request. Harlow v. Sunnyside Presbyterian Retirement, VWC File No. 181-19-83 (April 16, 2002).

    Limitations on Medical Examination:

    IME spanning two days with a psychologist permitted where the claimant’s mental status and disability related to his psychological conditions. Even though the IME was scheduled over two days, it constituted one examination. Williams, Sr. v. SAJA-Norfolk, JCN VA0000207214 (Mar. 30, 2012).

    If the medical evidence is not in conflict, the Commission will not allow closely scheduled, independent medical examinations from multiple physicians in the same specialty. Dixon v. Sentara Leigh Hospital, 69 O.I.C. 143 (1990).

    Code § 65.2-607 provides that no employer may obtain more than one examination of an employee per medical specialty without prior authorization from the Commission, based upon a showing of good cause or necessity. However, where the claimant pursues a claim in a foreign jurisdiction that allows such multiple examinations, and there is no evidence of bad faith on the part of the employer in requesting the multiple examinations, the deputy commissioner erred in excluding medical evidence of all the examinations. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    After the claimant’s work accident, the insurer scheduled the claimant for an employer’s medical examination by a chiropractor. A request by the insurer for an evaluation by another chiropractor one year later was denied by the Commission as unwarranted. The insurer thereafter advised the claimant of an employer’s examination to be performed by a physiatrist, but the claimant did not appear for the evaluation, asserting that the employer was obliged to schedule the examination after considering the claimant’s schedule and availability, and that the insurer was not entitled to the new examination without prior approval. The Commission was not persuaded that the schedule and availability of the claimant justified his failure to appear for the examination, and further held that the insurer was entitled by statute to request an examination by a physician practicing in another medical specialty, without prior approval of the Commission. Bunch v. Pennington Seed, Inc., 79 O.W.C. 174 (2000).

    An independent medical examiner cannot admit an employee to a hospital for diagnostic and work-up procedures unless the employee, or his counsel, agree and the treating physician approves. Rice v. Misty Bec Coal Corp., 70 O.I.C. 302 (1991).

    Reasonable, noninvasive medical tests and procedures, specifically including MRI and thermogram studies, required or specifically prescribed by a physician who examines and reports under the provisions of Code § 65.2-607 , are properly allowed as part of the right to examination under that Code section. Bowen v. Winter Harbor Seafood, 79 O.W.C. 59 (2000) (see also Willis v. William Bohannon, 70 O.I.C. 300 (1991) (reasonable noninvasive tests and procedures such as MRI and thermographic examination allowed)).

    While an employer has a right to an independent medical examination it does not have the authority to require an employee to attend an institution’s program without the concurrence of the treating physician or the Commission. Hasler v. Rockingham Memorial Hospital, 70 O.I.C. 298 (1991).

    Where claimant’s physician advised him to refuse myelogram examination, such refusal was justified. Howard v. Porter Co., 44 O.I.C. 146 (1962); Shifflett v. Schewel Furniture, 40 O.I.C. 141 (1958).

    An employee was justified in refusing to take a stress test during an independent medical examination because of a genuine fear of the testing and the potential for injury. In addition, the physical requirements of the test were contrary to the treatment prescribed by her treating physician. Justification for refusal must be determined based on an objective view of all circumstances as they reasonably appeared to the employee. R. G. Moore Building Corp. v. Mullins, 10 Va. App. 211, 390 S.E.2d 788, 6 Va. Law Rep. 1997, 1990 Va. App. LEXIS 61 (1990).

    Transportation:

    Claimant who was on crutches, had difficulty walking, was without transportation, and notified doctor’s office why he could not report and did report as soon as he had transportation did not refuse examination. Johnson v. Williams Co., 42 O.I.C. 85 (1960).

    Failure to report for medical examination justified when transportation expenses were not provided. Diggins v. Grace & Co., 46 O.I.C. 66 (1964).

    Claimant’s failure to appear for an independent examination justified in view of the inadequate five-day notice provided her, and the absence of any provision for or advice regarding the expense of transportation for the examination. Santirosa v. Washington Metropolitan Transit Authority, 63 O.I.C. 282 (1984).

    Incarceration:

    Claimant, in jail on appointment date, refused transportation by judge, claimant did not unjustifiably refuse to report for medical examination. Blankenship v. Giles, 46 O.I.C. 23 (1964).

    An incarcerated claimant who was unable to attend a medical examination arranged outside the prison neither precluded nor refused an independent medical examination and remained entitled to benefits. Escobar v. L. Sandler & Sons, Inc., 68 O.I.C. 206 (1989).

    Other:

    While examining physician has the right to relevant medical and other information from injured worker in connection with an evaluation, an effort must be made to reasonably accommodate employee’s lack of education and resulting difficulty in correctly supplying such information in writing. Bell v. Roberts Steel Company, 61 O.I.C. 29 (1982).

    Failure to keep appointment due to epilepsy was justified. Ashlock v. General Lumber Corp., 50 O.I.C. 11 (1968).

    Claimant advised carrier on January 19 of inability to keep January 23 appointment due to 14 inches of snow was justified in missing appointment. Frost v. Burnette, 50 O.I.C. 14 (1968).

    Refusal to be examined by internist where claimant was already being treated by specialist and general practitioner. Raines v. Stone & Webster, 58 O.I.C. 297 (1979) (appeal denied).

    Chapter 7. Procedure in Connection With Awards.

    § 65.2-700. Jurisdiction of Commission.

    All questions arising under this title, if not settled by agreements of the parties interested therein with the approval of the Commission, shall be determined by the Commission, except as otherwise herein provided.

    History. Code 1950, § 65-89; 1968, c. 660, § 65.1-92; 1991, c. 355.

    Law Review.

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    Research References.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 1 Courts. § 1.08 Workers’ Compensation Commission. Chapter 41 Rules of Procedure. § 41.05 Rules of the Virginia Workers’ Compensation Commission. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 60.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under prior law.

    Statutory grant of authority to the Workers’ Compensation Commission includes the power to enforce its orders and to resolve coverage and payment disputes. Combustion Eng'g, Inc. v. Lafon, 22 Va. App. 235, 468 S.E.2d 698, 1996 Va. App. LEXIS 249 (1996).

    The determination of jurisdiction is the first order of business. James v. Arlington County Bd. of Supvrs., 226 Va. 284 , 307 S.E.2d 900, 1983 Va. LEXIS 317 (1983).

    Jurisdiction over claims. —

    Pursuant to § 65.2-700 , all questions arising under the Virginia Workers’ Compensation title, if not settled by agreements of the parties interested therein with the approval of the Virginia Workers’ Compensation Commission, shall be determined by the Commission. Lanning v. Va. DOT, 2003 Va. App. LEXIS 81 (Va. Ct. App. Feb. 19, 2003).

    Deputy commissioner’s order directing the employer and/or the guaranty fund to pay the employee’s treating physician was within the deputy commissioner’s subject matter jurisdiction since the employee’s claim involved treatment for a work accident. Furthermore, the workers’ compensation commission could not rule on the merits of that order because the guaranty fund did not timely appeal the order once it was entered. Miller v. Potomac Hosp. Found., 50 Va. App. 674, 653 S.E.2d 592, 2007 Va. App. LEXIS 437 (2007).

    In a workers’ compensation case in which a deputy commissioner made the determination that an insurer did not provide coverage under the circumstances, the Virginia Uninsured Employers’ Fund argued unsuccessfully that the Virginia Workers’ Compensation Commission abused its discretion in declining to take further evidence or remand the issue to the deputy commissioner for further evidence. Under § 65.2-700 and subsection A of § 65.2-705 , the Commission had the authority to decide the issue of coverage without remanding to the deputy commissioner for further evidence. Chester v. Redifer, 2009 Va. App. LEXIS 519 (Va. Ct. App. Nov. 24, 2009).

    Although a claimant argued his due process rights were violated when he was not served with a Department of Child Support Enforcement administrative support order prior to workers’ compensation carriers paying the claimant’s child support arrearage to the Department of Child Support Enforcement from a settlement award, the Virginia Workers’ Compensation Commission lacked jurisdiction to interpret the service requirements for Department of Child Support Enforcement administrative support orders because interpretation of the service requirements for Department of Child Support Enforcement’s administrative support orders was not a question “arising under” the Workers’ Compensation Act. Minor v. Aramark/VCU & Indem. Ins. Co. of N. Am., 59 Va. App. 622, 721 S.E.2d 818, 2012 Va. App. LEXIS 48 (2012).

    When workers’ compensation carriers received an administrative order from the Department of Child Support Enforcement stating a claimant owed a child support arrearage in the amount of $22,784.46 and paid that amount from the claimant’s $30,000 settlement proceeds, the Virginia Workers’ Compensation Commission properly determined it lacked authority to invalidate the Department of Child Support Enforcement administrative support order because the validity of the order was not a question “arising under” or “otherwise provided for” in the Workers’ Compensation Act, § 65.2-700 . Minor v. Aramark/VCU & Indem. Ins. Co. of N. Am., 59 Va. App. 622, 721 S.E.2d 818, 2012 Va. App. LEXIS 48 (2012).

    Workers’ Compensation Commission properly found that it had jurisdiction to award compensation to a claimant because, the insurer agreed to pay compensation, the claimant did not have to establish coverage, nothing in the record established that employer failed to comply with the statutory requirements, and there was no merit to the insurer’s assertion that the Uninsured Employer’s Fund was responsible for paying compensation where the policy was not cancelled or not renewed. Nationwide Mut. Ins. Co. v. Estate of Harrison, 64 Va. App. 110, 765 S.E.2d 154, 2014 Va. App. LEXIS 396 (2014).

    Virginia Workers’ Compensation Commission did not err in exercising jurisdiction over a health care provider’s application because the Commission had before it a dispute among a medical care provider, an employee, and an employer concerning whether the employer was responsible, pursuant to a settlement order, for payment of the employee’s medical expenses. Northrop Grumman Shipbuilding, Inc. v. Wardell Orthopaedics, P.C., 67 Va. App. 420, 796 S.E.2d 469, 2017 Va. App. LEXIS 51 (2017).

    Virginia Workers’ Compensation Commission did not err in ruling that a stipulated order permitted an employer to unilaterally terminate attendant care benefits because the stipulated order stated only that the employer would pay benefits until conditions justified a change, with no requirement that any change be pursuant to the parties’ agreement or Commission order; the case was settled by the statute’s antecedent clause, notwithstanding the ambiguity that resulted from the agreement. Grizzard v. Sonny's Auto. Racing, Inc., 2018 Va. App. LEXIS 60 (Va. Ct. App. Mar. 13, 2018).

    Claims clearly outside act need not be submitted to Commission. —

    Where it is clear on the face of the pleadings that a claim is not within the purview of the workers’ compensation act, it is not necessary for plaintiffs to submit their claims to the Commission. Adams v. Alliant Techsystems, Inc., 261 Va. 594 , 544 S.E.2d 354, 2001 Va. LEXIS 57 (2001).

    Commission not authorized to apply laws of another state. —

    Although a Virginia court is free to recognize the perhaps paramount interests of another state by choosing to apply that state’s law in a particular case, the Compensation Commission does not have that power. Its jurisdiction is limited under this section to questions arising under the Virginia Workers’ Compensation Act. Thomas v. Washington Gas Light Co., 448 U.S. 261, 100 S. Ct. 2647, 65 L. Ed. 2d 757, 1980 U.S. LEXIS 54 (1980).

    Jurisdiction of Commission does not extend to litigation between two insurance carriers. —

    While the Compensation Commission has jurisdiction to do full and complete justice in each case, which includes the power and authority not only to make and enforce its awards but to protect itself and its awards from fraud, imposition and mistake, its jurisdiction does not extend to the litigation and resolution of issues between two insurance carriers which do not affect an award of the Commission. Generally, the Commission’s jurisdiction is limited to those issues which are directly or necessarily related to the right of an employee to compensation for a work-related injury. Hartford Fire Ins. Co. v. Tucker, 3 Va. App. 116, 348 S.E.2d 416, 3 Va. Law Rep. 668, 1986 Va. App. LEXIS 343 (1986).

    Questions between the insurer and the employer or another insurer do not “arise under” the act except insofar as they affect the rights of an injured employee. Hartford Fire Ins. Co. v. Tucker, 3 Va. App. 116, 348 S.E.2d 416, 3 Va. Law Rep. 668, 1986 Va. App. LEXIS 343 (1986).

    Question concerning insurance policy’s coverage of other partner properly invoked Commission’s jurisdiction. —

    Where an application for workers’ compensation coverage was completed by a partner on behalf of the partnership, the application contained an express election to include both partners as employees under the workers’ compensation coverage of the partnership as allowed by former § 65.1-4.2 (now § 65.2-101 ), a policy was then issued to the partnership, and the question before the commission concerned whether the insurance policy covered the other partner’s stipulated, compensable injury, the commission’s jurisdiction was properly invoked. Ace Metal Fabricators v. Counts, No. 0613-87-2 (Ct. of Appeals Feb. 26, 1988).

    Litigants left to their common-law remedies when claimant’s rights not at stake. —

    When the rights of the claimant are not at stake, the act clearly leaves the litigants to their common-law remedies, with the pleading requirements, broader discovery and the more stringent rules of evidence not applicable under the act. Hartford Fire Ins. Co. v. Tucker, 3 Va. App. 116, 348 S.E.2d 416, 3 Va. Law Rep. 668, 1986 Va. App. LEXIS 343 (1986).

    Generally, the Commission’s jurisdiction is limited to those issues which are directly or necessarily related to the right of an employee to compensation for a work-related injury; when the rights of the employee in a pending claim are not at stake, the Commission disavows jurisdiction and sends the parties to the courts for relief. Henry's Wrecker Serv. Co. v. Smoot, 35 Va. App. 365, 545 S.E.2d 551, 2001 Va. App. LEXIS 225 (2001).

    Commission was justified in requiring insurer to deal directly with pharmacy where insured was dilatory in paying bills. —

    Upon the finding that the carrier was dilatory in payment of the pharmacy bill and was obstinate in its dealing with the pharmacy, the Commission was justified in taking appropriate measures to resolve the difficulty, even if it meant requiring the insurance carrier against its wishes to pay and deal directly with the pharmacy, and to pay such pharmacy, or other suppliers of medications, promptly within 30 days of billing for the medication. Woody's Auto Parts v. Rock, 4 Va. App. 8, 353 S.E.2d 792, 3 Va. Law Rep. 1822, 1987 Va. App. LEXIS 160 (1987).

    Employers’s claim for reimbursement outside of Commission’s jurisdiction. —

    The Commission is empowered to decide matters between the employer and employee affecting compensation rights and directly related interests of the employee that spring from the act, but the act contains no provision entitling an employer or its insurer to reimbursement out of the employee’s tort settlement with a third party; neither a compensation right in claimant nor a reimbursement right in employer, which arises from the act, is at issue in such a case, and the employer’s reimbursement claim is outside the jurisdiction of the Commission. Henry's Wrecker Serv. Co. v. Smoot, 35 Va. App. 365, 545 S.E.2d 551, 2001 Va. App. LEXIS 225 (2001).

    Dispute over copying fees outside of Commission’s jurisdiction. —

    Workers’ Compensation Commission’s resolution of a dispute between a third party vendor and a workers’ compensation carrier regarding records copying fees did not relate to a pending case under the Workers’ Compensation Act, so the commission lacked subject matter jurisdiction relating to the dispute, and its decision was void. Smart Document Solutions, LLC v. Va. Farm Bureau Fire & Cas. Ins. Co., 2006 Va. App. LEXIS 308 (Va. Ct. App. July 11, 2006).

    CIRCUIT COURT OPINIONS

    Jurisdiction over claims. —

    Proper jurisdiction for the estate administrator’s lawsuit against the decedent’s employer and its safety technician was with the Virginia Workers’ Compensation Commission and the exclusive remedy arose under the Virginia Workers’ Compensation Act because the decedent’s alleged injury occurred in the employer’s dispensary where the decedent went to check his blood pressure and where he allegedly received negligent medical care from the safety technician, the employer’s policies subjected the decedent to the danger of the alleged negligent medical care he received, and the decedent’s heart attack symptoms occurred while he was at work. Sparks v. New Millennium Bldg. Sys., LLC, 104 Va. Cir. 341, 2020 Va. Cir. LEXIS 32 (Roanoke County Mar. 12, 2020).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Jurisdiction:

    Also see notes to § 65.2-307 for additional cases on jurisdiction.

    For cases discussing the Commission’s inherent jurisdiction see City of Norfolk v. Bennett, 205 Va. 877 , 140 S.E.2d 655, 1965 Va. LEXIS 148 (1965); Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573, 1946 Va. LEXIS 136 (1946).

    The Commission has no jurisdiction to order the carrier to reimburse the employer for medical bills paid while the issue of whether there was workers’ compensation insurance coverage was adjudicated. Pavon v. Yankee Concrete Construction, Inc., VWC File No. 223-00-87 (Feb. 21, 2007).

    The Commission does not have jurisdiction to award fees and cost for insufficient funds that occurred when the carrier’s stopped payment after the claimant deposited his compensation check. Peele v. Coca Cola Co., VWC File No. 203-62-67 (Dec. 19, 2005).

    The Commission has jurisdiction to determine whether medical expenses are causally related to, and reasonable and necessary for the work injury even though Medicare has paid the bill. Dubilewski v. Old Dominion University, VWC File No. 173-77-39 (Aug. 4, 2005).

    While challenges that the Commission exceeded its subject-matter jurisdiction may be raised at any time, in this case, employer is barred by laches from raising the issue because it waited more than one and one-half years to challenge the Commission’s jurisdiction to enter an Award to which the employer agreed and under which it had been paying benefits. Canfield v. A A C Consulting Group., Inc., VWC File No. 203-28-58 (Jan. 28, 2005).

    The Commission has no jurisdiction to order the reimbursement of a private health insurance company by a medical provider. Parham v. J.P. Distributing Co., VWC File No. 195-39-78 (Aug. 20, 2004).

    Where a claimant is paid full salary during periods of disability and there was no accrued compensation owed, the Commission may award attorney’s fees to be paid directly by the claimant. Swanigan v. City of Alexandria School Bd., VWC File No. 213-91-40 (June 15, 2004).

    Question of jurisdiction can be raised at any time. Ryals v. Humble Oil & Refining Co., 52 O.I.C. 220 (1970).

    Where the Commission failed to apply § 1.13-3 to extend the statute of limitations, the Commission under its implied power may take jurisdiction to correct its mistake even though a request for review was not timely filed. Perkins v. Alexandria City School Board, 71 O.W.C. 16 (1992).

    Res judicata was not applicable to a jurisdictional challenge of whether the claimant was an employee under the Act, where that question had never been litigated, where the employer had simply signed a Memorandum of Agreement, relying on the claimant’s representations that she was legally eligible to work. Res judicata is also not applicable where fraud or misrepresentation is alleged. However, the Commission has the implied power to entertain and hear an application, seasonably presented, to vacate and set aside an award procured through fraud or mistake. Where the employer establishes by clear and convincing evidence that the claimant was not legally eligible to work in the United States at the time of her hire and accident, that the claimant intentionally and fraudulently misrepresented her employment status to the employer, and that the employer reasonably and justifiably relied upon those representations to its detriment when it hired her and later agreed to the entry of an award of compensation benefits, the claimant’s fraud and misrepresentation resulted in an imposition on the Commission, and the Commission lacked subject matter jurisdiction to enter the award of compensation benefits. Quezada v. P M M C Associates, Inc., 79 O.W.C. 46 (2000).

    The employer was not required to make an independent inquiry concerning the claimant’s legal status because there was no reason to question the offered representation and documentation. To make such an investigation without reasonable justification could expose the employer to a legitimate claim of discrimination. Upon learning of the claimant’s misrepresentation of her legal status the employer seasonably filed an application. Quezada v. P M M C Associates, Inc., 79 O.W.C. 46 (2000).

    An employer, insurer, claimant, and health care provider each has standing to have their responsibility for medical charges related to an injury considered by the Commission. Brown v. Howmet Corporation, 76 O.W.C. 342 (1997).

    Proceedings by the Commission are exempt from an automatic stay in a case where the uninsured employer has filed for bankruptcy. Fisher v. G. & G. Welding Services Inc., 63 O.I.C. 119 (1984).

    The Commission under § 65.1-92 (now § 65.2-700 ), § 65.1-94 (now § 65.2-702 ) and § 65.1-100.3 (now § 65.2-712 ) has jurisdiction to determine if voluntary payments made by an employer were procured by fraud even though an award has not been entered. However, the Commission upon a finding of fraud has no authority to order repayment or allow a credit to the employer. Cecil v. Cardinal Construction, 68 O.I.C. 233 (1989).

    “Excess benefits” are not under the jurisdiction of the Commission as they are separate and apart from the Workers’ Compensation Act. Rider v. Associated Glass Company, 65 O.I.C. 316 (1986).

    The Workers’ Compensation Act does not provide for the payment of expenses associated with trial preparation or for mental anguish to family members. Muldoon v. Paramount Builders, Inc., 73 O.W.C. 1 (1994).

    Since there is no provision in the law for an employer to require or provide a waiver, the claimant’s signing of a form at the request of the employer stating, “I do not want workers’ compensation benefits to be involved in my on the job injury specified below,” is invalid. By requesting the employee to sign such a waiver where the case was clearly compensable, the employer violated the provisions of the Act. Alexander v. City of Richmond School Board, 73 O.W.C. 162 (1994).

    Other than the statutory penalties or the assessment of cost under § 65.1-101 (now § 65.2-713 ), the Commission has no power to resolve damages. Questions of consequential damages, which involve such matters as the projected effects of delay in the handling of claims by an insurer, are not matters intended by the General Assembly to be resolved by the Commission through assessment of damages and award to the claimant. Jeffries v. Southern Iron Works, 64 O.I.C. 181 (1985).

    The Commission does not have jurisdiction to adjudicate the priority of liens or compel disbursement of the proceeds of the recovery from a third-party action. Besley v. Chesterfield County Fire Dept., 70 O.I.C. 259 (1991).

    Section 8.01-2 71.1 empowers a “court” to impose monetary sanctions. Neither that section nor the general definition section, § 8.01-2 , defines the word court. However, § 8.01-271.1 is contained in Chapter 7 of Title 8.01, named “Civil Actions, Commencement, Pleadings and Motions.” All three articles of Chapter 7 relate to certain components of a civil action. Section 8.01-2, defines “Actions” to “include all civil proceedings whether at law, in equity or statutory in nature and whether in a circuit court or district court.” The Workers’ Compensation Commission is not included in that definition. Eliason v. Stellute, 78 O.W.C. 80 (1999).

    In declining to assess attorney’s fees incurred by an insured party against the uninsured entity, the Commission held that adjudication of issues between insured and insurers that is unrelated to the employee is appropriately decided in another forum. Speas v. Omega Interiors, Inc., et al., 71 O.W.C. 21 (1992).

    The Commission does not have jurisdiction to compel disbursements of proceeds of recovery from a third party action. This question must be addressed to a court of law in the forum in which the third party case arose. The claimant’s settlement of his third party claim without the consent of the employer extinguishes the workers’ compensation claim, but it does not confer on the Commission the authority to enter a judgment against the claimant. Sicilia v. Inner View, Ltd., 78 O.W.C. 274 (1999).

    An employer and its insurer have standing to have their responsibility for charges for medical treatment related to an injury considered by the Commission. Brown v. Howmet Corporation, 76 O.W.C. 342 (1997).

    Code § 65.2-714 (B) gives an interest in the payment of certain medical bills to a claimant’s attorney since an attorney’s fee may potentially be awarded out of medical bills. Danville Radiologists, Inc. v. Perkins held that fees are not awardable under § 65.2-714 until the medical bills are paid. Thus, the attorney has an interest in having medical bills covered by Code § 65.2-714(B) paid, so that a fee can ultimately be awarded. Brown v. Howmet Corporation, 76 O.W.C. 342 (1997).

    Effect of Proceedings in Court of Law:

    A decree by the Circuit Court declaring an insurance policy as null and void is entitled to full faith and credit by the Commission. Although the carrier is relieved of paying compensation, the Award remains in full force against the employer. Campbell v. William Simmons Construction Co., 68 O.I.C. 254 (1989).

    When an employer has the requisite number of employees to bring him within the jurisdiction of the Virginia Workers’ Compensation Act, the existence of an action at law pending in another Court does not preclude the Commission from exercising its jurisdiction nor does it limit that of the other forum. Higgins v. Roanoke Electric Steel Corporation, 65 O.I.C. 13 (1986).

    Concurrent Jurisdiction with Other States:

    An award in Virginia is not precluded merely because compensation has been awarded in another State. If a claim is compensable under Virginia law and the law of another State, concurrent jurisdiction exists. The employer will be granted a credit in Virginia for identical benefits paid under the law of another State. Whetzel v. Safeway Stores, Inc., 69 O.I.C 22 (1990).

    Where the accident happens in Virginia, even though another State has jurisdiction by virtue of a statutory provision of its act the Virginia Commission has primary jurisdiction. Haynes v. Hickman Plastering Co., 17 O.I.C. 298 (1935).

    The acceptance of a claim in Maryland is not the acceptance of a claim in Virginia and, therefore, National Linen Service v. McGuinn is not applicable. Lopez v. CLC Construction, 73 O.W.C. 13 (1994).

    An employer is not entitled to a credit for workers’ compensation benefits paid in another state for an overlapping period but for a different accident. The carrier would be entitled to a credit for payments made in another state for the same accident and same injuries. Harris v. Otis Elevator, 73 O.W.C. 223 (1994).

    Concurrent Jurisdiction with Federal Law:

    The Virginia Workers’ Compensation Act has concurrent jurisdiction with the Federal Government’s under the Longshore and Harbor Workers’ Act. Jones v. International Terminal Operations Corporation, 71 O.W.C. 302 (1992).

    In cases where there is concurrent jurisdiction between Virginia and the Federal Act, the employer will be given a credit under the Virginia Act for benefits paid under the Federal Act. The Virginia award will remain in effect and will not be suspended. Krise v. E. T. Gresham Company, 73 O.W.C. 222 (1994).

    Injuries sustained in course of ship repair are compensable under state and federal laws with jurisdiction determined on case by case basis. Ford v. American Original Foods, Inc., 221 Va. 557 , 272 S.E.2d 187, 1980 Va. LEXIS 276 (1980).

    In light of concurrent jurisdiction provisions a claimant may seek compensation under the Virginia Workers’ Compensation Act even though an application has also been filed under the Federal Act so long as double recovery of benefits is not received. Meynardie v. Dynalectron Corporation, 66 O.I.C. 99 (1987).

    The United States Constitution does not prevent an award for permanent partial benefits to an employee injured while repairing a completed vessel on navigational waters. Norfolk Shipbuilding and Dry Dock Corporation v. Lathey, 8 Va. App. 306, 380 S.E.2d 665, 5 Va. Law Rep. 2661, 1989 Va. App. LEXIS 67 (1989), cert. denied, 493 U.S. 1079, 110 S. Ct. 1133, 107 L. Ed. 2d 1038, 1990 U.S. LEXIS 857 (1990).

    Where the employee and employer are citizens of Virginia and the work is being performed in Virginia waters as a result of a local employment contract, there is proper state interest and control to fall within the classification of “maritime but local.” Therefore, the Virginia Workers’ Compensation Commission had jurisdiction over the claim. Norfolk Shipbuilding and Dry Dock Corporation v. Duke, 14 Va. App. 1027, 420 S.E.2d 528, 9 Va. Law Rep. 129, 1992 Va. App. LEXIS 227 (1992).

    The unsuccessful prosecution of a claim pursuant to the Federal Workers’ Compensation Act does not constitute a binding election of remedies such as to preclude the prosecution of the claim under the Virginia Workers’ Compensation Act. Huggins v. Marine Hydraulic International, 65 O.I.C. 20 (1986).

    An employee’s receipt of benefits under the Longshoremen and Harbor Workers’ Act does not preclude the entry of an award under the Virginia Act. The employer will be granted credit for identical benefits paid under the Federal law. McKnight v. Virginia International Terminals, 69 O.I.C. 19 (1990).

    § 65.2-701. Agreement as to compensation; penalty.

    1. If after injury or death, the employer and the injured employee or his dependents reach an agreement in regard to compensation or in compromise of a claim for compensation under this title, a memorandum of the agreement in the form prescribed by the Commission shall be filed with the Commission for approval. The agreement may be prepared by the employee, the employer or the compensation carrier. If approved, the agreement shall be binding, and an award of compensation entered upon such agreement shall be for all purposes enforceable as provided by § 65.2-710 . If not approved, the same agreement shall be void. Such agreement may be approved only when the Commission, or any member thereof, is clearly of the opinion that the best interests of the employee or his dependents will be served thereby. The approval of such agreement shall bind infant or incapacitated dependents affected thereby. Any agreement entered into during the pendency of an appeal to the Court of Appeals shall be effective only with the approval of the Commission as herein provided.
    2. An employer or insurance carrier which fails to file a memorandum of such agreement with the Commission within fourteen calendar days of the date of its complete written execution as indicated thereon may be subject to a fine not to exceed $1,000 and to any other appropriate sanctions of the Commission.
    3. Nothing herein contained shall be construed so as to prevent settlements made by and between the employee and employer, but rather to encourage them, so long as the amount of compensation and the time and manner of payment are approved by the Commission. A copy of such settlement agreement shall be filed with the Commission by the employer.

    History. Code 1950, §§ 65-41, 65-90; 1954, c. 518; 1960, c. 299; 1968, c. 660, §§ 65.1-45, 65.1-93; 1971, Ex. Sess., c. 156; 1984, c. 703; 1989, c. 438; 1991, cc. 97, 355; 1997, c. 801.

    Law Review.

    For article, “Workers’ Compensation for Disease in Virginia: The Exception Swallows the Rule,” see 20 U. Rich. L. Rev. 161 (1985).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 1 Extra-Judicial Procedures. § 1.02 Joint action of both parties. Bryson.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 41.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former §§ 65.1-45, 65.1-93, or prior law.

    Construction with other laws. —

    Statutory scheme found in subsection C of § 65.2-701 , subsection A of § 65.2-702 and subsection A of § 65.2-705 , when read together, encourages agreements by the parties to settle claims while also permitting either party to withdraw from an agreement and allowing the Workers’ Compensation Commission to decide the merits of the claim; unlike subsection A of § 65.2-705 there is no time constraint on when either party may request a hearing from the Commission under subsection A of § 65.2-702 . Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    De facto awards authorized by subsection A. Ryan's Family Steak Houses Inc. v. Gowan, 32 Va. App. 459, 528 S.E.2d 720, 2000 Va. App. LEXIS 359 (2000).

    Power to correct mistake and vacate award. —

    Workers’ Compensation Commission did not err in vacating its award because without the employer’s signature as required by the form, that award order was procedurally deficient and entered by mistake; because of the Commission’s mistake, it had the power to correct its mistake and vacate the award, even though the period for an application for review lapsed. Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    Former § 65.1-72 (now § 65.2-520 ) does not authorize employer to ignore provisions of this section. Rather, it merely provides that payments voluntarily made prior to the rendition of an award may be deducted from the total amount of compensation due pursuant to the award subsequently entered. National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187, 4 Va. Law Rep. 1075, 1987 Va. App. LEXIS 239 (1987).

    Employer not to ignore mandatory wording of statute to detriment of employees. —

    Although this section does not explicitly provide penalties for an employer’s failure to comply with its provisions, an employer cannot be permitted to ignore the mandatory wording of the statute to the detriment of its employees. National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187, 4 Va. Law Rep. 1075, 1987 Va. App. LEXIS 239 (1987).

    Employer obligated to file memoranda of agreement. —

    This section refers to agreements reached “after injury” and does not expressly state or imply that the employer’s obligation to file memoranda of agreement is limited to the initial award. Whether an agreement between the parties pertains to an initial award or a supplemental award following a change of condition, the employer is still obligated to file a memorandum of agreement with the commission. Henrico Pub. Utils v. Taylor, 34 Va. App. 233, 540 S.E.2d 501, 2001 Va. App. LEXIS 30 (2001).

    Filing of memorandum of agreement satisfied claim filing requirements. —

    Memorandum of agreement, which was mailed by an employer to the Workers’ Compensation Commission, constituted a notice of claim pursuant to the requirements of § 65.2-701 , where an award that had been entered thereon was vacated, but the actual memorandum was not withdrawn or dismissed; the court noted that the memorandum contained the essential filing requirements of claims, pursuant to Va. Workers’ Comp. Comm’n R. 1.1(A). Fairfax County Sch. Bd. v. Humphrey, 41 Va. App. 147, 583 S.E.2d 65, 2003 Va. App. LEXIS 396 (2003).

    Failure to promptly file memorandum of agreements is violative of the statute and frustrates a primary purpose behind the Workers’ Compensation Act — to expedite the entry of awards in cases where the parties agree as to the compensability of the employee’s injury. National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187, 4 Va. Law Rep. 1075, 1987 Va. App. LEXIS 239 (1987).

    Employer’s failure to file a memorandum of agreement violated the statute, and it could not use its failure to comply with the statute as a means of circumventing the burden it would otherwise face. EWC Constr. v. Payne, 1996 Va. App. LEXIS 189 (Va. Ct. App. Mar. 12, 1996).

    Failure to list injury in agreement to pay benefits. —

    As the parties’ agreement to pay benefits did not mention the employee’s hand injury, which prevented his cooperation with vocational rehabilitation, it was not the subject of an enforceable award. Therefore, the employer, which applied for a hearing to terminate benefits under subsection B of § 65.2-603 , did not have the burden to show that the hand injury was not work-related. UPS v. Ilg, 54 Va. App. 366, 679 S.E.2d 545, 2009 Va. App. LEXIS 329 (2009).

    As an employee’s carpal tunnel syndrome was classified as an “ordinary disease of life” by § 65.2-401 , he had to establish by clear and convincing evidence, not merely by a preponderance, that the injury arose in the course of the employment. As the parties’ agreement to pay benefits did not mention this injury, the Virginia Workers’ Compensation Commission could not have exercised its equitable powers to alter the agreement that the parties actually made. UPS v. Ilg, 54 Va. App. 366, 679 S.E.2d 545, 2009 Va. App. LEXIS 329 (2009).

    Virginia Workers’ Compensation Commission properly denied a claimant additional benefits for a right shoulder injury allegedly suffered as a result of a workplace accident where the clear and specific terms of her Commission-approved settlement expressly provided that she would receive no benefits for her right shoulder, the claimant understood the terms of the settlement, and there was no evidence of fraud, misrepresentation, mutual mistake, or imposition. Giles v. Prince George Cty. Pub. Sch., 2019 Va. App. LEXIS 3 (Va. Ct. App. Jan. 8, 2019).

    Compromise settlement agreements are not binding until commission approves it, and either party may withdraw its offer to settle before approval. Damewood v. Lanford Bros. Co., 29 Va. App. 43, 509 S.E.2d 530, 1999 Va. App. LEXIS 41 (1999).

    Claimant and employer’s stipulation that compromise settlement agreement would be paid by a certain date did not supersede statutory time period for paying settlement by private contract; the settlement agreement had to be approved by the workers’ compensation commission and, thus, the two-week time period for paying the settlement was extended by the employer’s 20-day time period for seeking review before the full workers’ compensation commission and no statutory penalty could be imposed because the employer paid the settlement within the two-week period plus the 20-day period for review. Ratliff v. Carter Mach. Co., 39 Va. App. 586, 575 S.E.2d 571, 2003 Va. App. LEXIS 21 (2003).

    Approval by the Commission of memorandum of agreement is binding, and an award of compensation entered upon such agreement is as enforceable as an award entered in a contested proceeding. Hartford Fire Ins. Co. v. Tucker, 3 Va. App. 116, 348 S.E.2d 416, 3 Va. Law Rep. 668, 1986 Va. App. LEXIS 343 (1986).

    Filing of memorandum of agreement terminating award. —

    Because the parties agreed to terminate the award at the time claimant returned to work, and because the employer filed the executed agreement forms, it was not necessary for the employer to file an application for a hearing. Smith-Adams v. Fairfax Cnty Sch. Bd., 67 Va. App. 584, 798 S.E.2d 466, 2017 Va. App. LEXIS 109 (2017).

    Virginia Workers’ Compensation Commission did not err by enforcing a termination agreement and by denying the claimant’s request for benefits and penalties pursuant to a June 2005 award because, the parties actually executed a termination agreement that was submitted to the Commission and then proceeded for eight years acting as though the award had been terminated; enforcing the award would result in unjust enrichment for the claimant, who returned to work and did not suffer any lost wages attributable to the 2005 accident; and the claimant did not dispute that she returned to work in 2005, and that, when she returned to full capacity work, she made more money than she did before the accident. Smith-Adams v. Fairfax Cnty Sch. Bd., 67 Va. App. 584, 798 S.E.2d 466, 2017 Va. App. LEXIS 109 (2017).

    Obligation of employer who pays benefits but fails to file memorandum of agreement. —

    If the employer had complied with the statute, the claimant would have been covered by the Commission’s award. The employer then would have been obligated to honor the award until it established by a preponderance of the evidence a change in condition under former § 65.1-99 (now § 65.2-708 ) and had been authorized by the Commission to terminate the payment of benefits to claimant. Where the employer paid compensation benefits to claimant for 13 months and failed to file with the Commission a memorandum of agreement, it should be held to the same burden. To hold otherwise would be to allow an employer or its carrier to unilaterally violate the clear requirements of this section and thereby frustrate the purpose behind that statute. National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187, 4 Va. Law Rep. 1075, 1987 Va. App. LEXIS 239 (1987).

    Employer’s voluntary payment of benefits for eight months without the submission of a memorandum of agreement did not make the instant case analogous to National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187 (1987). The holding in McGuinn is not applicable to the facts of the instant case: McGuinn was decided on the claimant’s original application, not a change in condition application; moreover, the burden of proof was shifted to the employer in McGuinn on the ground that, by voluntarily paying the claimant for 13 months, the employer effectively acknowledged the compensability of his claim, while instant claimant, however, unlike McGuinn, had an original award and had returned to his pre-injury work, prior to employer’s voluntary payment of benefits; and in addition, there is no evidence that claimant suffered any prejudice or was misled by employer’s voluntary payments during the pendency of his application. Comer v. Kawneer Co., 1994 Va. App. LEXIS 564 (Va. Ct. App. Aug. 30, 1994).

    An employer insurer’s failure to file an executed agreement to pay workers’ compensation benefits, as required under subsection A of § 65.2-701 , did not entitle a claimant to a de facto award, as there was no evidence that the employer was attempting to manipulate a more favorable position while accepting the claim in practical terms; the record indicated that the claimant and the employer had a dispute about the amount of the average weekly wage, and credible evidence supported the finding that the parties never reached an agreement about the amount of the weekly wage. Watts v. P & J Hauling, Inc., 41 Va. App. 278, 584 S.E.2d 457, 2003 Va. App. LEXIS 421 (2003).

    De facto award of benefits. —

    Where the employer has stipulated to the compensability of the claim, has made payments to the employee for some significant period of time without filing a memorandum of agreement and fails to contest the compensability of the injury, it is reasonable to infer that the parties have reached an agreement as to the payment of compensation, and a de facto award will be recognized. Henrico Pub. Utils v. Taylor, 34 Va. App. 233, 540 S.E.2d 501, 2001 Va. App. LEXIS 30 (2001).

    The presence of fraud or concealment by the employer is not a requisite precondition for determining that a de facto award should be recognized. Henrico Pub. Utils v. Taylor, 34 Va. App. 233, 540 S.E.2d 501, 2001 Va. App. LEXIS 30 (2001).

    Where an employer has stipulated to the compensability of a claim, has made payments to the employee for some significant period of time without filing a memorandum of agreement, and fails to contest the compensability of the injury, it is reasonable to infer that the parties have reached an agreement as to the payment of compensation and a de facto award will be recognized. Casey Chevrolet Corp. v. Danforth, 2001 Va. App. LEXIS 76 (Va. Ct. App. Feb. 20, 2001).

    As the workers’ compensation commission’s finding that the parties never reached an agreement as to the amount of compensation was supported by credible evidence, the commission did not err in finding that claimant was not entitled to a de facto award; the claimant elected not to sign the agreement form because he did not agree with the average weekly wage calculation. White v. Redman Corp., 41 Va. App. 287, 584 S.E.2d 462, 2003 Va. App. LEXIS 420 (2003).

    Award to the claimant of wage compensation and medical benefits for a neck and upper back work-related injury was proper because the elements warranting a de facto award were present, so the award was supported by the evidence. In part, the parties were in agreement as to the amount of compensation as set forth in the supplemental agreement; the employer made wage loss compensation payments and medical payments for the claimant’s neck injury for over 10 years without contesting compensability; and there was an agreement as to the compensability of the neck injury as evidenced by employer paying wage loss benefits. Tyco Elecs. & Ins. Co. of the Pa. v. Vanpelt, 62 Va. App. 160, 743 S.E.2d 293, 2013 Va. App. LEXIS 185 (2013).

    Because an employer did not waive its right to rely on the statute, and because there was no de facto award that would extend the filing deadline set out in the statute, the Virginia Workers’ Compensation Commission did not err in concluding that an employee’s application for a change-in-condition award was not timely filed; the voluntary payments the employer made did not constitute a de facto award. Roske v. Culbertson Co., 62 Va. App. 512, 749 S.E.2d 550, 2013 Va. App. LEXIS 323 (2013).

    In a workers’ compensation case, the de facto award doctrine set forth in Va. Code Ann. § 65.2-701 did not apply because the record showed that there was no actual agreement between claimant and employer regarding the compensability of the accident. Claimant neither signed nor returned the agreement forms to employer, manifesting that he had not actually agreed to the terms employer offered. Mitchell v. Weather Control, Inc., 2021 Va. App. LEXIS 179 (Va. Ct. App. Oct. 5, 2021).

    Authority as to penalty. —

    Subsection B does not restrict the Workers’ Compensation Commission to a monetary penalty but is a broad grant of authority, limited only with respect to the amount of any financial penalty. Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    Authority as to sanctions. —

    Workers’ Compensation Commission had the discretion to decline to impose any sanctions; because no valid award agreement between the employee and the employer was ever approved by the Commission, either party was permitted to make an application to the Commission for a hearing and ruling on the matters at issue. Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    Imposition elements. —

    Although employer neither complied with the commission’s reporting requirements nor filed a memorandum of agreement after accepting claimant’s claim as required by this section, these actions by themselves do not necessarily constitute a de jure case of imposition. Westvaco Corp. v. Linkenhoker, 1996 Va. App. LEXIS 764 (Va. Ct. App. Dec. 31, 1996).

    As an award accepting the parties’ agreement to pay benefits was not erroneous due to misinformation, there was no evidence that a failure to perform some act in a timely fashion deprived the Virginia Workers’ Compensation Commission of jurisdiction, and the medical evidence did not clearly indicate that the denial of benefits for an employee’s hand problem resulted in an unjust deprivation under the Virginia Workers’ Compensation Act, the Commission was not entitled to apply the doctrine of imposition to amend the agreement to include the hand injury. UPS v. Ilg, 54 Va. App. 366, 679 S.E.2d 545, 2009 Va. App. LEXIS 329 (2009).

    “Imposition” not found. —

    Because claimant was aware of the existence of procedural requirements necessary to preserve his claim and because he had a prior relationship with an attorney familiar with the Workers Compensation Act, the current statutory bar of claimant’s claim was not caused by the employer imposing upon the commission or upon the claimant. Westvaco Corp. v. Linkenhoker, 1996 Va. App. LEXIS 764 (Va. Ct. App. Dec. 31, 1996).

    Virginia Workers’ Compensation Commission improperly applied the doctrine of imposition to modify a compromise settlement agreement and extend the expiration date for payment of an employee’s medical benefits five months from the date of its opinion because the employer’s single “counteroffer” of payment for a less expensive weight loss program did not constitute evidence of a series of acts by the employer to which it was reasonable the employee relied upon to her detriment; the employer’s actions were consistent with an intent to comply with the Workers’ Compensation Act and the compromise settlement agreement because the employer agreed that the claim was compensable, but it in good faith contested payment of the employee’s weight loss program in favor of a less expensive weight loss program. Hampton Inn & Selective Ins. Co. of Am. v. King, 58 Va. App. 286, 708 S.E.2d 450, 2011 Va. App. LEXIS 176 (2011).

    Agreement sent to claimant but not returned. —

    This section was not breached by the insurance company’s agent; there was credible evidence to support the finding that the agreements were sent to the claimant but never returned. Cumbie v. Dining & Wall Sys., No. 0550-92-2 (Ct. of Appeals Dec. 1, 1992).

    Stipulation that benefits be paid was enforceable. —

    Where the parties stipulated in the memorandum of agreement that compensation should be paid to the employee under the Workers’ Compensation Act, the employer could not contend on appeal that the stipulation was erroneous, and it could not contend on appeal that it should be permitted an opportunity to show fraud, mutual mistake of fact or imposition where those issues were not timely raised. Moon Eng'g Co. v. Nash, 1987 Va. App. LEXIS 272 (Va. Ct. App. Oct. 26, 1987).

    Res judicata did not apply. —

    Because the Virginia Workers’ Compensation Commission found that the parties agreed to expand the type of injury with the supplemental agreement, the Commission did not fail to rule on employer’s abandonment and res judicata defenses; such a ruling was subsumed in the Commission’s finding regarding the scope of the supplemental agreement. The parties agreed to modify the original order, so res judicata did not apply. Tyco Elecs. & Ins. Co. of the Pa. v. Vanpelt, 62 Va. App. 160, 743 S.E.2d 293, 2013 Va. App. LEXIS 185 (2013).

    Applying the principles of res judicata to bar an employee’s claim would thwart several important public policy considerations relating to the Virginia Workers’ Compensation Act, including the encouragement of voluntary settlement of claims; the statute requires the Workers’ Compensation Commission to approve award agreements only when they are in the best interests of the employee, and if res judicata bars employees from bringing claims for additional injuries not included in initial award agreements, the need for increased scrutiny will place further administrative demands on the Commission. Advance Auto & Indem. Ins. Co. v. Craft, 63 Va. App. 502, 759 S.E.2d 17, 2014 Va. App. LEXIS 250 (2014).

    CIRCUIT COURT OPINIONS

    No right to subrogation against legal malpractice proceeds. —

    Employer and its workers’ compensation insurer were not entitled to a lien against the verdict that an employee obtained in a medical malpractice suit against a doctor because the employer and insurer were compelled to provide workers’ compensation benefits as a result of the on-the-job accident and not as a result of the doctor’s medical negligence; the employer was required to provide compensation benefits to the employee or on his behalf, but the award orders of the Workers’ Compensation Commission conclusively established that those benefits were for the employee’s broken leg, not for damages caused by a third party. Thompson v. Alhadeff, 2011 Va. Cir. LEXIS 137 (Roanoke Oct. 11, 2011).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    De Facto Awards:

    De facto award found where sixteen months of disability payments were made without the filing of an agreement. The existence of an actual agreement cannot be undermined by the defendants’ failure to file the agreement form due to a change of heart after some additional months of voluntary payments. Orem v. Donnelly Concrete, Inc., JCN VA00000939277 (Apr. 7, 2017).

    Claimant under de facto award not required to market residual work capacity upon release to light duty. Orem v. Donnelly Concrete, Inc., JCN VA00000939277 (Apr. 7, 2017).

    De facto award appropriate where defendants conceded they paid benefits to claimant for a five-month period and stipulated that claimant was disabled for reasons causally related to work accident at least during some of this time. Defendants did not submit to claimant or file with Commission any agreement forms memorializing these periods of causally related disability and payment of benefits and only contested a portion of the claim after it was filed. Barnes v. Do330979 Drivers (Greyhound Lines, Inc.), JCN VA00000733697 (Feb. 27, 2015).

    The Commission rejected the employer’s assertion that the claimant was not entitled to a de facto award because the claimant failed to sign and return agreement forms, because the employer did not introduce sufficient evidence to establish that agreements had been tendered. Caballero v. Erickson Retirement Communities, JCN VA00000178656 (Nov. 30, 2011).

    Where the claim was not accepted in Virginia, payments made based on acceptance of the claim in Texas are not a basis for a de facto award in Virginia. Beausoleil v. Plasser American Corp., VWC File No. 219-86-90 (March 31, 2006).

    Where the employer pays benefits, files an application to terminate benefits which is rejected because there is no award, and at the hearing does not contest specific injuries but only argues that there is no causation between the original injury and current disability, a de facto award is appropriate. Valentine v. V.M.W. Express, Inc., VWC File No. 217-34-09 (Jan. 10, 2006).

    De facto award properly entered by deputy commissioner despite voluntary payments by employer at higher average weekly wage than eventually stipulated at hearing; evidence did not show dispute as to average weekly wage but mutual mistake of fact as to precise amount; deputy commissioner correctly awarded credit to employer for overpayment during period of voluntary payments. Garner v. St. Coletta of Greater Washington, Inc., VWC File No. 211-74-41 (Mar. 15, 2004).

    No de facto award shown, despite employer’s payment of compensation benefits for approximately three months, when employer vigorously defended against compensability of claim and employee did not prove at hearing any compensable injury or disease; Commission found that entry of de facto award when evidence failed to show compensable injury or disease would be contrary to the Act. Try v. Berry Patch Florist, VWC File No. 211-57-12 (Feb. 23, 2004).

    The Commission refused to recognize a de facto award where the carrier promptly forwarded an agreement form, but the claimant did not execute it until several months later, after the carrier had taken the position that the condition was no longer related to the accident. Thomas v. C. Thomas Jr. Trucking, VWC File No. 204-41-12 (February 26, 2002).

    Where the employer accepted the claim and paid benefits for almost four months, and did not contest compensability of the claim at the evidentiary hearing, but never provided the claimant with agreement forms, such factors were sufficient to establish a de facto award. Where the Commission finds a de facto award, the claimant has no burden to prove continuing disability or marketing of remaining work capacity. Rather, the burden of proof is on the employer to establish a basis for terminating compensation benefits. Ryan’s Family Steak Houses Inc. v. Gowan, 32 Va. App. 459, 528 S.E.2d 720 (2000), 78 O.W.C. 117 (1999).

    The Deputy Commissioner did not violate the employer’s due process rights by recognizing, sua sponte, the existence of a de facto award. The Act encourages voluntary settlement of disputes. However, once an agreement has been reached, Virginia Code § 65.2-701 requires that a memorandum of agreement be filed by the employer with the Commission for its approval. Because the employer never disputed compensability, paid compensation benefits voluntarily for over 18 months, but failed to submit a memorandum of agreement, the Commission found that the employer was on “constructive notice” of the possibility of entry of a de facto award. Godwin v. Canon USA, Inc., VWC File No. 202-36-53 (October 10, 2001).

    Where the employer voluntarily pays compensation for eight months without submitting a Supplemental Memorandum of Agreement, the Commission found a de facto award. Testimony challenging causation was not allowed. To terminate benefits the employer must comply with § 65.2-708 and Rule 1.4(C). Anderson v. City of Roanoke Fire Department, 73 O.W.C. 34 (1994).

    Memorandum/Supplemental Agreements:

    Where the Memorandum of Agreement (now titled Award Agreement) listed “multiple bruises and contusions” as the injured body parts, it was not error for the Deputy Commissioner to include left hip and leg, because the wording on the agreement form was too vague to determine what injuries were included or excluded. Willis v. Coleman Construction Corporation, VWC File No. 142-35-46 (Jan. 10, 2012).

    The initial claim listed left knee and right hip injuries but the Stipulated Award Order referenced injuries to the left lower extremity. A claim for a right hip filed almost three years after the accident was barred by the statute of limitations. With the entry of the Stipulated Award Order listing only the left lower extremity, the claim for a right hip injury was merged into that award, waived, or abandoned. As distinguished from facts in similar cases, the insurance carrier did not pay benefits for a brief period of treatment to the right hip. Swain v. City of Petersburg Social Services, VWC File No. 214-93-41 (Sept. 4, 2007).

    A majority held that where the initial award was for a left leg injury, a claim for a back injury filed almost nine years after the accident date is barred by the statute of limitations. The payment of medical expense for the back is not sufficient to establish estoppel, imposition, or a basis for a de facto award. Brickley v. Pardee Coal Company, Inc., VWC File No. 186-35-42 (April 4, 1997), aff’d, No. 116-07-3 (Ct. App. of Va., Sept. 11, 2007) (unpublished opinion).

    A majority found that the claimant’s 2005 claim for a shoulder injury was barred by the statute of limitations because the compensable back injury from the 1998 accident was a separate and distinct injury. Moyer v. David A. Nice Builders, VWC File No. 194-62-94 (Mar. 12, 2007). (Dismissed by Ct. of App., June 4, 2007).

    Code § 65.2-701 provides that a Memorandum of Agreement shall be filed where the employer agrees to compensability of an injury. The employer cannot condition its obligation by requiring the claimant to limit the period of compensable disability by Agreed Statement of Fact before the Memorandum of Agreement will be filed. Where the employer fails or refuses to file a Memorandum of Agreement for an acknowledged compensable disability, it bears the burden to prove the change in condition that would justify termination of payments, as if an award had been formally entered. Maunder v. Lanier Worldwide, Inc., 75 O.W.C. 1 (1996).

    The description of the injury on a Memorandum of Agreement, while important, is not required to be precise. People without a medical background routinely prepare Memoranda of Agreement, and the injured worker usually does not have any medical expertise. Thus, the language describing the injury should not be strictly construed. Strict construction under such circumstances defeats the purpose of the Act. The claimant’s injury was described in the Employer’s First Report as “lumbar & cervical strains,” and the Claim For Benefits filed by the employee alleged “acute lumbar & cervical sprain.” However, the Memorandum of Agreement endorsed by the parties and filed with the Commission identified only a “back strain.” The Commission held on these facts that the employer acknowledged in its First Report the lumbar and cervical injuries, that the initial claim was clearly for lumbar and cervical injuries, that there was no evidence that the employer had disputed the claim for a cervical injury, that the omission of a cervical sprain from the Memorandum was inadvertent, and that the employer was liable for treatment of the cervical injury. McCracken v. Life Ins. Co. of Georgia, 79 O.W.C. 104 (2000), affirmed in an unpublished Court of Appeals opinion issued February 13, 2001. [But see the unpublished Court of Appeals opinions in Fleetwood Homes of Virginia, Inc. v. McNeal, Record No. 2236- 00-3 (June 5, 2001), and McKee Foods Corporation v. Atkins, Record No. 2727-00-3 (July 3, 2001), both opinions reversing the Commission and holding that the employer’s acceptance of a shoulder injury cannot be so broadly construed as to include adjacent body parts, i.e., a cervical injury.] [See also; Corporate Res. Mgmt. v. Southers, 51 Va. App. 118, 655 S.E.2d 34, 2008 Va. App. LEXIS 10 (2008) (en banc) where a claim for a shoulder injury preserved a claim for a neck injury and Sam Moore Furniture Industries v. Smith, Record No. 0685-07-3 (Feb. 26, 2008) where an award for an arm was sufficient to include a timely claim for a shoulder injury.].

    An agreed settlement approved by the Commission has the force and effect of an award entered after a hearing in a contested case. The Commission may not disturb awards, from which no appeal is taken, unless the parties agree. Janney v. Sullivan’s Heating & Cooling Co., 52 O.I.C. 155 (1970).

    In the absence of fraud, duress, mutual mistake, or other facts which would entitle the parties to invoke the aid of a court of equity for reformation of a contract, such an award is binding upon both parties and is conclusive of the fact that employer and employee came under the provisions of the Act, that the injury resulted from an accident which arose out of and in course of employment, and that the Commission had jurisdiction over the parties for enforcement and regulation of compensation due, or which might become due, for the injury. City of Norfolk v. Bennett, 205 Va. 877 , 140 S.E.2d 655, 1965 Va. LEXIS 148 (1965).

    An employer that initially accepts the claim as compensable, but reverses its position before an award is entered, is not estopped from denying liability. Dovel v. Perdue Farms, Inc., 75 O.W.C. 265 (1996).

    Where either party withdraws their approval of a Memorandum of Agreement prior to the entry of an award, the award will not be entered and the case will be scheduled for a hearing. If, however, the request is made after the award has been entered, a request for Review must be made within twenty days in order for the award to be vacated without the necessity of establishing fraud, mutual mistake or imposition. If the request for Review is not timely made, the only means for vacating the award is by establishing fraud, mutual mistake or imposition. Sovran Financial Corp. v. Nanney, 12 Va. App. 1156, 408 S.E.2d 266 (1991), 69 O.I.C. 55 (1990).

    Where the parties enter a Memorandum of Agreement requiring payment of permanent disability for a specific period of time, the Commission will not disturb the agreement even though medical reports suggest an entitlement to compensation for a lesser period. Smith v. Stackhouse, Inc., 66 O.I.C. 138 (1987).

    Where a Memorandum of Agreement is executed by the parties an employer may not offer a defense of no injury by accident to a change of condition application unless there is evidence of fraud, mutual mistake or imposition. Meynardie v. Dynalectron Corporation, 66 O.I.C. 99 (1987).

    Since no compensation had been paid, there was no conflict with § 65.1-99 (now § 65.2-708 ) in reforming a Memorandum of Agreement to commence on the date compensation was first due. Seabrook v. American Airlines, Inc., 68 O.I.C. 3 (1989).

    When a timely request is made by a party that the Claims Division not approve a previously tendered agreement and an issue arises as to whether the action of the Claims Division in not approving the agreement is proper, either party is entitled to an evidentiary hearing on the issues involved. Greene v. Ward Company, Inc., 63 O.I.C. 149 (1984).

    The fact that an employer pays benefits under the laws of another state does not establish either directly or by inference that the parties have reached an agreement as to the payment of compensation under the Virginia Act. Payment of benefits in another state does not estop the employer from asserting the defense of failure to market remaining capacity. Johnson v. Associated Transportation Services, Inc., 69 O.I.C. 80 (1990).

    Where an employer withholds a Memorandum of Agreement purposefully and without just cause when there was an agreement as to the injury and a specific period of disability but insufficient evidence to terminate or suspend the award and the employee refuses to sign an Agreed Statement of Fact, the Commission may assess attorney fees. Howard v. Little River Seafood, 71 O.W.C. 293 (1992).

    Where the employer files supplemental memorandum of agreements and agreed statement of facts but fails to file an executed memorandum of agreement, the Court upheld the Commission’s finding that an imposition was established and that an award was in effect notwithstanding that the memorandum of agreement was not provided. It was also noted that the employee dealt directly with the employer in signing and returning the papers and was assured that all necessary papers were filed with the Commission. Therefore, the claim was not barred by the statute of limitations. Avon Prods., Inc. v. Ross, 14 Va. App. 1, 415 S.E.2d 225, 8 Va. Law Rep. 2299, 1992 Va. App. LEXIS 73 (1992).

    Agreed Statement of Fact:

    The signing of an agreed statement of fact is not a requirement for payment of compensation. Owens v. Va. Beach City School Board, 53 O.I.C. 238 (1971).

    The signing of an agreed statement by the employee does not prevent him from obtaining an award for any additional compensation benefits that he is due under the Act. Wise Coal & Coke Co. v. Roberts, 157 Va. 782 , 161 S.E. 911 , 1932 Va. LEXIS 327 (1932).

    Where an agreed statement of fact has been executed by the employee and approved by the Commission any additional claim must be made under § 65.1-99 (now § 65.2-708 ). Biggs v. Clinchfield Coal Corp., 9 O.I.C. 950 (1927).

    An agreed statement of fact executed while the employee is still disabled and unable to return to work is void. Johnson v. Jewell Ridge Coal Corp., 58 O.I.C. 203 (1978).

    Vacating Agreements:

    It is well settled that stipulations may not be set aside except in very limited circumstances. In this case, although carrier submitted a letter accepting the claim, it did not rise to the level of being a stipulation to which the employer was bound although that is how the Deputy Commissioner categorized the letter. The employer could withdraw consent to the entry of an award based upon that letter because the letter did not stipulate to specific facts, as required for a stipulation, but merely agreed to the payment of benefits for a brain injury. The letter was more akin to a memorandum of agreement or agreement to pay benefits. Sauer v. Virginia Commonwealth University/Commonwealth of Virginia, VWC File No. 237-51-08 (April 9, 2010).

    The Commission has no jurisdiction to vacate an award based on agreement where the carrier alleged unilateral mistake of claims representative who thought he was agreeing to a medical only award, and the Request for Review of the award was untimely. Hamilton v. Quebecor World, Inc., VWC File No. 218-22-73 (Oct. 22, 2004).

    Appropriate to vacate compromise settlement agreement only when claimant and claimant’s attorney refund to carrier money received by virtue of settlement. Allen v. Staunton School Board, VWC File No. 207-01-34 (Apr. 25, 2003).

    Where either party withdraws its approval of a Memorandum of Agreement after the award has been entered, a request for review must be made within twenty days, and the award may then be Vacated by the Commission without the necessity of establishing fraud, mistake, or imposition. Cornish v. Anheuser Busch Co., Inc., 76 O.W.C. 47 (1997).

    The Commission has implied power, upon application seasonably made, to vacate an award procured through fraud or mutual mistake, even after the lapse of period for application for review. Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573 (1946); Cain v. Morris, et al., 58 O.I.C. 45 (1978).

    The burden of proof is on party alleging mistake. Fraud cannot be presumed, but must be proved by clear and satisfactory evidence. City of Norfolk v. Bennett, 205 Va. 877 , 140 S.E.2d 655 (1995) (rehearing denied); Walters v. Frank R. Jelleff, Inc., 50 O.I.C. 330 (1968); Mann v. Westmoreland Coal Co., 59 O.I.C. 185 (1980); Russell v. Island Creek Coal Co., 59 O.I.C. 271 (1980).

    The Commission vacated an Agreed Statement of Fact upon finding that it was invalid because the employer was aware the claimant was represented by counsel but did not submit the agreement to him; the claimant was not receiving wages equal to his pre-injury wage; and the nature of the document was misrepresented to the injured worker. The Commission held that the 90-day provision of Rule 1.2 was inapplicable. Eudailey v. Fairfield Williamsburg Property, 73 O.W.C. 57 (1994).

    Application of S. Klein Department Stores and its insurer to have award vacated on ground of mutual mistake of fact in that actual employer was Wharton Drugs, which leased space in department store, was denied. Gomez v. S. Klein Department Stores, Inc., 57 O.I.C. 135 (1975).

    Where a carrier, by its own negligence, accepted a claim as compensable and paid benefits for some two years before discovering that its coverage for the employer had expired prior to the date of the accident, the doctrine of laches precludes shifting the burden of paying the claim to the correct carrier whose right to protect itself from liability had been signed away without its knowledge or agreement. Matthews v. Potomac Insulation, 63 O.I.C. 226 (1984).

    If an award is set aside it will be as of date of last payment because the Commission is precluded from entering any award affecting moneys already paid. Dandridge v. Pryor, 51 O.I.C. 69 (1969).

    Compromise Settlement:

    Claimant’s confidential letter filed in support of a full and final settlement agreement is inadmissible to alter the terms of the complete, unambiguous and unconditional written settlement petition, even if the letter contained parole evidence of prior or contemporaneous oral negotiations or stipulations. Johnson v. Chamberlain Mechanical Service, Inc., JCN VA02000005137 (Aug. 28, 2018).

    The parties reached an agreement in mediation to settle the case. This agreement was not approved as it did not comply with the rules of the Commission. The plaintiff appealed, arguing that Rule 1.9 required the Commission to enforce the agreement reached at the mediation. The Full Commission held that Rule 1.7 and Section 65.2-701 require that certain documentation is required before the Commission will enforce agreements reached in mediation. Brown v. Pepsi Bottling Group, Inc., VWC File No. 209-73-44 (June 4, 2010).

    At oral argument on review, claimant alleged fraudulent conduct by his counsel in procuring settlement agreement. Commission vacated settlement order and remanded to the deputy commissioner to take testimony from the claimant and to make a finding regarding the allegation of fraud. Hurtado v. Summit Roofing Contractors, Inc., VWC File No. 208-32-37 (March 15, 2005).

    Blanket releases are not favored and will be subject to a high degree of scrutiny. Such releases should be the exception rather than the rule and should be approved only when the deputy commissioner reviewing the settlement is convinced of the appropriateness of the release. Chism v. Norfolk (City of) Utilities, VWC File No. 217-46-42 (March 3, 2005).

    For a discussion of blanket releases see Jocham v. Retired Persons Services, Inc., 76 O.W.C. 433 (1997) (must identify specific date and time, must show parties even if represented by counsel considered the reason and gave consideration for the release, and language limits the release to injuries or disabilities incurred in the employment before the date of the settlement).

    Commission may extend medical treatment under settlement agreement due to employer/carrier’s delay in authorizing the treatment. Fraysier v. Clinch River Health Services, Inc., VWC File No. 193-86-18 (May 28, 2004).

    Employee not allowed to re-open claim settled by final petition and order to recover benefits for compensable consequence of original injury that arose only after claim settled; employee suffered severe burn injury in 1986, requiring blood transfusions during treatment, and Commission approve full settlement of workers’ compensation claim in 1991; employee diagnosed in 2000 with Hepatitis C, allegedly caused by transfusions; employee’s claim to re-open claim as compensable consequence denied. Stevenson v. Insulation Specialties, Inc., VWC File No. 208-62-85 (Aug. 15, 2003).

    Deputy Commissioner erred by refusing to approve parties’ compromise settlement; employee injured in 1986 and filed claim in 2002; employer filed first report in 2002; parties reached compromise settlement; Commission found jurisdiction was not being conferred by consent of parties because parties disputed whether statute of limitations would bar claim. Owens v. American of Martinsville, VWC File No. 210-14-35 (May 27, 2003).

    It is appropriate to vacate a compromise settlement agreement only when the claimant and claimant’s attorney refund to the carrier money received by virtue of the settlement. Allen v. Staunton School Board, VWC File No. 207-01-34 (Apr. 25, 2003).

    In the absence of requested medical reports, the Commission cannot find a compromise settlement to be in the best interest of the claimant. Lewis v. K-Mart Corporation, 73 O.W.C. 227 (1994); Herring v. Shotgun Express, Inc., 76 O.W.C. 135 (1997).

    Where documents filed with the Commission failed to show that the claimant had fully recovered and had been released to his preinjury work, but suggest that he continues under a doctor’s care, and no provision is made to pay for the claimant’s health care providers, the Commission could not find that approval would be in the claimant’s best interests. Herring v. Shotgun Express, Inc., 76 O.W.C. 135 (1997).

    A compromise settlement bars any subsequent claim. Myerhoeffer v. Marval Poultry, 59 O.I.C. 222 (1981).

    The Commission requires that the parties identify the specific claims which are being compromised. A general release of all claims, without specific reference to a date of injury or a specific claim, cannot operate in the best interest of the claimant. Isner v. Griffith Commercial Interiors, 76 O.W.C. 249 (1997).

    All compromise settlements of claims involving rights under the Workers’ Compensation Act must be approved by the Commission before such rights can be extinguished. Boozer v. Otis Johnson a/k/a Mike Johnson, 65 O.I.C. 297 (1986).

    A compromise settlement may be approved when the Commission is clearly of the opinion that the best interests of the employee will be served thereby. Herring v. Shotgun Express, Inc., 76 O.W.C. 135 (1997).

    Before approving a settlement proposal, the Commission must determine that the compromise is in the best interest of the claimant. Isner v. Griffith Commercial Interiors, 76 O.W.C. 249 (1997).

    Code § 65.2-701 requires that all compromise settlements between the parties shall be filed with the Commission for approval, and such agreement may be approved only when the Commission is clearly of the opinion that the best interests of the employee will be served thereby. If the agreement is not approved, it shall be void. Vercoe v. Air Wisconsin, 76 O.W.C. 288 (1997).

    Code § 65.2-701 is clear in its purpose and mandatory in its language. Vercoe v. Air Wisconsin, 76 O.W.C. 288 (1997).

    Before a compromise settlement will be approved, the Commission must be furnished with sufficient information to determine that approval is in the best interests of the employee. The information must include evidence that the employee’s injuries are stabilized, that permanency exists, that there is evidence of the employee’s capability to handle the funds, and that there is a detailed plan for using or investing the proceeds of the settlement. Herring v. Shotgun Express, Inc., 76 O.W.C. 135 (1997).

    The particular facts and circumstances of each case determine whether a compromise settlement proposal is in the best interests of the employee. The Commission will not approve a compromise settlement that it finds is not in the claimant’s best interests. Jocham v. Retired Persons Services, Inc., 76 O.W.C. 433 (1997).

    The Deputy Commissioner did not err in failing to address whether the parties had reached a binding compromise of the claim, because there can be no “binding” settlement of a claim until it is approved by the Commission. Stone v. Fairfax County Bd. of Sup’rs, 76 O.W.C. 109 (1997).

    Release obtained by defendant from injured employee held invalid as terms of alleged settlement were not approved by the Commission and did not conform with the provisions of § 65.1-45 (now § 65.2-701 ) and § 65.2-93 (now § 65.2-701 ). McMillian v. Shopping Centers Constr. Co., 41 O.I.C. 107 (1959).

    Settlement void because it was never sent to the Commission for approval. The amount was deducted from accrued compensation. Marrs v. Betty B. Coal Co., 54 O.I.C. 252 (1972).

    An Order approving a compromise settlement may be vacated if the employee notifies the Commission of his request to withdraw approval within 20 days of the date the Order was entered. Shields v. Napit Construction Corp., 70 O.I.C. 258 (1991).

    Whenever either party withdraws its agreement to a compromise settlement and so advises the Commission before the entry of the settlement order, the Commission will not enter the order. If the order has been entered prior to the receipt of the party’s withdrawal of agreement, the party may petition for review of the order in a timely manner without the necessity of establishing fraud, mutual mistake, or imposition. Damewood v. Lanford Brothers Co., Inc., 77 O.W.C. 101 (1998).

    The death of an employee prior to the Commission’s approval of a compromise settlement does not void the settlement agreement entered into by the parties some weeks prior to the employee’s death. Lloyd v. Halifax Cotton Mills, 64 O.I.C. 209 (1985).

    The claimant and the carrier negotiated a compromise settlement of the claim, and it was submitted to the Commission. The carrier was thereafter advised that the claimant had since died from causes unrelated to his work injuries, and it withdrew its agreement to the settlement. The Commission held that the carrier’s request was timely and declined to enter the compromise settlement order. Damewood v. Lanford Brothers Co., Inc., 77 O.W.C. 101 (1998).

    Where surgery is delayed while the carrier obtains other opinions to determine whether it is reasonable and necessary treatment of the work injury, the agreed period during which medical care is to be provided by the employer pursuant to a compromise settlement may be extended to the extent of such delay. Fox v. W. G. Enterprises, 75 O.W.C. 243 (1996).

    An employee, whose claim for an injury by accident from an electrical shock was settled by Petition and Order, is not precluded from filing a claim for the occupational disease of carpal tunnel syndrome. An application for benefits for an occupational disease is a distinct and different cause of action from an application for an injury by accident. White v. Planters Peanuts, 70 O.I.C. 150 (1991).

    An employee’s claim for permanent total disability benefits held not barred by an Order of the Commission approving a compromise settlement of his permanent partial disability claim, even though the Order provided that the employer would also pay up to 500 weeks of temporary total disability. The settlement agreement did not indicate that the employee intended a final settlement of his claim, to the exclusion of a claim for permanent total disability, but only for his permanent partial disability claim. Holt v. Wood Brokers Co., 76 O.W.C. 13 (1997).

    Code § 65.1-100.3 (now § 65.2-712 ) is applicable where an employee fails to disclose to the employer during the negotiations for a settlement that he is currently working. Magic City Motor City Corp. v. Helmick, 10 Va. App. 10, 390 S.E.2d 1, 6 Va. Law Rep. 1725, 1990 Va. App. LEXIS 39 (1990).

    An attorney’s fee agreed to and provided for in a Petition and Order may be reduced by the Commission to comport with the actual work required to reach a compromise settlement in an uncontested compensation case. The change in the attorney’s fee does not reduce the carrier’s liability under the Petition and Order but only increase the proportion of the proceeds that the claimant will directly receive. Smith v. Catron Companies, 68 O.I.C. 245 (1989).

    The claimant filed a claim for benefits in Virginia, and was awarded compensation and medical benefits. He subsequently filed a claim for Illinois workers’ compensation compensation, which was settled for a lump sum in an agreement that provided “the settlement of this matter will close all matters in all jurisdictions and specifically Illinois and Virginia.” Neither party filed the settlement proposal with the Virginia Commission. The Virginia Workers’ Compensation Commission Commission held that the claimant’s rights under the Virginia Act were not extinguished and that the Award in this case remained outstanding. Vercoe v. Air Wisconsin, 76 O.W.C. 288 (1997).

    Rule 1.7, effective January 1, 1994, provides that payments must be made within 10 days after entry of an order approving a compromise settlement. However, that Rule was superseded by the amendment to Code § 65.2-524 , effective July 1, 1994, providing that payments shall not be subject to a penalty until two weeks after the period within which a party may request review of such order. Hunt v. Southern Industrial At Union Camp, 76 O.W.C. 215 (1997).

    The Commission approved a compromise settlement to be paid within a reasonable time after the order entered on June 25, 1996. The 20 days allowed for an appeal of that order expired on July 15, 1996, and the employer had an additional two weeks to make payment, to July 30, 1996, even if the order was not appealed. Hunt v. Southern Industrial At Union Camp, 76 O.W.C. 215 (1997).

    The Commission approved a compromise settlement on June 25, 1996. The employer mailed payment to the claimant’s attorney on July 22, 1996. Counsel, in turn, mailed the check to the claimant on July 29, 1996, and claimant received it on July 31, 1996 or August 1, 1996. The Commission held that payment was made on July 29, 1996 when counsel placed the check for the claimant in the regular mail. Because payment was therefore made before July 30, 1996, the last date it was due, no penalty could be assessed against the employer. Hunt v. Southern Industrial At Union Camp, 76 O.W.C. 215 (1997).

    A compromise settlement of the employee’s claim, approved by a judge in a foreign state, under the foreign state’s laws, does not preclude the employee from proceeding in her claim under Virginia law. The employee, a resident of Florida injured while working for the employer in Virginia, filed claims in both Florida and Virginia. She negotiated a compromise settlement in Florida, which was approved by a workers’ compensation judge there. She then sought an award in Virginia. The employer objected, arguing that the Florida judgment was entitled to full faith and credit under the United State Constitution. Applying the cases Thomas v. Washington Gas Light Co., 448 U.S. 261 (1980), and United Airlines, Inc. v. Kozel, 33 Va. App. 695, 536 S.E.2d 473 (2000), the Commission found that the employee could proceed with her claim. The compromise settlement negotiated in Florida was never submitted to the Virginia Commission for approval, and the employee would not agree to its terms when presented to the Deputy Commissioner for approval. Steinerman v. Nelsons Engineering Serv., Inc., VWC File No. 199-45-71 (April 12, 2001).

    Compensation benefits paid by the insurer after a compromise settlement has been approved, but paid prior to the date they were due under § 65.2-524 , constitute voluntary payments pursuant to § 65.2-520 , for which the insurer is entitled to a credit. Here, the insurer paid four days of compensation benefits in advance of the dates they were due. When the lump-sum compromise settlement was eventually paid, the insurer reduced the amount owed to the claimant by the amount paid to him in advance of settlement. The Commission found that the Deputy Commissioner erred in ordering the insurer to pay the four days of benefits, plus a 20% penalty. The insurer was entitled to a credit for the four days of voluntary payments it made. Baber v. Roughton Pontiac Corporation, VWC File No. 179-44-26 (April 5, 2002).

    Lump Sum:

    In order for a lump sum settlement to be approved, the Commission must be furnished sufficient information to determine if it is in the best interest of the employee. The information must include evidence that the employee’s injuries are stabilized, permanency exists, evidence of the employee’s capabilities to handle the funds, and a detailed plan of how the proceeds will be used or invested. Warrick v. Goodyear Tire & Rubber Co., 69 O.I.C. 131 (1990).

    Uninsured Motorist:

    Compromise with his own insurer of claim against third party uninsured motorist did not prejudice employer’s rights since employer was subrogated to no rights against the uninsured motorist carrier. Horne v. Superior Life Ins. Co., 203 Va. 282 , 123 S.E.2d 401, 1962 Va. LEXIS 140 (1962).

    Claim under uninsured motorist provisions is irrelevant to deciding Workmen’s Compensation claim. Garner v. Petroleum Transit Corp. of Va., 49 O.I.C. 121 (1967).

    Employer not subrogated under uninsured motorist provision of claimant’s liability policy. Graves v. Impulse Elec. Co., Inc., 50 O.I.C. 159, 162 (1968).

    Note: On July 1, 1995 § 38.2-2206 became effective allowing a set off between uninsured coverage and compensation benefits in certain circumstances.

    § 65.2-702. Disagreement on compensation; venue.

    1. If the employer and the injured employee or his dependents fail to reach an agreement in regard to compensation under this title, or if they have reached such an agreement which has been signed and filed with the Commission and compensation has been paid or is due in accordance therewith and the parties thereto then disagree as to the continuance of any weekly payment under such agreement, either party may make application to the Commission for a hearing in regard to the matters at issue and for a ruling thereon.
    2. Immediately after such application has been received the Commission shall set the date for a hearing, which shall be held as soon as practicable, and shall notify the parties at issue of the time and place of such hearing. The hearing shall be held in the city or county where the injury occurred, or in a contiguous city or county, unless otherwise designated by the Commission.

    History. Code 1950, § 65-91; 1968, c. 660, § 65.1-94; 1974, c. 315; 1991, c. 355; 1993, c. 693.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 55, 58, 60, 62, 70.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-94 or prior law.

    Construction with other laws. —

    Statutory scheme found in Va. Code Ann. subsection C of § 65.2-701 , subsection A of 65.2-702 and subsection A of 65.2-705 , when read together, encourages agreements by the parties to settle claims while also permitting either party to withdraw from an agreement and allowing the Workers’ Compensation Commission to decide the merits of the claim; unlike subsection A of § 65.2-705 there is no time constraint on when either party may request a hearing from the Commission under subsection A of § 65.2-702 . Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    This section applies to disputes arising before an award is made, whereas former § 65.1-99 (now § 65.2-708 ) applies to disputes arising after the award. Parker v. Manchester Bd. & Paper Co., 201 Va. 328 , 111 S.E.2d 453, 1959 Va. LEXIS 230 (1959).

    In former § 65.1-85 (now § 65.2-600 ) and this section the legislature used the word “employer” in a generic sense to describe whichever employer, actual or statutory, from whom the worker seeks workers’ compensation benefits. Race Fork Coal Co. v. Turner, 237 Va. 639 , 379 S.E.2d 341, 5 Va. Law Rep. 2382, 1989 Va. LEXIS 70 (1989).

    It is not imperative that the record show an ineffectual attempt to settle all the issues or the claim before filing it with the Commission under this section. Nor is provision as to failure of the employer and employee to reach an agreement jurisdictional. Chalkley v. Nolde Bros., 186 Va. 900 , 45 S.E.2d 297, 1947 Va. LEXIS 208 (1947).

    Statute of limitations. —

    Virginia Workers’ Compensation Commission did not err in concluding that it lacked jurisdiction to consider the case because an employer’s request was not timely filed within the statute of limitations; thus, after the employee’s estate claims were dismissed, there was no timely filed claim for the Commission to consider. Intercept Youth Servs. v. Estate of Lopez, 71 Va. App. 760, 840 S.E.2d 25, 2020 Va. App. LEXIS 99 (2020).

    Because the statute of limitations had run and, therefore, expired when the claims of an employee’s estate were withdrawn and dismissed by the Virginia Workers’ Compensation Commission, the estate was forever barred from prosecuting a claim for the employee’s death under the Workers’ Compensation Act; consequently, the employer was not subject to liability under the Act for the employee’s death, and its request that the Commission determine the compensability of the claim was moot. Intercept Youth Servs. v. Estate of Lopez, 71 Va. App. 760, 840 S.E.2d 25, 2020 Va. App. LEXIS 99 (2020).

    Authority of Commission. —

    In the absence of a properly executed and approved agreement, subsection A clearly granted the Workers’ Compensation Commission the authority to decide the merits of an employee’s claim for benefits, pursuant to the employer’s request for review. Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    Workers’ Compensation Commission had the discretion to decline to impose any sanctions; because no valid award agreement between the employee and the employer was ever approved by the Commission, either party was permitted to make an application to the Commission for a hearing and ruling on the matters at issue. Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    CIRCUIT COURT OPINIONS

    Commission lacked jurisdiction. —

    There was no basis for jurisdiction by the workers’ compensation commission because the employee and the employer never had a disagreement about compensation, the employee was not under a disability at the time of his death, and no compensation could be awarded because the employee had no dependents. Neither the policy behind the Workers’ Compensation Act nor its jurisdictional basis provided a statutory framework for resolution of the claims under the Act. Skopic v. Tate, 2009 Va. Cir. LEXIS 132 (Fairfax County Nov. 18, 2009).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Employer has no right to referral of application to docket where claim previously was dismissed with prejudice; the dismissal rendered issues of the employer’s liability under the Act moot. Demke v. DC Water & Sewer Authority, JCN VA02000028399 (Oct. 19, 2017).

    Employer has the right to file claim, right to a hearing even though employee has not filed a claim and believes accident did not occur in the course of his employment. Leavelle v. City of Roanoke, JCN VA00000901003 (June 17, 2014).

    Either party may file an application with the Commission for a hearing to determine the compensability of a claim. Silberman v. Prince William School Board, 76 O.W.C. 231 (1997).

    Code § 65.2-702 provides that either party to a claim may make application to the Commission for a hearing in regard to the matters at issue and for a ruling thereon. Petty v. Duffie Graphics, Inc., 76 O.W.C. 306 (1997).

    There is no requirement that there be a pending claim for benefits before a hearing on the merits can be requested. It is an accident, not a claim, that triggers the employer’s right to request a hearing to determine contested issues. Petty v. Duffie Graphics, Inc., 76 O.W.C. 306 (1997).

    An employer has standing to file an Application For Hearing to establish its rights and obligations under the Virginia Act. Harrison v. City of Portsmouth School Bd., 75 O.W.C. 305 (1996).

    Where the claimant alleges and has presented evidence of a carpal tunnel syndrome condition, the employer is entitled to a determination of its rights and responsibilities in regard to that condition, regardless of the fact that the claimant has since withdrawn her claim. Specifically, the employer has a right to an opportunity to depose the claimant, any potential witnesses, and the diagnosing physician regarding the facts surrounding the claimed condition while the events are fresh in people’s memories and documentation is still available. In addition, the employer is entitled to a final determination regarding whether it will be responsible for indemnity and lifetime medical benefits causally related to the claimed condition, and the carrier is entitled to the opportunity to establish appropriate reserves. Petty v. Duffie Graphics, Inc., 76 O.W.C. 306 (1997) (see also Silberman v. Prince William School Board, 76 O.W.C. 231 (1997)).

    Virginia Code Ann. § 65.2-702 , which provides that either party may make application to the Commission for a hearing in regard to the matters at issue and for a ruling thereon, does not authorize a third party co-employee to file an application and compel a hearing, even though the co-employee could otherwise be liable for civil penalties. Randolph v. Southern States Coop., Inc., 76 O.W.C. 339 (1997).

    There is no requirement that an application from a health care provider be filed by a licensed attorney. Blevins v. Williamsburg Pottery, 75 O.W.C. 103 (1996).

    When a timely request is made by a party that the Claims Division not approve a previously tendered agreement and an issue arises as to whether the action of the Claims Division in not approving the agreement is proper, either party is entitled to a hearing on the issues involved. Greene v. Ward Company, Inc., 63 O.I.C. 149 (1984).

    Where either party withdraws its approval of a Memorandum of Agreement prior to the entry of an award, the award will not be entered and the case will be scheduled for a hearing. If, however, the request is made after the award has been entered, a request for Review must be made within twenty days in order for the award to be vacated without the necessity of establishing fraud, mutual mistake or imposition. If the request for Review is not timely made, the only means for vacating the award is by establishing fraud, mutual mistake or imposition. Sovran Financial Corp. v. Nanney, 12 Va. App. 1156, 408 S.E.2d 266 (1991), 69 O.I.C. 55 (1990).

    The fact that an employer pays benefits under the laws of another state does not establish either directly or by inference that the parties have reached an agreement as to the payment of compensation under the Virginia Act. Payment of benefits in another state does not estop the employer from asserting the defense of failure to market remaining capacity. Johnson v. Associated Transportation Services, Inc., 69 O.I.C. 80 (1990).

    § 65.2-703. Interrogatories and depositions.

    1. Any party to a proceeding under this title may serve interrogatories or cause the depositions of witnesses residing within or without the Commonwealth to be taken, the costs to be taxed as other costs by the Commission. All interrogatories, depositions, or any other discovery shall conform to rules governing discovery promulgated by the Commission.
    2. The Commission shall adopt rules governing discovery conforming as nearly as practicable to Part Four of the Rules of the Virginia Supreme Court. Such rules shall be adopted in accordance with and pursuant to the Administrative Process Act (§ 2.2-4000 et seq.).

    History. Code 1950, § 65-91.1; 1968, c. 660, § 65.1-95; 1970, c. 470; 1991, c. 355; 1993, c. 694.

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 9 Discovery. § 9.03 Scope; § 9.05 Depositions; § 9.06 Interrogatories. Bryson.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 1 Courts. § 1.08 Workers’ Compensation Commission. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 56.

    CASE NOTES

    Appeal not authorized from discovery decisions. —

    As is clear by the plain language of the statute, § 65.2-703 does not provide an avenue of appeal from a Virginia Workers’ Compensation Commission decision to grant or deny discovery, which is separate and apart from a legal proceeding before that administrative body. Indeed, with the exception of provisions concerning appeals from fines and penalties levied by the Commission for failure to maintain evidence of compliance with the requirements of Title 65.2, the only provision concerning appeals from Commission action is found in § 65.2-706 . Green v. Keil Plumbing & Heating, Inc., 42 Va. App. 539, 593 S.E.2d 525, 2004 Va. App. LEXIS 108 (2004).

    Failure to respond to discovery. —

    Failure to respond to discovery can be penalized, but not without clear authority for such a penalty; Virginia Workers’ Compensation Commission can choose, in some circumstances, to exclude evidence when a party fails to disclose information during its discovery responses; however, there is no authority for the proposition that a deficiency in discovery responses relieves a claimant of its burden of proof. Lanning v. Va. DOT, 2003 Va. App. LEXIS 81 (Va. Ct. App. Feb. 19, 2003).

    Written answers. —

    Virginia Workers’ Compensation Commission acted within its discretion in denying a claimant attorney fees or, at minimum, reimbursement for the cost of deposing his treating physician because the Commission’s decision was in keeping with its own prior decisions and reflected a reasonable interpretation of its own rules; the physician cooperated in every possible way and provided adequate information via written answers to the questionnaires he was given, as well as extensive opinions. Wells v. Auto. Serv. Garage, 2018 Va. App. LEXIS 43 (Va. Ct. App. Feb. 20, 2018).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Also see notes under Rule 1.8.

    A claimant’s on-going award of medical benefits constitutes a sufficient issue or proceeding to allow the defendants to propound discovery concerning medical treatment. Greenwood v. B W I Distribution, VWC File No. 194-35-98 (May 13, 2005).

    Where the claimant is on an outstanding award there is a proceeding under the title such as to allow for discovery, and the Commission has the authority to require the production of documents and other things. Habina v. Jasper Construction, VWC File No. 173-22-55 (Aug. 26, 2005).

    The 21 day time frame contained in Rule 1.8 for providing answers to interrogatories also applies to request for production of documents. After a party has been provided the initial 21 days, it is within the discretion of the deputy commissioner to determine the time frame for responses to an Order to Compel. Habina v. Jasper Construction, VWC File No. 173-22-55 (Aug. 26, 2005).

    Section 65.2-703 asserts, inter alia, that all interrogatories, depositions, or any other discovery shall conform to rules governing discovery promulgated by the Commission, and that such rules shall conform as nearly as practicable to the Rules of the Virginia Supreme Court regarding discovery. The Commission has interpreted this Section to allow reasonable discretion to most efficiently administer the Act and to do justice for all parties, as may be suggested by the facts of a particular case. Magana v. Sosa, 79 O.W.C. 136 (2000).

    The scope of discovery in a Commission proceeding is determined not only by Commission Rule 1.8 but also by Supreme Court Rule 4:1(b)(1), which in part provides that, “[p]arties may obtain discovery regarding any matter, not privileged, which is relevant to the subject matter involved in the pending action, whether it relates to the claim or defense of the party seeking discovery or to the claim or defense of any other party.” Craft v. Commercial Courier Express, Inc., 78 O.W.C. 270 (1999).

    Claimant’s ongoing award for medical benefits constitutes an “issue” or “proceeding” pending before the Commission as those terms are used in Commission Rule 1.8 and in Virginia Code § 65.2-703 . Also, Virginia Code § 65.2-711 requires a claimant under an open award to inform the employer of his current residential address unless there is reasonable justification for refusing to do so. A residential address is not equivalent to a post office box address. Craft v. Commercial Courier Express, Inc., 78 O.W.C. 270 (1999).

    The employer is entitled to a determination of its rights and responsibilities in regard to a claimant’s condition even if the initial claim has been withdrawn. Specifically, the employer has a right to depose the claimant, any potential witnesses, and the diagnosing physician regarding the facts surrounding the accident while the events are fresh in people’s memories and documentation is still available. It is entitled to a final determination regarding its responsibility for indemnity lifetime and lifetime medical benefits and to establish appropriate reserves. Petty v. Duffie Graphics, Inc., 76 O.W.C. 306 (1997) (see also Silberman v. Prince William School Board, 76 O.W.C. 231 (1997)).

    An employee’s ongoing award of medical benefits constitutes a sufficient “issue” or “proceeding” before the Commission to allow the issuance of discovery requests under Rule 1.8(A). The employer sought leave to issue a subpoena to a third party entity, on whose premises the accident occurred, seeking information regarding the accident and a possible claim against the third-party. The employee was under a medical award, but no other matter was pending before the Commission, and the third party argued that the subpoena exceeded the scope of discovery under Commission rules. The Commission disagreed, finding that the claim remained before it on the open medical award, noting the impact that the discovery could have on the award and subrogation rights under Code §§ 65.2-309 and 65.2-310 . Johnson v. Laurel Trucking, Inc., VWC File No. 200-18-25 (August 29, 2001) see also Fields v. Labor Ready, Inc., VWC File No. 203-70-99 (November 16, 2001) (applying the same rule to demand for answers to interrogatories).

    Depositions:

    The deputy commissioner did not err in failing to admit claimant’s discovery deposition where employer objected, and claimant testified extensively at the hearing regarding the events surrounding his injury. Thaxton v. United Parcel Service, Inc., VWC File No. 218-71-85 (Feb. 1, 2005).

    The moving party must pay cost of deposition. Hernandez v. The Alexandria Hospital, 57 O.I.C. 172 (1977).

    Interrogatories:

    Where a claimant fails to file answers to Interrogatories over two and one-half years after their approval and after being advised the claim would be dismissed if a response was not received by a specific time, the Commission may dismiss the application on the basis that the inaction was an abandonment of claim. Peoples v. Marriott Hotel, 67 O.I.C. 25 (1988).

    Dismissal of a claim, with a condition that a new claim will be accepted only if outstanding discovery interrogatories are answered, is an appropriate sanction where there is chronic failure to file discovery responses. After a claim is dismissed without prejudice, it is treated as if no claim had been filed. Bryant v. Fieldcrest Cannon, Inc., 75 O.W.C. 184 (1996).

    A claimant’s inaccurate or incomplete answers to interrogatories concerning medical conditions which were unrelated to her carpal tunnel syndrome was not a bar to an award of compensation benefits. Davis v. Pannill Knitting Company, Inc., 66 O.I.C. 71 (1987).

    In workers’ compensation cases the parties will be required to provide upon request the identity and addresses of witnesses who may have knowledge of pertinent facts relating to the claim. Gary v. Thomas E. Gary Trucking, 69 O.I.C. 62 (1990).

    Where counsel fails to object or to provide the names, addresses and summary of facts and opinions of each witness as requested by interrogatories, it is appropriate to exclude the testimony of any witness for whom the requested information was not provided. Johnson v. Blue Ridge Talc Co., 69 O.I.C. 66 (1990).

    So long as a claimant remains under an open award, the employer has the right to discover medical evidence relevant to the claimant’s physical and medical condition. Discovery is permissible while a claimant is under an open award even in the absence of a pending application for hearing. Craft v. Commercial Courier Express, Inc., 78 O.W.C. 270 (1999).

    § 65.2-704. Hearing; award or opinion by Commission.

    1. The Commission or any of its members or deputies shall hear the parties at issue, their representatives, and witnesses; shall decide the issues in a summary manner; and shall make an award or opinion carrying out the decision.
    2. Any member of the Commission who hears the parties at issue and makes an award under the provisions of subsection A shall not participate in a rehearing and review of such award provided under § 65.2-705 .
    3. Hearings convened by the Commission shall be public proceedings and, upon proper request to the Commission, may, in the discretion of the Commission, be video recorded for public broadcast at the expense of the requesting party, subject only to the same limitations and conditions as apply to court proceedings in the Commonwealth.

    History. Code 1950, § 65-92; 1954, c. 370; 1962, c. 340; 1968, c. 660, § 65.1-96; 1980, c. 600; 1989, c. 318; 1991, c. 355; 1997, c. 225; 2003, cc. 664, 671; 2010, cc. 160, 564; 2012, c. 588.

    Cross references.

    As to prohibition on certain subrogation provisions and limitations upon recovery in insurance policies, see § 38.2-3405 .

    The 2003 amendments.

    The 2003 amendments by cc. 664 and 671 are identical, and substituted “by priority mail with delivery confirmation or equivalent mailing option” for “by registered or certified mail” at the end of the second sentence and added the third sentence of subsection A.

    The 2010 amendments.

    The 2010 amendments by cc. 160 and 564 are identical, and deleted “A copy of the award or opinion shall be sent immediately to the parties at issue by priority mail with delivery confirmation or equivalent mailing option. If any party at issue is represented by counsel, receipt of the award or opinion by counsel shall be deemed receipt by the party for purposes of subsection A of § 65.2-705 ” at the end of subsection A.

    The 2012 amendments.

    The 2012 amendment by c. 588, in subsection B, deleted the former second sentence, which read: “When a member is absent or is prohibited by the provisions of this subsection from sitting with the full Commission to hear a review, the Chairman shall appoint one of the deputies to sit with the other Commission members”; and made a minor stylistic change.

    Research References.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 1 Courts. § 1.08 Workers’ Compensation Commission. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 1A M.J. Administrative Law, § 11; For related discussion, see 21 M.J. Workers’ Compensation, §§ 62, 76.; 21 M.J. Workers’ Compensation, §§ 62, 76.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-96 or prior law.

    Copies must be mailed to individual parties. —

    Plain language of subsection A of § 65.2-704 makes it clear that copies of decisions must be mailed to the individual parties as well as to their counsel; if this is not done, the time limit for seeking review does not begin to run. Peacock v. Browning Ferris, Inc., 38 Va. App. 241, 563 S.E.2d 368, 2002 Va. App. LEXIS 294 (2002).

    Commission has authority to hear case de novo and will not be bound by the findings of the deputy. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Failure to have full commission hear review. —

    Decision reviewing the award of benefits to a claimant was reversed on appeal as the Virginia Workers’ Compensation Commission lacked authority to review the employer’s appeal of that decision as a result of having only two out of three statutorily required Commissioners hear the review due to a vacancy existing on the Commission. The employer had not waived the issued since it had raised the same in a motion to reconsider or vacate the decision. Hitt Constr. v. Pratt, 53 Va. App. 422, 672 S.E.2d 904, 2009 Va. App. LEXIS 76 (2009).

    Commission is not empowered to make rulings on issues not presented by the application for hearing and which the employer does not have notice that it will be required to defend. Fas Mart Convenience Stores, Inc. v. Tyndell, No. 1806-89-2 (Ct. of Appeals Oct. 9, 1990).

    Subsection B does not limit chairman’s authority. —

    Subsection B of this section empowers the chairman, individually, to name a deputy to act with the two members who are present and qualified but, in granting the chairman authority to act when the full Commission would not be available, the statute does not thereby limit the authority of the full Commission to act in other situations. Clinch Valley Med. Ctr. v. Hayes, 34 Va. App. 183, 538 S.E.2d 369, 2000 Va. App. LEXIS 835 (2000).

    Proceedings before the Commission are intended to be summary. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923).

    No strict conformity for hearings but minimal due process for review. —

    Hearings before the commission are not required to be held in strict conformity as are trials in common-law courts. However, the commission’s authority to consider an application for original injury benefits as an application for review on change of condition is not without limitation. The procedure utilized must afford the parties minimal due process. Fas Mart Convenience Stores, Inc. v. Tyndell, No. 1806-89-2 (Ct. of Appeals Oct. 9, 1990).

    “On the record” procedure satisfied due process. —

    Because no genuine controversy existed, the “on the record” hearing procedure utilized by the deputy commissioner met the requirements of due process. Duncan v. ABF Freight Sys., 20 Va. App. 418, 457 S.E.2d 424, 1995 Va. App. LEXIS 456 (1995).

    Witnesses not necessary to prove matters agreed upon. —

    This section does not mean that witnesses must be heard in extenso to prove matters upon which the parties may agree. Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573, 1946 Va. LEXIS 136 (1946).

    The opinion of an independent medical expert, selected by the Commission pursuant to former § 65.1-90 (now § 65.2-606 ), is subject to the same examination and challenge as that of any other witness and to hold otherwise would result in a transfer to the independent medical examiner of the commission’s role as finder of fact and such a holding would contradict subsection A, which assigns the commission responsibility to decide all issues presented before it. Island Creek Coal Co. v. Honaker, 9 Va. App. 336, 388 S.E.2d 271, 6 Va. Law Rep. 1218, 1990 Va. App. LEXIS 13 (1990).

    Hearsay statements are admissible in evidence before Commission. —

    The Compensation Commission is not governed in its decisions by common-law rules of evidence, and hearsay statements are properly admissible in evidence before it. The Commission has the discretion to give probative weight to hearsay statements in arriving at its findings of facts. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958).

    Hearsay statements may be given probative weight. —

    Commission’s broad statement that it could not rely on history taken from a claimant to determine how an accident occurred was contrary to the common law principles enunciated in appellate court decisions but more importantly, was contrary to Workers’ Compensation Rule 2.2 which gives the Commission the discretion to give probative weight to hearsay statements in arriving at its finding of facts. Pence Nissan Oldsmobile v. Oliver, 20 Va. App. 314, 456 S.E.2d 541, 1995 Va. App. LEXIS 417 (1995).

    Relation of Commission to award. —

    After an award, and during the whole compensation period applicable to the injury in question, the relation of the Commission to the award is that of a court to a judgment during the term at which it is rendered. American Mut. Liab. Ins. Co. v. Hamilton, 145 Va. 391 , 135 S.E. 21 , 1926 Va. LEXIS 399 (1926); Old Dominion Land Co. v. Messick, 149 Va. 330 , 141 S.E. 132 , 1928 Va. LEXIS 369 (1928).

    The Commission is not required to state the evidence on which it bases its findings of fact, but only its findings of fact. In the instant case the findings of fact of the Commission did set out some of the evidence upon which its findings were based, and this is the better practice, but the Commission was under no obligation to give the details of the evidence, and it cannot be gotten from any other source. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923) (see Berry v. F.S. Royster Guano Co., 161 Va. 442 , 171 S.E. 519 (1933)).

    Deputy commissioner’s findings as to credibility not necessarily binding. —

    A specific, recorded observation of a key witness’ demeanor or appearance in relation to credibility is an aspect of the hearing that the Commission may not arbitrarily disregard. However, the deputy commissioner’s findings as to credibility do not necessarily bind the Commission. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Court rejected an employer’s contention that the Virginia Workers’ Compensation Commission erroneously deferred to the deputy commissioner’s findings, as the record showed that the Commission explicitly rejected any reliance upon the deputy commissioner’s credibility determination, reviewed the entire record, and made its own determination as to the credibility of the witnesses and the sufficiency of the evidence. Clinchfield Coal Co. v. Bowman, 2003 Va. App. LEXIS 706 (Va. Ct. App. Dec. 30, 2003).

    Commission entitled to defer to deputy commissioner’s findings. —

    There was no error in the decision of the Virginia Workers’ Compensation Commission to defer to a deputy commissioner’s findings and affirm the deputy commissioner’s decision, which found that a claimant failed to prove that he sustained an injury by accident arising out of and in the course of his employment, because: (1) the Commission reviewed and summarized the relevant testimony and medical records, and then noted the deputy commissioner’s findings, including his credibility determinations; (2) the Commission implicitly recognized that those findings were based upon the substance of the witnesses’ testimony and the medical records considered by the deputy commissioner and the inconsistencies therein; and (3) the Commission was entitled to defer to the deputy commissioner’s findings when it did not hear the case de novo, under former § 65.1-96 (now § 65.2-704 ) and former § 65.1-97 (now § 65.2-705 ). Petraitis v. Prevent Blindness Am., 2007 Va. App. LEXIS 427 (Va. Ct. App. Dec. 4, 2007).

    When full Commission does not hear witness’ testimony, deputy’s observations about witness credibility become a part of the evidence which the Commission may not arbitrarily ignore and dismiss. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Evidentiary proffer needed in order to allow earlier deposition. —

    Deputy commissioner did not abuse his discretion in refusing to allow deposition from an earlier claim to be used at hearing notwithstanding the lack of an evidentiary proffer. Piedmont Mfg. Co. v. East, 17 Va. App. 499, 438 S.E.2d 769, 10 Va. Law Rep. 681, 1993 Va. App. LEXIS 642 (1993), disapproved, Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    After-discovered evidence. —

    Disability certificate signed by a doctor almost two years before a deputy commissioner for the Virginia Workers’ Compensation Commission heard an employee’s claim for workers’ compensation benefits was not after-discovered evidence, and the Commission did not err by refusing to consider it after the employee failed to present it to the hearing officer, but submitted it as part of the package she presented to the Commission when she appealed the deputy commissioner’s decision denying her claim. Johnson v. Region Ten Cmty. Serv., 2003 Va. App. LEXIS 451 (Va. Ct. App. Aug. 26, 2003).

    Res judicata. —

    In a proper case principles of res judicata may be applied. Absent fraud or mistake, the decisions of the Commission or its deputy commissioners from which no party seeks timely review are binding upon the Commission. Unless otherwise prescribed by statute, the relationship of the Commission to an award is that of a court to a judgment during the term at which it is rendered. K & L Trucking Co. v. Thurber, 1 Va. App. 213, 337 S.E.2d 299, 1985 Va. App. LEXIS 88 (1985).

    Issue of deputy’s participation in review of case would not be considered for first time on appeal, since claimant failed to move to reconsider or vacate opinion during thirty-day period that it remained within commission’s jurisdiction. Juarez v. C. Woolfrey Constr., 1999 Va. App. LEXIS 370 (Va. Ct. App. June 22, 1999).

    The doctrine of res judicata is applicable to decisions of deputy commissioners and the full commission and generally precludes the re-litigation of a claim or issue once a final determination on the merits has been reached. Boyer v. Sundown Express, Inc., 2000 Va. App. LEXIS 788 (Va. Ct. App. Dec. 5, 2000).

    Due process. —

    Appellants were afforded due process because they were apprised of the pendency of the action and were given an opportunity to present their objections, and they cited no law that the commission had to address all of the defenses asserted in a matter in order to comport with due process. Target Corp. v. Hussein, 2014 Va. App. LEXIS 279 (Va. Ct. App. Aug. 12, 2014).

    “Cause of action” for res judicata purposes is defined as an assertion of particular legal rights which have arisen out of a definable factual transaction. A contested matter before the Commission is such a cause of action. K & L Trucking Co. v. Thurber, 1 Va. App. 213, 337 S.E.2d 299, 1985 Va. App. LEXIS 88 (1985).

    Doctor’s report not binding in view of conflicts within it. —

    The Commission, as fact finder, was not bound by the portion of the doctor’s report that supported a causal connection between the original accident and the disability, in view of the apparent conflict in the report and two exacerbating non-work-related incidents. Hoskins v. St. Joseph Leasing Corp., No. 0323-85 (Ct. of Appeals Dec. 23, 1985).

    Review of ruling based on claimant’s appearance and demeanor. —

    When the deputy commissioner’s finding of credibility is based, in whole or in part, upon the claimant’s appearance and demeanor at the hearing, the Commission may have difficulty reversing that finding without recalling the witness. On the other hand, if the deputy commissioner’s determination of credibility is based on the substance of the testimony and not upon the witness’ demeanor and appearance, such a finding is as determinable by the full Commission as by the deputy. Only when the deputy’s finding as to credibility is specifically based upon the witness’ appearance and demeanor is a due process question raised. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Reasons for believing one witness over another need not be stated. —

    The law does not require the Commission to state its reasons for believing one witness over another. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Consideration of evidence. —

    There was no merit to an employer’s claim that the Workers’ Compensation Commission had not addressed and analyzed whether the claimant had proven a mechanical or structural change in his lumbar spine as a result of his accident. Although the Commission had not specifically mentioned a physician’s statement that the claimant had not experienced a mechanical or structural change in his spine, it could be inferred from the record and the content of the Commission’s opinion that it had considered the isolated statement but gave it no weight in light of the claimant’s testimony and the overwhelming medical evidence to the contrary. CVS # 00871 VA Distrib., Inc. v. Brett, 2007 Va. App. LEXIS 376 (Va. Ct. App. Oct. 9, 2007).

    When an employer offers selective employment to an injured employee suitable to his residual capacity, the burden of persuasion shifts to the employee to show justification for refusing the offer; this principle is equally applicable to cases involving the refusal to participate in vocational rehabilitation offered under § 65.2-603 . Ilg v. UPS, Inc., 284 Va. 294 , 726 S.E.2d 21, 2012 Va. LEXIS 128 (2012).

    Employee was not precluded from asserting that his refusal of vocational rehabilitation was justified because he remained fully disabled by his hand injury related to the industrial accident for which he was receiving benefits for his compensable knee injury. Ilg v. UPS, Inc., 284 Va. 294 , 726 S.E.2d 21, 2012 Va. LEXIS 128 (2012).

    Award supported by sufficient evidence. —

    Where a claimant reported his work-related inguinal hernia in a timely manner, the medical record was consistent with his report of injury to his doctors, and his claim that he was in good health before his alleged accident was corroborated by other evidence, the evidence supported the Virginia Workers’ Compensation Commission’s finding that he proved an identifiable incident resulting in compensable injury; the existence of some contrary evidence was immaterial. Clinchfield Coal Co. v. Bowman, 2003 Va. App. LEXIS 706 (Va. Ct. App. Dec. 30, 2003).

    Award and opinion did not fully carry out decision. —

    Case was remanded to the Virginia Workers’ Compensation Commission because its award and opinion did not fully carry out its decision or provide the named parties with complete relief. Jeffreys v. Uninsured Employer's Fund, 2017 Va. App. LEXIS 249 (Va. Ct. App. Oct. 3, 2017), aff'd, 297 Va. 82 , 823 S.E.2d 476, 2019 Va. LEXIS 8 (2019).

    CIRCUIT COURT OPINIONS

    No right to subrogation against legal malpractice proceeds. —

    Employer and its workers’ compensation insurer were not entitled to a lien against the verdict that an employee obtained in a medical malpractice suit against a doctor because the employer and insurer were compelled to provide workers’ compensation benefits as a result of the on-the-job accident and not as a result of the doctor’s medical negligence; the employer was required to provide compensation benefits to the employee or on his behalf, but the award orders of the Workers’ Compensation Commission conclusively established that those benefits were for the employee’s broken leg, not for damages caused by a third party. Thompson v. Alhadeff, 2011 Va. Cir. LEXIS 137 (Roanoke Oct. 11, 2011).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Notice:

    Pre-Hearing Statement referenced in the Notice of Hearing properly apprised defendants of additional claims being made; those additional claims may be considered at hearing. Dewey v. Cowan Distribution Services, JCN VA00000907306 (Oct. 16, 2018).

    At the hearing, the claimant was permitted to amend his claims to include an additional period of disability over the defendants’ objection because the defendants had sufficient evidence of the additional dates, and included the date the claimant was taken out of work in their medical evidence. The additional period of disability was brief and the defendants were not denied the opportunity to confront and cross-examine the evidence of disability. Saville, Jr. v. Spichers Appliance, Inc., JCN VA00000657794 (Sept. 30, 2013).

    Commission did not violate employer’s due process rights by failing to send hearing notice to its third party administrator where the Commission notified both employer and insurer of scheduled hearing. Hayes v. Cadmus Specialty Publication, VWC File No. 215-94-05 (June 29, 2004).

    Counsel for employee and employee’s own representations that neither received notice of hearing accepted; dismissal for failure to appear at hearing vacated and new hearing ordered. Lewis v. D.A. Foster Co., VWC File No. 191-21-58 (Dec. 30, 2003).

    Attorney fee assessment appropriate when employer and insurer received notice of hearing but did not appear at hearing, and offered no argument how award entered after hearing was improper or unsupported by evidence; separate notice not required to be sent to claims adjuster. Simons v. Federal Painting, Inc., VWC File No. 210-75-01 (June 20, 2003).

    Deputy Commissioner’s fee assessment inappropriate although insurer failed to appear at hearing; insurer did not issue coverage for employer when notice of hearing received, and notice indicated employer not insured; insurer not notified it did provide coverage until day before hearing; notice sufficient to conduct hearing, but not to assess fees. Broughton v. Craven Hall Adult Home, Inc., VWC File No. 206-25-45 (Apr. 18, 2003).

    An elementary and fundamental requirement of due process, in any proceeding that is to be accorded finality, is notice reasonably calculated under all the circumstances to apprise interested parties of the action and afford them an opportunity to present their objections. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Due process requires that an individual be granted an opportunity for a hearing appropriate to the nature of his case before he is deprived of any significant property interest. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Where the employer was not given notice that a change in the treating physician was an issue to be decided by the Deputy Commissioner, that issue was not properly before the Commission at the evidentiary hearing and the finding on that question must be Vacated. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Fees for medical services arising out of compensable injuries are subject to the jurisdiction of the Virginia Worker’s Compensation Commission. Here, the health care provider availed himself of the Commission’s jurisdiction and initiated the proceeding that contested medical expenses. Although the health care provider did not affirmatively file a pleading to join in the proceeding, he was designated a party and was sent copies of correspondence and the final Opinion, and had notice of his right to appeal. The fact that the health care provider elected not to participate in the on-the-record proceeding is not sufficient to prevent him from being bound by the final Opinion. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    The Commission found that there was a compensable accident, and that the claimant’s medical treatment was related to the accident. The claim of the health care provider to recover the cost of its services was denied, because the treatment was not reasonable and necessary. Since the health care provider availed himself of the Commission’s jurisdiction and is bound by that decision denying a recovery, he no longer has a cause of action for the subject charges against either the claimant or the employer/insurer. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    Law of the Case, Res Judicata:

    Claim to add shoulder injury barred by res judicata where prior stipulations omitted that injury and agreed that the Order entering the stipulations alleviated the need for a hearing. Hall v. First Care Health Services, Inc., JCN VA00001015991 (Oct. 20, 2017).

    The doctrine of res judicata proceeds upon the principle that one person shall not the second time litigate precisely the same question, particular controversy, or issue, which has been necessarily tried and finally determined, upon the merits, by a court of competent jurisdiction, in a judgement in personam in a former suit. The Commission held that res judicata was not applicable to a jurisdictional challenge of whether the claimant was an employee under the Act, where that question had never been litigated, where the employer had simply signed a Memorandum of Agreement, relying on the claimant’s representations that she was legally eligible to work. Quezada v. P M M C Associates, Inc., 79 O.W.C. 46 (2000).

    The “law of the case” doctrine provides that, where there have been two appeals in the same case, between the same parties, and the facts are the same, nothing decided on the first appeal can be reexamined on a second appeal. Right or wrong, it is binding on the trial court and the appellate court, and is not subject to reexamination by either. The rule also applies where the question raised on the second appeal was necessarily involved in the first appeal, whether actually adjudicated or not. Under the doctrine of the law of the case, the issue previously decided must be the basis for the tribunal’s decision. Dictum or closely related statements made about portions of the case not under consideration are not within the rule. Only a particular point urged and considered by the tribunal falls within the doctrine of the law of the case. Hayes v. 4 E Corporation, 78 O.W.C. 147 (1999).

    The claimant suffered compensable injuries on November 5, 1983. The carrier subsequently informed the Commission that the 500 weeks of total benefits expired on June 10, 1993, and that the last payment had been made. On June 1, 1994, the claimant filed an application alleging a change in condition and seeking permanent total disability benefits. In its September 13, 1996 Opinion denying the claim, the Commission reported that the claimant last received benefits under an award on December 13, 1993. The claimant appealed to the Court of Appeals, which affirmed. On November 5, 1996, the claimant filed another application for permanent total disability benefits. The claimant argued that the earlier Opinions reporting that benefits were paid through 1994 was binding in future proceedings in this case, under the theory that these findings were now the “law of the case.” The Commission disagreed, holding that the earlier “findings” were not a conclusion of law or a finding of f act to which the doctrine of the law of the case applies, because the earlier decision did not turn on when payments were last made, and the erroneous statement played no role in the decision denying the 1994 claim, which was based solely on the finding that the claimant failed to prove he was unable to use his right hand and leg to any substantial degree in gainful employment. Hayes v. 4 E Corporation, 78 O.W.C. 147 (1999).

    Pre-Hearing Issues:

    The purpose of a pre-trial hearing is to determine whether the Commission has jurisdiction. Harris v. Va. Elec. & Power Co., 54 O.I.C. 165 (1972).

    Where the employer establishes by clear and convincing evidence that the claimant was not legally eligible to work in the United States at the time of her hire and accident, that the claimant intentionally and fraudulently misrepresented her employment status to the employer, and that the employer reasonably and justifiably relied upon those representations to its detriment when it hired her and later agreed to the entry of an award of compensation benefits, the claimant’s fraud and misrepresentation resulted in an imposition on the Commission, and the Commission lacked subject matter jurisdiction to enter the award of compensation benefits. Quezada v. P M M C Associates, Inc., 79 O.W.C. 46 (2000).

    For the purpose of evaluating work capacity, the employer and insurance representative are entitled to have the benefit of a physical capacities evaluation form executed by the attending physician. Written communication or depositions are the appropriate means for obtaining the physician’s opinion. Carter v. City of Falls Church Public Utilities, 69 O.I.C. 151 (1990).

    An employee is free to gather additional medical evidence prior to a hearing. He is not obligated to notify the employer or seek approval for examinations by other physicians. Pena v. Parcom Floor Systems, 70 O.I.C. 77 (1991).

    It is proper for the Commission to refuse to issue a subpoena duces tecum where the contracts sought were immaterial to the employment status of the deceased employee. Deacon v. Atlantic Lumber Co., 52 O.I.C. 78 (1970).

    Subpoenas of the Commission shall be served by officers designated in this section. Service of process by counsel is not valid service. Thompson v. AMF, Inc., 57 O.I.C. 348 (1976).

    A party seeking to enforce discovery must file a timely motion to compel discovery in the office where the case is assigned to be heard. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    The claimant alleged an injury by accident on February 16, 1995 by claim filed February 13, 1997. On June 24, 1997, the deputy commissioner dismissed the claim for her failure to answer interrogatories and execute medical releases in a timely manner. Claimant moved to vacate the order on July 1, 1997. The deputy commissioner vacated her dismissal order on July 21, 1997. Defense counsel on July 28, 1997 filed a motion to reconsider the order to vacate, simultaneously filing a request for review of that order. The Commission held that the deputy commissioner was without jurisdiction to reconsider, amend, or vacate her June 24, 1997 dismissal order, on July 21, 1997, and the dismissal order was still valid. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    For the purpose of determining eligibility for cost-of-living benefits the Commission has the authority to require a claimant to present information concerning whether an application for Social Security benefits was filed and the outcome. However, an employer may not require a claimant to sign an authorization to receive federally protected information when no claim has been made for cost-of-living benefits. Singleton v. Fairfax Hospital Association, 68 O.I.C. 226 (1989).

    Continuances:

    The Deputy Commissioner did not abuse her discretion in denying the defendants’ continuance request where the hearing notices had been mailed; the insurer was advised to retain counsel; after the letter of representation from defense counsel there was no inquiry of the hearing date or request for a copy of the file; and the claimant’s counsel copied defense counsel on need for a translator, which referenced the date and time of hearing. Nogales-Sanchex v. Forever 21, Inc., VWC File No. 235-99-03 (Aug. 18, 2008).

    It is within the discretionary power of the deputy commissioner to grant or deny motions to continue a case to allow for mediation. Surrett v. Paramont Coal Co., VWC File No. 211-17-53 (May 9, 2007).

    It is within the discretionary power of the Deputy Commissioner to grant or deny motions to continue a case. Leeson v. Washington County School Board, 76 O.W.C. 193 (1997).

    Rule 2 (now Rule 2.2 A), of the Commission relating to continuances is a reasonable one and failure of claimant to appear does not, of itself, constitute a proper ground for continuing the case. Nicholson v. Clinchfield Coal Corp., 154 Va. 401 , 153 S.E. 805 , 1930 Va. LEXIS 222 (1930).

    The Commission is not required to grant a continuance or to allow an employee to withdraw an “Application for Hearing.” Keenan v. Westinghouse Elevator Co., 10 Va. App. 232, 391 S.E.2d 342, 6 Va. Law Rep. 2276, 1990 Va. App. LEXIS 75 (1990).

    Where the claim was filed January 15, 1997, but interrogatories were not propounded by the employer until April 21, 1997, and the Motion to Compel was not filed until May 20, 1997, the Deputy Commissioner did not abuse his discretion in finding that the filing of the motion just ten days before the hearing left him insufficient time to issue an order compelling the claimant to respond and for counsel to receive the answers, and the Deputy Commissioner did not abuse his discretion in refusing the employer’s request for a continuance. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    Nonsuit:

    A nonsuit cannot be used to extend the provision of Commission Rule 1.2(B); the Commission does not follow the provisions of Code § 8.01-229 (E)(3). Reynolds v. Banker Steel Company, LLC, JCN VA00001157598 (Aug. 15, 2018).

    A claimant’s voluntary nonsuit does not toll the statute of limitations of Code § 65.2-601 . Morneault v. Tidewater Temps Inc., VWC File No. 202-31-60 (July 26, 2004).

    There is no provision in the Rules of the Commission regarding a nonsuit. The Commission has followed § 8.01-380 and allowed a party to nonsuit a claim at any time prior to its being submitted for decision. While Code § 8.01-380 states that only one nonsuit may be taken against a party to the proceedings, it also provides that the court may allow additional nonsuits. However, a party may not obtain two nonsuits as a matter of right, and nonsuits are not condoned on the day before hearing. Norman v. Reynolds Metal Co., 75 O.W.C. 353 (1996).

    The Commission has historically conformed to the Civil Nonsuit Section, Virginia Code § 8.01-380 , and allowed a nonsuit any time before the hearing record was closed and the claim submitted to the Deputy Commissioner for a decision. A nonsuit is not allowed after a decision has been rendered. Worrell v. Samax Eggleston, et al., 75 O.W.C. 158 (1996) (see also Emmert v. York International Corporation, VWC File No. 201-28-89 (October 31, 2001)).

    Va. Code Ann. § 8.01-380 (B) provides that a claimant may have one voluntary non-suit as a matter of right. When the claimant petitions for relief to withdraw his claim a second time, it is left to the discretion of the hearing officer to determine whether the dismissal will be with prejudice or without prejudice. Zirkle v. Rocco Farms, 78 O.W.C. 36 (1999).

    The standard for review as to nonsuits is whether the Deputy Commissioner abused her discretion by granting it. Where the record fails to state the reason the nonsuit was requested or the rationale for granting it, the Commission cannot state that discretion was abused. Norman v. Reynolds Metal Co., 75 O.W.C. 353 (1996).

    The claimant sought to withdraw his request for nonsuit 22 hours after it was communicated to the Deputy Commissioner, when he realized that the effect of such nonsuit would be to extinguish his claim. This harsh result is inconsistent with the beneficent purposes of the Act. The purpose of the Workers’ compensation Act is to protect the employee and avoid harsh results inconsistent with such purposes, and the Deputy Commissioner erred in denying the motion to vacate. Leeson v. Washington County School Board, 76 O.W.C. 193 (1997).

    Hearing:

    General:

    Also see Notes to Rule 2 and Rule 3.

    Prior testimony in a criminal proceeding by deceased witness is admissible in a workers’ compensation case if the requirements of Gray v. Graham, 231 Va. 1 , 341 S.E.2d 153 (1986) are met. Campbell v. Campbell’s Ceramic Supply, Inc., VWC File No. 222-30-83 (Feb. 8, 2006).

    Where employer showed blatant disregard for Commission’s discovery orders, deputy commissioner properly struck defense to the compensability of the accident and prohibited testimony of witnesses on this issue. Branham v. Runk & Pratt of Forest, VWC File No. 213-15-02 (Sept. 1, 2004).

    Denial of evidentiary hearing is appropriate in permanent partial disability case where deputy commissioner can make a reasoned and accurate determination of the extent of loss of use by reference to the medical records and depositions of the treating physician. Edeline v. JTE, Inc., VWC File No. 204-28-62 (June 9, 2004).

    The parties are entitled to a fair but expeditious hearing and decision, but the Commission must apply certain constraints to the litigation. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    A copy of the hearing Opinion sent to counsel satisfied the Commission’s obligation to send copies to “the parties at issue.” Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    Dismissal of a claim, with a condition that a new claim will be accepted only if outstanding discovery interrogatories are answered, is an appropriate sanction where there is chronic failure to file discovery responses. After a claim is dismissed without prejudice, it is treated as if no claim had been filed. Bryant v. Fieldcrest Cannon, Inc., 75 O.W.C. 184 (1996).

    The “Deadman’s Statute,” § 8.01-397 , does not apply in workers’ compensation cases. Armada, Inc. v. Lucas, 2 Va. App. 414, 345 S.E.2d 14, 1986 Va. App. LEXIS 288 (1986).

    Section 8.01-398 , which provides that a spouse shall not testify without the consent of the other “as to any communication privately made by one to the other while married,” even if and after the marriage relation ceases, must be observed in cases before the Workers’ Compensation Commission. The spousal privilege to exclude private communications applies to words and acts intended to be concealed, even if witnessed by a third party. Wright v. Harrison’s Supermarket, 75 O.W.C. 195 (1996).

    Rule 1 (now Rule 2.2) of the Commission releases it from complying with the statutory or common law rules of pleading or technical rules of practice. Therefore, it is not appropriate for the Commission to grant a motion to strike or summary judgment until after the entire record has been reviewed. Francisco v. O’Sullivan Industries, 70 O.I.C. 132 (1991).

    The Commission is not required to provide a language translator at hearings. Doulgerakis v. Captain Georges Seafood Restaurant, 71 O.W.C. 105 (1992).

    The Commission’s on-the-record hearing procedures meet the constitutional due process requirements by giving a party a specific period of time in which to note objections to evidence filed and to request an ore tenus hearing based upon identification of other evidence which would be presented at such hearing. Williams v. Virginia Electric & Power Company, 18 Va. App. 569, 445 S.E.2d 693 (1994); 71 O.W.C. 101 (1992).

    Certain issues, such as those involving medical questions, can be fully and fairly determined from documentary evidence and do not require an evidentiary hearing. Contested matters that involve the credibility of a witness or party are not appropriate for on the record determinations. Where inconsistent medical opinions are based on different assessments of the employee’s subjective statements, the employee’s credibility is in issue and an on the record determination is inappropriate. Stanley v. Westmoreland Coal Co., 75 O.W.C. 91 (1996).

    Whether asthma may be caused by dust and mites and is therefore an ordinary disease of life is not a fact commonly known from human experience, and the Commission may not take judicial notice of such “fact.” Ruiz v. Abbotts Upholstery, 75 O.W.C. 213 (1996).

    The striking of evidence is an extraordinary action taken only in response to an egregious action, such as the failure to comply with Commission orders and directives. Hassell v. Arlington County Human Services, 79 O.W.C. 141 (2000).

    Where an employer’s motion to strike is granted and the Commission subsequently determines that there was a prima facie case of a compensable industrial accident, the proper procedure is to remand the case to the hearing docket in order for the employer to have an opportunity to present evidence on the merits of its position on the claim. U.S. Gypsum Co. v. Searles, 9 Va. App. 488, 389 S.E.2d 177, 6 Va. Law Rep. 1365, 1990 Va. App. LEXIS 35 (1990).

    Where the issue alleged in the Employer’s Application For Hearing was that the claimant had returned to light duty work at earnings less than his pre-injury average weekly wage, the Deputy Commissioner properly terminated the outstanding Award and entered an Award for temporary partial disability. McRea v. Int’l Sewer Service, Inc., 75 O.W.C. 71 (1996).

    A party that alleges material evidentiary fraud in the case presented to the Commission must raise the issue at the evidentiary hearing or within the time allowed for review or appeal. Pollard v. First General Services, 77 O.W.C. 259 (1998).

    Reconsideration, Request for Review or Vacating Decision:

    A request for review of a decision or award of the Commission must be filed in writing by a party within twenty days of the date of such decision or award. Barrett v. University of Virginia, 74 O.W.C. 49 (1995).

    The Deputy Commissioner retains jurisdiction over Orders and Awards for twenty days from issuance, during which time he may vacate, amend, or reconsider his decision. Leeson v. Washington County School Board, 76 O.W.C. 193 (1997).

    A Deputy Commissioner has the authority to reconsider a decision within the twenty days subsequent to an order before it becomes final. Barring a pleading based on fraud or mistake, the Deputy Commissioner loses jurisdiction to vacate an award after twenty days of the entry of that award. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    A Deputy Commissioner maintains control and retains jurisdiction over a claim only for twenty days after issuing an Opinion. However, where the Deputy Commissioner vacates his original opinion, he has jurisdiction to issue a subsequent opinion, even a year later. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    Where the Deputy Commissioner writes that he grants the request for reconsideration and will issue a new opinion on the merits, the effect of such language is to vacate his original decision and to preserve his jurisdiction to issue another opinion. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    Whether an application to set aside an award of the Commission is seasonably presented must necessarily depend upon the facts and circumstances of the particular case. If an application to vacate an award of the Commission is made on the ground of fraud or mistake, the Commission retains authority to act upon any relevant evidence offered in support of the motion. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    A Motion For Reconsideration does not substitute for a request for a review. Ferguson v. Olsten Kimberly Quality Care, 76 O.W.C. 52 (1997).

    The Commission permits parties to file requests for reconsideration. However, requests for reconsideration are different from requests for review. A request for reconsideration does not toll the statute for filing a review request. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    An application to vacate is not, strictly speaking, an application for a review. A request that a deputy reconsider to vacate an order does not preserve the claimant’s rights to challenge the deputy’s decision on review if the deputy denies or does not consider the motion within the twenty-day period before the order becomes final. Therefore, unless counsel files a motion for reconsideration or a motion to vacate in the alternative with a petition for review, the Commission’s jurisdiction to act upon its order expires with the passing of the twenty-day period. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    Representation at Hearing:

    A nonlawyer representative of the carrier may request review of a Commission decision, but arguing the case ore tenus or by brief constitutes the practice of law and will be heard only from licensed attorneys. Smith v. Orange Livestock Market, Inc., 75 O.W.C. 129 (1996).

    Proceedings before the Commission constitute practice before a tribunal, so only attorneys licensed to practice law in Virginia may represent another person before the Commission. A nonlawyer may request a hearing or submit a petition for review for another person, and the provisions of Rule 1.9 of the Rules of the Commission allows nonlawyers to submit arguments for a party in Informal Dispute Resolution proceedings. Pannell v. Gerdy Construction Co., Inc., 75 O.W.C. 219 (1996).

    An employer has standing to file an Application For Hearing to establish its rights and obligations under the Virginia Act. Harrison v. City of Portsmouth School Bd., 75 O.W.C. 305 (1996).

    Representation of parties before the Commission constitutes practice of law and defendant’s representatives will not be permitted to represent the corporation if they are not licensed attorneys. Hewitt v. Norfolk Shipbuilding & Drydock Corp., 51 O.I.C. 121 (1969).

    Representation of parties before the Virginia Workers’ Compensation Commission constitutes the practice of law. A proper person may appear pro se , but a corporate party may appear only through an attorney licensed to practice law in Virginia. A nonlawyer employee/agent of a corporate party may request a hearing or review, and offer written argument in a matter before the Commission’s Informal Dispute Resolution Department, pursuant to Rule 1.9 of the Rules of the Commission. However, nonlawyers may not represent a party in ore tenus proceedings before the Commission, or file written argument or other pleadings in a case referred for review. Washington v. City of Richmond Fire Dept., 75 O.W.C. 347 (1996).

    Illinois counsel advised that he would not associate Virginia counsel regarding this claim, and he refused to allow defense counsel to contact the claimant. The Commission held that the claimant was therefore deemed to be proceeding pro se in Virginia, and the employer was therefore granted permission to contact the claimant directly, until he retained Virginia counsel. Vercoe v. Air Wisconsin, 76 O.W.C. 288 (1997).

    Failure to Appear:

    Attorney fee assessment appropriate when employer and insurer received notice of hearing but did not appear at hearing, and offered no argument how award entered after hearing was improper or unsupported by evidence; separate notice not required to be sent to claims adjuster. Simons v. Federal Painting, Inc., VWC File No. 210-75-01 (June 20, 2003).

    An application may be dismissed with prejudice if a Deputy Commissioner is convinced that a party is abusing the hearing process. If the non-appearance may be the result of failure to receive notice of the hearing or other reasonable explanation, a Show Cause hearing should be scheduled. Green v. Goodwin House, Inc., 70 O.I.C. 68 (1991).

    Notice to counsel of record of a hearing date is proper notice to the employee/client. Where the employee fails to appear at the hearing and sufficient evidence to sustain the burden of proof is not presented, it is proper to dismiss the claim. McGuinn v. National Linen Service, 69 O.I.C. 61 (1990).

    Although application for hearing may make out a case, claim will be dismissed if party fails to appear and offer evidence in support of claim. Loehr v. Seward Lumber Co., Inc., 51 O.I.C. 155 (1969).

    Admissions and Stipulations:

    The initial claim listed left knee and right hip injuries but the Stipulated Award Order referenced injuries to the left lower extremity. A claim for a right hip filed almost three years after the accident was barred by the statute of limitations. With the entry of the Stipulated Award Order listing only the left lower extremity, the claim for a right hip injury was merged into that award, waived, or abandoned. As distinguished from facts in similar cases, the insurance carrier did not pay benefits for a brief period of treatment to the right hip. Swain v. City of Petersburg Social Services, VWC File No. 214-93-41 (Sept. 4, 2007).

    Admissions and stipulations made in good faith should be encouraged. Coley v. Southeastern Tidewater Area Manpower Authority, 221 Va. 859 , 275 S.E.2d 598 (1981).

    While the Commission encourages stipulations to narrow disputed issues and avoid unnecessarily litigious hearings, an employee is not obligated to admit facts not within his personal knowledge. Foster v. Hooker Furniture Corp., 75 O.W.C. 355 (1996).

    Once parties stipulate to the facts of a claim, they are bound by those stipulations. Pinto v. Williams, 75 O.W.C. 255 (1996).

    Stipulations made at hearing regarding the compensability of the claim cannot be withdrawn based on medical evidence developed after the proceeding where the employee had ample opportunity to investigate and develop evidence prior to the hearing. Watson v. Quality Assistance, 70 O.I.C. 65 (1991).

    Burden of Proof:

    While claimant may offer alternative theories of recovery, he may not offer two conflicting sets of facts as to cause of accident. Bruney-Divens v. Community Corrections Administration, JCNs VA000000656197 and VA000000667552 (Sept. 16, 2015), aff’d, No. 1588-15-1 (Va. Ct. App. May 3, 2016).

    In order to recover on a workers’ compensation claim, a claimant must prove (1) an injury by accident, (2) arising out of and (3) in the course of his employment. The burden is upon the claimant to prove the foregoing by a preponderance of the evidence. Morgan v. City of Norfolk School Board, 76 O.W.C. 359 (1997).

    A party’s evidence can rise no higher than his own testimony. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    The claimant bears the burden of proving that his injury arose out of his employment. The phrase “arising out of” refers to the origin or cause of the injury. An injury arises out of the employment when there is apparent to the rational mind upon consideration of all the circumstances, a casual connection between the conditions under which the work is required to be performed and the resulting injury. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    The claimant has the burden of proving by a preponderance of the evidence that he suffered a compensable injury by accident on March 6, 1995. A compensable injury is one caused by an accident arising out of and in the course of the employment. To prove an injury by accident, the claimant must establish an identifiable incident that occurred at a reasonably definite time, with a sudden mechanical or structural change in the body, and a causal connection between the incident and that bodily change. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    To prove that the injury arose out of the employment, a claimant must establish a causal connection between the conditions under which the work is required to be performed and the resulting injury. The claimant must show that the conditions of the workplace or some significant work-related exertion caused the injury. The causative danger must be peculiar to the work, incidental to the character of the business, and not independent of the master-servant relationship. In cases where an injury does not follow as a natural incident of the work and does not result from exposure occasioned by the nature of the employment, the injury does not arise out of the employment. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    The burden is on claimant to prove causal connection by a preponderance of the evidence. He need not prove this beyond a reasonable doubt. Rogers v. Williams, 196 Va. 39 , 82 S.E.2d 601, 1954 Va. LEXIS 198 (1954).

    The medical evidence showed that the claimant was able to perform light-duty work, and the issue was whether the light-duty restriction would allow the claimant to perform all the duties of his pre-injury work. Evidence of the claimant’s pre-injury work duties necessary to resolve this issue was absent from the record. Since the employer, as the proponent of the change in condition application, had the burden to supply evidence to prove its claim by a preponderance of the evidence, and since evidence of the claimant’s pre-injury work was not presented, the Commission held that the employer failed to prove the claimant could return to his pre-injury work. Meekins v. Heritage Golf Club, 77 O.W.C. 81 (1998).

    While it is the endeavor of the courts to construe the compensation statute liberally in order to carry out its beneficial purpose, liability cannot be based upon imagination, speculation or conjecture but must be based upon facts established by the evidence. Johnson v. Capitol Hotel, 189 Va. 585 , 54 S.E.2d 106, 1949 Va. LEXIS 202 (1949); Bailey v. Stonega Coke & Coal Co., 185 Va. 653 , 40 S.E.2d 254, 1946 Va. LEXIS 238 (1946).

    Proof of causal connection between accident and claimed disability must go beyond conjecture. Lucas v. Eccon Construction Company, 60 O.I.C. 292 (1981).

    The Commission looks primarily to the medical evidence to determine the mechanism or cause of an injury. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    The claimant has the burden to prove that he is an employee subject to the control of the employer, that he is under a contract of hire that provides an agreed remuneration for services rendered, and that the work being performed is in the business, trade, occupation, or profession of the employer. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    Where the treating physician has prescribed specific medical treatment for the claimant’s work injury, the employer or its workers’ compensation carrier, not the employee, has the burden to proceed with evidence which would relieve it from the mandate of the act. Leon v. Lewis-Gale Clinic, 76 O.W.C. 350 (1997).

    Claimant may establish his case by circumstantial evidence. Byrd v. Stonega Coke & Coal Co., 182 Va. 212 , 28 S.E.2d 725, 1944 Va. LEXIS 170, limited, Carter v. Hercules Powder Co., 182 Va. 282 , 28 S.E.2d 736, 1944 Va. LEXIS 177 (1944).

    Where the claimant is not inherently incredible, the Commission will look to his testimony and the medical record to determine whether he has met his burden of proving that a condition of the employment caused the accident. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    Testimony that is not inherently incredible, but is consistent, credible, and unimpeached by the records of her treating physicians, is sufficient to establish an injury by accident. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997), aff’d, Nos. 1238-97-3 & 1290-97-3 (Va. Ct. App., Dec. 23, 1997).

    Hearsay Evidence:

    Hearsay evidence, in view of Rule 1 (now Rule 2.2) of the Commission, may be introduced and, if credible and not contradicted, may alone constitute the basis for award. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562 (1958); Derby v. Swift, 188 Va. 336 , 49 S.E.2d 417 (1948); Humphries v. Boxley Bros. Co., 146 Va. 91 , 135 S.E. 890 (1927); Graves v. American Furniture Co., 141 Va. 1 , 126 S.E. 213 (1925); Jenkins v. Bowman Apple Products Co., Inc., 48 O.I.C. 125 (1966); Gray v. East Coast Oil Corp. (appeal denied), 58 O.I.C. 154 (1979).

    Although the Commission is not bound by statutory rules of evidence, it is guided by them. Thus, Rule 2.2 allows the Commission to accept hearsay evidence, but hearing officers may exclude such evidence not considered reasonably reliable. Wright v. Harrison’s Supermarket, 75 O.W.C. 195 (1996).

    The claimant died from unrelated causes prior to the evidentiary hearing. The employer argued that it would be severely prejudiced if the claim was allowed, because it could not cross-examine the claimant. The Commission disagreed that the contested issues could not be decided without the claimant’s testimony, since the Act’s liberal hearsay rule would allow the evidence to be presented through the testimony of other witnesses and other evidence in the record. The Commission acknowledged that the absence of a significant witness would affect the quality of the evidence in the record, but that such an obstacle was not so critical as to render the proceedings fundamentally unfair. Echols v. Rite Aid Corporation, 78 O.W.C. 16 (1999).

    The Commission acted appropriately by refusing to allow evidence concerning racial discriminatory conduct. Claims of race discrimination have never been considered to fall within the generic term “industrial accidents.” A pattern of racial discrimination would not affect the Commission’s determination of whether an injury by accident occurred or whether a compensable ordinary disease of life which arose out of or in the course of employment was present. Teasley v. Montgomery Ward & Company, Inc., 14 Va. App. 45, 415 S.E.2d 596, 8 Va. Law Rep. 2327, 1992 Va. App. LEXIS 77 (1992).

    Medical Evidence:

    Where a physician’s statement as to causation is one of possibility, not probability, and the possibility of a causal connection does not rise to the level of an opinion to a reasonable degree of medical probability, it is insufficient to satisfy the claimant’s burden of proof. The preponderance of evidence must show that work was the cause of the disability under the more probable than not rule. Parker v. Wal-Mart Associates, Inc., JCN VA00000223428 (Aug. 31, 2011).

    A nurse practitioner’s unchallenged opinion concerning causation and disability will be considered. However a contradictory opinion from a physician will be given greater weight than a nurse practitioner. Counts v. Virginia Dept. of Transportation/Commonwealth of Va., VWC File No. 220-85-21 (March 9, 2006) see also Shine v. Teco Energy, Inc., VWC File No. 223-46-12 (April 5, 2006) (nurse practitioner’s notes are admissible) and Patterson-Parker v. Lowe’s Home Centers, Inc., VWC File No. 212-86-74 (Sept. 29, 2006) (release to work by nurse practitioner is sufficient where notes reflect discussed with doctor).

    A physician assistant’s opinion as to diagnosis and disability is admissible but unless a medical doctor has endorsed the conclusion, it will not be given the same weight as a physician’s determination. Austin v. Allstate Insurance Co., VWC File No. 224-68-41 (Aug. 1, 2006).

    A chiropractor’s opinion concerning a thumb and hand condition is beyond the scope of the “practice of chiropractic” as defined by § 54.1-2900 and therefore will not be considered. Fedorko v. Prince William Hospital, VWC File No. 208-77-08 (Feb. 7, 2006) see also Torres v. Maid Brigade, #153, VWC File No. 203-57-08 (April 1, 2004) (chiropractor’s rating to an arm not considered).

    The Commission has authority to exclude medical evidence. However, the employer has the right to see all the medical records, because this information is, or might lead to, admissible evidence. In this case, the Commission found that the Deputy Commissioner erred by allowing the claimant’s treating physician to submit redacted and summarized records relevant to the claimant’s post traumatic stress disorder claim, and that the employer was entitled to review all of the physician’s records for his treatment of the claimant, unredacted and unsummarized. Hassell v. Arlington County Human Services, 79 O.W.C. 141 (2000).

    Non-designated medical reports and records are automatically a part of the hearing record. Lowery v. Globe Iron Const. Co., Inc., 76 O.W.C. 221 (1997).

    A conflict in the testimony of medical experts presents an issue of fact. In such case the Commission may adopt that view which is most consistent with reason and justice, taking into consideration also the lay testimony introduced, in the same manner a jury would. While great weight should be given testimony of the attending physician, his opinion is not binding upon the Commission. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958); Southall v. Eldridge Reams, Inc., 198 Va. 545 , 95 S.E.2d 145, 1956 Va. LEXIS 240 (1956); Johnson v. Capitol Hotel, 189 Va. 585 , 54 S.E.2d 106, 1949 Va. LEXIS 202 (1949); Baltimore v. Benedict Coal Co., 182 Va. 446 , 29 S.E.2d 234, 1944 Va. LEXIS 194 (1944); Commonwealth v. Hughes, 161 Va. 714 , 172 S.E. 155 , 1934 Va. LEXIS 296 (1934); Bristol Builders Supply Co. v. McReynolds, 157 Va. 478 , 162 S.E. 8 (1932).

    Where there is conflict in medical evidence, greater credence is given to the opinion of the treating physician than to that of another physician of the same medical specialty who has only recently been consulted. Green v. Audley Farms, 57 O.I.C. 143 (1976) (appeal denied); Harding v. Mother Goose, Inc., 57 O.I.C. 159, 1977(aff’d on review) (appeal denied).

    A party has the right to have the entire deposition testimony of a doctor received into the evidentiary record, notwithstanding the requirement in Rule 2.2 (B)(3) that the transcript must be specifically identified by page and line. Lowery v. Globe Iron Const. Co., Inc., 76 O.W.C. 221 (1997).

    Opinions of general practitioners fall short of overcoming view of specialists. Russell v. Wright Mining Co., 49 O.I.C. 284 (1967).

    The Commission will not substitute its own opinion for those of a medical expert where no contrary evidence is presented and the opinion is fully explained. Palmer v. City of Roanoke Emergency Services, 70 O.I.C. 147 (1991).

    Once an accident has been established without consideration of the medical history, medical histories may be considered to determine whether the treatment was for injury related to that accident. Sandra R. Hall v. Spartan Industries/Barnes and Company, Inc., 74 O.W.C. 56 (1995).

    Credible testimony of the claimant may be sufficient to establish an injury by accident unimpeached by the medical records, even if the medical histories refer only to general repetitive tasks the claimant performed when the accident occurred. Mullins v. Dickenson County Medical Center, 74 O.W.C. 176 (1995).

    Historical inconsistencies alone may be insufficient to nullify or compromise a treating physician’s opinion on causation, where he is the spine specialist to whom the claimant was referred, his opinion is not based totally on the precise details of the history, the substance of the history relied upon by the physician is correct, and he is the only physician who expressed an opinion on causation. Smith v. Southeastern Virginia Training Center, 78 O.W.C. 69 (1999).

    Claimant’s bona fide effort to work is better evidence than physician’s opinion. Wills v. Green, 56 O.I.C. 340 (1975).

    A physician’s release from medical treatment does not establish an employee has been released to return to regular work, light work or any type of work. Blake v. Banner Constructors, Inc., 69 O.I.C. 71 (1990).

    A physician’s release to return to work on a trial basis is not sufficient to suspend compensation benefits. The physician must state unconditionally that the claimant is able to perform all aspects of his pre-injury employment. Byrd v. Island Creek Coal Company, 74 O.W.C. 45 (1995).

    A release to return to work one week following an examination is considered a prospective release and does not establish that an employee is able to return to work. Haggins v. American Academy of Otolaryngology, 70 O.I.C. 293 (1991).

    A doctor’s release to return to work more than seven days after the examination is prospective and anticipatory, and is insufficient to establish an ability to work on the future date. Devault v. Virginia Imports, Ltd., 74 O.W.C. 174 (1995).

    Videotape surveillance of the claimant showed him using a piece of cloth to wipe an automobile, lifting a bicycle carrier, attaching the carrier to the vehicle, and thereafter placing a bicycle in the carrier. These actions, at face value, reflect an ability to perform tasks greater than that noted in the medical reports and alluded to in the claimant’s testimony. However, the Commission found that such evidence was insufficient to prove an ability to return to work. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    Where an employer files an application alleging that the claimant is able to return to regular work, medical evidence is not limited to reports available at the time of the application but includes all reports available prior to the hearing. Turner v. Wilson Brothers, Inc., 69 O.I.C. 73 (1990).

    The medical evidence showed that the claimant was able to perform light-duty work, and the issue was whether the light-duty restriction would allow the claimant to perform all the duties of his pre-injury work. Evidence of the claimant’s pre-injury work duties necessary to resolve this issue was absent from the record. Since the employer, as the proponent of the change in condition application, had the burden to supply evidence to prove its claim by a preponderance of the evidence, and since evidence of the claimant’s pre-injury work was not presented, the Commission held that the employer failed to prove the claimant could return to his pre-injury work. Meekins v. Heritage Golf Club, 77 O.W.C. 81 (1998).

    Mental health records are not admissible without testimony of the counselor unless the care has been rendered by or at the direction of a practitioner of the healing arts licensed under § 54.1-2929 , Code of Virginia. Potter v. Island Creek Coal Co., 69 O.I.C. 67 (1990).

    The report of a clinical psychologist may be admitted as evidence under Rule 1 (now Rule 2.2). Landy v. Eastern State Hospital, 69 O.I.C. 212 (1989).

    A doctor’s office note stating that the claimant failed to attend a medical appointment was admissible as a record of the physician’s care of the patient. Griffith v. Commonwealth Steel Erectors, Inc., 68 O.I.C. 218 (1989).

    The person requesting a witness subpoena for a medical expert must pay the witness fee set by the Commission. Dotti v. Sonco Wholesale Fence Co., Inc., 70 O.I.C. 307 (1991).

    Witness Credibility:

    For cases discussing credibility findings by deputy commissioners and their affect on Full Commission decisions see Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987); Corestaff Corp. Servs. Group v. Carter, 2004 Va. App. LEXIS 128 (Va. Ct. App. Mar. 30, 2004) (see also the Notes under § 65.2-705 .).

    A deputy commissioner’s determination of a witness’ credibility based on issues such as demeanor and appearance, may not be arbitrarily disregarded, unless it is evident from the record that there existed some basis for the Commission’s different interpretation of the witness’ credibility. When a credibility decision is reversed, it should be evident from the record how the Commission resolved the credibility issue consistent with the deputy’s observations at the evidentiary hearing. When the deputy commissioner’s finding of credibility is based, in whole or in part, upon the claimant’s appearance and demeanor at the hearing, the commission may have difficulty reversing that finding without recalling the witness. On the other hand, if the deputy commissioner’s determination of credibility is based on the substance of the testimony and not upon the witness’ demeanor and appearance, such a finding is as determinable by the Commission as by the deputy. Al-Janabi v. MCI Communications Corp., 76 O.W.C. 290 (1997).

    Post-hearing Evidence:

    The burden is on the moving party to see that the record affirmatively reflects a motion for leave to file post-hearing medical reports. Hayward v. Pep Boys, 1 Va. App. 483, 339 S.E.2d 908, 1986 Va. App. LEXIS 227 (1986).

    Time limit for filing post-hearing evidence is within hearing commissioner’s discretion. Chabot v. Commonwealth of Virginia, Virginia Polytechnic Institute & State University, 60 O.I.C. 85 (1981).

    A request to depose a physician first made at or close in time to the evidentiary hearing is untimely where there was ample time after the physician’s report was issued and before the hearing to cross examine the physician by deposition. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    After Discovered Evidence:

    Employer’s request to admit evidence after the hearing regarding a credit for short-term disability payments made during the period of disability is not subject to the rule governing after-discovered evidence. An employer may seek credit for benefits paid at the hearing or by post-hearing application. Juhl v. Monumental Life, Inc., VWC File No. 217-76-00 (Feb. 1, 2005).

    Since case was still pending a decision by the deputy commissioner when he issued his decision to reconvene the hearing, the case was not “under review” as contemplated by Rule 3.3, and deputy commissioner retained discretion to hear and review additional evidence. Collick v. Batey Enterprises II, Inc., VWC File No. 216-57-38 (Oct. 22, 2004).

    Deputy commissioner’s opinion vacated and remanded for consideration of evidence that claimant and his wife pled guilty to certain federal criminal charges where credibility was central issue in case. Martin v. Groome Transp., Inc., VWC File No. 209-63-38 (Oct. 15, 2004).

    Rule 3 (now Rule 3.3), of the Commission, providing that a petition for reopening of a case to permit the taking of additional testimony will only be acted upon by the full Commission where it appears that such course is absolutely necessary and advisable and also where the party requesting same is able to conform to the rule prevailing in the courts of the State for the introduction of after-discovered evidence, means that such evidence must not be cumulative, corroborative or collateral and must be evidence that could not have been discovered before the hearing by the exercise of due diligence. Defonis v. Clinchfield Coal Corp., 186 Va. 715 , 43 S.E.2d 852 (1947); Nicholson v. Clinchfield Coal Corp., 154 Va. 401 , 153 S.E. 805 (1930); Barsa v. Kator, 121 Va. 290 , 296, 93 S.E. 613 (1940); Brown v. City of Suffolk Police Dept., 59 O.I.C. 39 (1981).

    The petition for leave to introduce additional evidence must be filed before the hearing on review. Baker v. Va. Lee Co., Inc., 12 O.I.C. 1 (1930).

    Employer had ample time to investigate claim prior to hearing; petition to admit new evidence denied. Clark v. Harris Industries, Inc., 58 O.I.C. 61 (1979).

    § 65.2-705. Review of award; rehearing.

    1. If an application for review is made to the Commission within 30 days after issuance of an award, the full Commission, except as provided in subsection B of § 65.2-704 and if the first hearing was not held before the full Commission, shall review the evidence or, if deemed advisable, as soon as practicable, hear the parties at issue, their representatives, and witnesses. The Commission shall make an award which, together with a statement of the findings of fact, rulings of law, and other matters pertinent to the questions at issue, shall be filed with the record of the proceedings.
    2. A rehearing convened under this section shall be a public proceeding and, upon proper request, may, in the discretion of the Commission, be video recorded for public broadcast at the expense of the requesting party, subject only to the same limitations and conditions as apply to court proceedings in the Commonwealth.
    3. Upon an application for review made pursuant to subsection A, the opposing party at issue shall have 14 days thereafter to make an independent application for review.
    4. When a vacancy on the Commission exists, or when one or more members of the Commission are absent or are prohibited from sitting with the full Commission to hear a review, the Chairman may appoint one or more deputy commissioners or recall one or more retired members of the Commission to participate in the review. The retired member or members recalled shall be the member or members who occupied the seat for which such member or members are being recalled, unless the parties otherwise consent. If retired members of the Commission are recalled as provided in this subsection, they shall be compensated as provided in § 17.1-327 .

    History. Code 1950, § 65-93; 1954, c. 450; 1956, c. 79; 1968, c. 660, § 65.1-97; 1980, cc. 600, 606; 1989, c. 318; 1991, c. 355; 1994, c. 289; 1998, c. 95; 2003, cc. 664, 671; 2010, cc. 160, 564; 2012, c. 588; 2014, c. 205.

    Cross references.

    As to prohibition on certain subrogation provisions and limitations upon recovery in insurance policies, see § 38.2-3405 .

    The 1998 amendment, in subsection A, in the first sentence, substituted “after receipt of notice” for “from the date,” substituted “of such award” for “of the award,” and inserted “to be sent as provided in subsection A of § 65.2-704 .”

    The 2003 amendments.

    The 2003 amendments by cc. 664 and 671 are identical, and in subsection A, substituted “20 days” for “twenty days” in the first sentence and added “by priority mail with delivery confirmation or equivalent mailing option” at the end of the third sentence; and substituted “14 days” for “fourteen days” in subsection C.

    The 2010 amendments.

    The 2010 amendments by cc. 160 and 564 are identical, and in subsection A, substituted “30 days after issuance of an award” for “20 days after receipt of notice of such award to be sent as provided in subsection A of § 65.2-704 ” in the first sentence, and deleted “A copy of the award shall be sent immediately to the parties at issue by priority mail with delivery confirmation or equivalent mailing option” at the end.

    The 2012 amendments.

    The 2012 amendment by c. 588 added subsection D and made a minor stylistic change.

    The 2014 amendments.

    The 2014 amendment by c. 205 rewrote subsection D, which formerly read “When a vacancy on the Commission exists, or when a member of the Commission is absent or is prohibited from sitting with the full Commission to hear a review, the Chairman may appoint a deputy commissioner to participate in the review.”

    Law Review.

    For an article relating to the most significant developments in the law of workers’ compensation since September 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 51, 71, 76.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-97.

    Construction with other laws. —

    Statutory scheme found in subsection C of § 65.2-701 , subsection A of § 65.2-702 and subsection A of § 65.2-705 , when read together, encourages agreements by the parties to settle claims while also permitting either party to withdraw from an agreement and allowing the Workers’ Compensation Commission to decide the merits of the claim; unlike subsection A of § 65.2-705 there is no time constraint on when either party may request a hearing from the Commission under subsection A of § 65.2-702 . Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    Scope of duty. —

    The Commission was not required to re-read each document in the historical record of the case. What is required of the Commission is that it not ignore relevant evidence and base its findings of fact on credible evidence. Dynalectric Co. v. Ellis, 19 Va. App. 541, 452 S.E.2d 372, 1995 Va. App. LEXIS 384 (1995).

    When a workers’ compensation claimant sought cost-of-living adjustment benefits because she began receiving Social Security retirement benefits, as opposed to Social Security disability benefits, the Workers’ Compensation Commission had to make adequate factual findings, under subsection A of § 65.2-705 , supporting its award, and its failure to do so required that its award be vacated and the matter remanded for adequate findings. Powhatan Corr. Center v. Mitchell-Riggleman, 40 Va. App. 491, 579 S.E.2d 696, 2003 Va. App. LEXIS 288 (2003).

    Commission has authority to hear case de novo and will not be bound by the findings of the deputy. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    By statute, the workers’ compensation commission was entitled to hear the case de novo and since competent, credible evidence supported its finding that the claimant was disabled from his employment due to an injury at work that did not involve a pre-existing condition, that finding was affirmed on appeal. Clinchfield Coal Co. v. Jordan, 2003 Va. App. LEXIS 602 (Va. Ct. App. Nov. 25, 2003).

    When an award of the Virginia Workers’ Compensation Commission was appealed to the Virginia Court of Appeals, the employer’s obligation to pay benefits was suspended, under subsection C of § 65.2-706 , and the Commission’s decision that an appeal from a deputy commissioner to the Commission likewise suspended the employer’s obligation to pay benefits was not unreasonable, because the deputy commissioner’s decision was not final if a timely request for review was filed, as, under § 65.2-705 , a request for review empowered the Commission to hear the case de novo, so it left more to be done than to ministerially execute the award. Gallahan v. Free Lance Star Publ'g Co., 41 Va. App. 694, 589 S.E.2d 12, 2003 Va. App. LEXIS 607 (2003).

    Effect of findings of fact at initial hearing. —

    If review by the full Commission of an award at an initial hearing occurred pursuant to this section, the findings of facts by the initial hearing are not binding. Williams v. Auto Brokers, 6 Va. App. 570, 370 S.E.2d 321, 5 Va. Law Rep. 99, 1988 Va. App. LEXIS 74 (1988).

    Deputies may be designated to review awards. —

    This section does not limit the general powers of the Commission to delegate duties to deputies; a deputy commissioner can be designated to sit in place of a commissioner when the Commission reviews a case by ore tenus hearing of the parties, their representatives and witnesses or when the review is a review of the record without an appearance by the parties, representatives and witnesses. Clinch Valley Med. Ctr. v. Hayes, 34 Va. App. 183, 538 S.E.2d 369, 2000 Va. App. LEXIS 835 (2000).

    Deputy commissioner’s findings as to credibility not necessarily binding. —

    A specific, recorded observation of a key witness’ demeanor or appearance in relation to credibility is an aspect of the hearing that the Commission may not arbitrarily disregard. However, the deputy commissioner’s findings as to credibility do not necessarily bind the Commission. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    When commissioner not bound by deputy commissioner’s findings. —

    Credible evidence supported the Virginia Workers’ Compensation Commission’s decision that the employer failed to establish that employee was no longer disabled due to a work-related injury. Because the deputy commissioner’s finding was not based on the surgeon’s demeanor or appearance, the Commission was not bound by that finding and could make its own finding. Corestaff Corp. Servs. Group v. Carter, 2004 Va. App. LEXIS 128 (Va. Ct. App. Mar. 30, 2004).

    Commission entitled to defer to deputy commissioner’s findings. —

    There was no error in the decision of the Virginia Workers’ Compensation Commission to defer to a deputy commissioner’s findings and affirm the deputy commissioner’s decision, which found that a claimant failed to prove that he sustained an injury by accident arising out of and in the course of his employment, because: (1) the Commission reviewed and summarized the relevant testimony and medical records, and then noted the deputy commissioner’s findings, including his credibility determinations; (2) the Commission implicitly recognized that those findings were based upon the substance of the witnesses’ testimony and the medical records considered by the deputy commissioner and the inconsistencies therein; and (3) the Commission was entitled to defer to the deputy commissioner’s findings when it did not hear the case de novo, under former § 65.1-96 (now § 65.2-704 ) and former § 65.1-97 (now § 65.2-705 ). Petraitis v. Prevent Blindness Am., 2007 Va. App. LEXIS 427 (Va. Ct. App. Dec. 4, 2007).

    Appellate court found there was certainly credible evidence in the record to support the Virginia Workers’ Compensation Commission’s finding that the claimant continued to suffer temporary total disability related to the factures of her vertebrae that she sustained from the fall, thus, the court could not say that the Commission erred in its unanimous ruling awarding the claimant continuing temporary total disability benefits; nothing in the record supports the conclusion that the Commission did not fulfill its responsibilities under this section. Truteam Ace Am. Ins. Co. v. Dequintanilla, 2022 Va. App. LEXIS 26 (Va. Ct. App. Feb. 1, 2022).

    Authority to accept claimant’s testimony as credible. —

    Award of benefits to the claimant in a workers’ compensation action was appropriate, in part under subsection A of § 65.2-705 because the deputy commissioner and the Workers’ Compensation Commission were not plainly wrong in accepting the claimant’s testimony as credible. Oftentimes the full Commission would not review the evidence in the same way that the deputy commissioner did and to the extent the full Commission had not actually viewed the witnesses and their appearance or demeanor, it naturally followed that it would simply adopt the deputy commissioner’s credibility determinations about those witnesses, which it was free to do without explanation. Va. Int'l Terminals v. McCarthy, 2011 Va. App. LEXIS 216 (Va. Ct. App. June 28, 2011).

    Power to correct mistake and vacate award. —

    Workers’ Compensation Commission did not err in vacating its award because without the employer’s signature as required by the form, that award order was procedurally deficient and entered by mistake; because of the Commission’s mistake, it had the power to correct its mistake and vacate the award, even though the period for an application for review lapsed. Irby v. Lifepoint Health & Safety Nat'l Cas. Corp., 2020 Va. App. LEXIS 286 (Va. Ct. App. Nov. 17, 2020).

    When full Commission does not hear witness’ testimony, deputy’s observations about witness credibility become a part of the evidence which the Commission may not arbitrarily ignore and dismiss. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Necessity for review by full Commission. —

    Decisions of a deputy commissioner that are not reviewed by the full Commission cannot be brought before the Court of Appeals. Duncan v. ABF Freight Sys., 20 Va. App. 418, 457 S.E.2d 424, 1995 Va. App. LEXIS 456 (1995).

    Prior affiliation of a deputy commissioner appointed to serve on a review panel is irrelevant as to whether the panel was properly constituted. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Language of both subsection D of § 65.2-705 and subsection D of § 65.2-200 is clear and unambiguous. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Subsection D refers solely to the composition of the Workers’ Compensation Commission itself; its plain language provides no commentary on any prior affiliation requirement for deputy commissioners appointed to a review panel. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Failure to have full commission hear review. —

    Decision reviewing the award of benefits to a claimant was reversed on appeal as the Virginia Workers’ Compensation Commission lacked authority to review the employer’s appeal of that decision as a result of having only two out of three statutorily required Commissioners hear the review due to a vacancy existing on the Commission. The employer had not waived the issued since it had raised the same in a motion to reconsider or vacate the decision. Hitt Constr. v. Pratt, 53 Va. App. 422, 672 S.E.2d 904, 2009 Va. App. LEXIS 76 (2009).

    Matter was not heard before a properly constituted full Virginia Workers’ Compensation Commission because only two of the three statutorily authorized commissioners decided it; because the Commission’s authority is a matter of legislative prerogative, the Commission is bound by the plain meaning of the words in the Workers’ Compensation Act, and § 17.1-327 , which fail to provide the authority to recall or designate a retired commissioner to serve in a review proceeding. Layne v. Crist Elec. Contr., Inc., 62 Va. App. 632, 751 S.E.2d 679, 2013 Va. App. LEXIS 371 (2013).

    Workers’ compensation claimant raised a timely objection to the composition of the review panel in his motion for reconsideration, which the full Virginia Workers’ Compensation Commission denied; therefore, while a challenge to the authority of the Commission was subject to being waived, that challenge was not waived. Layne v. Crist Elec. Contr., Inc., 62 Va. App. 632, 751 S.E.2d 679, 2013 Va. App. LEXIS 371 (2013).

    Composition of the Virginia Workers’ Compensation Commission review panel was proper because the mechanism provided in subsection D, was triggered since one commissioner was absent, and thus, the chairman appointed a deputy commissioner to the review panel, which consisted of two commissioners and one deputy commissioner; because a majority of commissioners existed, a quorum was achieved, and the review panel was authorized to take judicial, legislative, and discretionary action. McCluster v. Baltazar, 2017 Va. App. LEXIS 308 (Va. Ct. App. Dec. 5, 2017).

    Member of panel absent. —

    Word “or” is a disjunctive that provides an alternative; as such, the statute provides that the chairman may appoint either a deputy commissioner or, in the alternative, a retired member of the Workers’ Compensation Commission, to serve on a review panel if a member of the commission is absent. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Retired members on panel. —

    Clearly the term “member” exclusively references “the retired member or members recalled,” i.e., retired members of the Workers’ Compensation Commission that can participate in review panels by designation of the Chairman; under the plain language of subsection D, the statute only requires that when a retired member of the Commission is recalled to serve on a review panel, they must occupy “the seat,” i.e., be of the same classification under § 65.2-200 , as the Commission member they are replacing. As this portion of the statute plainly refers only to “retired members” of the Commission, it does not compel the conclusion that a deputy commissioner, serving by appointment on a review panel, must be of a certain affiliation. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Under the plain language of subsection D, the statute only requires that when a retired member is recalled to serve on a review panel, they must occupy “the seat,” i.e., be of the same classification as the Commission member they are replacing; as this portion of the statute plainly refers only to “retired members” of the Commission, it does not compel the conclusion that a deputy commissioner, serving by appointment on a review panel, must be of a certain affiliation. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Workers’ Compensation Commission properly found that the composition of the review panel did not contravene the statutory requirement because the chairman of the commission correctly appointed a deputy commissioner to participate in the panel in light of a commissioner’s absence; the deputy commissioner was not and had never been a “retired member” of the commission, and thus, his background as either an employee or employer representative was irrelevant. Dollar Tree Stores, Inc. v. Tefft, 69 Va. App. 15, 813 S.E.2d 908, 2018 Va. App. LEXIS 146 (2018).

    Defendant may be permitted to file additional defense. —

    Under this section and former § 65.1-18 (now § 65.2-201 ) and the rule adopted by the Commission in pursuance of former § 65.1-18 referring to the conduct of reviews, the full Commission did not err on review of the findings first made by the hearing commissioner in permitting the defendant, after written notice to the plaintiff, to file an additional ground of defense that claimant was a casual employee and argue the same, nor in holding that such defense could be considered upon a review of the case. Hoffer Bros. v. Smith, 148 Va. 220 , 138 S.E. 474 , 1927 Va. LEXIS 223 (1927).

    Application to vacate is not within this section. —

    Whether an application to set aside an award of the Commission is seasonably presented must necessarily depend upon the facts and circumstances of the particular case, but such application need not be filed within the seven (now 20) days allowed by this section, which applies to applications for review, since an application to vacate is not, strictly speaking, an application to review within the contemplation of this section. Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573, 1946 Va. LEXIS 136 (1946).

    Timeliness for application for review. —

    If the application for a review is not made within the 20-day limitation period, in the absence of fraud or mistake, the Commission has no authority to review the matter and consider evidence which could have been tendered at the prior hearing. However, if the application is to vacate an award on the ground of fraud or mistake, the Commission retains authority to act upon any relevant evidence offered in support thereof. K & L Trucking Co. v. Thurber, 1 Va. App. 213, 337 S.E.2d 299, 1985 Va. App. LEXIS 88 (1985).

    The standard of review established in Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573 (1946), i.e., that an award may be set aside only for fraud, mutual mistake or imposition, does not apply when there has been a timely application for review. Sovran Fin. Corp. v. Nanney, 12 Va. App. 1156, 408 S.E.2d 266, 8 Va. Law Rep. 545, 1991 Va. App. LEXIS 214 (1991).

    If the application for review is not made within the twenty-day limitation period, the Commission has no jurisdiction to review the matter unless the petitioning party alleges fraud or mistake in the procurement of the award. McCarthy Elec. Co. v. Foster, 17 Va. App. 344, 437 S.E.2d 246, 10 Va. Law Rep. 592, 1993 Va. App. LEXIS 554 (1993).

    If the application for review alleges fraud or mistake, the Commission retains jurisdiction insofar as is necessary to act upon any relevant evidence offered in support thereof. McCarthy Elec. Co. v. Foster, 17 Va. App. 344, 437 S.E.2d 246, 10 Va. Law Rep. 592, 1993 Va. App. LEXIS 554 (1993).

    This section requires that an application for review to the full Commission must be made within 20 days from the date of the award. Absent fraud or mistake, the decisions of the Commission or its deputy commissioners from which no party seeks timely review are binding upon the Commission. Reuben v. Integrated Health Servs., Inc., 1997 Va. App. LEXIS 12 (Va. Ct. App. Jan. 21, 1997).

    Employer made a timely application for review of decision rendered on July 25, 1996. The subsequent order, dated August 12, 1996, simply amended, without displacing, the earlier award. Thus, employer’s request for review provided the Commission with jurisdiction over the disputed award, permitting it to consider, sua sponte, any issues deemed relevant on appeal. Ceres Marine Terms., Inc. v. Ward, 1997 Va. App. LEXIS 600 (Va. Ct. App. Sept. 23, 1997).

    Workers’ Compensation Commission erred in holding that the actual notice provision applied only to awards that were entered following an evidentiary hearing and did not apply to awards entered upon agreement; therefore, the Commission erred in holding that a worker’s request to review an award was untimely under Va. Sup. Ct. R. 3.1 because it was not filed within 20 days of the date of the award rather than within 20 days of when the worker received notice of the award. Since the worker’s request for review of the award was filed within 20 days of the date he receiving notice from the Commission of the award being entered, the worker’s request was timely under Va. Sup. Ct. R. 3.1. Ashby v. Ramar Coal Co., 47 Va. App. 8, 622 S.E.2d 230, 2005 Va. App. LEXIS 472 (2005).

    A request for review of a decision or award of the Commission must be filed in writing by a party within twenty days of the date of such decision or award. Workers’ Compensation Commission erred in holding that the actual notice provision of § 65.2-705 applied only to awards that were entered following an evidentiary hearing and did not apply to awards entered upon agreement; therefore, the Commission erred in holding that a worker’s request to review an award was untimely under Va. Sup. Ct. R. 3.1 because it was not filed within 20 days of the date of the award rather than within 20 days of when the worker received notice of the award. Ashby v. Ramar Coal Co., 47 Va. App. 8, 622 S.E.2d 230, 2005 Va. App. LEXIS 472 (2005).

    Virginia Workers’ Compensation Commission did not err in determining that its review of a deputy commissioner’s award of attorney’s fees to a claimant attorney was time-barred because the application for review was not made within the thirty-day limitation period. Moreover, the Commission properly found no evidence of fraud, mistake, or imposition sufficient to permit the Commission to review the deputy commissioner’s opinion. Town Country Hosp., LP v. Davis, 64 Va. App. 658, 770 S.E.2d 790, 2015 Va. App. LEXIS 138 (2015).

    Timeliness of payment of settlement. —

    Claimant was not entitled to 20 percent statutory penalty that the claimant requested, because payment of compromise settlement agreement was not late; § 65.2-524 allowed for 20 percent penalty for payment not made within two weeks after it became due, but the two week period did not apply if the employer could request review by the full workers’ compensation commission pursuant to § 65.2-705 , in which case the two week time period was extended by the 20-day time period the employer had for requesting review by the full workers’ compensation commission and the payment was made to the claimant within the two weeks plus that additional 20-day time period. Ratliff v. Carter Mach. Co., 39 Va. App. 586, 575 S.E.2d 571, 2003 Va. App. LEXIS 21 (2003).

    Time period runs from claimant’s receipt of denial. —

    Twenty-day period for seeking review of an administrative order denying a claim for benefits did not begin to run until the claimant himself received the notice of denial; receipt by his lawyer did not count. Peacock v. Browning Ferris, Inc., 38 Va. App. 241, 563 S.E.2d 368, 2002 Va. App. LEXIS 294 (2002).

    Mistake in calculating deadline did not fall within exception. —

    Where appellant merely alleges that he made a mistake in calculating the deadline for filing his review application, this is not the type of mistake which falls within the exception noted in Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573 (1946) and K. & L. Trucking Co., Inc. v. Thurber, 1 Va. App. 213, 337 S.E.2d 299 (1985); accordingly, the Commission correctly dismissed appellant’s request for review. Welch v. Tysons Toyota, Inc., No. 0133-90-4 (Ct. of Appeals July 3, 1990).

    Deputy commissioner authorized to take additional evidence. —

    The Commission has authority to take additional evidence. The Commission also has the power to delegate duties to the deputy commissioners. Therefore, the deputy commissioner has authority to take additional evidence in a case when ordered to do so by the Commission. Smith v. Weber, No. 0873-85 (Ct. of Appeals, Nov. 5, 1986).

    Review of ruling based on claimant’s appearance and demeanor. —

    When the deputy commissioner’s finding of credibility is based, in whole or in part, upon the claimant’s appearance and demeanor at the hearing, the Commission may have difficulty reversing that finding without recalling the witness. On the other hand, if the deputy commissioner’s determination of credibility is based on the substance of the testimony and not upon the witness’ demeanor and appearance, such a finding is as determinable by the full commission as by the deputy. Only when the deputy’s finding as to credibility is specifically based upon the witness’ appearance and demeanor is a due process question raised. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Reasons for believing one witness over another need not be stated. —

    The law does not require the Commission to state its reasons for believing one witness over another. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Inability to review all evidence because of malfunction of recording equipment. —

    Where the full Commission did not review all the evidence because a nine minute portion of the proceedings was missing due to a mechanical malfunction of the tape recording equipment, it could not be said as a matter of law that the nine minutes of evidence, which were not presented to the full Commission or to the Court of Appeals, had no effect on the outcome of the case. Flavin v. J.C. Penney Co., 1 Va. App. 1, 332 S.E.2d 805, 1985 Va. App. LEXIS 51 (1985).

    Absence of an actual transcript due to the malfunction of tape recording equipment or an agreed upon account of the evidence foreclosed the Commission’s ability to discharge its duty to review the evidence as required by this section, and further prevented the Court of Appeals from examining a complete record for the purpose of appellate review. Burkholder & Kreig, Inc. v. Hughes, No. 0125-84 (Ct. of Appeals Aug. 29, 1985).

    Where Commission reverses significant finding of fact, the Commission’s opinion should demonstrate how the Commission could have arrived at their conclusion. When the Commission offers no rationale for its reversal, then evidence to support the award is lacking. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Consideration of evidence discovered while review hearing pending. —

    Where, pending the review hearing, additional medical treatment has occurred which has resulted in a diagnosis being made or findings reported which are material to determining the nature and character of the claimant’s condition, the extent of incapacity, or the etiology of any disability, the Commission would be remiss in discharging its duty under this section by failing to reopen and receive and consider such evidence. Mize v. Rocky Mount Ready Mix, Inc., 11 Va. App. 601, 401 S.E.2d 200, 7 Va. Law Rep. 1484, 1991 Va. App. LEXIS 13 (1991).

    Remand for additional evidence. —

    Although claimant’s application for hearing could and should have been considered a petition for review on change of condition, and although the Commission had the authority to so consider it by consolidating the application with the prior claim or by adopting a procedure which would have provided the employer minimal notice to permit an adequate defense at some stage of the proceedings, where it was first determined by the Commission on review to address the claim as one for change of condition, and the Commission did not permit or require either party to present additional evidence, although it was empowered to do so, the case would be remanded so that both parties could be afforded the opportunity to present evidence on the issue of whether claimant’s condition was a compensable result of her prior injury or the result of her medical treatment for that injury. Sergio's Pizza v. Soncini, 1 Va. App. 370, 339 S.E.2d 204, 1986 Va. App. LEXIS 209 (1986).

    The Commission did not err in remanding the case to a deputy commissioner for additional evidence on the issue of the claimant’s burden of proof of change of condition, where the deputy’s holding on that issue was properly appealed and was, therefore, before the Full Commission on review. Delta Airlines v. Smith, No. 0890-89-4 (Ct. of Appeals May 8, 1990).

    In a workers’ compensation case in which a deputy commissioner made the determination that an insurer did not provide coverage under the circumstances, the Virginia Uninsured Employers’ Fund argued unsuccessfully that the Virginia Workers’ Compensation Commission abused its discretion in declining to take further evidence or remand the issue to the deputy commissioner for further evidence. Under § 65.2-700 and subsection A of § 65.2-705 , the Commission had the authority to decide the issue of coverage without remanding to the deputy commissioner for further evidence. Chester v. Redifer, 2009 Va. App. LEXIS 519 (Va. Ct. App. Nov. 24, 2009).

    Discretion regarding evidence. —

    Workers’ Compensation Commission had the discretion either to review the evidence presented to the deputy commissioner or allow the parties to present additional evidence; the Commission did not err when it relied on the medical evidence that was already in the record, and no abuse of discretion was found. McGuire v. VDOT-Tazewell, 2015 Va. App. LEXIS 287 (Va. Ct. App. Oct. 13, 2015).

    A holding adverse to a claimant in a change of condition hearing will be res judicata for the claimant to establish by evidence that was available or obtainable at the time that the condition was disabling or was caused by the industrial accident. If a claimant does not prevail on the issue whether the condition was disabling or was caused by the accidental injury, the claimant would be forever barred from proving that the specific disability was caused by the accidental injury or was a compensable consequence thereof. Mize v. Rocky Mount Ready Mix, Inc., 11 Va. App. 601, 401 S.E.2d 200, 7 Va. Law Rep. 1484, 1991 Va. App. LEXIS 13 (1991).

    Where a prior, unappealed decision determined that the worker had not sustained any discal pathology and that a proposed surgery was not causally related to a prior work accident, the doctrine of res judicata barred a subsequent claim. Wheeler v. Carey Corp., 2003 Va. App. LEXIS 109 (Va. Ct. App. Mar. 4, 2003).

    Application of res judicata provides reason under Rule 2(C) to reopen claim. —

    Because a final judgment based on a determination by the Commission on the issue of causation conclusively resolves a claim as to a particular injury, absent fraud or mistake, the doctrine of res judicata bars further litigation on that claim. This holding can preclude refiling of a change of condition application, and this holding provides the reason under Industrial (now Workers’ Compensation) Commission Rule 2(C) to satisfy the requirement that a claim be reopened when “absolutely necessary and advisable.” Mize v. Rocky Mount Ready Mix, Inc., 11 Va. App. 601, 401 S.E.2d 200, 7 Va. Law Rep. 1484, 1991 Va. App. LEXIS 13 (1991).

    Deputy commissioner’s informal consolidation of separate but related claims did not preclude review. —

    Though claims against a claimant’s first and second employers were never consolidated by formal order, they were litigated and adjudicated by the deputy commissioner on a consolidated basis. As the claims were consolidated “in effect” by both the parties and the deputy commissioner, the full Virginia Workers’ Compensation Commission’s subsequent review was not limited to the decision only as it pertained to the claim against the first employer. Interstate Truck Serv. v. Ricketts, 2006 Va. App. LEXIS 348 (Va. Ct. App. Aug. 1, 2006).

    Commission erred by refusing to reopen application. —

    Where the Commission based its refusal to reopen claimant’s application for worker’s compensation benefits on the misconception that newly obtained evidence could form the basis for filing a new change of condition application, when in fact the issue raised in such application for a change in condition would become barred due to res judicata, the Commission erred by denying the request to reopen. Mize v. Rocky Mount Ready Mix, Inc., 11 Va. App. 601, 401 S.E.2d 200, 7 Va. Law Rep. 1484, 1991 Va. App. LEXIS 13 (1991).

    No error in refusal to receive after discovered evidence. —

    Where surgery for claimant’s necrosis took place in August 1995 and the record on employer’s change in condition application was not closed until January 26, 1996, the Commission could reasonably conclude that employer had ample opportunity to review doctor’s opinion before the record closed. Therefore, the Commission did not err in denying employer’s petition to receive after-discovered evidence. County of Chesterfield v. Scott, 1996 Va. App. LEXIS 790 (Va. Ct. App. Dec. 17, 1996).

    Granting of request to reconsider vacated original opinion. —

    Deputy commissioner’s letter to counsel, granting request to reconsider earlier opinion, acted to vacate his original opinion, and thus deputy had jurisdiction to issue later opinion despite passage of more than twenty days since original opinion. Basic Constr. Co. v. Hamilton, 1999 Va. App. LEXIS 502 (Va. Ct. App. Aug. 17, 1999).

    Commission lacked authority to modify order where failure to meet time requirement. —

    Where Commission awarded claimant temporary total disability benefits in 1989 but suspended that award in 1991 because of his third-party recovery, and in 1996, claimant applied for a new offset calculation based on Section 65.2-313 , if an application for review of a final order of the Commission is not made within twenty days of the date of the order, the Commission has no jurisdiction to review the matter unless the petitioning party alleges fraud or mistake in the procurement of the award. Because claimant failed to meet this time requirement and had not alleged fraud or mistake, the Commission correctly found that it lacked authority to modify the 1991 order. Robinson v. Trego Stone Corp., 26 Va. App. 97, 493 S.E.2d 389, 1997 Va. App. LEXIS 718 (1997).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Where payment is required pursuant to an award or order that would be subject to the review period set forth in § 65.2-705 of the act, including an order for a compromise settlement, payment is due within 14 days of the expiration of the review period. The period begins to run from the date that counsel for the defendants receives the settlement order not the date the carrier receives the order. Swartz v. Home Depot, VWC File No. 200-65-49 (July 7, 2006).

    Because the Uninsured Employer’s Fund is not a party to a Show Cause Hearing for failing to comply with § 65.2-800 , it does not have standing to appeal a fine assessed against the employer. Bowser v. Michael Eugene Boggan, VWC File No. 223-95-20 (June 29, 2006).

    In general, a right of review lies only to a final decision or award “that is, a decision of the [Workers’ Compensation Commission] granting or denying, or changing or refusing to change some benefit payable or allowable under the Workers’ Compensation Act and leaving nothing to be done except to superintend ministerially the execution of the award.” Morgan v. Eastern State Hospital, 78 O.W.C. 192 (1999).

    Written statements on review must be filed by an attorney licensed to practice law in Virginia, unless the person filing the statement is a pro se litigant. McRea v. Int’l Sewer Service, Inc., 75 O.W.C. 71 (1996).

    The Commission has no jurisdiction over issues on appeal to the Virginia Supreme Court, but it retains jurisdiction over issues not on appeal. The jurisdiction of a court initially considering a matter is limited to the issues framed in the pleadings, and the same is true for the jurisdiction of the Supreme Court on appeal. Dancy v. Georgia Pacific Corporation, 76 O.W.C. 446 (1997).

    An appeal places the entire award before the Commission, and it may on review address any error and correct any decision if necessary for a just determination of the issues. Perrigan v. Clinchfield Coal Co., 75 O.W.C. 324 (1996).

    Where there has been an evidentiary hearing, a transcript of that hearing is necessary for Commission and appellate review of the Opinion of the hearing officer. Unless the parties can stipulate to factual evidence presented at the hearing, loss of the record requires remand for a new hearing. Saunders v. Management Consulting, Inc., 75 O.W.C. 22 (1996).

    So long as any portion of an award is under review or subject to the review process, the employer and carrier are not required to make payment pursuant to the award and cannot be penalized for payment not made within two weeks of the award under review, even if the review was requested by the claimant. Dees v. Crown, Cork and Seal Co., 75 O.W.C. 48 (1996).

    The employer and carrier are liable for judgment interest for payments not made pursuant to an award that is on review or subject to the review process, even if the review was requested by the claimant. Dees v. Crown, Cork and Seal Co., 75 O.W.C. 48 (1996).

    Practice Before Commission: Lawyer, Non-lawyers, Corporations:

    Proceedings before the Commission constitute practice before a tribunal, so only attorneys licensed to practice law in Virginia may represent another person before the Commission. A nonlawyer may request a hearing or submit a petition for review for another person, and the provisions of Rule 1.9 of the Rules of the Commission allows nonlawyers to submit arguments for a party in Informal Dispute Resolution proceedings. Pannell v. Gerdy Construction Co., Inc., 75 O.W.C. 219 (1996).

    A nonlawyer employee/agent of a corporate party may request a hearing or review, and offer written argument in a matter before the Commission’s Informal Dispute Resolution Department, pursuant to Rule 1.9 of the Rules of the Commission. However, nonlawyers may not represent a party in ore tenus proceedings before the Commission, or file written argument or other pleadings in a case referred for review. Washington v. City of Richmond Fire Dept., 75 O.W.C. 347 (1996).

    Representation of parties before the Virginia Workers’ Compensation Commission constitutes the practice of law. A proper person may appear pro se , but a corporate party may appear only through an attorney licensed to practice law in Virginia. Washington v. City of Richmond Fire Dept., 75 O.W.C. 347 (1996).

    A nonlawyer representative of the carrier may request review of a Commission decision, but arguing the case ore tenus or by brief constitutes the practice of law and will be heard only from licensed attorneys. Smith v. Orange Livestock Market, Inc., 75 O.W.C. 129 (1996).

    Time For Filing Review:

    For cases addressing “law of the case” see topic in notes under § 65.2-704 .

    See § 65.2-101 for definition of “filed”.

    The 20-day Review period began to run with the delivery of the Opinion to the attorney’s post office box rather than the date the mail is actually received. It is irrelevant that the attorney’s office was closed on the Saturday that the Opinion was delivered and that it was not retrieved until the following Tuesday. Prunty v. Goodyear Tire & Rubber Co., VWC File No. 212-77-70 (June 6, 2005).

    The confirmation of delivery to the claimant’s address of record is all that is required for an Opinion to be considered “received” by a party and begin the twenty-day period for a review request. The fact that the claimant was traveling and did not actually receive the Opinion does not negate that the review request was untimely. Lee v. County of Fairfax School Bd., VWC File No. 581-804 (May 10, 2005).

    The full Commission cannot review an award of a hearing Commissioner unless the application for review is received in the office of the Commission within the statutory number of days from date of original award. Harris v. Diamond Constr. Co., 184 Va. 711 , 36 S.E.2d 573, 1946 Va. LEXIS 136 (1946); Merrimac Anthracite Coal Corp. v. Showalter, 158 Va. 227 , 163 S.E. 73 , 1932 Va. LEXIS 250 (1932).

    An application for review must be made within twenty days after receipt of notice of an award. The twenty-day period established by Code § 65.2-705 and Rule 3.1 is jurisdictional, and the Commission has no jurisdiction to review a case if the request for review is not filed within that time period, except to correct for fraud or mistake. Markham v. City of Norfolk Fire & Paramedical, 78 O.W.C. 189 (1999).

    A request for review of a decision or award of the Commission must be filed in writing by a party within twenty days of the date of such decision or award. A request filed by the claimant’s father was not a valid request for review by a party. The Commission noted that the father was not a member of the claimant’s household or even living in the State. Barrett v. University of Virginia, 74 O.W.C. 49 (1995).

    An application for review is deemed “filed” on the date it is hand delivered to the Commission’s office in Richmond, or any regional office maintained by the Commission; or the date on which it is posted through the United States Postal Service by certified or registered mail. Filing by first-class mail, telegraph, electronic mail, or facsimile transmission shall be deemed completed only when the application actually reaches a Commission office. Markham v. City of Norfolk Fire & Paramedical, 78 O.W.C. 189 (1999).

    The employer mailed its original request for review in a timely manner. However, by electing to send the notice by first-class mail, the employer risked the possibility, however remote, that it would not be actually delivered to the Commission within the twenty-day period necessary to perfect the review request. Because no notice or request for review was received by a Commission office within the period required by law, the Commission held that it had no jurisdiction to hear the employer’s petition subsequently, but untimely, filed. Markham v. City of Norfolk Fire & Paramedical, 78 O.W.C. 189 (1999).

    Actual receipt of notice of award is not a condition precedent to the running of the limitation. Failure to claim the letter containing award does not operate to toll the statute. Stoll v. Campbell, 38 O.I.C. 167 (1956).

    The twenty day period to file a review request is not tolled where the employer does not receive a copy of the deputy commissioner’s opinion. Hyman v. U.S. Air, Inc., 74 O.W.C. 153 (1995).

    An award of the Commission is final if not reviewed in due time. Upon withdrawal of a Request for Review, an award becomes final. Hodge v. Great Coastal Express, 63 O.I.C. 182 (1984).

    Whenever either party withdraws its agreement to a compromise settlement and so advises the Commission before the entry of the settlement order, the Commission will not enter the order. If the order has been entered prior to the receipt of the party’s withdrawal of agreement, the party may petition for review of the order in a timely manner without the necessity of establishing fraud, mutual mistake, or imposition. Damewood v. Lanford Brothers Co., Inc., 77 O.W.C. 101 (1998).

    Where either party withdraws its approval of a Memorandum of Agreement after the award has been entered, a request for review must be made within twenty days, and the award may then be Vacated by the Commission without the necessity of establishing fraud, mistake, or imposition. Cornish v. Anheuser Busch Co., Inc., 76 O.W.C. 47 (1997).

    The claimant and the carrier negotiated a compromise settlement of the claim, and it was submitted to the Commission. The carrier was thereafter advised that the claimant had since died from causes unrelated to his work injuries, and it withdrew its agreement to the settlement. The Commission held that the carrier’s request was timely and declined to enter the compromise settlement order. Damewood v. Lanford Brothers Co., Inc., 77 O.W.C. 101 (1998).

    Employer’s petition to vacate award of medical benefits held to be “seasonably presented” where application for review was timely filed before review conducted. Altizer v. City of Williamsburg, 220 Va. 9 , 255 S.E.2d 536, 1979 Va. LEXIS 225 (1979).

    In the absence of evidence of mistake, fraud, misrepresentation or imposition, a request to amend an average weekly wage six months after the award was entered is untimely. Spencer v. Dept. of State Police, 70 O.I.C. 4 (1991).

    A party that alleges material evidentiary fraud in the case presented to the Commission must raise the issue at the evidentiary hearing or within the time allowed for review or appeal. Pollard v. First General Services, 77 O.W.C. 259 (1998).

    An employer who failed to appeal a hearing Opinion but raised issues in a reply brief to claimaint’s appeal was not entitled to have the issue heard. In the absence of a timely appeal, the Commission is not required to review each ruling made by the Deputy Commissioner that is unrelated to the issue on appeal. It is the parties’ responsibility to make a timely request for review of any contested issue. Classic Floors, Inc. v. Guy, 9 Va. App. 90, 383 S.E.2d 761, 6 Va. Law Rep. 288, 1989 Va. App. LEXIS 126 (1989).

    The parties and their counsel are responsible for reviewing the applicable statute or rule governing requests for review, and the period within which one must be filed. A party or attorney who relies upon informal information regarding filing deadlines, given to him over the telephone by someone in the Clerk’s office, does so at his peril. The Commission dismissed the Petitioner’s request for review, finding that it was filed untimely. Even though counsel was apparently misinformed about the filing deadline, the Commission found the law is clear that relying on inaccurate information does not toll a review statute. In Re: Camay Alcira, VWC File No. B-00-10 (March 13, 2002).

    Computing Time:

    Code § 1-13.3:1 [see now § 1-210 ] provides that where the last day for any paper to be served, delivered or filed, falls on a Saturday, Sunday, or legal holiday, the act may be done on the next day that is not a Saturday, Sunday or legal holiday. Burrus v. Hofheimer’s, Inc., 47 O.I.C. 53 (1965).

    Under § 1-13.3 [see now § 1-210 ] computation of time “within” which a certain action shall be taken, that time shall be allowed in addition to the day on which the event occurred. Where death occurred July 9, 1961, claim filed on July 9, 1962 was timely. Cooley v. Hundley, 45 O.I.C. 45 (1963).

    Interlocutory Reviews:

    Deputy Commissioner did not abuse her discretion in referring matter for evidentiary hearing as requested by claimant rather than conducting on-the-record hearing. Gammell v. UPS, JCN VA00000272557 (Dec. 1, 2014).

    The filing of an interlocutory request for Review does not automatically stay the underlying evidentiary, on the-the-record or show cause proceeding. Proceedings in those cases may go forward absent a preliminary Order or substantive Opinion from the Commission specifically imposing a stay. It remains within the Deputy Commissioner’s discretion to determine whether to continue a scheduled proceeding pending a decision from the Commission on the interlocutory matter. Boylan v. Cunningham Tires, VWC File No. 223-87-08 (September 8, 2010).

    Generally, a right of review lies only to a final decision or award of the Commission, granting or denying, or changing or refusing to change, some benefits payable or allowable under the Workers’ Compensation Act, and leaving nothing to be done except to superintend ministerially the execution of the award. However, the Commission possesses the discretionary authority to allow interlocutory review of evidentiary or procedural matters not involving final decisions or awards, where substantial prejudice might result from a contestable decision, upon a showing of good cause. Echols v. Rite Aid Corporation, 78 O.W.C. 16 (1999); Handlovitch v. Chesapeake General Hosp., 75 O.W.C. 293 (1996); Saunders v. Management Consulting, Inc., 75 O.W.C. 22 (1996).

    The Commission has the discretionary authority to allow interlocutory review of evidentiary or procedural matters. However, requests for such interlocutory reviews are usually denied, except for good cause. Morgan v. Eastern State Hospital, 78 O.W.C. 192 (1999).

    The claimant appealed a discovery order issued by the deputy commissioner for information deemed to be relevant and material. The claimant made no showing that the ruling of the deputy commissioner was clearly wrong or that it would result in substantial prejudice, and the Commission declined to consider the issue on review, but deferred to the deputy commissioner, who had jurisdiction. Dancy v. Georgia Pacific Corporation, 76 O.W.C. 446 (1997).

    Where the determination of a discovery issue may have great impact on an employee’s claim, interlocutory review may be appropriate. Handlovitch v. Chesapeake General Hosp., 75 O.W.C. 293 (1996).

    A decision to refer the case to the review docket is not a final decision as contemplated § 65.2-705 , but it is merely a procedural and interlocutory order not addressing the merits of a claim, and a petition on review to vacate such decision is not untimely. Saunders v. Management Consulting, Inc., 75 O.W.C. 22 (1996).

    Where the Commission remanded a case for the taking of evidence to identify periods of disability, there has been no final award for which an appeal to the Court of Appeals may be filed. Holly Farms Foods, Inc. v. Carter, 15 Va. App. 29, 422 S.E.2d 165, 9 Va. Law Rep. 191, 1992 Va. App. LEXIS 231 (1992).

    The Commission has the discretion to undertake interlocutory review of a discovery decision when failure to do so might result in substantial prejudice. The Deputy Commissioner ruled that the claimant did not have to attend an independent medical evaluation (IME) scheduled by the defendants shortly before the evidentiary hearing. The Commission reversed the Deputy Commissioner, finding that the IME had the potential of being outcome-determinative in the case. The Commission held that good cause and the potential for substantial prejudice exists when resolution of an interlocutory issue could provide the Commission with outcome-determinative testimony. Lavender v. City of Richmond Police Department, VWC File No. 201-96-35 (January 25, 2001).

    Applications/Claims Reviews:

    Absent a conflict of interest, the employer is bound by the actions of its insurance carrier in agreeing to the entry of an award and the employer cannot unilaterally contest the award or withdraw consent to its entry. Reuter v. Virginia Homes Manufacturing Corporation, VWC File No. VA00000247084 (Aug. 9, 2010).

    A decision by the Claims Department to place an application on hold until supporting documentation is received is not a judicial action and, therefore, Commission Rule 2, and its requirement that a party file a request for Review within twenty days from the date of the decision does not apply. Kibler v. Alger Brothers Construction Co., 73 O.W.C. 157 (1994).

    No statutory provision sets forth a specific statute of limitations for responding to a letter decision from a Claims Examiner. Rule 1.6 provides that a request for review of a decision accepting or rejecting a change in condition claim or application must be filed within twenty days from the date of the decision, but that Rule specifically does not refer to initial claims for benefits. The Commission’s Rule 1.1 states that an employee’s original claim for benefits shall be filed within the applicable statutes of limitations; however, this Rule does not establish a specific time in which the employee must respond if the Claims Examination Department questions whether his claim has been filed within the statute of limitation period. The Commission found that the employee’s response to the Claims Examiner thirty-three days after the claim was rejected was timely filed. Tang v. Progressive Engineering Co., 77 O.W.C. 276 (1998).

    The procedure regarding the review of a decision to accept or reject a claim or application does not provide for a written statement to be filed. The letter requesting a review should specify each determination of fact and law to which exception is taken. Rule 1.6 (D) provides that “[o]nly information contained in the file at the time of the original decision, along with the review request and any response from the opposing party, will be considered. Additional evidence will not be accepted.” Campbell v. Perdue Foods, Inc., 76 O.W.C. 157 (1997).

    Motions for Reconsideration:

    Where a motion for reconsideration is timely made, the parties will not be penalized by the Commission’s failure to rule upon the motion within twenty days. Cole v. Simmons-Rand Company, 71 O.W.C. 64 (1992).

    A Motion For Reconsideration does not substitute for a request for a review. Ferguson v. Olsten Kimberly Quality Care, 76 O.W.C. 52 (1997).

    The Commission permits parties to file requests for reconsideration. However, requests for reconsideration are different from requests for review. A request for reconsideration does not toll the statute for filing a review request. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    An application to vacate is not, strictly speaking, an application for a review. A request that a deputy reconsider to vacate an order does not preserve the claimant’s rights to challenge the deputy’s decision on review if the deputy denies or does not consider the motion within the twenty-day period before the order becomes final. Therefore, unless counsel files a motion for reconsideration or a motion to vacate in the alternative with a petition for review, the Commission’s jurisdiction to act upon its order expires with the passing of the twenty-day period. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    A Deputy Commissioner maintains control and retains jurisdiction over a claim only for twenty days after issuing an Opinion. However, where the deputy commissioner vacates his original opinion, he has jurisdiction to issue a subsequent opinion, even a year later. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    Where the Deputy Commissioner writes that he grants the request for reconsideration and will issue a new opinion on the merits, the effect of such language is to vacate his original decision and to preserve his jurisdiction to issue another opinion. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    Correcting Errors:

    Where the employer establishes by clear and convincing evidence that the claimant was not legally eligible to work in the United States at the time of her hire and accident, that she intentionally and fraudulently misrepresented her employment status to the employer, and that the employer reasonably and justifiably relied upon those representations to its detriment when it hired her and later agreed to the entry of an award of compensation benefits, the claimant’s fraud and misrepresentation resulted in an imposition on the Commission. The Commission lacked subject matter jurisdiction to enter the award of compensation benefits. The employer was under no obligation to make further independent inquiry as to the claimant’s legal status, as it had no reason to question the representations and documents produced by the claimant. To require such an investigation without reasonable justification, might result in a legitimate claim of discrimination. The employer acted seasonably in filing its application upon learning that the claimant had misrepresented her legal work status. Quezada v. P M M C Associates, Inc., 79 O.W.C. 46 (2000).

    The Commission has no jurisdiction to vacate an award based on agreement where the carrier alleged unilateral mistake of claims representative who thought he was agreeing to a medical only award, and the Request for Review of the award was untimely. Hamilton v. Quebecor World, Inc., VWC File No. 218-22-73 (Oct. 22, 2004).

    Res judicata is not applicable where fraud or misrepresentation is alleged. Even where an award has become final, the Commission has the authority to reconsider such awards that are entered through fraud, mistake or imposition. The Commission has the implied power to entertain and hear an application, seasonably presented, to vacate and set aside an award procured through fraud or mistake. Quezada v. P M M C Associates, Inc., 79 O.W.C. 46 (2000).

    Where the Commission failed to apply § 1.13-3 to extend the statute of limitations, the Commission under its implied power may take jurisdiction to correct its mistake even though a request for review was not timely filed. Perkins v. Alexandria City School Board, 71 O.W.C. 16 (1992).

    Where a second medical opinion is approved for the employer by the Commission, but the results of the completed examination are not thereafter filed with the Commission by the employer, such evidence is significant to the deliberations of the Commission and the Award entered without it may be vacated upon Motion by the claimant on the grounds of imposition. Cornish v. Anheuser Busch Co., Inc., 76 O.W.C. 47 (1997).

    Procedure:

    Oral argument will be allowed on Review only if requested by a party and the Commission deems it to be helpful in determining the issues to be reviewed. Williams v. Virginia Electric & Power Company, 18 Va. App. 569, 445 S.E.2d 693 (1994); 71 O.W.C. 101 (1992).

    The purpose of Rule 3.1 is to apprise opposing parties and the Commission of alleged errors to be considered. Where a case involves no factual disputes and the only issue is the applicability of the time limitation in Code § 65.2-708 , the issue under consideration is obvious to all. The Commission held that the employer’s request for review adequately apprised all parties of the error assigned, that no party was prejudiced by any lack of specificity, and that the request for review filed on behalf of the employer/insurer was adequate. Attia v. W9Y Construction Co., Inc., 76 O.W.C. 332 (1997).

    Where the employer does not argue an issue in its written statement on review, the Commission may deem it waived or abandoned. Leon v. Lewis-Gale Clinic, 76 O.W.C. 350 (1997).

    Where the claimant fails to identify in her request for review, specific findings of fact or conclusions of law she believes to be erroneous, and thereafter fails to submit a written statement supporting the request for review, the Commission may conclude that she waived her right to review. Stanley v. Heritage Hall/Genesis Health Ventures, Inc., VWC File No. 200-15-83 (April 5, 2002).

    Credibility Issues:

    For cases discussing credibility findings by deputy commissioners and their affect on Full Commission decisions see Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987); Corestaff Corp. Servs. Group v. Carter, 2004 Va. App. LEXIS 128 (Va. Ct. App. Mar. 30, 2004).

    A deputy commissioner’s determination of a witness’ credibility based on issues such as demeanor and appearance, may not be arbitrarily disregarded, unless it is evident from the record that there existed some basis for the Commission’s different interpretation of the witness’ credibility. When a credibility decision is reversed, it should be evident from the record how the Commission resolved the credibility issue consistent with the deputy’s observations at the evidentiary hearing. When the deputy commissioner’s finding of credibility is based, in whole or in part, upon the claimant’s appearance and demeanor at the hearing, the commission may have difficulty reversing that finding without recalling the witness. On the other hand, if the deputy commissioner’s determination of credibility is based on the substance of the testimony and not upon the witness’ demeanor and appearance, such a finding is as determinable by the Commission as by the deputy. Al-Janabi v. MCI Communications Corp., 76 O.W.C. 290 (1997).

    Absent a specific recorded observation by a Deputy Commissioner regarding behavior, demeanor or appearance of a witness, the Full Commission in reversing a lower decision has no duty to explain why it found one witness more credible than another. Bullion Hollow Enterprises, Inc. v. Lane, 14 Va. App. 725, 418 S.E.2d 904, 8 Va. Law Rep. 3527, 1992 Va. App. LEXIS 174 (1992).

    When the Commission reverses a specific credibility determination of a Deputy Commissioner that is based on a recorded observation of the demeanor or appearance of a witness, the Commission must articulate its reasons for reversing the credibility finding. Bullion Hollow Enterprises, Inc. v. Lane, 14 Va. App. 725, 418 S.E.2d 904, 8 Va. Law Rep. 3527, 1992 Va. App. LEXIS 174 (1992).

    If a Deputy Commissioner’s determination of credibility is based on a key witness’s demeanor or appearance, the Commission may have difficulty reversing that finding without recalling the witness. However, if the determination of credibility is based upon the substance of the testimony rather than upon the witness’ demeanor such a finding is as determinable by the Full Commission as by the deputy. Kroger Company v. Morris, 14 Va. App. 233, 415 S.E.2d 879, 8 Va. Law Rep. 2552, 1992 Va. App. LEXIS 107 (1992).

    § 65.2-706. Conclusiveness of award; appeal.

    1. The award of the Commission, as provided in § 65.2-704 , if not reviewed in due time, or an award of the Commission upon such review, as provided in § 65.2-705 , shall be conclusive and binding as to all questions of fact. No appeal shall be taken from the decision of one Commissioner until a review of the case has been had before the full Commission, as provided in § 65.2-705 , and an award entered by it. Appeals shall lie from such award to the Court of Appeals in the manner provided in the Rules of the Supreme Court.
    2. The notice of appeal shall be filed with the clerk of the Commission within 30 days from the date of such award. A copy of the notice of appeal shall be filed in the office of the clerk of the Court of Appeals as provided in the Rules of Court.
    3. Cases so appealed shall be placed upon the privileged docket of the Court of Appeals and be heard at the next ensuing term thereof. In case of an appeal from the decision of the Commission to the Court of Appeals, or from the decision of the Court of Appeals to the Supreme Court, the appeal shall operate as a suspension of the award and no employer shall be required to make payment of the award involved in the appeal until the questions at issue therein shall have been fully determined in accordance with the provisions of this title.

    History. Code 1950, § 65-94; 1968, c. 660, § 65.1-98; 1971, Ex. Sess., c. 156; 1972, c. 696; 1977, c. 624; 1984, cc. 659, 703; 1991, c. 355; 1999, c. 938; 2003, cc. 664, 671; 2010, cc. 160, 564.

    Cross references.

    For special rule applicable to appeals from the Virginia Workers’ Compensation Commission, see Supreme Court Rule 5A:11.

    The 1999 amendment inserted “or from the decision of the Court of Appeals to the Supreme Court” in subsection C.

    The 2003 amendments.

    The 2003 amendments by cc. 664 and 671 are identical, and in the first sentence of subsection B, substituted “30 days” for “thirty days” twice and substituted “by priority mail with delivery confirmation or equivalent mailing option of such award” for “by registered or certified mail of such award.”

    The 2010 amendments.

    The 2010 amendments by cc. 160 and 564 are identical, and deleted “or within 30 days after receipt of notice to be sent by priority mail with delivery confirmation or equivalent mailing option of such award” at the end of the first sentence of subsection B.

    Law Review.

    For comment on section, see 45 Va. L. Rev. 1448 (1959).

    For survey of Virginia law on torts for the year 1969-1970, see 56 Va. L. Rev. 1419 (1970).

    For article, “Appellate Justice: A Crisis in Virginia?” see 57 Va. L. Rev. 3 (1971).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    For note discussing the Virginia Judicial Council’s intermediate appellate court proposal, see 16 U. Rich. L. Rev. 209 (1982).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 2 Potential Jurisdiction. § 2.03 Courts. Bryson.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 1 Courts. § 1.08 Workers’ Compensation Commission. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 1A M.J. Administrative Law, § 18; 15 M.J. Public Service and State Corporation Commissions, §§ 20, 33; 20 M.J. Water Companies and Waterworks, § 2; 3B M.J. Carriers, § 104; 15 M.J. Public Service and State Corporation Commissions, §§ 2, 30.

    CASE NOTES

  • Analysis
  • I.General Consideration.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-98 or prior law.

    Validity of section has never been questioned. —

    The validity of this provision of the Workmen’s (now Workers’) Compensation Act has never been questioned. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923); Town of Falls Church v. County Bd., 166 Va. 192 , 184 S.E. 459 , 1936 Va. LEXIS 181 (1936).

    When questions on appeal “fully determined.” —

    Where an employee had filed a petition for rehearing with the court of appeals, the earliest date that the court could have issued a mandate, which would have “fully determined” the issues on appeal and triggered the employer’s duty to pay benefits, was when it denied the employee’s petition. Childress v. Appalachian Power Co., 2001 Va. App. LEXIS 13 (Va. Ct. App. Jan. 16, 2001).

    II.Conclusiveness of Findings.
    A.Findings of Commission.

    Supreme Court is bound by Commission’s findings. —

    Under the provisions of the Virginia Workmen’s (now Workers’) Compensation Act, the Supreme Court is bound by the findings of fact of the Compensation Commission. Scott County School Bd. v. Carter, 156 Va. 815 , 159 S.E. 115 , 1931 Va. LEXIS 234 (1931); Butler v. Nolde Bros., 189 Va. 932 , 55 S.E.2d 36, 1949 Va. LEXIS 229 (1949); Stephens v. A.L. Wright & Co., 194 Va. 404 , 73 S.E.2d 399, 1952 Va. LEXIS 245 (1952); Mills v. VEPCO, 197 Va. 547 , 90 S.E.2d 124, 1955 Va. LEXIS 254 (1955); Rogers v. Sky Chefs, Inc., 222 Va. 800 , 284 S.E.2d 605, 1981 Va. LEXIS 376 (1981).

    The Commission’s findings of fact, when based on evidence deemed by it to be credible, are conclusive and binding on the Supreme Court, and in the absence of fraud are not subject to review. Carter v. Hercules Powder Co., 182 Va. 282 , 28 S.E.2d 736, 1944 Va. LEXIS 177 (1944); Estep v. Blackwood Fuel Co., 185 Va. 695 , 40 S.E.2d 181, 1946 Va. LEXIS 244 (1946); Stump v. Norfolk Shipbuilding & Dry Dock Corp., 187 Va. 932 , 48 S.E.2d 209, 1948 Va. LEXIS 280 (1948); Mulkey v. Firth Bros. Iron Works, 188 Va. 451 , 50 S.E.2d 404, 1948 Va. LEXIS 179 (1948); Johnson v. Capitol Hotel, 189 Va. 585 , 54 S.E.2d 106, 1949 Va. LEXIS 202 (1949); Southall v. Eldridge Reams, Inc., 198 Va. 545 , 95 S.E.2d 145, 1956 Va. LEXIS 240 (1956); Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958); Fairfax Hosp. v. DeLaFleur, 221 Va. 406 , 270 S.E.2d 720, 1980 Va. LEXIS 258 (1980); Morris v. Badger Powhatan/Figgie Int'l, Inc., 3 Va. App. 276, 348 S.E.2d 876, 3 Va. Law Rep. 856, 1986 Va. App. LEXIS 362 (1986).

    The Supreme Court does not retry the facts before the Commission nor does it review the weight, preponderance of the evidence, or the credibility of witnesses. If there is evidence or reasonable inference that can be drawn from the evidence to support the Commission’s findings, they will not be disturbed by the court on appeal, even though there is evidence in the record to support contrary findings of fact. Caskey v. Dan River Mills, Inc., 225 Va. 405 , 302 S.E.2d 507, 1983 Va. LEXIS 237 (1983).

    It is the Supreme Court’s duty to determine whether credible evidence supports the Commission’s finding and, if such evidence exists, to sustain the finding. Cook v. City of Waynesboro Police Dep't, 225 Va. 23 , 300 S.E.2d 746, 1983 Va. LEXIS 188 (1983).

    “The actual determination of causation is a factual finding that will not be disturbed on appeal if there is credible evidence to support the finding.” Utility Trailer Mfg. v. Prater, 1996 Va. App. LEXIS 300 (Va. Ct. App. Apr. 23, 1996).

    An award of the Workers’ Compensation Commission is conclusive and binding as to all questions of fact. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    In an appeal, it was determined that a workers’ compensation commission properly denied a worker claim for workers’ compensation benefits based on carpal tunnel syndrome under subsection C of § 65.2-400 and § 65.2-401 , as the worker failed to show that pre-existing blood disorders did not contribute to the development of the carpal tunnel syndrome. Leuthner v. Can. Dry Potomac Corp., 2005 Va. App. LEXIS 331 (Va. Ct. App. Aug. 30, 2005).

    If supported by evidence. —

    A finding of fact by the Commission is binding upon the Supreme Court if it is supported by the evidence. American Motorists Ins. Co. v. Summers, 183 Va. 428 , 32 S.E.2d 673, 1945 Va. LEXIS 189 (1945); Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953); Clinchfield Coal Co. v. Bowman, 229 Va. 249 , 329 S.E.2d 15, 1985 Va. LEXIS 199 (1985).

    When there is no conflict of evidence, then, if there is any evidence to support the findings of fact of the Commission, such findings are conclusive and binding. Humphries v. Newport News Shipbuilding & Dry Dock Co., 183 Va. 466 , 32 S.E.2d 689, 1945 Va. LEXIS 193 (1945); Allstate Messenger Serv. v. James, 220 Va. 910 , 266 S.E.2d 86, 1980 Va. LEXIS 183 (1980); Press v. Ale, 1 Va. App. 153, 336 S.E.2d 522, 1985 Va. App. LEXIS 77 (1985).

    Decisions of the commission as to questions of fact, if supported by credible evidence, are conclusive and binding on the court of appeals. The fact that contrary evidence may be found in the record is of no consequence if credible evidence supports the commission’s finding. Manassas Ice & Fuel Co. v. Farrar, 13 Va. App. 227, 409 S.E.2d 824, 2000 Va. App. LEXIS 86 (1991).

    The Commission’s finding on the issues of willful misconduct by an employee and proximate cause of an accident, these issues being issues of fact, is binding on appeal if sustained by credible evidence. Mills v. VEPCO, 197 Va. 547 , 90 S.E.2d 124, 1955 Va. LEXIS 254 (1955).

    The Commission’s finding may not be disturbed if it be sustained by credible evidence. Island Creek Coal Co. v. Fletcher, 201 Va. 645 , 112 S.E.2d 833, 1960 Va. LEXIS 140 (1960); LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970) (Ct. of Appeals Aug. 21, 1990); LeWhite Constr. Co. v. Dunn, 211 Va. 279 , 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970) (Ct. of Appeals Aug. 28, 1990); LeWhite Constr. Co. v. Dunn, 211 Va. 279, 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970) (Ct. of Appeals Aug. 28, 1990); LeWhite Constr. Co. v. Dunn, 211 Va. 279, 176 S.E.2d 809, 1970 Va. LEXIS 247 (1970); Keller Mfg. Co. v. Hoke, 215 Va. 525 , 211 S.E.2d 82, 1975 Va. LEXIS 184 (1975); McCaskey v. Patrick Henry Hosp., 225 Va. 413 , 304 S.E.2d 1, 1983 Va. LEXIS 238 (1983); Chandler v. Schmidt Baking Co., 228 Va. 265 , 321 S.E.2d 296, 1984 Va. LEXIS 198 (1984).

    Workers’ compensation commission’s finding that the claimant did not establish that her injury arose out of her employment where she tripped on gravel surrounding a storm drainage grate and injured her knee as she crossed a traffic lane to enter the store where she worked and, thus, the appellate court was bound by that finding. Cleveland v. Food Lion, L.L.C. # 0578, 43 Va. App. 514, 600 S.E.2d 138, 2004 Va. App. LEXIS 375 (2004).

    A finding of fact by the Commission, if supported by credible evidence, is conclusive and binding upon the Supreme Court. And a finding upon conflicting medical evidence that a certain physical condition does or does not exist is such a conclusive finding of fact. McPeek v. P.W. & W. Coal Co., 210 Va. 185 , 169 S.E.2d 443, 1969 Va. LEXIS 219 (1969).

    Upon appeal the Commission’s findings of fact are conclusive and binding upon the Supreme Court if supported by credible evidence. Great Atl. & Pac. Tea Co. v. Robertson, 218 Va. 1051 , 243 S.E.2d 234 (1978); Stocks v. Fauquier County School Bd., 222 Va. 695 , 284 S.E.2d 588 (1981); Ivey v. Jerry P. Puckett Constr. Co., 230 Va. 486 , 338 S.E.2d 640 (1986); Austin v. Gheen Roofing Co., No. 0806-85 (Ct. of Appeals Feb. 12, 1986).

    A finding by the Commission upon conflicting facts as to causal relationship is conclusive and binding on the Supreme Court, absent fraud, when such determination is supported by competent, credible evidence. C.D.S. Constr. Servs. v. Petrock, 218 Va. 1064 , 243 S.E.2d 236, 1978 Va. LEXIS 266 (1978).

    Finding that the claimant had not established the necessary causal connection between the industrial accident and the employee’s death, supported by credible evidence, was conclusive on appeal. Mulkey v. Firth Bros. Iron Works, 188 Va. 451 , 50 S.E.2d 404, 1948 Va. LEXIS 179 (1948).

    The Commission’s finding that employee had not given notice as required by former § 65.1-51 (now § 65.2-405 ) was based on credible evidence and therefore conclusive. Lewis v. Lynchburg Foundry Co., 204 Va. 303 , 130 S.E.2d 429, 1963 Va. LEXIS 148 (1963).

    A determination by the Commission upon conflicting facts as to causal relationship is conclusive and binding on appeal, absent fraud, when such finding is supported by competent, credible evidence. Likewise, the Commission’s conclusions upon conflicting inferences, legitimately drawn from proven facts, are equally binding on appeal. Watkins v. Halco Eng'g, Inc., 225 Va. 97 , 300 S.E.2d 761, 1983 Va. LEXIS 196 (1983); Dairymen/Flav-O-Rich, Inc. v. Shaffer, 225 Va. 163 , 300 S.E.2d 774, 1983 Va. LEXIS 203 (1983).

    Findings of fact made by the Commission are conclusive on appeal when supported by credible evidence. Caskey v. Dan River Mills, Inc., 225 Va. 405 , 302 S.E.2d 507, 1983 Va. LEXIS 237 (1983); Southland Corp. v. Parson, 1 Va. App. 281, 338 S.E.2d 162, 1985 Va. App. LEXIS 100 (1985)(Ct. of Appeals Dec. 10, 1985); Southland Corp. v. Parson, 1 Va. App. 281, 338 S.E.2d 162, 1985 Va. App. LEXIS 100 (1985); VPI & State Univ. v. Wood, 5 Va. App. 72, 360 S.E.2d 376, 4 Va. Law Rep. 621, 1987 Va. App. LEXIS 271 (1987); Elgnawey v. Commonwealth, 2000 Va. App. LEXIS 213 (Va. Ct. App. Mar. 21, 2000).

    If there is evidence or a reasonable inference that can be drawn from the evidence to support the Commission’s finding, they will not be disturbed by the court on appeal. Jules Hairstylists, Inc. v. Galanes, 1 Va. App. 64, 334 S.E.2d 592 (1985); Watts v. Woodrow Wilson Rehabilitation Center, No. 0495-85 (Ct. of Appeals Dec. 10, 1985).

    Where Commission’s findings that employee’s hearing loss was caused by his employment and that it was not caused by factors outside of his employment were supported by credible evidence, the court was bound to support such findings. Island Creek Coal Co. v. Breeding, 6 Va. App. 1, 365 S.E.2d 782, 4 Va. Law Rep. 1900, 1988 Va. App. LEXIS 29 (1988).

    The court of appeals must uphold the Workers’ Compensation Commission’s factual findings when those findings are supported by credible evidence. VEPCO v. Bobbitt, 1997 Va. App. LEXIS 145 (Va. Ct. App. Mar. 11, 1997).

    When a commission opinion is based upon medical findings, that resolution is a factual finding based on credible evidence that binds the court. Utility Trailer Mfg. v. Prater, 1996 Va. App. LEXIS 300 (Va. Ct. App. Apr. 23, 1996).

    Factual findings of commission are conclusive and binding upon court of appeals, if such findings are supported by credible evidence. Turpin v. Fairfax County Sch. Bd., 1999 Va. App. LEXIS 614 (Va. Ct. App. Nov. 2, 1999).

    Credible evidence existed to support the workers’ compensation commission’s decision to terminate the claimant’s benefits based on the fact that she voluntarily quit her work without justification, and, thus, that finding was binding on the appellate court that she asked to review the decision. Mileos v. Venus Pizza, 2003 Va. App. LEXIS 416 (Va. Ct. App. July 29, 2003).

    Although there was contrary evidence in the record, there was credible evidence to support the workers’ compensation commission’s finding that a worker’s shoulder injury was causally related to a prior compensable injury. Wellmont Lonesome Pine Hosp. v. Cantor, 2003 Va. App. LEXIS 435 (Va. Ct. App. Aug. 12, 2003).

    Where the parties agreed in a memorandum of agreement that the nature of an employee’s work-related injury was cervical strain, lumbar strain, and left carpal tunnel syndrome, credible evidence clearly supported the workers’ compensation commission’s finding that an employee’s proposed carpal tunnel surgery was related to a compensable accident; therefore, the commission’s award of benefits was affirmed. Bell Atlantic-Virginia, Inc. v. Jett, 2004 Va. App. LEXIS 105 (Va. Ct. App. Mar. 9, 2004).

    Reports of three medical expert witnesses presented to the workers’ compensation commission supported the Commission’s finding that there was no causal relationship between the employee’s compensable injury and the employee’s claims for medical treatment following the date on which the employee was found to have reached maximum medical improvement. Thus, the reviewing court pursuant to subsection A of § 65.2-706 was required to defer to the Commission as to that finding. McWhorter v. Williamsburg/James City County & Cmty. Action Agency, Inc., 2008 Va. App. LEXIS 218 (Va. Ct. App. May 6, 2008).

    Workers’ Compensation Commission, which essentially concluded that the evidence was, at best, indeterminate as to the state of a mat before appellant’s fall, did not err in rejecting appellant’s claim for benefits. The Commission’s decision was consistent with the evidence, binding precedent, and the text of the Workers’ Compensation Act. Effler v. Cardinal Logistics Mgmt. Corp., 2019 Va. App. LEXIS 198 (Va. Ct. App. Sept. 3, 2019).

    But if review by the full Commission of an award at an initial hearing occurred pursuant to former § 65.1-97 (now § 65.2-705 ), the findings of facts by the initial hearing would not be binding. Williams v. Auto Brokers, 6 Va. App. 570, 370 S.E.2d 321, 5 Va. Law Rep. 99, 1988 Va. App. LEXIS 74 (1988).

    Even though weight of evidence may be contra. —

    If the findings of fact by the Commission are supported by substantial evidence, such findings are conclusive upon the Supreme Court even though the weight of the evidence may be contra. Kelly v. Pendleton Constr. Co., 182 Va. 191 , 28 S.E.2d 621, 1944 Va. LEXIS 167 (1944).

    Or if there is a conflict of evidence. —

    Where there is a conflict of evidence, the Commission’s finding of fact is conclusive upon the Supreme Court. Holt v. Stone & Webster Eng’r Corp., 179 Va. 625 , 20 S.E.2d 498 (1942); Byrd v. Stonega Coke & Coal Co., 182 Va. 212 , 28 S.E.2d 725 (1944); Vassal v. Lane Co., No. 0831-89-3 (Ct. of Appeals May 1, 1990).

    Whenever there is a conflict in the evidence, the finding of fact of the Commission, based upon a preponderance of the evidence, or upon that evidence deemed credible by the Commission, are conclusive and binding. Humphries v. Newport News Shipbuilding & Dry Dock Co., 183 Va. 466 , 32 S.E.2d 689, 1945 Va. LEXIS 193 (1945).

    Findings of fact made by the Commission are conclusive on appeal when supported by credible evidence. If there is evidence or reasonable inference that can be drawn from the evidence to support the Commission’s findings, they will not be disturbed by the Court of Appeals, even though there is evidence in the record to support contrary findings of fact. Boddie-Noell v. Deloatch, No. 0651-85 (Ct. of Appeals Feb. 12, 1986).

    Commission determination that an employer was not entitled to a credit under § 65.2-712 for benefits paid to or on behalf of a worker was proper because the commission resolved any inconsistency in the testimony by crediting the charity motive as the driving force behind the benefits conferred on the worker, and was not persuaded that the allowances made to the worker were truly a substitute for wages. Fairfax Hosp. v. McKaveney, 2007 Va. App. LEXIS 365 (Va. Ct. App. Oct. 2, 2007).

    Or where conflicting inferences may be drawn from facts. —

    Where divergent or conflicting inferences reasonably might be drawn from established facts their determination is exclusively for the fact-finding body. Hopson v. Hungerford Coal Co., 187 Va. 299 , 46 S.E.2d 392, 1948 Va. LEXIS 223 (1948).

    Upon review, the Court of Appeals will uphold findings of fact made by the Commission when supported by credible evidence, even though there is evidence in the record to support contrary findings of fact. Hahn v. Aeco Bldg. Co., No. 0329-85 (Ct. of Appeals Dec. 4, 1985); Forbes v. Marval Poultry Co., No. 0759-85 (Ct. of Appeals Dec. 23, 1985).

    Under familiar principles, the Court of Appeals cannot disturb a finding unless there is no credible evidence in the record to support it. Phrased differently, if there is evidence, or a reasonable inference that can be drawn from the evidence, to support the Commission’s finding, it will not be reversed on appeal even though there is evidence in the record to support a contrary finding of fact. Link v. Consolidated Freightways, No. 0122-85 (Ct. of Appeals Jan. 8, 1986).

    The appellate court does not retry the facts before the Commission nor does it review the weight or preponderance of the evidence or the credibility of witnesses. If there is evidence or reasonable inferences that can be drawn from the evidence to support the Commission’s findings, they will not be disturbed by the court on appeal, even though there is evidence in the record to support contrary findings of fact. Board of Supvrs. v. Taylor, 1 Va. App. 425, 339 S.E.2d 565, 1986 Va. App. LEXIS 219 (1986).

    Commission decides weight of evidence. —

    It is peculiarly within the province of the Commission to decide what evidence, if credible, is entitled to greater weight. McPeek v. P.W. & W. Coal Co., 210 Va. 185 , 169 S.E.2d 443, 1969 Va. LEXIS 219 (1969).

    Facts are considered from viewpoint most favorable to prevailing party. See VPI & State Univ. v. Wood, 5 Va. App. 72, 360 S.E.2d 376, 4 Va. Law Rep. 621, 1987 Va. App. LEXIS 271 (1987); Helfer v. Va. Dep't of Rehabilitative Servs., 2003 Va. App. LEXIS 224 (Va. Ct. App. Apr. 15, 2003).

    This section authorizes the full commission to reverse factual findings, including a credibility determination based on behavior, appearance and demeanor, when it articulates a basis for its different conclusion that is supported by credible evidence in the record. Williams v. Auto Brokers, 6 Va. App. 570, 370 S.E.2d 321, 5 Va. Law Rep. 99, 1988 Va. App. LEXIS 74 (1988).

    In the absence of fraud, the findings of fact by the Commission are not subject to review. It is the sole judge of the facts established by the evidence, and neither evidence adduced before it nor any other evidence can be introduced to impeach or qualify the facts found by it. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923); Berry v. F.S. Royster Guano Co., 161 Va. 442 , 171 S.E. 519 , 1933 Va. LEXIS 334 (1933); Blair v. Buchanan Coal Corp., 171 Va. 102 , 198 S.E. 491 , 1938 Va. LEXIS 260 (1938); Burlington Mills Corp. v. Hagood, 177 Va. 204 , 13 S.E.2d 291, 1941 Va. LEXIS 207 (1941), limited, Chesterfield County v. Dunn, 9 Va. App. 475, 389 S.E.2d 180, 6 Va. Law Rep. 1384, 1990 Va. App. LEXIS 31 (1990).

    Court cannot hear any evidence in the cause. —

    On appeal from an award of the Compensation Commission, the Supreme Court cannot hear any evidence in the cause. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923).

    Or consider any evidence in conflict with findings. —

    The findings of fact by the Compensation Commission in a proceeding under this Act, when supported by the evidence, are binding upon the Supreme Court, which cannot consider any other evidence in conflict therewith. Turner v. Virginia Fireworks Co., 149 Va. 371 , 141 S.E. 142 , 1928 Va. LEXIS 375 (1928).

    Only question is whether facts justify award. —

    Where the Compensation Commission makes an award, and, although some contradiction may arise from speculative inferences, there is no positive or direct evidence in conflict therewith, the facts found are binding and controlling upon the Supreme Court, and all that remains to be determined is whether the facts are sufficient in law to justify the allowance of compensation. Lynchburg Foundry Co. v. Irvin, 178 Va. 265 , 16 S.E.2d 646, 1941 Va. LEXIS 162 (1941).

    But court is not bound in absence of credible evidence. —

    If there is no credible evidence on which the Commission’s finding of fact is based, then such finding is not binding upon the Supreme Court. The question then becomes a question of law. Byrd v. Stonega Coke & Coal Co., 182 Va. 212 , 28 S.E.2d 725, 1944 Va. LEXIS 170, limited, Carter v. Hercules Powder Co., 182 Va. 282 , 28 S.E.2d 736, 1944 Va. LEXIS 177 (1944); Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953); Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962); Great Atl. & Pac. Tea Co. v. Robertson, 218 Va. 1051 , 243 S.E.2d 234, 1978 Va. LEXIS 264 (1978); Morris v. Badger Powhatan/Figgie Int'l, Inc., 3 Va. App. 276, 348 S.E.2d 876, 3 Va. Law Rep. 856, 1986 Va. App. LEXIS 362 (1986); Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    If there is no credible evidence to support the Commission’s findings of fact, its findings are not binding on the Supreme Court and the question of the sufficiency of the evidence becomes one of law. Goodyear Tire & Rubber Co. v. Watson, 219 Va. 830 , 252 S.E.2d 310 (1979); Stocks v. Fauquier County School Bd., 222 Va. 695 , 284 S.E.2d 588 (1981); Austin v. Gheen Roofing Co., No. 0806-85 (Ct. of Appeals Feb. 12, 1986).

    As there was no evidence that an injured employee made a reasonable effort to market his residual work capacity, under subsection A of § 65.2-502 , he was not entitled to temporary partial disability benefits for the weeks during which he was placed on light duty work and did not receive overtime, which he had regularly received before his injury. The Virginia Workers’ Compensation Commission’s conclusion that accepting available jobs would have interfered with his duties to his employer, including his ability to accept any overtime work it offered, was not supported by any evidence. Ford Motor Co. v. Favinger, 275 Va. 83 , 654 S.E.2d 575, 2008 Va. LEXIS 4 (2008).

    Employee who waited over 10 months after his retirement due to an occupational disease to seek employment, did not offer evidence as to what jobs were available based on his education, training, and limitations, and sought no further employment for higher pay after accepting a low-paying part-time position did not reasonably market his residual work capacity, such that an award of total partial disability benefits by the Virginia Workers’ Compensation Commission was not supported by the evidence pursuant to the applicable standard of review under § 65.2-706 . County of James City Fire Dep't v. Smith, 54 Va. App. 448, 680 S.E.2d 307, 2009 Va. App. LEXIS 348 (2009).

    For an award which is unsupported by evidence is illegal and should be set aside. Holt v. Stone & Webster Eng'r Corp., 179 Va. 625 , 20 S.E.2d 498, 1942 Va. LEXIS 256 (1942).

    And sufficiency of evidence is question of law. —

    Where the only complaint against an award of the Commission is that the evidence is insufficient to support the finding of the Commission, there being no conflict in the evidence, a question of law is raised, and petitioner for a writ of error is entitled to have the evidence certified. Scott v. Willis, 150 Va. 260 , 142 S.E. 400 , 1928 Va. LEXIS 311 (1928).

    Unless it can be said as a matter of law that the evidence submitted by claimant was sufficient to sustain his burden of proving injury by accident, then the Commission’s finding that he did not suffer injury by accident is binding and conclusive on appeal. Tomko v. Michael's Plastering Co., 210 Va. 697 , 173 S.E.2d 833, 1970 Va. LEXIS 186 (1970).

    On appeal, the Commission’s findings of fact are conclusive and binding, but when there is no conflict in the evidence, the question of the sufficiency thereof is one of law. The same is true when there is no credible evidence to support the Commission’s factual findings. VEPCO v. Kremposky, 227 Va. 265 , 315 S.E.2d 231, 1984 Va. LEXIS 242 (1984).

    Factual findings of the commission are binding on appeal. “The question of whether an employee was guilty of willful misconduct is a question of fact. But if there is no credible evidence to support a finding of fact, the issue becomes sufficiency of the evidence as a matter of law for us to decide.” Uninsured Employers' Fund v. Mason, 1996 Va. App. LEXIS 246 (Va. Ct. App. Apr. 9, 1996).

    When sufficiency of evidence reviewable. —

    Only if the factual findings are not supported by credible evidence does the question of sufficiency of the evidence become one of law and a proper subject for review on appeal. Jules Hairstylists, Inc. v. Galanes, 1 Va. App. 64, 334 S.E.2d 592, 1985 Va. App. LEXIS 62 (1985).

    When two conclusions may be drawn from the evidence, one favorable to the claimant and the other favorable to the employer, then a factual question is presented. The Commission must evaluate the evidence and make a finding of fact. If the finding of fact is supported by credible evidence, then it is binding on appeal. United Va. Bank v. Yates, No. 0266-85 (Ct. of Appeals Sept. 27, 1985).

    Reasons for believing one witness over another need not be stated. —

    The law does not require the Commission to state its reasons for believing one witness over another. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Court will not accept finding it judicially knows is untrue. —

    The court will not accept as a finding of fact by the Commission that which it judicially knows is not a fact. So where the Commission found that the complainant was a special deputy employed by the sheriff and injured in the discharge of his duties, such finding will not be accepted by the court as conclusive because a sheriff has no authority to employ a special officer. Board of Supvrs. v. Lucas, 142 Va. 84 , 128 S.E. 574 , 1925 Va. LEXIS 320 (1925).

    Finding of Commission as to number of employees is conclusive. —

    Where the majority of the Commission found as a fact that the defendant company at no time had as many as 11 (now three) men in its employment at or prior to the date of the accident, the appellate court is bound by such finding. Vanzant v. Southern Bending Co., 143 Va. 244 , 129 S.E. 268 , 1925 Va. LEXIS 262 (1925).

    A finding of the Commission upon conflicting medical testimony is one of fact. Johnson v. Capitol Hotel, 189 Va. 585 , 54 S.E.2d 106, 1949 Va. LEXIS 202 (1949).

    Factual findings by the Commission are “conclusive and binding” and a question raised by conflicting medical opinion is a question of fact. Virginia Beach Gen. Hosp. v. Watson, No. 0432-85 (Ct. of Appeals Dec. 10, 1985); McDaniel v. Triple B. Mechanical Contractors, No. 0319-85 (Ct. of Appeals Jan. 8, 1986).

    The Court of Appeals does not review the weight or preponderance of the evidence nor the credibility of the witnesses, except to consider whether there exists sufficient credible evidence to sustain the findings. A finding based upon conflicting expert medical opinions is one of fact which cannot be disturbed; to the extent no conflict exists between the medical opinions, the sole question to be reviewed is the legal sufficiency of the evidence to support the finding. Virginia Dep't of State Police v. Talbert, 1 Va. App. 250, 337 S.E.2d 307, 1985 Va. App. LEXIS 94 (1985).

    A question raised by conflicting medical evidence is a question of fact. Factual findings of the Commission, if supported by credible evidence, are conclusive and binding upon appeal. If credible evidence exists to support the Commission’s finding, it must be sustained. This is true even if there is evidence to support contrary findings of fact. Jacobs Transfer, Inc. v. Dion, No. 0795-85 (Ct. of Appeals Jan. 8, 1986).

    Finding that death was due to disease rather than accident. —

    A finding of the Commission upon conflicting medical testimony that a condition or death was due to a disease rather than to an industrial accident is such a finding of fact. Johnson v. Capitol Hotel, 189 Va. 585 , 54 S.E.2d 106, 1949 Va. LEXIS 202 (1949); Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958).

    Findings based on conflicting expert opinions. —

    A finding by the Commission as to questions of fact, if supported by credible evidence, is conclusive and binding upon the Supreme Court. This rule also applies to facts found from conflicting expert opinions. When there is an internal conflict in an expert’s opinion, the Commission may consider other evidence in determining whether a claimant has met his burden of proof. The rule respecting conflicting expert opinions also applies when a sole expert gives conflicting opinions. Chandler v. Schmidt Baking Co., 228 Va. 265 , 321 S.E.2d 296, 1984 Va. LEXIS 198 (1984).

    Employee’s workers’ compensation claim based on an injury allegedly occurring while the employee was working as a flight attendant failed because, inter alia, medical opinions contradicted the employee’s physician’s testimony that a diagnosis of decompression sickness explained the employee’s symptoms. Pang v. Air Wis. Airlines, 2019 Va. App. LEXIS 206 (Va. Ct. App. Sept. 24, 2019).

    Conclusions of the Commission on questions of law, or mixed questions of law and fact, are not binding on the Supreme Court. Brown v. Fox, 189 Va. 509 , 54 S.E.2d 109, 1949 Va. LEXIS 193 (1949); Richmond Newspapers, Inc. v. Gill, 224 Va. 92 , 294 S.E.2d 840, 1982 Va. LEXIS 273 (1982).

    There being no conflict in the evidence, the question of the sufficiency thereof is one of law, and the decision of the Commission is not, therefore, such as is conclusive and binding upon the Supreme Court, and it must inquire to determine if the correct legal conclusion has been reached. City of Norfolk v. Bennett, 205 Va. 877 , 140 S.E.2d 655, 1965 Va. LEXIS 148 (1965).

    The issue of whether a worker has suffered an impairment that constitutes a compensable disease is a mixed question of law and fact and, hence, a Commission finding on the question is not conclusive and binding on the appellate court, but is properly the subject of judicial review. Stenrich Group v. Jemmott, 251 Va. 186 , 467 S.E.2d 795, 1996 Va. LEXIS 30 (1996).

    Whether employee has suffered an “accident” is mixed question. —

    If the Commission had found as a fact that the claimant suffered an accident while in the employ of the defendant, its finding in that respect would not be binding upon the Supreme Court, for the reason that whether, under a given state of facts and circumstances, an employee has suffered an accident, within the meaning of the Workmen’s (now Workers’) Compensation Act, is a mixed question of law and fact which is properly reviewable by the Supreme Court. Clinchfield Carbocoal Corp. v. Kiser, 139 Va. 451 , 124 S.E. 271 , 1924 Va. LEXIS 122 (1924).

    As is what constitutes “employee.” —

    What constitutes an “employee” is a question of law and fact. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923).

    And finding that accident arose out of and in the course of employment. —

    A finding that an injury was sustained from an accident arising out of and in the course of employment, is a mixed conclusion of law and fact. American Furn. Co. v. Graves, 141 Va. 1 , 126 S.E. 213 , 1925 Va. LEXIS 386 (1925); Conner v. Bragg, 203 Va. 204 , 123 S.E.2d 393, 1962 Va. LEXIS 129 (1962).

    A finding that an injury arose out of and in the course of employment is a mixed finding of law and fact and is properly reviewable by the Court. City of Richmond v. Braxton, 230 Va. 161 , 335 S.E.2d 259, 1985 Va. LEXIS 263 (1985).

    A finding of the Commission that an injury arose out of the employment is a mixed question of law and fact, and is reviewable on appeal. The Court of Appeals must determine, therefore, whether the Commission’s findings from the facts presented are sufficient as a matter of law to justify the compensation award on the basis that the claimant’s injury arose out of his employment. Richmond King, Inc. v. Poling, No. 0816-85 (Ct. of Appeals Jan. 8, 1986).

    Virginia Workers’ Compensation Commission’s finding that a widow was not entitled to workers’ compensation benefits was upheld under subsection A of § 65.2-706 because a reasonable mind could conclude as the Commission did where the widow equivocally testified that the decedent was riding his motorcycle on a work errand after Sunday dinner but there was no evidence to corroborate the assertion that the decedent was delivering paper work to his bookkeeper, and as such, the widow failed to prove that the decedent’s death, which occurred as a result of an accident on a public highway, arose out of or in course of his employment under § 65.2-101 . Clifton v. Clifton Cable Contr., LLC, 54 Va. App. 532, 680 S.E.2d 348, 2009 Va. App. LEXIS 361 (2009).

    Virginia Workers’ Compensation Commission (Commission) properly found that the claimant’s injury arose out of her employment under § 65.2-101 where the claimant fell because her purse was caught on a hook located on a merchandise shelf in a grocery store aisle; the Commission’s finding that the hook was peculiar to the claimant’s grocery store workplace and was not common to the neighborhood was entitled to deference under subsection A of § 65.2-706 . Giant Food LLC & Indem. Ins. Co. of N. Am. v. Wu, 2013 Va. App. LEXIS 69 (Va. Ct. App. Mar. 5, 2013).

    Whether a Virginia state trooper’s post-traumatic stress disorder resulted from a sudden fright or shock and thus, occurred in the course of employment, was a factual determination made by the Virginia Workers’ Compensation Commission, and since evidence supported that determination, it was not further reviewable on appeal; the trooper’s traumatic experience was not a sudden or unexpected shock or fright for a state trooper who received fatal accident and crash scene reconstruction training. Hess v. Va. State Police, 68 Va. App. 190, 806 S.E.2d 413, 2017 Va. App. LEXIS 280 (2017).

    Whether employee was exposed to an increased risk of injury is a mixed question. —

    In order to be entitled to compensation under the “arising out of” prong of the test which is used to determine if an employee is entitled to workers’ compensation benefits, an employee must prove that the employment activity in which he was engaged exposed him to an injurious risk to an extent to which people are not ordinarily exposed, and thus caused his injuries. This determination involves a mixed question of law and fact, and the Court of Appeals of Virginia is bound by the Virginia Workers’ Compensation Commission’s factual findings so long as they are supported by credible evidence, even if contrary evidence may be found in the record. Va. Empl. Comm'n v. Hale, 43 Va. App. 379, 598 S.E.2d 327, 2004 Va. App. LEXIS 304 (2004).

    Finding that relationship was that of independent contractor rather than master and servant was held not a question of fact but a conclusion of law reviewable by the Supreme Court. Brown v. Fox, 189 Va. 509 , 54 S.E.2d 109, 1949 Va. LEXIS 193 (1949).

    Willful misconduct is issue of fact. —

    The questions of whether or not a claimant has been guilty of willful misconduct and whether such misconduct was a proximate cause of the employee’s accident are issues of fact. But, if there is no credible evidence to support a finding of fact, the issue becomes sufficiency of the evidence as a matter of law for the court to decide. Uninsured Employer's Fund v. Keppel, 1 Va. App. 162, 335 S.E.2d 851, 1985 Va. App. LEXIS 78 (1985).

    Findings supported by credible evidence. —

    Since credible evidence supported a factual finding by the Virginia Workers’ Compensation Commission that an employee’s treating physician referred the employee’s continuing care and treatment for a work-related injury to another physician, that factual finding was binding in the employer’s appeal to the Court of Appeals of Virginia. Since that factual finding supported the Commission’s decision to grant the employee’s application to change physicians, the Commission also properly determined that the employee did not refuse medical treatment by his treating physician and the employer’s application to suspend compensation was also properly denied. Mullican Flooring v. Parsons, 2004 Va. App. LEXIS 347 (Va. Ct. App. July 20, 2004).

    Award finding that the employer unreasonably defended its failure to pay medical benefits pursuant to an existing award and that upheld the payment of 24-hour attendant care expenses to the claimant’s wife was upheld on appeal where the employer’s new adjuster ceased the payments to the claimant without notice and without checking the file to find that such amounts had been approved already. Va. Polytechnic Inst. v. Posada, 47 Va. App. 150, 622 S.E.2d 762, 2005 Va. App. LEXIS 508 (2005).

    Virginia Workers’ Compensation Commission properly found that a claimant did not aggravate his prior compensable injury but sustained a new injury, as it could reasonably have inferred that when he picked up a box and felt radiating pain and numbness, this caused a sudden mechanical or structural change in his back, resulting in increase in his back pain. Dean Steel Erection Co. v. Arbaugh, 2006 Va. App. LEXIS 309 (Va. Ct. App. July 11, 2006).

    Workers’ Compensation Commission’s decision to award a claimant permanent total disability benefits for a change in condition was supported by sufficient credible evidence because while a videotape of the claimant indicated that she could possibly do more than she indicated, such as shopping alone at a grocery store, any exaggeration of the extent of the effect of her injury on her ability to perform everyday functions did not discredit the other evidence supporting her claim, including testimony by her treating physician of 10 years that indicated that the claimant could not be engaged in any gainful employment due to her injury. Mount Vernon Hosp. v. Devers, 2008 Va. App. LEXIS 494 (Va. Ct. App. Nov. 4, 2008).

    Pursuant to subsection A of § 65.2-605 , the record on review supported the findings of the Workers’ Compensation Commission that the claimant testified credibly as to his pain and reports to treating doctor regarding pain and that the testimony of the employer’s insurance claims adjuster was not credible. Outreach Constr. & S. Ins. Co. v. Peterson, 2010 Va. App. LEXIS 10 (Va. Ct. App. Jan. 12, 2010).

    Finding that the employee was entitled to ongoing workers’ compensation benefits was appropriate because the record supported the finding that the employer failed to prove that it was prejudiced by the third-party settlement since the evidence, viewed in the light most favorable to claimant, established that claimant suffered no exacerbation of his compensable 2004 brain injury in the 2006 auto accident and continued to be temporarily and totally disabled as a result of the 2004 brain injury after the 2006 auto accident. United Airlines, Inc. v. Hayes, 58 Va. App. 220, 708 S.E.2d 418, 2011 Va. App. LEXIS 163 (2011).

    Denial of benefits was appropriate because (1) the Virginia Workers’ Compensation Commission had reason to doubt the conclusions of three physicians on whose opinions the claimant relied because the opinions were inconclusive or inconsistent; (2) the Commission was able to consider the opinion of one doctor as the opinion rested on an adequate foundation and whatever flaws were ascribed to it did not render it inadmissible as a matter of law; and (3) the Commission committed no error in assessing one doctor’s testimony. Stokes v. Monogram Snacks Martinsville, LLC, 2012 Va. App. LEXIS 90 (Va. Ct. App. Mar. 27, 2012).

    Credible evidence supported the Workers’ Compensation Commission’s decision that a claimant, who suffered a head injury at work, was not totally disabled because the claimant’s treating physician did not take the claimant out of work or indicate she was disabled, the claimant’s headache symptoms were subjective, and the claimant’s other conditions, including bipolar disorder and substance abuse, were not work-related and could have contributed to her inability to keep a job. Hoerst v. Janelia Farm Research Campus, 2014 Va. App. LEXIS 57 (Va. Ct. App. Feb. 25, 2014).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s finding that a firefighter’s leukemia did not result in a disability because he was still capable of performing his full duties; the firefighter did not establish a prima facie case necessary to secure the benefit of the rebuttable presumption because he failed to prove that his leukemia had reached a stage that prevented him from performing his work efficiently, thereby making him disabled as a result of his disease. Samartino v. Fairfax County Fire & Rescue, 64 Va. App. 499, 769 S.E.2d 692, 2015 Va. App. LEXIS 84 (2015).

    Having found that credible evidence supported the Virginia Workers’ Compensation Commission’s factual finding that a treating physician did not refer a claimant for a second opinion, the appellate court was bound by that finding on appeal. Harvey v. Old Dominion Univ., 2015 Va. App. LEXIS 272 (Va. Ct. App. Sept. 22, 2015).

    Virginia Workers’ Compensation Commission did not err in denying an employee benefits because the employee failed to establish that his injuries were caused by an actual risk of his employment; credible evidence supported the Commission’s determination that the employee was injured when he merely stood from a bent position after placing an angle iron on a tarp, and that determination was binding on appeal. Shrewsberry v. Martinsville Mach. Works, Inc., 2018 Va. App. LEXIS 56 (Va. Ct. App. Mar. 6, 2018).

    Virginia Workers’ Compensation Commission did not err in concluding that an employer was obligated to pay for a claimant’s surgery and related treatment with her treating physician because the claimant offered sufficient medical evidence to establish that the surgery was reasonable, necessary, and causally related to the work accident; the Commission, as fact-finder, permissibly credited the claimant’s evidence and rejected the conflicting evidence. Hyatt Place-Chantilly Dulles v. Alvarenga, 2019 Va. App. LEXIS 234 (Va. Ct. App. Oct. 22, 2019).

    Workers’ Compensation Commission did not err in accepting the 2% permanent partial disability (PPD) rating for the claimant’s left arm as the award was based on credible evidence because the claimant’s treating physician agreed that she had reached maximum medical improvement and that the functional capacity evaluation conclusion was correct; the treating physician was aware the claimant had suffered a frozen shoulder that was being treated in the same office by the second doctor; the second doctor had released her from treatment; and there was no evidence in the record that the second doctor diagnosed the frozen shoulder as contributing to a permanent disability or disagreed with the treating physician’s opinion regarding the PPD rating. Allen v. County of Henrico Pub. Schs., 2019 Va. App. LEXIS 303 (Va. Ct. App. Dec. 10, 2019).

    Evidence supported the Virginia Workers’ Compensation Commission’s award of workers’ compensation benefits to a police officer because there was credible evidence that supported his assertion that his injury occurred as a result of a specific incident during the final scenario; the officer’s evidence was uncontradicted because the city offered no evidence to refute his claim that the specific incident caused his injury. City of Charlottesville v. Sclafani, 300 Va. 212 , 862 S.E.2d 101, 2021 Va. LEXIS 93 (2021).

    Workers’ Compensation Commission did not err by awarding temporary total disability because there was not sufficient support in the record to support a termination for poor work performance as alleged by the employer in its application and supporting materials. There was also no error in limiting the allegation to poor performance because the Commission’s finding that it could not adjudicate an issue that was not before it was not arbitrary and capricious. Cty. of Chesterfield v. Overton, 2021 Va. App. LEXIS 209 (Va. Ct. App. Nov. 16, 2021).

    Award for medical benefits causally related to a claimant’s left knee sprain and left knee injury, including the requested left knee total knee replacement surgery, was appropriate because the claimant’s treating physician opined, to a reasonable degree of medical probability, that the claimant’s work accident aggravated the claimant’s pre-existing osteoarthritis, that the claimant suffered a meniscal root tear stemming from the work accident, and that the claimant required surgery as a result of the work accident. Goodyear Tire & Rubber Co. v. Foley, 2022 Va. App. LEXIS 137 (Va. Ct. App. May 3, 2022).

    Finding that burden of proof not met. —

    The Court of Appeals may not disturb a finding that the claimant had not met his burden of proof because of the many inconsistencies and contradictions in his testimony even though the record also contains evidence that would support the contrary finding. Waldron v. Skyline Constr., Inc., No. 0721-85 (Ct. of Appeals Dec. 23, 1985).

    Remand was necessary because the Virginia Workers’ Compensation Commission erred by finding that a claimant met the claimant’s burden to prove that the claimant reasonably marketed the claimant’s residual work capacity after obtaining part-time work. The claimant should have present evidence of: (1) the names of businesses the claimant contacted; (2) the types of positions sought; (3) the number of contacts made; and (4) the time frame within which work was sought. Tricon Constr., Inc. v. Rojas-Rojas, 2014 Va. App. LEXIS 49 (Va. Ct. App. Feb. 18, 2014).

    Unless an appellate court can say as a matter of law that a workers’ compensation claimant sustained the claimant’s burden of proving an “injury by accident,” the findings of the Virginia Workers’ Compensation Commission to the contrary on that issue are binding and conclusive upon the appellate court. Helfer v. Va. Dep't of Rehabilitative Servs., 2003 Va. App. LEXIS 224 (Va. Ct. App. Apr. 15, 2003).

    In light of the testimony of the employer’s witnesses and the employee’s inconsistent explanations for her fall, the Virginia Workers’ Compensation Commission could reasonably have concluded that the employee was speculating as to the cause of her fall and, therefore, she failed to sustain her burden of proof by a preponderance of the evidence. Rygielski v. Lynchburg Gen. Hosp., 2004 Va. App. LEXIS 25 (Va. Ct. App. Jan. 20, 2004).

    Failure to prove causal connection. —

    Virginia Workers’ Compensation Commission did not err in denying a claim seeking temporary total disability benefits and lifetime medical benefits from a work accident because the claimant did not prove a causal connection between his alleged disability and the accident as, although he testified that he received medical treatment soon after his symptoms began, the first medical record he submitted in support was dated nearly a month after the accident; the first medical record that alluded to him suffering a work injury was dated nine days after his termination from employment and nearly two months following the accident; and there was no medical evidence attributing the metal boom hitting his helmet to his neck and right shoulder pain. Blue v. Michels Corp., 2022 Va. App. LEXIS 193 (Va. Ct. App. May 31, 2022).

    The Commission’s factual findings are conclusive and binding on appellate court and a question raised by conflicting expert medical opinions is one of fact; but where there is no conflict in the evidence, the question of the sufficiency thereof is one of law. Eccon Constr. Co. v. Lucas, 221 Va. 786 , 273 S.E.2d 797, 1981 Va. LEXIS 209 (1981).

    Workers’ Compensation Commission’s award is conclusive and binding to all questions of fact, therefore a court had to affirm the Commission’s finding that there was a causal link between a worker’s head injury and subsequent herniated disc; it could not be said that the evidence supporting the Commission’s finding of fact was incredible as a matter of law. Daugherty Bros. Chevrolet, Inc. v. Estate of Tabor, 2004 Va. App. LEXIS 175 (Va. Ct. App. Apr. 13, 2004).

    Virginia Workers’ Compensation Commission held that the evidence established that the claimant developed sexual/erectile dysfunction (and a need for a prescription drug), at least in part, as a direct consequence of the workplace injury to his back. Given the weight afforded the opinion of a treating physician, coupled with the compounding weight that opinion had once it had been accepted as true by the Commission, there was no basis for overturning the Commission’s decision to treat the claimant’s sexual dysfunction as a compensable consequence of his workplace injury. Berglund Chevrolet, Inc. v. Landrum, 43 Va. App. 742, 601 S.E.2d 693, 2004 Va. App. LEXIS 418 (2004).

    Workers’ Compensation Commission’s finding that references to an employee’s left knee in medical reports submitted after the settlement of her claim arising out of a 1997 accident were too vague to constitute the filing of a claim for the left knee was supported by the record and could not be set aside, pursuant to subsection A of § 65.2-706 . Jones v. United States Senate Fed. Credit Union, 55 Va. App. 227, 685 S.E.2d 189, 2009 Va. App. LEXIS 522 (2009).

    Award of temporary total disability benefits to an employee in a workers’ compensation action was appropriate pursuant to subsection A of § 65.2-706 because the persuasive reasoning of the dissenting commissioner involved a dispute over factfinding and the appellate court was not a factfinder. Further, neither of the principles that the Virginia Workers’ Compensation Commission allegedly violated was an axiom of law; nothing required the Commission to adopt the treating physician’s opinion or required the Commission to defer to the credibility factfinding of its deputies. U.S. Airways, Inc. v. Taite-Pressey, 2010 Va. App. LEXIS 67 (Va. Ct. App. Feb. 23, 2010).

    Federal court may not relitigate issues litigated before Commission as long as the record shows that plaintiff was afforded a full and fair adjudication. Sherman v. City of Richmond, 543 F. Supp. 447, 1982 U.S. Dist. LEXIS 13762 (E.D. Va. 1982).

    Setting aside award on grounds of fraud or mistake. —

    In the exercise of its power to set aside a final award upon the ground of fraud or mistake, the Commission applies the same rules applicable to a proceeding in equity to annul a final judgment at law. In order to prevail, the moving party must prove the allegations upon which he seeks relief by positive and direct evidence which is clear and convincing. J & D Masonry, Inc. v. Kornegay, 224 Va. 292 , 295 S.E.2d 887, 1982 Va. LEXIS 294 (1982).

    Credible evidence supported a finding that there was insufficient proof of constructive fraud by a claimant because the claimant did not withhold information or misrepresent the facts, but relief on contradictory information from her doctor, which was also provided to the employer, and the employer did not detrimentally rely on a misrepresentation or omission. Transit Mgmt. Co. v. Williams, 2009 Va. App. LEXIS 429 (Va. Ct. App. Sept. 29, 2009).

    Unilateral mistake of fact by carrier. —

    Where the evidence proves merely a unilateral mistake of fact by the carrier unaccompanied by any fraud attributable to the claimant, relief will not be granted. J & D Masonry, Inc. v. Kornegay, 224 Va. 292 , 295 S.E.2d 887, 1982 Va. LEXIS 294 (1982).

    B.Findings of Commissioner or Deputy Commissioner.

    Effect of findings of fact at initial hearing. —

    If review by the full commission of an award at an initial hearing occurred pursuant to former § 65.1-97 (now § 65.2-705 ), the findings of facts by the initial hearing are not binding. Stonega Coke & Coal Co. v. Sutherland, 136 Va. 489 , 118 S.E. 133 , 1923 Va. LEXIS 100 (1923); Town of Falls Church v. County Bd., 166 Va. 192 , 184 S.E. 459 , 1936 Va. LEXIS 181 (1936).

    No finality. —

    Deputy commissioner’s letter to counsel, granting request to reconsider earlier opinion, acted to vacate his original opinion, and thus deputy had jurisdiction to issue later opinion despite passage of more than twenty days since original opinion. Basic Constr. Co. v. Hamilton, 1999 Va. App. LEXIS 502 (Va. Ct. App. Aug. 17, 1999).

    When an award of the Virginia Workers’ Compensation Commission was appealed to the Virginia Court of Appeals, the employer’s obligation to pay benefits was suspended, under subsection C of § 65.2-706 , and the Commission’s decision that an appeal from a deputy commissioner to the Commission likewise suspended the employer’s obligation to pay benefits was not unreasonable, because the deputy commissioner’s decision was not final if a timely request for review was filed, as, under § 65.2-705 , a request for review empowered the Commission to hear the case de novo, so it left more to be done than to ministerially execute the award. Gallahan v. Free Lance Star Publ'g Co., 41 Va. App. 694, 589 S.E.2d 12, 2003 Va. App. LEXIS 607 (2003).

    Orders by the Virginia Workers’ Compensation Commission compelling a benefits recipient to comply with discovery requests were not appealable; the orders did not affect the recipient’s benefits, as there had been no request for review of the award, nor had the recipient been sanctioned for failing to comply with the discovery orders. Green v. Keil Plumbing & Heating, Inc., 42 Va. App. 539, 593 S.E.2d 525, 2004 Va. App. LEXIS 108 (2004).

    Appellants claimed the findings were binding on the Workers’ Compensation Commission, but appellants proceeded as if the deputy commissioner found that medical benefits beyond 2008 were barred and no longer necessary, but he did not express such a finding; a finding of very good resolution to the employee’s problems did not provide finality of the award, and the interpretation that the award was not final and did not preclude further claims was reasonable in light of the statute. Target Corp. v. Hussein, 2014 Va. App. LEXIS 279 (Va. Ct. App. Aug. 12, 2014).

    Commission has authority to hear case de novo and will not be bound by the findings of the deputy. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Deputy Commissioner’s findings as to credibility not necessarily binding. —

    A specific, recorded observation of a key witness’ demeanor or appearance in relation to credibility is an aspect of the hearing that the Commission may not arbitrarily disregard. However, the deputy commissioner’s findings as to credibility do not necessarily bind the Commission. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Where the full commission determined that claimant’s testimony was not credible and could not support a finding that he had sustained a compensable injury, even though the deputy commissioner found him to be a credible witness, the full commission was not bound to accept his testimony. Williams v. Auto Brokers, 6 Va. App. 570, 370 S.E.2d 321, 5 Va. Law Rep. 99, 1988 Va. App. LEXIS 74 (1988).

    When commissioner not bound by deputy commissioner’s findings. —

    Credible evidence supported the Virginia Workers’ Compensation Commission’s decision that the employer failed to establish that employee was no longer disabled due to a work-related injury. Because the deputy commissioner’s finding was not based on the surgeon’s demeanor or appearance, the Commission was not bound by that finding and could make its own finding. Corestaff Corp. Servs. Group v. Carter, 2004 Va. App. LEXIS 128 (Va. Ct. App. Mar. 30, 2004).

    When full Commission does not hear witness’ testimony, deputy’s observations about witness credibility become a part of the evidence which the Commission may not arbitrarily ignore and dismiss. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Review of ruling based on claimant’s appearance and demeanor. —

    When the deputy commissioner’s finding of credibility is based, in whole or in part, upon the claimant’s appearance and demeanor at the hearing, the Commission may have difficulty reversing that finding without recalling the witness. On the other hand, if the deputy commissioner’s determination of credibility is based on the substance of the testimony and not upon the witness’ demeanor and appearance, such a finding is as determinable by the full Commission as by the deputy. Only when the deputy’s finding as to credibility is specifically based upon the witness’ appearance and demeanor is a due process question raised. Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987).

    Necessity for review by full commission. —

    Decisions of a deputy commissioner that are not reviewed by the full commission cannot be brought before the Court of Appeals. Duncan v. ABF Freight Sys., 20 Va. App. 418, 457 S.E.2d 424, 1995 Va. App. LEXIS 456 (1995).

    Because employer did not request full commission review of deputy’s decision failing to award it credit for certain payments to claimant, deputy’s denial of relief to employer for such payments was not before full commission on review; court could therefore not subsequently entertain error in attendant decision of commission for a failure to address that issue. Newport News Shipbuilding & Dry Dock v. Lawrence, 1999 Va. App. LEXIS 477 (Va. Ct. App. Aug. 3, 1999).

    The full commission acted arbitrarily when it disregarded a deputy commissioner’s credibility determination without offering any basis for its decision. Williams v. Auto Brokers, 6 Va. App. 570, 370 S.E.2d 321, 5 Va. Law Rep. 99, 1988 Va. App. LEXIS 74 (1988).

    III.Procedure on Appeal.

    Appeals do not lie as a matter of right, irrespective of the amount in controversy, from awards of the Compensation Commission. Bee Hive Mining Co. v. Ford, 144 Va. 21 , 131 S.E. 203 , 1926 Va. LEXIS 226 (1926).

    “Such award” means final award. —

    The words “such award,” as used in this section, mean final award, that is, a decision of the Compensation Commission granting or denying, or changing or refusing to change, some benefit payable or allowable under the Workers’ Compensation Act and leaving nothing to be done except to superintend ministerially the execution of the award. Jewell Ridge Coal Corp. v. Henderson, 229 Va. 266 , 329 S.E.2d 48, 1985 Va. LEXIS 202 (1985); Holly Farms Foods, Inc. v. Carter, 15 Va. App. 29, 422 S.E.2d 165, 9 Va. Law Rep. 191, 1992 Va. App. LEXIS 231 (1992).

    An opinion of the full commission affirming a deputy commissioner on the jurisdictional issue of whether the employer regularly employed three or more employees and remanding the case to the deputy commissioner for a determination of the claimant’s entitlement to benefits did not constitute a final award appealable to the court of appeals because it was not an award that left nothing to be done. Uninsured Employer's Fund v. Kramer, 32 Va. App. 77, 526 S.E.2d 304, 2000 Va. App. LEXIS 218 (2000).

    Full Commission must review order of single member. —

    Where a claimant made no application to the full Commission for review of the order of a single member, but filed his petition in the Supreme Court for a writ of error from that order, a motion to dismiss must be sustained. Gray v. Underwood Bros., 167 Va. 182 , 188 S.E. 151 , 1936 Va. LEXIS 289 (1936).

    Time for taking appeal. —

    There can be no appeal from the decision of the Commission after 30 days have expired. Richmond Cedar Works & Liberty Mut. Ins. Co. v. Harper, 129 Va. 481 , 106 S.E. 516 , 1921 Va. LEXIS 111 (1921).

    Decision was not final until entry of the deputy commissioner’s award establishing periods of compensable disability, and where the deputy commissioner’s duties on remand were not merely “ministerial,” the commission erred when it held that, because its decision of December 26, 1990, was not appealed, that decision became final on January 26, 1991. The commission’s December opinion did not take final effect until the deputy commissioner identified the periods of disability and entered an award to claimant. Holly Farms Foods, Inc. v. Carter, 15 Va. App. 29, 422 S.E.2d 165, 9 Va. Law Rep. 191, 1992 Va. App. LEXIS 231 (1992).

    Commission’s decision to deny referral for peer review under former Chapter 13 (§ 65.1-153 et seq.) of this title (now § 65.2-1300 et seq.) is not appealable. Jewell Ridge Coal Corp. v. Henderson, 229 Va. 266 , 329 S.E.2d 48, 1985 Va. LEXIS 202 (1985).

    Ruling that claim had not been abandoned not reviewable. —

    A finding by the full Commission that an employee’s change-in-condition application was properly filed and not abandoned by the employee did not constitute a final award appealable to the Court of Appeals, in that the Commission referred the matter back to the hearing docket for a determination of the substantive issues surrounding the employee’s application and did not dispose of the merits of the claim, leaving nothing further to be done. 7-Eleven v. Smith, 2001 Va. App. LEXIS 317 (Va. Ct. App. June 5, 2001).

    Appeal of first review findings not waived. —

    Virginia Workers’ Compensation Commission could not, and did not, find in a second review opinion that an appeal challenging any of the Commission’s findings in its first review opinion had been waived or was otherwise precluded. Meidan, Inc. v. Leavell, 62 Va. App. 436, 749 S.E.2d 201, 2013 Va. App. LEXIS 291 (2013).

    Filing by certified mail. —

    Where plaintiff’s petition for appeal from a decision of the Commission was timely forwarded by certified mail, postage prepaid, to the clerk of the court, the petition was deemed timely filed since there is no reason for a distinction in the manner in which petitions for appeal from the Commission are physically filed as compared to those in civil and criminal litigation. Reese v. Wampler Foods, Inc., 222 Va. 249 , 278 S.E.2d 870, 1981 Va. LEXIS 297 (1981).

    Timely filing for review. —

    Decision that awarded a claimant permanent partial disability benefits was summarily affirmed because the employer did not seek timely review of that decision pursuant to subsection A of § 65.2-706 ; therefore, the decision became final and was not subject to review by the court. Newport News Shipbuilding & Dry Dock Co. v. Wilson, 2006 Va. App. LEXIS 459 (Va. Ct. App. Oct. 17, 2006).

    Reviewing court’s duty is to determine whether credible evidence supports the Commission’s finding. Jules Hairstylists, Inc. v. Galanes, 1 Va. App. 64, 334 S.E.2d 592, 1985 Va. App. LEXIS 62 (1985).

    Reviewing court does not retry facts before the Commission, nor does it review the weight, preponderance of the evidence, or the credibility of witnesses. Jules Hairstylists, Inc. v. Galanes, 1 Va. App. 64, 334 S.E.2d 592, 1985 Va. App. LEXIS 62 (1985).

    Findings supported by credible evidence. —

    Virginia Workers’ Compensation Commission properly held that an employee was entitled to a change in his treating physician, when a referring physician referred him to one of his partners, as: (1) both doctors were on the panel of doctors provided by the employer to the employee; (2) it was appropriate for the partner doctor to treat the employee; and (3) the treatment was reasonable, necessary, and related to the employee’s work injury. K & K Repairs & Constr. v. Endicott, 47 Va. App. 1, 622 S.E.2d 227, 2005 Va. App. LEXIS 465 (2005).

    Virginia Workers’ Compensation Commission’s determination that the claimant was not required to market the claimant’s residual work capacity was supported by credible evidence under subsection A of § 65.2-706 ; evidence of the prognosis of the claimant, a professional hockey player, for a full recovery before the next hockey season, combined with evidence of the intensity of the claimant’s rehabilitation and the level of involvement of the employer’s agents in overseeing the rehabilitative process, constituted credible evidence supporting the finding that the claimant had no duty to market the claimant’s residual capacity under the facts of the case. Norfolk Admirals v. Jones, 2005 Va. App. LEXIS 443 (Va. Ct. App. Nov. 1, 2005).

    Virginia Workers’ Compensation Commission’s conclusion that an employee failed to show that he made a reasonable effort to market his remaining work capacity was supported by the evidence because the employee’s disability was self-defined and his restrictions were not documented by his treating physician; the employee’s job search lacked documentation, the employee would approach construction companies and advise them of his “restrictions,” he acknowledged that he never had an interview where the job duties were compatible with his “restrictions,” and the employee applied for positions he, himself, thought he could not perform. Strickland v. Jones Bros., 2009 Va. App. LEXIS 77 (Va. Ct. App. Feb. 17, 2009).

    CIRCUIT COURT OPINIONS

    No right to subrogation against legal malpractice proceeds. —

    Employer and its workers’ compensation insurer were not entitled to a lien against the verdict that an employee obtained in a medical malpractice suit against a doctor because the employer and insurer were compelled to provide workers’ compensation benefits as a result of the on-the-job accident and not as a result of the doctor’s medical negligence; the employer was required to provide compensation benefits to the employee or on his behalf, but the award orders of the Workers’ Compensation Commission conclusively established that those benefits were for the employee’s broken leg, not for damages caused by a third party. Thompson v. Alhadeff, 2011 Va. Cir. LEXIS 137 (Roanoke Oct. 11, 2011).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    The failure to timely file an appeal to the Court of Appeals is a jurisdictional defect. An appeal that is dismissed because it was not timely filed was never within that Court’s jurisdiction, and a penalty is owed on compensation not paid within 44 days of the date of notice to the employer of the Commission’s decision. Bartley v. Henrico County, 76 O.W.C. 407 (1997).

    The Commission has no jurisdiction over issues on appeal to the Virginia Supreme Court, but it retains jurisdiction over issues not on appeal. The jurisdiction of a court initially considering a matter is limited to the issues framed in the pleadings, and the same is true for the jurisdiction of the Supreme Court on appeal. Dancy v. Georgia Pacific Corporation, 76 O.W.C. 446 (1997).

    Where the Commission remanded a case for the taking of evidence to identify periods of disability, there has been no final award for which an appeal to the Court of Appeals may be filed. Holly Farms Foods, Inc. v. Carter, 15 Va. App. 29, 422 S.E.2d 165, 9 Va. Law Rep. 191, 1992 Va. App. LEXIS 231 (1992).

    Where the Commission failed to apply § 1.13-3 to extend the statute of limitations, the Commission under its implied power may take jurisdiction to correct its mistake even though a request for review was not timely filed. Perkins v. Alexandria City Sch. Board, 71 O.W.C. 16 (1992).

    Conclusiveness of Findings:

    A finding by the Commission that an accident happened will be binding on the Supreme Court, if sustained by credible evidence. Virginia Electric, Etc., Co. v. Quann, 197 Va. 9 , 87 S.E.2d 624 (1955). However, where claimant gives varied and uncorroborated accounts of alleged accident, which accounts are incredible in that others present at the same time would have been bound to have had knowledge of the accident had it happened as alleged, the Supreme Court will not sustain the finding of the Commission. Rust Eng. Co. v. Ramsey, 194 Va. 975 , 76 S.E.2d 195, 1953 Va. LEXIS 166 (1953); Watson v. Goodyear Tire & Rubber Co., 219 Va. 830 , 252 S.E.2d 310, 1979 Va. LEXIS 177 (1979).

    Upon appeal, the Commission’s findings, based upon credible evidence, are conclusive and binding upon Supreme Court, but if there is no credible evidence to support the Commission’s findings of fact, its findings are not binding and the question of the sufficiency of the evidence one of law. Stocks v. Fauquier County School Board, 222 Va. 695 , 284 S.E.2d 588, 1981 Va. LEXIS 360 (1981).

    Supreme Court is not bound by finding of fact made by the Commission based on evidence deemed credible by the Commission. Daniels v. Insurance Management Corporation of Tidewater, 222 Va. 434 , 281 S.E.2d 847, 1981 Va. LEXIS 326 (1981).

    An award of the Commission is final if not reviewed in due time. Upon withdrawal of a Request for Review, an award becomes final. Hodge v. Great Coastal Express, 63 O.I.C. 182 (1984).

    For cases in which no appeal is taken to the Court of Appeals, a penalty is assessed if payment is not paid within two weeks after 30 days, or 44 days. For cases that are appealed, §§ 65.2-706 (C) and 8.01-685 stay the award and a penalty does not apply until two weeks after the appellate decision is received by the Commission’s clerk. Bartley v. Henrico County, 76 O.W.C. 407 (1997).

    Computing Time:

    Code § 1-13.3:1 [see now § 1-210 ] provides that where the last day for any paper to be served, delivered or filed, falls on a Saturday, Sunday or legal holiday, the act may be done on the next day that is not a Saturday, Sunday or legal holiday. Burrus v. Hofheimer’s, Inc., 47 O.I.C. 53 (1965).

    Under § 1-13.3 [see now § 1-210 ] computation of time “within” which a certain action shall be taken, that time shall be allowed in addition to the day on which the event occurred. Where death occurred July 9, 1961, claim filed on July 9, 1962 was timely. Cooley v. Hundley, 45 O.I.C. 45 (1963).

    For additional information on Appeals from the Commission consult the Rules of the Supreme Court with special attention to Rule 5A:11 and Bond Form 7.

    § 65.2-706.1. Estoppel effect of a Virginia Workers’ Compensation Commission determination of employment status.

    A final, unappealed award by the Virginia Workers’ Compensation Commission that a person is or is not an employee of another for the purpose of obtaining jurisdiction shall estop either of said parties from asserting otherwise in any subsequent action between such parties upon the same claim or cause of action in a court of this Commonwealth.

    History. 1997, c. 333.

    § 65.2-706.2. Claims not barred.

    No order issued by the Commission awarding or denying benefits shall bar by res judicata any claim by an employee or cause a waiver, abandonment, or dismissal of any claim by an employee if the order does not expressly adjudicate such claim.

    History. 2021, Sp. Sess. I, c. 515.

    Effective date.

    This section is effective July 1, 2021, pursuant to Va. Const. Art IV, § 13.

    § 65.2-707. Interest on appealed award.

    An award entered by the Commission shall take effect on the date of entry. To the extent that any payment due under an award is delayed beyond its due date by reason of an appeal to the full Commission or an appellate court, payments so delayed shall bear interest at the judgment rate as provided in § 6.2-302 .

    History. 1982, c. 410, § 65.1-98.1; 1991, c. 355.

    Editor’s note.

    Effective October 1, 2010, “§ 6.2-302 ” was substituted for “§ 6.1-330.54” to conform to the recodification of Title 6.1 by Acts 2010, c. 794.

    CASE NOTES

    Commission, and not the Court of Appeals, was the proper forum for a claimant to raise issue. —

    The Virginia Workers’ Compensation Commission, and not the Court of Appeals of Virginia, was the proper forum for a claimant to raise his request for interest on an award, pursuant to § 65.2-707 . Clean Scape, Inc. v. Ramirez-Gutierrez, 2007 Va. App. LEXIS 423 (Va. Ct. App. Dec. 4, 2007).

    Payment from Uninsured Employer’s Fund. —

    Remand to the Virginia Workers’ Compensation Commission was necessary to clarify which party was required to pay interest on an award to a benefits claimant; the order did not specify the party responsible to pay the interest, and the text of the order did not indicate that the procedure in subsection A of § 65.2-1203 was followed. The Uninsured Employer’s Fund did not simply step into the shoes of the employer. Uninsured Employer's Fund v. Carter, 2013 Va. App. LEXIS 16 (Va. Ct. App. Jan. 15, 2013).

    Claimant not entitled to interest. —

    Although a claimant was entitled to unpaid compensation and late payment penalties because the employer and insurer erroneously credited her wages upon her return to work against the temporary total disability award, the claimant was not entitled to interest thereon since the penalties were not paid pursuant to an award. Diaz v. Wilderness Resort Ass'n & Liberty Mut. Ins. Co., 56 Va. App. 104, 691 S.E.2d 517, 2010 Va. App. LEXIS 148 (2010).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    An employer’s liability for interest is limited to the time the payment of compensation is delayed by the appeals process. There is no provision in the Act for interest on interest which is not promptly paid. Sauder v. The Times Journal Company, 71 O.W.C. 304 (1992).

    The Act does not provide for the assessment of interest on an award for previously contested medical cost. Martin v. Saunders B. Moon Community, 71 O.W.C. 198 (1992).

    The employer and carrier are liable for judgment interest for payments not made pursuant to an award that is on review or subject to the review process, even if the review was requested by the claimant. Dees v. Crown, Cork and Seal Co., 75 O.W.C. 48 (1996).

    § 65.2-708. Review of award on change in condition.

    1. Upon its own motion or upon the application of any party in interest, on the ground of a change in condition, the Commission may review any award of compensation and on such review may make an award ending, diminishing or increasing the compensation previously awarded, subject to the maximum or minimum provided in this title, and shall immediately send to the parties a copy of the award. No application filed by a party alleging a change in condition shall be docketed for hearing by the Commission unless any medical reports upon which the party is relying are submitted to the Commission. No such review shall affect such award as regards any moneys paid except pursuant to §§ 65.2-712 , 65.2-1105 , and 65.2-1205 . No such review shall be made after 24 months from the last day for which compensation was paid, pursuant to an award under this title, except: (i) 36 months from the last day for which compensation was paid shall be allowed for the filing of claims payable under § 65.2-503 and certain claims under subsection B of § 65.2-406 or (ii) 24 months from the day that the claimant undergoes any surgical procedure compensable under § 65.2-603 to repair or replace a prosthesis or orthosis.
    2. In those cases where no compensation has been paid, the Commission may make an award under § 65.2-503 within 36 months from the date of the accident.
    3. All wages paid, for a period not exceeding 24 consecutive months, to an employee (i) who is physically unable to return to his pre-injury work due to a compensable injury and (ii) who is provided work within his capacity at a wage equal to or greater than his pre-injury wage shall be considered compensation paid pursuant to an award for compensation but shall not result in a reduction of the maximum number of weeks of compensation benefits as described in §§ 65.2-500 and 65.2-518 .

    History. Code 1950, § 65-95; 1964, c. 209; 1968, c. 660, § 65.1-99; 1972, c. 229; 1975, c. 365; 1977, cc. 345, 380; 1985, c. 453; 1988, c. 518; 1989, cc. 313, 324, 552, § 65.1-55.1; 1991, c. 355; 2013, c. 445.

    The 2013 amendments.

    The 2013 amendment by c. 445 inserted “of compensation” in the first sentence in subsection A; inserted “paid pursuant to an award for compensation but shall not result in a reduction of the maximum number of weeks of compensation benefits as described in §§ 65.2-500 and 65.2-518 ” at the end of subsection C; and made minor stylistic changes.

    Law Review.

    For survey of Virginia law on torts for the year 1969-1970, see 56 Va. L. Rev. 1419 (1970).

    For survey of Virginia law on workers’ compensation for the year 1970-1971, see 57 Va. L. Rev. 1520 (1971).

    for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    for the year 1972-1973, see 59 Va. L. Rev. 1632 (1973).

    for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    Michie’s Jurisprudence.

    For related discussion, see 4C M.J. Constitutional Law, § 47; 12A M.J. Limitation of Actions, § 35; 21 M.J. Workers’ Compensation, §§ 45, 56, 58, 63, 65, 66, 70, 72, 73.

    CASE NOTES

  • Analysis
  • I.General Consideration.

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-97.

    Applicability. —

    In a workers’ compensation case in which the claimant alleged that reflex sympathetic dystrophy in the claimant’s right arm related to a 1994 work injury had spread to her left arm, the statute of limitations that applied was § 65.2-708 , which related to a claim based on a change of condition, rather than § 65.2-601 , which related to original claims; because the employer did not base its argument on § 65.2-708 , any argument regarding the statute of limitations was waived under Va. Sup. Ct. R. 5A:20(e) for failure to discuss the relevant legal principles and under Va. Sup. Ct. R. 5A:18 because no statute of limitations argument was made before the Workers’ Compensation Commission. Mount Vernon Hosp. v. Devers, 2008 Va. App. LEXIS 494 (Va. Ct. App. Nov. 4, 2008).

    Employee’s claim regarding her spinal injuries was filed as an initial claim rather than as a change in condition, and thus she was not required to prove a change in her condition since the entry of the award order, and the employer’s reference to review based on a change in condition was misdirected. Advance Auto & Indem. Ins. Co. v. Craft, 63 Va. App. 502, 759 S.E.2d 17, 2014 Va. App. LEXIS 250 (2014).

    Workers’ compensation claimant’s functional loss of use under § 65.2-503 was properly measured by the extent of his impairment before undergoing hip replacement surgery where that interpretation acknowledged the irreplaceable loss of the natural joint, the nonmonetary costs associated with the corrective surgery, and the permanent restrictions on the claimant’s activities resulting from the work-related injury. This construction did not create a windfall for claimants as §/ 65.2-708 reflected the General Assembly’s recognition that an artificial joint replacement was an imperfect treatment for a compensable injury that often required subsequent revision surgeries. Loudoun Cty. v. Richardson, 298 Va. 528 , 841 S.E.2d 629, 2020 Va. LEXIS 40 (2020).

    This section is procedural in nature, it affects remedy only and disturbs no vested or substantive rights of the employer, and it was intended to apply retroactively. Cohen v. Fairfax Hosp. Ass'n, 12 Va. App. 702, 407 S.E.2d 329, 8 Va. Law Rep. 201, 1991 Va. App. LEXIS 174 (1991).

    This section empowers the commission with the discretionary authority to review a change in condition application and alter the initial award. Williams v. VEPCO, 18 Va. App. 569, 445 S.E.2d 693, 10 Va. Law Rep. 1598, 1994 Va. App. LEXIS 398 (1994).

    This section is the only statutory authority for a review of an award of the Compensation Commission on the ground of change in condition. If the insurer or employer elect to make such application they must do so under this section. The claimant derives the same right from the same source. It is difficult to perceive why the same rule should not apply alike to both applicants. Bristol Door & Lumber Co. v. Hinkle, 157 Va. 474 , 161 S.E. 902 , 1932 Va. LEXIS 307 (1932).

    This section is the only statutory authority for a review on the ground of change of condition. Parker v. Manchester Bd. & Paper Co., 201 Va. 328 , 111 S.E.2d 453, 1959 Va. LEXIS 230 (1959).

    It applies to disputes after award. —

    Former § 65.1-94 (now § 65.2-702 ) applies to disputes arising before an award is made, whereas this section applies to disputes arising after the award. Parker v. Manchester Bd. & Paper Co., 201 Va. 328 , 111 S.E.2d 453, 1959 Va. LEXIS 230 (1959).

    And provides procedure for review of such disputes. —

    Procedure for the review of disputes which may arise in connection with the Commission’s award must be under this section. Parker v. Manchester Bd. & Paper Co., 201 Va. 328 , 111 S.E.2d 453, 1959 Va. LEXIS 230 (1959).

    It applies to voluntary agreements approved by Commission. —

    Although this section refers specifically to awards, it has been interpreted as applying also to voluntary agreements that have been approved by the Commission. Dillard v. Industrial Comm'n, 416 U.S. 783, 94 S. Ct. 2028, 40 L. Ed. 2d 540, 1974 U.S. LEXIS 143 (1974).

    Section 65.2-601 provides that compensation shall be forever barred, unless a claim is filed with the Commission within two years after an accident; during this period an employee must assert against his employer “any claim” that he might have for an injury growing out of the accident. However here, claimant made an original claim for medical mileage and prescriptions which was satisfied voluntarily by the employer without an award, and then made a formal claim under § 65.2-503 in which a 36-month filing period is allowed pursuant to this section; thus claimant properly received permanent partial disability award. Lynchburg Foundry Co. v. McDaniel, 22 Va. App. 307, 469 S.E.2d 85, 1996 Va. App. LEXIS 266 (1996).

    But provides no substitute for original hearing on new accident. —

    An application for compensation based on a “change in condition” cannot be used as a substitute for an original hearing on a new and separate accident. Leonard v. Arnold, 218 Va. 210 , 237 S.E.2d 97, 1977 Va. LEXIS 180 (1977); Board of Supvrs. v. Martin, 3 Va. App. 139, 348 S.E.2d 540, 3 Va. Law Rep. 707, 1986 Va. App. LEXIS 346 (1986).

    Where the facts establish a new and separate compensable injury rather than a compensable change in condition, the time limitations of former § 65.1-87 (now § 65.2-601 ) are applicable and the claimant may not use a change in condition application to invoke the time limitations of this section. Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    Provides incentive to suspend benefits. —

    As a consequence of this section’s provisions denying an insurer the right to recoup benefits wrongly paid to an employee, the insurer has a clear incentive to suspend benefits whenever it believes it has cause. Fleming v. Workers' Comp. Comm'n, 878 F. Supp. 852, 1995 U.S. Dist. LEXIS 3097 (E.D. Va. 1995), aff'd, 78 F.3d 578, 1996 U.S. App. LEXIS 10634 (4th Cir. 1996).

    Subsection C supplements subsection A. —

    Virginia Workers’ Compensation Act, subsection C supplements subsection A, and the two subsections operate in conjunction with each other; because subsection C of § 65.2-708 is not a stand-alone provision but instead provides a definition for the tolling mechanism applied to subsection A, where a claimant has received wages (rather than compensation) as provided in subsection C, the subsection A statute of limitations runs anew under each successive award of compensation for a particular compensable injury and is triggered on the last day for which compensation was paid, and subsection C, by providing for wages meeting certain prescribed conditions to be treated as compensation, applies to each such award. Ford Motor Co. v. Gordon, 281 Va. 543 , 708 S.E.2d 846, 2011 Va. LEXIS 84 (2011).

    Legislative intent of former § 65.1-55.1 (see now subsection C). —

    Former § 65.1-55.1 (see now subsection C) was designed to prevent possible abuse by employers of the two year limitation period set forth in former § 65.1-99 (see now subsection A). The General Assembly enacted former § 65.1-55.1 to prevent employers from lulling partially disabled workers into a false sense of security during this two year period by providing employees light duty work at their pre-injury wage for two years and then terminating the employee without liability for future disability benefits. Scott v. Scott, 16 Va. App. 815, 433 S.E.2d 259, 10 Va. Law Rep. 77, 1993 Va. App. LEXIS 316 (1993).

    Former section not a statute of repose. —

    Since former § 65.1-55.1 (now this section) applied only to the limitation period set forth in former § 65.1-99 (now also this section) and did not contain within its provisions a substantive extinguishment of a cause of action, it was not a statute of repose. Cohen v. Fairfax Hosp. Ass'n, 12 Va. App. 702, 407 S.E.2d 329, 8 Va. Law Rep. 201, 1991 Va. App. LEXIS 174 (1991).

    For discussion of the limitation provided in this section in relation to that prescribed in former § 65.1-87 (now § 65.2-601 ), see Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    Former § 65.1-55.1 (now subsection C) has no application to jurisdictional time bar. —

    Former § 65.1-55.1 applies only to proceedings under former § 65.1-99 (now subsections A and B), relating to changes in condition, and it has no application to the jurisdictional time bar imposed by former § 65.1-87 (now § 65.2-601 ) for the filing of an original application. Rose v. Red's Hitch & Trailer Serv., Inc., 11 Va. App. 55, 396 S.E.2d 392, 1990 Va. App. LEXIS 162 (1990).

    Effect of former § 65.1-100.3 (now § 65.2-712 ). —

    Since the effective date of former § 65.1-100.3, the commission has held that, by reading this section and former § 65.1-100.3 together, it is clear that former § 65.1-100.3 created a new substantive right in the employer which could not be asserted before in the Commission. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    Retroactive application of 1977 amendment. —

    The 1977 amendment to this section increasing to two years the limitation period for filing for review based upon a change of condition should be applied retroactively where the claim has not been barred by the previous limitation period before the amendment became effective. Buenson Div., Aeronca, Inc. v. McCauley, 221 Va. 430 , 270 S.E.2d 734, 1980 Va. LEXIS 262 (1980).

    The language “all wages,” in this section evidences a retrospective legislative intent to include all wages, those already paid at the time of its enactment, and those thereafter paid. Cohen v. Fairfax Hosp. Ass'n, 12 Va. App. 702, 407 S.E.2d 329, 8 Va. Law Rep. 201, 1991 Va. App. LEXIS 174 (1991).

    “Provided work” applies only to work provided by pre-injury employer. —

    The language “provided work” as used in former § 65.1-55.1 (see now subsection (C)) is unambiguous and applies only to work provided by the pre-injury employer. Scott v. Scott, 16 Va. App. 815, 433 S.E.2d 259, 10 Va. Law Rep. 77, 1993 Va. App. LEXIS 316 (1993).

    Burden of proof is on party alleging change. —

    In an application for a review of an award on the ground of a change in condition, under this section, the burden is on the party alleging such change to prove his allegation by a preponderance of the evidence. J.A. Jones Constr. Co. v. Martin, 198 Va. 370 , 94 S.E.2d 202, 1956 Va. LEXIS 217 (1956); Pilot Freight Carriers, Inc. v. Reeves, 1 Va. App. 435, 339 S.E.2d 570, 1986 Va. App. LEXIS 220 (1986).

    The burden of proof is upon the claimant seeking additional compensation for a change in condition under this section to show that his present condition resulted naturally and unavoidably from the accident for which the previous award was made. Old Dominion Land Co. v. Messick, 149 Va. 330 , 141 S.E. 132 , 1928 Va. LEXIS 369 (1928).

    When an employee seeks compensation under this section, the employee must prove that the change in condition is causally connected with the injury originally compensated. Fisherman's Wharf of Am. v. Wolfe, 2001 Va. App. LEXIS 281 (Va. Ct. App. May 22, 2001).

    Virginia Workers’ Compensation Commission did not err in finding that it was an employee’s burden to establish a new period of temporary total disability because the employee never sought full commission review of the deputy commissioner’s decision to terminate the temporary total disability award effective on the date that the parties stipulated he had returned to light-duty work; therefore, the termination of the award was final. Windsor v. Loomis Fargo & Co., 2011 Va. App. LEXIS 407 (Va. Ct. App. Dec. 20, 2011).

    To establish a change in condition and thus successfully carry its burden, employer has to introduce evidence that claimant was either able to return to his regular employment or that he had been offered or provided selective employment within his work capacity. National Linen Serv. v. McGuinn, 5 Va. App. 265, 362 S.E.2d 187, 4 Va. Law Rep. 1075, 1987 Va. App. LEXIS 239 (1987).

    The claimant has the burden of proving a change in his condition which resulted naturally and unavoidably from the industrial accident. A mere opinion that the condition may have resulted from the accident is not sufficient. Clinchfield Coal Co. v. Bowman, 229 Va. 249 , 329 S.E.2d 15, 1985 Va. LEXIS 199 (1985).

    Evidence not required to be produced within statutory period. —

    A claimant is not required to produce the evidence of a change in condition prior to the expiration of the twenty-four month limitations period so long as the application alleges that a change in condition existed within the time of the filing. Southwest Virginia Tire, Inc. v. Bryant, 31 Va. App. 655, 525 S.E.2d 563, 2000 Va. App. LEXIS 145 (2000).

    Thus burden is on employer or insurance carrier seeking modification of award. —

    When the employer called for a hearing under this section alleging a change in claimant’s condition, the burden of proof was upon it to show that there was such a change as would affect the claimant’s ability to earn wages. J.A. Foust Coal Co. v. Messer, 195 Va. 762 , 80 S.E.2d 533, 1954 Va. LEXIS 155 (1954).

    Employer or insurer bears the burden of proving a change in a claimant’s condition that justifies rescission of an award or agreement. Dillard v. Industrial Comm'n, 416 U.S. 783, 94 S. Ct. 2028, 40 L. Ed. 2d 540, 1974 U.S. LEXIS 143 (1974).

    An insurance carrier which seeks modification of an award for temporary total incapacity, alleging change of the claimant employee’s condition to that of permanent partial loss of use of his legs, has the burden of proving its allegation by a preponderance of the evidence. Virginia Oak Flooring Co. v. Chrisley, 195 Va. 850 , 80 S.E.2d 537, 1954 Va. LEXIS 164 (1954).

    Transposition of burden of proof. —

    Virginia Workers’ Compensation Commission transposed the burden of proof in requiring an employer to disprove the causation of a claimant’s seizures and stress spells as the Commission’s review was limited to the award in place, which was the agreement regarding the claimant’s ankle injury and related reflex sympathetic dystrophy, and her alleged unjustified refusal of selective employment; the claimant had the burden to prove a causal connection between the conditions that allegedly justified her refusal of selective employment that were not the subject of the award. Wal-Mart v. Poorman, 60 Va. App. 84, 724 S.E.2d 212, 2012 Va. App. LEXIS 122 (2012).

    It is error to show any condition existing before first award. —

    Where an employee seeks compensation for a recurrence of an injury, the changes occurring in his condition since the former hearing, on which the award was based, are all that may be shown, and it is error to show any condition existing previous to the first award. Allen v. Mottley Constr. Co., 160 Va. 875 , 170 S.E. 412 , 1933 Va. LEXIS 264 (1933).

    Or that facts were not as found at time of original award. —

    Upon an application to modify an award on account of change in condition, it cannot be shown that the facts were really different from what they were found to be at the time of making the original award. Allen v. Mottley Constr. Co., 160 Va. 875 , 170 S.E. 412 , 1933 Va. LEXIS 264 (1933).

    Change of condition claim implicit. —

    Workers’ compensation claimant implicitly made a change of condition claim where he argued that his brain injury developed as a consequence of his depression, and was a compensable consequence of his original injury to his arm. Johnson v. Paul Johnson Plastering, 37 Va. App. 716, 561 S.E.2d 40, 2002 Va. App. LEXIS 183 (2002), aff'd in part and rev'd in part, 265 Va. 237 , 576 S.E.2d 447, 2003 Va. LEXIS 28 (2003).

    Former claimant, having disability reappear after returning to work, again entitled to benefits. —

    If, after receiving benefits for a period of time, the claimant returns to work, but thereafter has a change in condition justifying further payments, he may recover them under the act as long as he applies within 24 months from the date of the last payment and provided he has not already received 500 weeks of disability payments. Whitten v. Mead Paperboard Prods., 4 Va. App. 182, 355 S.E.2d 349, 3 Va. Law Rep. 2224, 1987 Va. App. LEXIS 178 (1987).

    Change in condition held not caused by subsequent industrial accident. —

    In view of an unrefuted and unequivocal report from the doctor who operated on claimant’s knee, which stated that the cause of claimant’s knee problems, which the doctor had discovered and repaired, was a 1975 injury, and in view of the fact that the record was devoid of any credible evidence connecting a change in claimant’s physical condition to an industrial accident of 1978, the Commission’s finding that claimant’s continuing problems were caused by the 1978 accident would be reversed. Clinchfield Coal Co. v. Bowman, 229 Va. 249 , 329 S.E.2d 15, 1985 Va. LEXIS 199 (1985).

    Compensable change in condition proven where lay off occurred while performing only light duty work. —

    Although a workers’ compensation claimant signed two agreement forms indicating that the claimant was released to the claimant’s pre-injury job as of March 18, 2001, regardless of whether the forms and any final orders memorializing them were binding, substantial evidence, including the claimant’s testimony and a doctor’s medical report, supported the Virginia Workers’ Compensation Commission’s finding that the claimant was not released to perform the claimant’s pre-injury job as of June 20, 2001, the date that the claimant experienced a layoff, and that the claimant, thus, proved a compensable change in condition as of that date, because: (1) even if the forms and orders were binding and proved that the claimant was at full duty on March 18, 2000, the doctor’s June 20, 2001, report proved that the claimant’s condition changed, as the doctor found as of June 20, 2001, that the claimant was only able to perform light duty, and (2) if the forms and orders were not binding, then the claimant was on light duty from when the claimant returned to work on March 18, 2000, and was entitled to benefits since the layoff happened while the claimant was working in a light duty position. A.O. Smith Corp. v. Goad, 2003 Va. App. LEXIS 79 (Va. Ct. App. Feb. 19, 2003).

    Change in condition properly denied. —

    Workers’ Compensation Commission properly denied a nurse’s change in condition application pursuant to § 65.2-708 , because the commission properly determined that the nurse’s legs were not permanently and totally disabled pursuant to § 65.2-503 based on a prior work-related back injury. Mawson v. Rappahannock Gen. Hosp., 2003 Va. App. LEXIS 236 (Va. Ct. App. Apr. 22, 2003).

    Workers’ Compensation Commission properly denied claimant’s change in condition application where a surgery to claimant’s knee to remove body tissue surrounding her knee prosthesis to improve the environment surrounding her prosthesis was not a “repair” to the prosthesis as that term was defined by § 65.2-708 ; claimant failed to prove that the surgery related to restoring the condition of the prosthesis itself. Locksmith v. Chippenham Hosp., 2004 Va. App. LEXIS 217 (Va. Ct. App. May 11, 2004).

    Evidence supported change in condition resulting in partial disability from carpal tunnel syndrome. —

    The claimant’s testimony regarding her inability to do the work and her doctor’s diagnosis were credible evidence sufficient to support the commission’s decision that the claimant was partially disabled as a result of traumatic carpal tunnel syndrome and that a change had occurred in the claimant’s condition. Philip Morris USA v. Marshall, 1997 Va. App. LEXIS 22 (Va. Ct. App. Jan. 21, 1997).

    Evidence sufficient to support change of condition. —

    Based upon a doctor’s office notes, coupled with an employee’s testimony of a change in a preexisting compensable condition, the workers’ compensation commission, as fact finder, reasonably inferred that an employee had a continuing total disability. Parkview Nursing & Rehab. Ctr. v. Hickman, 2003 Va. App. LEXIS 684 (Va. Ct. App. Dec. 23, 2003).

    Claimant was entitled to file for temporary partial disability benefits pursuant to § 65.2-708 , as the claimant proved a change in condition; there was ample evidence to prove that in December 2007 and January and February 2008, the claimant’s wages decreased as a result of a job for an employer that took longer than expected to complete through no fault of the claimant’s. Atlas Van Lines & Legion Ins. Co. v. Kerr, 2011 Va. App. LEXIS 127 (Va. Ct. App. Apr. 12, 2011).

    Evidence insufficient to support change of condition. —

    Physician’s note which said an employee could “do the work” and “return to work” was insufficient to satisfy an employer’s burden of showing a change of condition, in its attempt to terminate the employee’s workers’ compensation award, particularly in light of a subsequent medical evaluation which found the employee could only do light duty work. Impact Mgmt. Serv. v. Forrest, 2003 Va. App. LEXIS 128 (Va. Ct. App. Mar. 11, 2003).

    Because an employee’s leg and back were injured in the same accident, the leg injury did not arise out of the back injury, therefore, the two-year limitation period in § 65.2-601 , rather than the limitation period in subsection A of this section applied; consequently, the employee’s claim for benefits was time-barred. Arias v. United Masonry of Va., Inc., 2006 Va. App. LEXIS 227 (Va. Ct. App. May 23, 2006).

    Credible evidence supported the decision of the Virginia Workers’ Compensation Commission to award an employee temporary total disability benefits only through the date he was to return to his treating physician for reassessment because Commission found that the employee failed to prove that the temporary total disability continued after that date; although the physician instructed the employee to continue with out of work status with reassessment, there was no indication that a reassessment occurred. Windsor v. Loomis Fargo & Co., 2011 Va. App. LEXIS 407 (Va. Ct. App. Dec. 20, 2011).

    II.Change in Condition.

    This section defines a change in condition as a change in physical condition of the employee as well as any change in the conditions under which compensation was awarded, suspended or terminated that would affect the right to, amount of, or duration of compensation; these changes include progression, deterioration or aggravation of the compensable condition, appearance of new or more serious features, and failure to recover within the time originally predicted. Fisherman's Wharf of Am. v. Wolfe, 2001 Va. App. LEXIS 281 (Va. Ct. App. May 22, 2001).

    The submission of a standardized, uniform award review application, although preferable and more conducive to the orderly administration and disposition of [workers’] compensation claims, is not a prerequisite for compliance with § 65.1-99 [now § 65.2-708 ].” Danville Sch. Bd. v. Chilton, 1996 Va. App. LEXIS 211 (Va. Ct. App. Mar. 26, 1996).

    Manner in which duties actually performed controls. —

    In determining whether an injured employee can return to his pre-injury employment duties, the commission does not look at how the duties could ideally be performed, but rather, how the duties were actually performed. Island Creek Coal Co. v. Adkins, 2001 Va. App. LEXIS 138 (Va. Ct. App. Mar. 20, 2001).

    This section applies to an actual change in the physical condition of the employee. Allen v. Mottley Constr. Co., 160 Va. 875 , 170 S.E. 412 , 1933 Va. LEXIS 264 (1933).

    An award based on a change in condition is different from the right to recover for the injury itself; a change in condition is remedial and enlarges or diminishes a former award to meet the circumstances of a particular case. Philip Morris USA v. Marshall, 1997 Va. App. LEXIS 22 (Va. Ct. App. Jan. 21, 1997).

    Change of condition is only basis for review. —

    Only one ground for the reopening of an award made by the Commission is added by this section, and that is a change in the condition of the injured party. Wise Coal & Coke Co. v. Roberts, 157 Va. 782 , 161 S.E. 911 , 1932 Va. LEXIS 327 (1932).

    Change in medical expert’s opinion is not sufficient. —

    A change in condition means an actual change in the condition of the injured employee and not a mere change in the opinion of the medical expert as to the employee’s preexisting condition. J.A. Jones Constr. Co. v. Martin, 198 Va. 370 , 94 S.E.2d 202, 1956 Va. LEXIS 217 (1956); Boxley v. Onorato, 218 Va. 931 , 243 S.E.2d 201, 1978 Va. LEXIS 249 (1978).

    Nor is continued incapacity of the same kind. —

    A change in condition means a different condition from that existent when the award was made; and a continued incapacity of the same kind and character, and for the same injury, is not a change in condition. J.A. Jones Constr. Co. v. Martin, 198 Va. 370 , 94 S.E.2d 202, 1956 Va. LEXIS 217 (1956).

    Nor are injuries resulting from new and separate accident. —

    Where the injuries sustained by plaintiff in the fall did not naturally flow from a progression, deterioration or aggravation of the injury sustained in the original industrial accident, the injuries were the result of a new and separate accident, not a “change in condition” resulting from his first accident. Leonard v. Arnold, 218 Va. 210 , 237 S.E.2d 97, 1977 Va. LEXIS 180 (1977).

    Change in condition must be related to previously compensated injury. —

    A change in an employee’s physical condition that is compensable under this section includes, among certain other changes, any progression, deterioration or aggravation of a previously compensated injury, but a new and separate accidental injury may not be compensated as a change in condition of a previous injury. Fisherman's Wharf of Am. v. Wolfe, 2001 Va. App. LEXIS 281 (Va. Ct. App. May 22, 2001).

    Disability from another cause. —

    Where the causal connection between an industrial accident and disability has been established, employer may apply for termination of benefits claiming that the effects of the injury have dissipated and the disability resulted from another cause. Miller v. Island Creek Coal Co., 2001 Va. App. LEXIS 634 (Va. Ct. App. Nov. 20, 2001).

    Cessation of payment under former § 65.1-56 (now § 65.2-503 ), standing alone, is not “change in conditions.” —

    A cessation of payments of a former § 65.1-56 award is not, standing alone, a change in the conditions under which compensation was awarded or terminated which would affect the right to, amount of, or duration of compensation which would trigger this section. Armstrong Furn. v. Elder, 4 Va. App. 238, 356 S.E.2d 614, 3 Va. Law Rep. 2583, 1987 Va. App. LEXIS 258 (1987).

    Changed condition does not include aggravated “mental state.” —

    Commission was in error in basing award of compensation on legal conclusion that if changed condition was an aggravated “mental state” resulting from termination of compensation, it was a compensable condition. Keller Mfg. Co. v. Hoke, 215 Va. 525 , 211 S.E.2d 82, 1975 Va. LEXIS 184 (1975).

    “Change in condition” includes physical condition of employee or conditions under which compensation was awarded. —

    This section is triggered by a “change in condition.” That change can be in the physical condition of the employee, as well as a change in the conditions under which the compensation was awarded. Armstrong Furn. v. Elder, 4 Va. App. 238, 356 S.E.2d 614, 3 Va. Law Rep. 2583, 1987 Va. App. LEXIS 258 (1987).

    Termination of employment because of reduction in force is not change in condition. —

    The termination of the employment of the injured employee because of a reduction in force does not constitute a change in condition which warrants a review of a previous award of compensation benefits. J.A. Jones Constr. Co. v. Martin, 198 Va. 370 , 94 S.E.2d 202, 1956 Va. LEXIS 217 (1956).

    Cost of living supplement requires change of condition application. —

    The statutory cost-of-living provision is not self-executing, and a claim for a cost-of-living supplement is cognizable only under the change-of-condition sections of the Virginia Workers’ Compensation Act, which require an application and a showing of eligibility by the claimant and an award by the Commission. Jewell Ridge Coal Corp. v. Wright, 222 Va. 68 , 278 S.E.2d 820, 1981 Va. LEXIS 276 (1981).

    Doctrine of compensable consequences. —

    The doctrine of compensable consequences provides that when the primary injury is shown to have arisen out of and in the course of employment, every natural consequence that flows from the injury likewise arises out of the employment, unless it is the result of an independent intervening cause attributable to the claimant’s own intentional conduct. Fleetwood Homes of Va., Inc. v. McNeal, 2001 Va. App. LEXIS 311 (Va. Ct. App. June 5, 2001).

    The simplest application of the principle that a change of condition claim based on the aggravation of a prior compensable injury falls within the compensable consequences doctrine is the rule that all the medical consequences and sequelae that flow from a primary injury are compensable. Fleetwood Homes of Va., Inc. v. McNeal, 2001 Va. App. LEXIS 311 (Va. Ct. App. June 5, 2001).

    The doctrine of compensable consequences is applicable both to aggravation of a prior compensable injury and a new injury for the purpose of establishing compensability of the subsequent injury. Fisherman's Wharf of Am. v. Wolfe, 2001 Va. App. LEXIS 281 (Va. Ct. App. May 22, 2001).

    Statutory period not tolled during pendency of appeal from award. —

    There is no provision in this section tolling the 12-month (now 24-month) period during the pendency of an appeal of the award to the full Commission. Lucas v. Research Analysis Corp., 215 Va. 336 , 210 S.E.2d 143, 1974 Va. LEXIS 287 (1974).

    For a discussion on the relationship of this section with the Virginia Supreme Court’s decision in Bristol Door & Lumber Co. v. Hinkle, 157 Va. 474 , 161 S.E.2d 902 (1932), and subsection (b) of Industrial (now Workers’ Compensation) Commission Rule 13, see Graham v. Peoples Life Ins. Co., 7 Va. App. 61, 372 S.E.2d 161, 5 Va. Law Rep. 248, 1988 Va. App. LEXIS 93 (1988).

    Tolling of limitations period. —

    Evidence supported commission’s finding that employee was able to perform fully the duties of her pre-injury position when she returned to work, and thus tolling provision contained in subsection C of this section did not apply to extend limitations period for filing of employee’s claim for temporary partial disability benefits. Ogolo v. Pie Gourmet, Ltd., 1999 Va. App. LEXIS 334 (Va. Ct. App. June 8, 1999).

    Subsection C did not apply to toll the statute of limitations where the employee was physically able to return to his pre-injury work and was not promoted in order to provide work within his capacity; the employee did not provide evidence that the employer lulled him into a false sense of security, and the employer did not attempt to fire him. Reid v. Controlled Conditions Corp., 2002 Va. App. LEXIS 167 (Va. Ct. App. Mar. 19, 2002).

    Worker’s change-in-condition application was not time-barred because the subsection A statute of limitations ran anew under each successive award of compensation for a compensable injury, and was triggered on the last day for which compensation was paid; post-injury light duty wages paid to the worker were compensation for purposes of subsection C of § 65.2-708 , and tolled the limitations period. Gordon v. Ford Motor Co., 53 Va. App. 616, 674 S.E.2d 545, 2009 Va. App. LEXIS 148 (2009).

    Two-year statute of limitations under the Virginia Workers’ Compensation Act, subsection A of § 65.2-708 , is tolled while the claimant receives compensation, “pursuant to an award”; accordingly, the determining factor concerning whether a change-in-condition application is time-barred under subsection A is the date on which compensation was last paid, pursuant to an award. Ford Motor Co. v. Gordon, 281 Va. 543 , 708 S.E.2d 846, 2011 Va. LEXIS 84 (2011).

    Court of appeals did not err in reversing the decision of the Workers’ Compensation Commission that a workers’ compensation claimant’s change-in-condition application was time-barred under the Virginia Workers’ Compensation Act, because the subsection A of § 65.2-708 statute of limitations was tolled under subsection C of § 65.2-708 , and that the claimant’s change-in-condition application, which was filed in September 2006, was not time-barred; subsection C required that the wages the employer paid to the claimant during the first twenty-four months of the third period of the claimant’s light-duty employment for the employer, from April 20, 2003, through April 20, 2005, be considered “compensation” for purposes of tolling the subsection A of § 65.2-708 statute of limitations. Ford Motor Co. v. Gordon, 281 Va. 543 , 708 S.E.2d 846, 2011 Va. LEXIS 84 (2011).

    If there has been a previous award entered by the Virginia Workers’ Compensation Commission, the determining factor concerning whether a change-in-condition application is time-barred under subsection A of § 65.2-708 is the date for which compensation was last paid, pursuant to an award. In determining the date for which compensation was last paid, the tolling provision in subsection C of § 65.2-708 tolls the operation of the subsection A of § 65.2-708 statute of limitations in the same manner as the payment of compensation pursuant to an award. Therefore, once an award is entered, the statute of limitations provided in subsection A then begins to run after the date of the entry of the award from either the date compensation was last paid pursuant to the award or pursuant to subsection C. Prince William County Sch. Bd. v. Rahim, 58 Va. App. 493, 711 S.E.2d 241, 2011 Va. App. LEXIS 235 (2011), aff'd, 284 Va. 316 , 733 S.E.2d 235, 2012 Va. LEXIS 158 (2012).

    Statute of limitations bar. —

    Although the workers’ compensation commission awarded medical benefits “for as long as necessary after the accident” to the employee regarding the employee’s work-related right knee injury pursuant to subdivision A 1 of § 65.2-603 , the employee was still required to file a change-in-condition application within two years of the time the employee last received disability benefits, pursuant to subsection A of § 65.2-708 , to have a viable change-in-condition claim regarding the pain in the employee’s left knee. Since the employee did not file his § 65.2-101 change-in-condition application within the required two-year time period, the employee’s claim for change-in-condition benefits was time barred by subsection A of § 65.2-708 . Tricord Homes, Inc. v. Smith, 2008 Va. App. LEXIS 573 (Va. Ct. App. Dec. 30, 2008).

    Statute of limitations contained in the Workers’ Compensation Act, subsection A of this section, applies to an application for a change in condition that seeks “compensation,” and if the claim is not for compensation, the time bar found in subsection A does not apply; the term “compensation” in this setting does not encompass medical benefits. Prophet v. Bullock Corp., 59 Va. App. 313, 718 S.E.2d 477, 2011 Va. App. LEXIS 403 (2011).

    Virginia Workers’ Compensation Commission erred in concluding that an employee’s claim for medical benefits was time-barred under the Workers’ Compensation Act, because the time bar did not apply since the employee’s claim for a prescription drug did not constitute a claim for “compensation”; read in its entirety, and in the broader context of the Workers’ Compensation Act, the statute of limitations in subsection A of § 65.2-708 , which governs changes in condition, bars claims for compensation rather than for medical benefits. Prophet v. Bullock Corp., 59 Va. App. 313, 718 S.E.2d 477, 2011 Va. App. LEXIS 403 (2011).

    Because an employer did not waive its right to rely on the statute, and because there was no de facto award that would extend the filing deadline set out in the statute, the Virginia Workers’ Compensation Commission did not err in concluding that an employee’s application for a change-in-condition award was not timely filed; the voluntary payments the employer made did not constitute a de facto award. Roske v. Culbertson Co., 62 Va. App. 512, 749 S.E.2d 550, 2013 Va. App. LEXIS 323 (2013).

    Virginia Workers’ Compensation Commission did not err in holding that an employee’s application for a change-in-condition award was time barred because the employer did not waive its right to rely on the statute. Roske v. Culbertson Co., 62 Va. App. 512, 749 S.E.2d 550, 2013 Va. App. LEXIS 323 (2013).

    Evidence did not support change in condition. —

    Virginia Workers’ Compensation Commission did not err in holding that the evidence did not support a change in condition under subsection A of § 65.2-708 where there was no affirmative finding by a second physician that the claimant experienced a change in condition from the time that he met with the first physician to the time he met with the second; rather, the only finding by the second physician related to the claimant’s prior condition was that there had been no significant improvement in his condition. Boukhira v. George Mason Univ., 2015 Va. App. LEXIS 363 (Va. Ct. App. Dec. 8, 2015).

    Evidence supported the Virginia Workers’ Compensation Commission’s weighing of a doctor’s opinion and its finding of no causal relationship between claimant’s left shoulder condition and his compensable right shoulder injury and the Commission did not err in denying the claim alleging a change in condition; when the doctor opined there was a causal connection, he was stating his opinion on a condition that was never presented to him or diagnosed or treated by him. Martin v. United Cont'l Holdings, Inc., 2019 Va. App. LEXIS 296 (Va. Ct. App. Dec. 17, 2019).

    III.Limitations Period.

    Time limitation is clear and unambiguous. —

    The language of this section setting out the 12-month (now 24-month) review limitation is clear and unambiguous. Lucas v. Research Analysis Corp., 215 Va. 336 , 210 S.E.2d 143, 1974 Va. LEXIS 287 (1974).

    The 12-month (now 24-month) limitation of this section is in fact a limitation only and not a mandatory requirement as a prerequisite to jurisdiction. Its provisions could be waived, or a party could be estopped by his actions and conduct from availing himself of its provisions. Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    The 12-month (now 24-month) limitation provided in this section is not jurisdictional. Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    Petition timely although hearing not held within three years. —

    When a deputy commissioner found that an employee’s claim for permanent disability benefits was premature because she had not then reached maximum medical improvement, that ruling was interlocutory regarding her future condition and did not bar the employee from proving at a time more than three years from the date compensation was last paid that she had attained maximum medical improvement. The deputy commissioner’s ruling that the employee’s timely-filed application be removed from the docket removed the matter from the hearing docket but did not dismiss the claim so as to render untimely the employee’ subsequent request that the matter be scheduled for a hearing. Brown v. United Airlines, Inc., 34 Va. App. 273, 540 S.E.2d 521, 2001 Va. App. LEXIS 49 (2001).

    Two-year limitation period of this section applies to filing an application for additional workers’ compensation benefits pursuant to a change in condition as defined by former § 65.1-8 (now § 65.2-101 ). Conversely, the one year limitation period of former § 65.1-56 (now § 65.2-503 ) applies to filing an application for additional workers’ compensation benefits in a situation when the disability is at the same level both when the award begins and ends. Thus, the limitation period of former § 65.1-56 is triggered by a cessation of payments and a continued incapacity to work. Armstrong Furn. v. Elder, 4 Va. App. 238, 356 S.E.2d 614, 3 Va. Law Rep. 2583, 1987 Va. App. LEXIS 258 (1987).

    The 24-month tolling period provided for by subsection C begins on the date that a claimant returns to light duty work without a wage loss, rather than on the subsequent date that the claimant is last paid permanent partial disability benefits. Phelps v. Safeway Stores, Inc., 1999 Va. App. LEXIS 128 (Va. Ct. App. Feb. 16, 1999).

    In a case of claiming a change of condition, the statute of limitations in this section, and not § 65.2-501 , controlled. Va. Elec. & Power Co. v. Crawford, 2001 Va. App. LEXIS 680 (Va. Ct. App. Dec. 11, 2001).

    Limitations period only runs from date of award under this act. —

    The time limit established by this section only applies when there has been a prior award of benefits under the Workers’ Compensation Act and, since an award of benefits under the Longshore and Harbor Workers’ Compensation Act is not an award of workers’ compensation benefits under this act, such an award does not begin the running of the two-year limitations period. Metro Mach. Corp. v. Lamb, 33 Va. App. 187, 532 S.E.2d 337, 2000 Va. App. LEXIS 598 (2000), overruled in part, King William Cnty. v. Jones, 66 Va. App. 531, 789 S.E.2d 133, 2016 Va. App. LEXIS 226 (2016) (applying an economic loss test as opposed to loss of earning capacity analysis).

    The court has interpreted subsection A to mean that “the change in condition must occur within twenty-four months from the date compensation was last due or paid.” Eastman Kodak Co. v. Stremovihtg, 1996 Va. App. LEXIS 208 (Va. Ct. App. Mar. 26, 1996).

    Former § 65.1-55.1 (now § 65.2-708 ) applies only to proceedings under this section, relating to changes in condition, and it has no application to the jurisdictional time bar imposed by former § 65.1-87 (now § 65.2-601 ) for the filing of an original application. Rose v. Red's Hitch & Trailer Serv., Inc., 11 Va. App. 55, 396 S.E.2d 392, 1990 Va. App. LEXIS 162 (1990).

    Claimant under former § 65.1-47.1 (now § 65.2-402 ) subject to time limitation in this section. —

    A claimant, who is entitled to the presumption of former § 65.1-47.1, is subject to the time limitation contained in this section when he suffers additional disability from the same occupational disease. City of Waynesboro Sheriff's Dep't v. Harter, 1 Va. App. 265, 337 S.E.2d 901, 1985 Va. App. LEXIS 97 (1985).

    This section does not preserve otherwise untimely claim where an employee did not file a claim for an injury to his left leg within two years of the accident date, no prior award existed with respect to his left leg injury and this section did not save the claim from the jurisdictional bar of the two-year statute of limitations. Campbell v. Lyntool, Inc., 2000 Va. App. LEXIS 706 (Va. Ct. App. Oct. 31, 2000).

    Section is not a statute of limitation in the ordinary sense. It does not provide that a claimant has 24 months to file from the date the change in condition (cause of action) occurs. Instead, it provides that the change in condition (cause of action) must occur within 24 months from the date for which the last compensation was paid. Whitten v. Mead Paperboard Prods., 4 Va. App. 182, 355 S.E.2d 349, 3 Va. Law Rep. 2224, 1987 Va. App. LEXIS 178 (1987); Armstrong Furn. v. Elder, 4 Va. App. 238, 356 S.E.2d 614, 3 Va. Law Rep. 2583, 1987 Va. App. LEXIS 258 (1987).

    It is only a time limitation and as such can be waived. Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    What may constitute waiver. —

    The voluntary execution of a supplemental memorandum of agreement by the parties and the voluntary payment of compensation thereunder may constitute a waiver. Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    Fraud or concealment only grounds to estop employer from asserting section. —

    Fraud or concealment are the only grounds to estop an employer from asserting the statute of limitations under this section. Niblett v. Piedmont Aviation, Inc., 12 Va. App. 652, 405 S.E.2d 635, 7 Va. Law Rep. 2906, 1991 Va. App. LEXIS 135 (1991).

    Estoppel of an employer’s right to assert the time limitation in this section requires evidence of fraud or concealment. Sparrer v. Commonwealth, 9 Va. App. 251, 385 S.E.2d 908, 6 Va. Law Rep. 855, 1989 Va. App. LEXIS 147 (1989).

    Where an employer had agreed in writing, before the statute of limitations ran, to pay for the claimant’s surgery and the related temporary total disability benefits, but then delayed approval of the surgery until the statutory period for claiming the related disability benefits had expired, the employer was estopped from relying upon the statute of limitations. Fernandes v. Handyman Servs., Inc., 20 Va. App. 708, 460 S.E.2d 602, 12 Va. Law Rep. 96, 1995 Va. App. LEXIS 644 (1995).

    To support estoppel, an employee must prove by clear, precise and unequivocal evidence that in refraining from filing a claim within the statutory period, he relied upon an act or statement of the employer or its agent. Werbinski v. City of Norfolk Police Dep't, 2001 Va. App. LEXIS 316 (Va. Ct. App. June 5, 2001).

    Voluntary payment of medical expenses by the employer is not the payment of compensation which tolls the running of the statute of limitations. Meade v. Clinchfield Coal Co., 215 Va. 18 , 205 S.E.2d 410, 1974 Va. LEXIS 224 (1974).

    “The last day for which compensation was paid,” as used in this section, refers only to compensation paid to the employee and not to payment of medical expenses. Meade v. Clinchfield Coal Co., 215 Va. 18 , 205 S.E.2d 410, 1974 Va. LEXIS 224 (1974).

    The plain meaning of the phrase “from the last day for which compensation was paid” in this section can only mean a date for which a compensation payment was to be applied rather than the date the payment was actually made. Franklin v. Lynchburg Foundry Co., 1994 Va. App. LEXIS 580 (Va. Ct. App. Sept. 13, 1994).

    Claimant’s application for permanent partial disability benefits was time-barred, since subdivision A (i) of this section did not specify thirty-six months from last day “on which” compensation was paid, but thirty-six months from last day “for which” compensation was paid. Holman v. Southwestern Va. Mental Health Inst., 1999 Va. App. LEXIS 625 (Va. Ct. App. Nov. 9, 1999).

    Where a claim for a consequent injury was filed within 24 months of the last date for which disability compensation was paid, the Virginia Workers’ Compensation Commission properly reviewed a claimant’s change-in-condition application pursuant to § 65.2-708 and not § 65.2-601 . Lite-Tech, Inc. v. Charles, 2005 Va. App. LEXIS 114 (Va. Ct. App. Mar. 22, 2005).

    Application for reinstatement of suspended benefits held untimely. —

    Employee’s application for reinstatement of benefits that were suspended was subject to statute of limitations contained in § 65.2-708 , the Commission’s judgment that employee’s application for reinstatement of benefits was untimely because it was filed more than two years after benefits were last received would be sustained. Harris v. Va. Beach Gen. Hosp., 38 Va. App. 187, 562 S.E.2d 365, 2002 Va. App. LEXIS 239 (2002).

    Time limitation applied to filing, not to presentation of evidence. —

    Where workers’ compensation claimant’s application for a hearing alleging change of condition was filed within the 36 month statute of limitations, he was not barred from review of award even though evidence of the change of condition was not presented until after the expiration of the 36 month period. Johnson v. Smith, 16 Va. App. 167, 428 S.E.2d 508, 9 Va. Law Rep. 1125, 1993 Va. App. LEXIS 77 (1993).

    Virginia Workers’ Compensation Commission did not err in awarding permanent partial disability benefits to a claimant as the claimant filed a claim for permanent disability benefits well within the 36-month time period in Va. Code Ann. § 65.2-708 (B); the fact that she did not obtain medical evidence supporting this claim until after the 36-month period had passed did not bar her claim. The claimant presented credible evidence before the Commission establishing the existence of a disability which was the consequence of the injury by accident and which was present and existing when the application was filed. Target Corp. v. Velasquez, 2013 Va. App. LEXIS 4 (Va. Ct. App. Jan. 8, 2013).

    s A claimant’s neck injury was not a medical consequence that flowed from the primary injury but part of the primary injury and, since this injury was not a subsequent condition that developed as a result of the accident, the limitation period in this section was inapplicable. Fleetwood Homes of Va., Inc. v. McNeal, 2001 Va. App. LEXIS 311 (Va. Ct. App. June 5, 2001).

    Limitation held waived. —

    Where an employer and its insurer could have asserted the 12-month (now 24-month) limitation provided by this section but elected not to do so, they thereby knowingly waived the statutory limitation. Binswanger Glass Co. v. Wallace, 214 Va. 70 , 197 S.E.2d 191, 1973 Va. LEXIS 257 (1973).

    Tolling provision. —

    Employee’s need for occasional breaks was a work restriction that transformed his employment into selective employment, supporting the finding of the Workers’ Compensation Commission that the employee was physically unable to return to his pre-injury work without accommodations; Since the employee was unable to return to his pre-injury work, the Commission properly found that the tolling provision in this section applied. City of Fredericksburg v. Wilson, 0723-13-4, 2013 Va. App. LEXIS 307 (Va. Ct. App. Oct. 29, 2013).

    Subsection A of § 65.2-708 limitations period was not tolled by § 65.2-506 as that statute addressed only how wage benefits were to be paid if a claimant simultaneously was otherwise entitled to wage benefits for two separate injuries that occurred at different times and did not reference filings, filing deadlines, statutes of limitations, tolling, or subsection A of § 65.2-708 . Morris v. Fed. Express Corp., 70 Va. App. 571, 829 S.E.2d 578, 2019 Va. App. LEXIS 167 (2019).

    Error to allow review where application not filed within statutory period. —

    Where the application for review was filed long after the 12-month (now 24-month) period had passed, it was error for the Commission to allow the review and enter a new award. Sledge v. Price, 211 Va. 724 , 180 S.E.2d 674, 1971 Va. LEXIS 253 (1971).

    Time limit for applying for cost-of-living supplements. —

    This section sets forth the statute of limitations for applying for cost-of-living supplements and an application for such supplements filed within 24 months of the last of the 500 weeks for which a claimant received benefits was timely. ARA Health Servs. v. Flax, 2000 Va. App. LEXIS 228 (Va. Ct. App. Mar. 28, 2000).

    Application held timely filed where disability continued and unjustified refusal of treatment cured. —

    An application for change of condition was timely where filed within two years of the last payment of benefits, but while benefits had been suspended, where the Commission found that the claimant’s disability continued between the date compensation was last paid and the date the claimant cured his unjustified refusal to accept medical treatment and this disability was present and existing when the application was filed. Continental Forest Indus. v. Wallace, 1 Va. App. 72, 334 S.E.2d 149, 1985 Va. App. LEXIS 64 (1985).

    Claimant’s application was not timely filed. —

    Where employee sustained a compensable injury by accident on January 26, 1990 and her employer paid her compensation benefits from January 26, 1990 through May 4, 1990, pursuant to an award, her application filed on September 16, 1992, alleging a change in condition and requesting an award of temporary total disability benefits was not timely filed, for the application was filed more than two years from May 4, 1990, the date for which compensation was last paid. Harris v. Amelia Dress Co., 1994 Va. App. LEXIS 453 (Va. Ct. App. July 12, 1994).

    Virginia Workers’ Compensation Commission did not err in finding the change-in-condition application untimely since the employee’s application came 16 years after the last compensation payment; and there was no medical evidence connecting the subsequent medical treatments and prescription costs to the compensable injury. Birch v. Kellam Distrib. Co., 2002 Va. App. LEXIS 638 (Va. Ct. App. Oct. 22, 2002).

    Virginia Workers’ Compensation Commission’s finding that a claimant failed to prove that he was incapacitated during the time period in which he was required to file his application so as to toll, under § 65.2-528 , the statute of limitations provided in subsection A of § 65.2-708 for a change-in-condition application was supported by credible evidence where: (1) The claimant’s treating physician opined after the fact that the claimant was incapacitated, but his contemporaneous treatment notes did not reflect an incapacity; (2) The treating physician conceded that his after-the-fact opinion letter may have been a little overstated; and (3) The employer’s expert opined that the claimant had not been incompetent or incapacitated during the relevant period. Walker v. General Shale Prods. Corp., 2003 Va. App. LEXIS 411 (Va. Ct. App. July 22, 2003).

    Evidence presented by the claimant did not establish that his permanent partial disability occurred within 36 months of the last day for which he was paid compensation, as required by subsection A of § 65.2-708 ; although a doctor concluded after the 36-month period had run, that the claimant’s injury had resulted in a permanent functional impairment, the claimant presented no evidence that the impairment continued unabated or resulted in a permanent impairment. Marvin v. Rountree Constr. Co., 2003 Va. App. LEXIS 466 (Va. Ct. App. Sept. 9, 2003).

    Virginia Workers’ Compensation Commission’s decision that a workers’ compensation claimant’s change-in-condition claim was barred by the statute of limitations in § 65.2-708 was affirmed as the claimant filed his claim more than 36 months after compensation was last paid pursuant to the award and as the claimant returned to his employment and performed tasks that were indistinguishable from his pre-injury tasks, the tolling provision of § 65.2-708 C was inapplicable. Morris v. Dunham-Bush, Inc., 2004 Va. App. LEXIS 136 (Va. Ct. App. Mar. 30, 2004).

    Virginia Workers’ Compensation Commission correctly viewed the claimant’s sexual dysfunction as a change in condition, not a new and separate injury, which tracked the treating physician’s opinion attributing the sexual dysfunction to a combination of the chronic pain syndrome/complex regional pain disorder caused in part by the workplace accident and the medications used to treat them. As a result, his claim was not subject to the statute of limitations period in § 65.2-601 , but was subject to the statute of limitations period codified in subsection A of § 65.2-708 ; by filing his claim for benefits while under an open award of temporary total disability benefits, the claimant acted before the time limitation outlined in subsection A of § 65.2-708 even began to run and, therefore, his claim was not barred by the statute of limitations. Berglund Chevrolet, Inc. v. Landrum, 43 Va. App. 742, 601 S.E.2d 693, 2004 Va. App. LEXIS 418 (2004).

    Credible evidence supported the Virginia Workers’ Compensation Commission’s finding that a surgery in which a claimant’s ankle prosthesis was removed and her ankle joint was fused was not a surgical procedure to “replace” a prosthesis under clause (ii) of subsection A of § 65.2-708 as the record reflected that no substitute or equivalent for the prosthesis took the place of the prosthesis that was removed during the procedure; instead, the purpose of removing the claimant’s prosthesis and fusing the joint was to prevent any motion of the joint. Saffert v. Fairfax County Sch. Bd., 59 Va. App. 458, 720 S.E.2d 139, 2012 Va. App. LEXIS 11 (2012).

    Given the use of the specific word “replace,” clause (ii) of subsection A of § 65.2-708 applies when a prosthesis has been removed and a substitute or equivalent for the prosthesis has been put in its place; i.e., when the prosthesis has been replaced. Therefore, the commission did not err in concluding that clause (ii) of subsection A of § 65.2-708 was inapplicable on the basis that the claimant’s prosthesis was removed, not repaired or replaced, during surgery when her total ankle replacement prosthesis was removed and replaced by a longitudinal Steinmann pin and that, thus, the claimant’s change-in-condition application was untimely under the general 24-month limitations period in subsection A of § 65.2-708 as it was filed more than 24 months after the last day on which the employer paid the claimant compensation. Saffert v. Fairfax County Sch. Bd., 59 Va. App. 458, 720 S.E.2d 139, 2012 Va. App. LEXIS 11 (2012).

    Although a claimant asserted that the claimant’s second claim for temporary total disability workers’ compensation benefits relating to an occupational heart disease was transmuted from a new claim into a change in condition claim, the new claims contained in the claimant’s filing were barred by the statute of limitations because the filing by the claimant was not a change in condition application, as there was not a de facto award in place during the relevant time period. Northampton County & Va. Ass'n of Counties Group Self-Insurance v. Somers, 2015 Va. App. LEXIS 294 (Va. Ct. App. Oct. 20, 2015).

    Workers’ Compensation Commission properly found that an injured employee failed to file a proper claim for permanent disability benefits prior to the expiration of the statute of limitations because neither letter that the employee sent to the Commission mentioned a claim for permanent disability benefits, the first letter sought authorization for left wrist fusion surgery and the second was a response to the employer’s application for a hearing, and while the letters mentioned the types of injuries suffered, neither letter identified the date of the accident or the location of the accident. Gomez v. Garcia Constr. Co., 2016 Va. App. LEXIS 98 (Va. Ct. App. Mar. 29, 2016).

    Claimant failed to provide evidence of permanent partial disability to her left leg within the 36-month limitation period because the claimant did not claim a left leg injury on her November 2013 application requesting medical benefits, compensation, temporary total disability, and permanent disability; she did not provide evidence that the disability to her left leg existed at the time she filed the claim; the doctor’s evaluation submitted by the claimant in support of her claim — dated December 20, 2016, and amended on January 31, 2017 — did not state when the left leg disability began, what caused it, or its connection to the original injury; and she did not show that the leg disability was related to her compensable back injury. Rivera v. Kohl's Dep't Stores, Inc., 2018 Va. App. LEXIS 188 (Va. Ct. App. July 10, 2018).

    Subsection A of § 65.2-708 barred a workers’ compensation claim where it was undisputed that the application seeking additional compensation related to the 2015 injury was filed more than 24 months from the last day for which compensation was paid pursuant to a workers’ compensation award. Morris v. Fed. Express Corp., 70 Va. App. 571, 829 S.E.2d 578, 2019 Va. App. LEXIS 167 (2019).

    Timeliness of claim. —

    Because an employee’s claim for permanent partial disability was filed within the 36-month period set forth in subsection B, the employee’s claim was not barred by the statute of limitations. Medinsights & Lumbermens Mut. Cas. Co. v. Kisner, 2006 Va. App. LEXIS 228 (Va. Ct. App. May 23, 2006).

    Virginia Workers’ Compensation Commission’s award of temporary total disability benefits to a teacher on the teacher’s change-in-condition application was affirmed, because the application was timely filed where the teacher received the equivalent of an award of compensation under the deputy commissioner’s award, as modified by a stipulated order, and the application was filed less than a year later. Augusta County Sch. Bd. v. Humphreys, 53 Va. App. 355, 672 S.E.2d 117, 2009 Va. App. LEXIS 52 (2009).

    Virginia Workers’ Compensation Commission erred in denying a workers’ compensation claimant permanent disability benefits because claimant timely filed her claim within two years of the accident pursuant to § 65.2-601 ; the joint stipulation claimant and her employer entered into did not operate as an abandonment or waiver of claimant’s permanency claim because it did not contain a clear showing that the claim had been withdrawn, and thus, the permanency claim remained ongoing and uninterrupted since claimant first filed the claim. Howard v. Cost Plus World Mkt., 2011 Va. App. LEXIS 182 (Va. Ct. App. May 24, 2011).

    IV.Imposition.

    Imposition. —

    The doctrine of imposition focuses on an employer’s or the commission’s use of superior knowledge of or experience with the workers’ compensation act or use of economic leverage that results in an unjust deprivation to the employee of benefits warranted under the act; in order for the doctrine to apply, the record must show a series of acts by the employer or the commission upon which a claimant naturally and reasonably relies to his or her detriment. Casey Chevrolet Corp. v. Danforth, 2001 Va. App. LEXIS 76 (Va. Ct. App. Feb. 20, 2001).

    The theory of “imposition” empowers the Workers’ Compensation Commission in appropriate cases to render decisions based on justice shown by the total circumstances even though no fraud, mistake or concealment has been shown rather than permit the statute of limitations to be successfully pled. Avon Prods., Inc. v. Ross, 14 Va. App. 1, 415 S.E.2d 225, 8 Va. Law Rep. 2299, 1992 Va. App. LEXIS 73 (1992).

    Evidence sufficient to establish imposition. —

    The doctrine of imposition worked to toll the statute of limitations on an employee’s change in condition application where the employer voluntarily paid wages in lieu of compensation benefits on numerous occasions and the employee contacted the commission prior to undergoing surgery and was incorrectly informed that the statute of limitations had expired. Casey Chevrolet Corp. v. Danforth, 2001 Va. App. LEXIS 76 (Va. Ct. App. Feb. 20, 2001).

    Commission’s application of the doctrine of imposition with regard to a claimant’s change-in-condition application was upheld on appeal, because both the claimant and the employer honestly believed that all had been done to complete the paperwork in order for the claimant to receive additional periods of disability compensation when in fact the employer conducted a series of acts with respect to the method by which it paid the claimant, which the claimant naturally relied upon to his detriment, in that the employer failed to provide or file the necessary forms. Staunton Corr. Center v. Sanderson, 2005 Va. App. LEXIS 144 (Va. Ct. App. Apr. 12, 2005).

    Doctrine of imposition not applicable. —

    As there was no evidence that the insurer’s adjuster tried to get the claimant to delay surgery or made any commitment to pay benefits once the statute of limitations expired, or that the adjuster had any superior knowledge of the Virginia Workers’ Compensation Act that he used to unjustly deprive the claimant of benefits, the doctrine of imposition did not apply and the employer was not prevented from asserting the limitations period contained in subsection A of § 65.2-708 . Arias v. United Masonry of Va., Inc., 2004 Va. App. LEXIS 386 (Va. Ct. App. Aug. 10, 2004).

    “Imposition” found. —

    Where representations were made by employer that whatever needed to be done had been done, these representations justified claimant’s actions in not following up to see that the original memorandum of agreement had been filed, and to permit the statute of limitations to be successfully pled would be an imposition on the Commission, the actions of the employer and its insurance carrier created an imposition on the Commission and the claimant which empowered the Commission do full and complete justice. Therefore, although the statute of limitations had expired, the Commission had jurisdiction to hear worker’s claim for additional benefits. Avon Prods., Inc. v. Ross, 14 Va. App. 1, 415 S.E.2d 225, 8 Va. Law Rep. 2299, 1992 Va. App. LEXIS 73 (1992) (decided under former § 65.1-99).

    V.Practice and Procedure.

    Standardized application not prerequisite. —

    The submission of a standardized, uniform award review application, although preferable and more conducive to the orderly administration and disposition of workers’ compensation claims, is not a prerequisite for compliance with this section. Reese v. Wampler Foods, Inc., 222 Va. 249 , 278 S.E.2d 870, 1981 Va. LEXIS 297 (1981).

    Application not required where parties agree to entitlement to benefits. —

    This section does not require a claimant to file an application for change of condition if he can reach a satisfactory agreement with his employer regarding his entitlement to continuing disability benefits. Henrico Pub. Utils v. Taylor, 34 Va. App. 233, 540 S.E.2d 501, 2001 Va. App. LEXIS 30 (2001).

    An employee was not required to file a change of condition application because her employer voluntarily paid the equivalent of temporary total disability benefits to her; having evidently conceded that the employee was entitled to these benefits, it was the employer’s responsibility to file a supplemental memorandum of agreement with the commission. Henrico Pub. Utils v. Taylor, 34 Va. App. 233, 540 S.E.2d 501, 2001 Va. App. LEXIS 30 (2001).

    Date on supporting documentation not controlling. —

    Claim for temporary total disability benefits was not barred, despite fact that doctor’s report supporting employee’s claim bore date which fell outside 24-month period set forth in subsection A of this section. Southwest Virginia Tire, Inc. v. Bryant, 31 Va. App. 655, 525 S.E.2d 563, 2000 Va. App. LEXIS 145 (2000).

    As to Rule 13 of the Commission, setting forth certain requirements that an employer must meet, with precision, before it can obtain the hearing under this section which is a prerequisite to formal termination of an award or agreement on the ground of change in condition, see Dillard v. Industrial Comm'n, 416 U.S. 783, 94 S. Ct. 2028, 40 L. Ed. 2d 540, 1974 U.S. LEXIS 143 (1974).

    Subdivision B of Industrial (now Workers’ Compensation) Commission Rule 13 does not reduce the number of weeks of disability from 500 weeks. It also does not reduce the 24-month period allowed to file for a change in condition under this section. Subdivision B of the rule merely requires that a claimant timely exercise his right to compensation by limiting the retrospective period of recovery to not more than 90 days prior to the filing of the application. Whitten v. Mead Paperboard Prods., 4 Va. App. 182, 355 S.E.2d 349, 3 Va. Law Rep. 2224, 1987 Va. App. LEXIS 178 (1987).

    Application of Rule 13(b) of Industrial (now Workers’ Compensation) Commission upheld. —

    Since Industrial (now Workers’ Compensation) Commission Rule 13(b) comports with the spirit of this section as defined by the Virginia Supreme Court, it represents a legitimate rule made in furtherance of the Workers’ Compensation Act’s purposes. Graham v. Peoples Life Ins. Co., 7 Va. App. 61, 372 S.E.2d 161, 5 Va. Law Rep. 248, 1988 Va. App. LEXIS 93 (1988).

    Commission’s decision that its Rule 13(b) prohibited an award of additional compensation for a work-related injury when the application for a change in condition was filed more than 50 days after the occurrence of the disability would be upheld. Graham v. Peoples Life Ins. Co., 7 Va. App. 61, 372 S.E.2d 161, 5 Va. Law Rep. 248, 1988 Va. App. LEXIS 93 (1988).

    As to Rule 1.4 of the Commission. —

    The procedures specified in Va. Workers’ Comp. Comm’n R. 1.4(E) provide that no change in condition application under § 65.2-708 shall be accepted unless filed within two years from the date compensation was last paid pursuant to an award. An employer was clearly in violation of that rule where it admitted it stopped paying its employee on July 30, 2000, but did not file its application to terminate payments until August, 2002, despite two letters from the Virginia Worker’s Compensation Commission to the employer’s insurer notifying it of its obligation to apply for a hearing to terminate benefits; therefore, the commission properly rejected the employer’s application to terminate paying benefits. Genesis Health Ventures, Inc. v. Pugh, 42 Va. App. 297, 591 S.E.2d 706, 2004 Va. App. LEXIS 21 (2004).

    Application timely. —

    Employer’s application to terminate temporary partial disability compensation was timely filed as the employer made a lump sum payment on the day that it filed the application, bringing its compensation payments current to two years prior to the date of filing its application to terminate, as required by § 65.2-708 and Va. Workers’ Comp. Comm’n R. 1.4(E). Davis v. City of Lynchburg Waste Mgmt. & Liberty Mut. Ins. Co., 57 Va. App. 278, 701 S.E.2d 93, 2010 Va. App. LEXIS 445 (2010).

    Virginia Workers’ Compensation Commission did not err in concluding that an employee’s amended claim for temporary total disability benefits based upon a change in condition was not barred by the statute of limitations under subsection A of § 65.2-708 because the change-in-condition claim was filed within 24 months of a medical-only award. Prince William County Sch. Bd. v. Rahim, 58 Va. App. 493, 711 S.E.2d 241, 2011 Va. App. LEXIS 235 (2011), aff'd, 284 Va. 316 , 733 S.E.2d 235, 2012 Va. LEXIS 158 (2012).

    Purpose of rule which suspends payments. —

    It is manifest from the practical application of Industrial (now Workers’ Compensation) Commission that its obvious purpose is to preserve the status quo ante. A suspension pursuant to Industrial (now Workers’ Compensation) Commission Rule 13(C) is simply preliminary and temporary, intended to protect both parties’ interests until the Commission resolves the noticed matter on its merits. Rule 13 is not an authorization for an employer or insurer to suspend payments with assurance that an employee may not have them reinstated. Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    Rule which suspends payments does not require employee to apply for reinstatement. —

    The language of Industrial (now Workers’ Compensation) Commission Rule 13(C) is not to be read as a permanent termination of award payments requiring an employee to apply for reinstatement under former § 65.1-99. Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    No language in this section gives an employer the unilateral right to cease paying compensation benefits to a partially disabled employee under an outstanding temporary total disability award, when that employee returns to work at a lesser than pre-injury wage, and the employer does not file an application or an agreed statement of fact along with a supplemental memorandum of agreement. Odin, Inc. v. Price, 23 Va. App. 66, 474 S.E.2d 162, 1996 Va. App. LEXIS 574 (1996).

    Employer was required to pay compensation pursuant to an award of the Virginia Workers’ Compensation Commission, and assessed a 20 percent penalty on unpaid compensation pursuant to § 65.2-524 because the employer unilaterally ceased paying an employee benefits due and owed under an open award. The employer stopped paying the employee compensation benefits when he returned to full-duty work, and did not file appropriate paperwork or an application to terminate the award until well outside the two-year period provided for doing so under § 65.2-708 , and in violation of Va. Workers’ Comp. Comm’n R. 1.4. Washington Post v. Fox, 49 Va. App. 692, 644 S.E.2d 105, 2007 Va. App. LEXIS 185 (2007).

    Effective date of termination. —

    Although the Workers’ Compensation Commission did not err in deciding that the claimant’s benefits should be terminated because she voluntarily quit her employment without justification, it should have decided that the termination was effective on the date the employer filed its third application for termination, rather than the date her treating physician released her to return to work, as doing so prevented the Workers’ Compensation Commission from issuing a ruling having a retroactive effect on benefits paid prior to the filing of the application to terminate. Mileos v. Venus Pizza, 2003 Va. App. LEXIS 416 (Va. Ct. App. July 29, 2003).

    Treatment of original application as one for change in condition. —

    An application for compensation based on a “change in condition” cannot be used as a substitute for an original hearing on a new and separate accident. It does not follow, however, that the converse of this proposition is equally true. The Commission may, under circumstances which do accord at least the minimal notice requirements that due process demands, treat an application for original injury or disease as an application for review on change of condition. In fact, the Commission is authorized to conduct a review for change of condition on its own motion at any time, subject to due process limitations. Sergio's Pizza v. Soncini, 1 Va. App. 370, 339 S.E.2d 204, 1986 Va. App. LEXIS 209 (1986).

    Due process safeguards. —

    The Commission’s authority to consider an application for original injury benefits as an application for review on change of condition is not without limitation. The procedure utilized must afford the parties minimal due process safeguards. Sergio's Pizza v. Soncini, 1 Va. App. 370, 339 S.E.2d 204, 1986 Va. App. LEXIS 209 (1986).

    When a workers’ compensation claimant notified the Workers’ Compensation Commission that his employer’s carrier was not paying workers’ compensation benefits he had been awarded, and sought additional compensation due to a change in condition, to which the employer responded that the claimant had returned to work and any change in his condition was unrelated to his compensable injury, the issue of causation of the change in condition was improperly considered by the Commission because the claimant did not concede it was properly before the Commission, it was not mentioned in the hearing notice, nor did the Commission say it was considering terminating the claimant’s award based on his change in condition application, under subsection A of § 65.2-708 , and the carrier did not seek permission to terminate the claimant’s benefits, so the only issue properly before the Commission was whether the carrier should be assessed a penalty under § 65.2-524 for not paying benefits. Washington v. UPS of Am., 267 Va. 539 , 593 S.E.2d 229, 2004 Va. LEXIS 31 (2004).

    Award on review should not be retroactive. —

    A retroactive award is in derogation of the spirit and intent of this section. The new award cannot be made effective as of any date prior to the application for review. Bristol Door & Lumber Co. v. Hinkle, 157 Va. 474 , 161 S.E. 902 , 1932 Va. LEXIS 307 (1932) (see Gray v. Underwood Bros., 164 Va. 344 , 180 S.E. 317 (1935)).

    Retroactive modification of award not authorized. —

    When an employer sought the retroactive modification of a claimant’s award of temporary total disability benefits, based on the claimant’s return to light-duty work, § 65.2-520 did not authorize such a modification because there was no evidence the claimant had misrepresented or failed to report her earnings, and no language in § 65.2-712 , § 65.2-708 , or Va. Workers’ Comp. Comm’n R. 1.4(C)(1) allowed a retroactive modification, under these facts. Newport News Shipbuilding & Dry Dock Co. v. Bailey, 2003 Va. App. LEXIS 681 (Va. Ct. App. Dec. 23, 2003).

    Commission cannot review prior award in order to revise or modify it in regard to moneys paid. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    Express provisions of §§ 65.2-708 and 65.2-712 governing the termination of an award based on a change in condition controlled the issue of whether the employer was entitled to a credit for workers’ compensation benefits it paid to the claimant for nearly nine months following his return to work after he had sustained a compensable injury and since those provisions did not dictate that the employer was entitled to a credit for the payments it made to the claimant despite its knowledge that he had returned to full-duty work, the workers’ compensation commission erred in finding that under § 65.2-520 , the employer was entitled to a credit for having made such payments, as that statutory interpretation thwarted the legislature’s intention, as set forth in the other two statutes, that an award of benefits only be altered prospectively. McFadden v. Carpet House, 42 Va. App. 302, 591 S.E.2d 708, 2004 Va. App. LEXIS 28 (2004).

    Evidence previously introduced is automatically before Commission. —

    Upon the hearing of an application to modify an award by reason of change in condition since the former hearing, all the evidence previously introduced is before the Commission without being reintroduced. Allen v. Mottley Constr. Co., 160 Va. 875 , 170 S.E. 412 , 1933 Va. LEXIS 264 (1933).

    Evidentiary hearing not requisite. —

    The Commission’s utilization of the on the record hearing procedure to review an award, without the time and cost of an evidentiary hearing, is not prohibited by this section. Williams v. VEPCO, 18 Va. App. 569, 445 S.E.2d 693, 10 Va. Law Rep. 1598, 1994 Va. App. LEXIS 398 (1994).

    Hearing not requisite. —

    The Commission does not have to docket for hearing every application filed pursuant to this section. Implicit in this section and the case law is the understanding that the Commission may exercise its method and procedures to effect the orderly administration of justice and need not engage in unnecessary machinations where an application, considered in its best light, is without merit. Leonard v. Caremark Homecare, No. 2103-91-2 (Ct. of Appeals July 14, 1992).

    Because the parties agreed to terminate the award at the time claimant returned to work, and because the employer filed the executed agreement forms, it was not necessary for the employer to file an application for a hearing. Smith-Adams v. Fairfax Cnty Sch. Bd., 67 Va. App. 584, 798 S.E.2d 466, 2017 Va. App. LEXIS 109 (2017).

    Employer entitled to an evidentiary hearing on basis of evidence. —

    Employer was entitled to a hearing, pursuant to Va. Workers’ Comp. Comm’n R. 1.4 and § 65.2-708 , based on the medical evidence, which consisted of reports written by doctors who had examined the employee, that was submitted with the employer’s application to suspend the disability benefits awarded to an employee based upon a change in the employee’s condition. Advanced Finishing Sys. v. Brown-Snyder, 2008 Va. App. LEXIS 76 (Va. Ct. App. Feb. 12, 2008).

    Preliminary suspension of payments did not become res judicata. —

    Where the decision to suspend payments was merely preliminary to a formal hearing and decision on the merits, nothing in the Act suggests that the preliminary suspension of payments became res judicata, precluding worker from requesting, and the Commission from granting, reinstatement of benefits from the point of suspension; thus, the Commission did not err in reinstating the award and granting company credits in accordance with former § 65.1-100.3 (now § 65.2-712 ). Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    An employee who suffers a new and separate injury, not a “change in condition” arising out of the first injury, is required to give notice of the accident to his employer, his agent or representative, and to file an application for compensation with the Commission within the time limitations prescribed by former §§ 65.1-85 and 65.1-87 (now §§ 65.2-600 and 65.2-601 ). Leonard v. Arnold, 218 Va. 210 , 237 S.E.2d 97, 1977 Va. LEXIS 180 (1977).

    Retroactive application of subsection C did not impair employer’s rights. —

    Former § 65.1-55.1 (now subsection C) was enacted on July 1, 1989, well before the claimant’s right to file for a change in condition had expired. Thus, retroactive application of former § 65.1-55.1 did not impair any substantive or vested right of the employer. Miller & Long Co. v. Planishek, No. 1008-92-4 (Ct. of Appeals Nov. 17, 1992).

    Relation back. —

    Fact that a change in condition application arises out of the same transaction and occurrence as the initial workers’ compensation claim cannot provide the basis for concluding that it relates back to the initial filing for the purposes of the statute of limitations found in subsection A of § 65.2-708 . Morris v. Fed. Express Corp., 70 Va. App. 571, 829 S.E.2d 578, 2019 Va. App. LEXIS 167 (2019).

    Remand for additional evidence. —

    Although claimant’s application for hearing could and should have been considered a petition for review on change of condition, and although the Commission had the authority to so consider it by consolidating the application with the prior claim or by adopting a procedure which would have provided the employer minimal notice to permit an adequate defense at some stage of the proceedings, where it was first determined by the Commission on review to address the claim as one for change of condition, and the Commission did not permit or require either party to present additional evidence, although it was empowered to do so, the case would be remanded so that both parties could be afforded the opportunity to present evidence on the issue of whether claimant’s condition was a compensable result of her prior injury or the result of her medical treatment for that injury. Sergio's Pizza v. Soncini, 1 Va. App. 370, 339 S.E.2d 204, 1986 Va. App. LEXIS 209 (1986).

    Claimant’s letter served as sufficient application for review of her previous compensation award where it was quite clear that the claimant, the employer, the insurance carrier, and the commission treated the letter as a sufficient and timely application for a review of the previous award. Reese v. Wampler Foods, Inc., 222 Va. 249 , 278 S.E.2d 870, 1981 Va. LEXIS 297 (1981).

    VI.Illustrative Cases.

    Incarceration of claimant with temporary partial incapacity. —

    In the case of temporary partial incapacity, when a claimant’s incarceration for a criminal act rather than his physical incapacity causes the claimant’s loss of earning power, the employer is relieved from paying benefits during the period of incarceration. Baskerville v. Saunders Oil Co., 1 Va. App. 188, 336 S.E.2d 512, 1985 Va. App. LEXIS 83 (1985).

    The commission did not deny employer due process by affirming employee’s award of disability benefits based upon a theory different from that adopted by the deputy commissioner. Employer contended that because the deputy commissioner awarded benefits based on the theory of a change in the condition under former § 65.1-99 [now this section], it did not have adequate notice and a fair opportunity, upon review, to present evidence or argument in defense of a claim based on the theory that employee’s partial disability was totally disabling because he would be required to complete a work hardening program in order to return to work. However, employer received fair notice and an opportunity to litigate the issues that the commission considered in making its ruling. Georgia Pac. Corp. v. Dancy, 17 Va. App. 128, 435 S.E.2d 898, 1993 Va. App. LEXIS 460 (1993).

    Reasonable marketing of residual work capacity found. —

    In view of the fact that the claimant was partially disabled and discharged from her position, she was entitled to temporary total disability benefits if she made a reasonable effort to market her residual work capacity; the commission correctly found that the claimant made a reasonable effort to market her residual work capacity by contacting more than 100 potential employers between January 1993 and June 1995 and by registering with the Virginia Employment Commission. Philip Morris USA v. Marshall, 1997 Va. App. LEXIS 22 (Va. Ct. App. Jan. 21, 1997).

    Supposition that disability might recur insufficient to continue benefits. —

    Where, after releasing a claimant to return to his pre-injury employment, a doctor expressed concern that there was “a good probability” that the claimant might, in the future, miss some time from work due to his injury, such expression was mere supposition, a prospective concern that disability might reoccur and was insufficient to support a finding that the employee remained partially disabled; the eventuality posited by the doctor might not come to be and, if it did, upon proper proof, an appropriate award could be made. United Airlines v. Rice, 2001 Va. App. LEXIS 139 (Va. Ct. App. Mar. 20, 2001).

    Benefits not terminated where evidence of job description, actual duties, and physical condition conflicted. —

    Denial of employer’s application to terminate benefits was affirmed on appeal, where there were conflicts in the evidence of employee’s job description, his actual duties, and his physical status, and Commission found that the job description did not describe the employee’s pre-injury employment with sufficient specificity to provide the treating physician with a full description of his duties, it found the physical status report and job description to be in substantial variance, and held that the employer failed to establish a change in condition that would permit him to return to his regular employment. Swede’s Lawn & Landscaping v. Wright, No. 0197-85 (Ct. of Appeals Oct. 7, 1985).

    Compensation should be paid to date of application for review. —

    Where the application for review was heard before the full compensation under the outstanding award had been paid to the date of the application contrary to a rule promulgated by the Commission, it was held that entertaining the application was error. Gray v. Underwood Bros., 164 Va. 344 , 180 S.E. 317 , 182 S.E. 547 , 1935 Va. LEXIS 209, altered, 164 Va. 679 , 182 S.E. 547 (1935).

    Time for calculating credit for benefits paid. —

    Employer was entitled to a credit for benefits paid to a worker’s compensation claimant, who was incarcerated and later convicted, only for those benefits paid after the date of the filing of the application because § 65.2-708 generally operated prospectively only and allowed for a credit only in a very limited set of circumstances not applicable here. Vico Constr. Corp. v. Taylor, 2013 Va. App. LEXIS 233 (Va. Ct. App. Aug. 13, 2013).

    Cost-of-living supplements. —

    This section provided applicable statute of limitations for receiving cost-of-living supplements, and employee was found to have brought her claim within the twenty-four month limitations period. ARA Health Servs. v. Flax, 2000 Va. App. LEXIS 228 (Va. Ct. App. Mar. 28, 2000).

    Sufficient application for cost-of-living supplement fund. —

    In an action challenging a decision of the Commission which awarded a worker a cost-of-living supplement and attorney fees after he returned to work from a compensable injury, the plaintiff was not entitled to reversal of the Commission’s decision for the worker’s alleged failure to file an application for a cost-of-living supplement because during oral argument the plaintiff conceded that the worker had sent a letter to the Commission stating that the plaintiff had failed to pay the cost-of-living increase and inquiring about the status of the matter; thus, the letter to the Commission constituted sufficient application for a cost-of-living supplement. Jewell Ridge Coal Corp. v. Wright, 222 Va. 68 , 278 S.E.2d 820, 1981 Va. LEXIS 276 (1981).

    Verbal cure of unjustified refusal of medical care must be made in good faith to be effective, and claimant must demonstrate his or her good faith through an affirmative action or a showing of circumstances mitigating the failure to act. Fairfax County Sch. Bd. v. Rose, 27 Va. App. 587, 500 S.E.2d 273, 1998 Va. App. LEXIS 337 (1998), set aside, 28 Va. App. 131, 502 S.E.2d 176, 1998 Va. App. LEXIS 419 (1998), different results reached on reh'g, 29 Va. App. 32, 509 S.E.2d 525, 1999 Va. App. LEXIS 69 (1999).

    For verbal cure of unjustified refusal of medical care to be effective, it must be made in good faith. A claimant must demonstrate his or her good faith through an affirmative action or a showing of circumstances mitigating the failure to act. Fairfax County Sch. Bd. v. Rose, 29 Va. App. 32, 509 S.E.2d 525, 1999 Va. App. LEXIS 69 (1999).

    Refusal of vocational rehabilitation. —

    Employee was not precluded from asserting that his refusal of vocational rehabilitation was justified because he remained fully disabled by his hand injury related to the industrial accident for which he was receiving benefits for his compensable knee injury. Ilg v. UPS, Inc., 284 Va. 294 , 726 S.E.2d 21, 2012 Va. LEXIS 128 (2012).

    Weight of evidence. —

    Where workers’ compensation commission weighed the medical evidence, accepted one doctor’s opinion, rejected a contrary opinion, and gave little probative weight to videotapes, there was ample support for the commission’s finding that a claimant was unable to return to the claimant’s pre-injury employment. Chevy Chase Bank F S B v. Johnson, 2003 Va. App. LEXIS 87 (Va. Ct. App. Feb. 25, 2003).

    Where workers’ compensation commission weighed the evidence and accepted an employee’s evidence over an employer/insurer’s evidence, the commission properly found that the employee could not perform all of the employee’s pre-injury duties. S.B. Cox Ready Mix, Inc. v. Saunders, 2003 Va. App. LEXIS 476 (Va. Ct. App. Sept. 16, 2003).

    Evidence that disability was no longer work-related held inadmissible where not alleged in application. —

    The Commission did not err in holding that the employer could not introduce evidence in support of its change-in-condition application which would have shown that claimant’s continued incapacity was due to a totally nonwork related disability, where the basis for the Commission’s ruling was that the only ground alleged in the application to suspend benefits — that claimant could return to her regular employment — did not put in issue whether the current disability was causally related to the compensable injury, but only whether claimant continued to be incapacitated. Central Virginia Training Center v. Martin, 2 Va. App. 188, 342 S.E.2d 652, 1986 Va. App. LEXIS 258 (1986).

    Claimant entitled to unpaid compensation and late payment penalties. —

    Although a request by an employer and its insurer to terminate benefits was timely, the claimant was entitled to unpaid compensation and late payment penalties because the employer and insurer erroneously credited the claimant’s wages upon her return to work against the temporary total disability award. Diaz v. Wilderness Resort Ass'n & Liberty Mut. Ins. Co., 56 Va. App. 104, 691 S.E.2d 517, 2010 Va. App. LEXIS 148 (2010).

    Request by an employer and its insurer to terminate benefits was timely even though compensation payments were not current to within two years to the date of filing because the clear language of the statute did not limit such applications only to those filed by claimant or only when no compensation award was in effect. Diaz v. Wilderness Resort Ass'n & Liberty Mut. Ins. Co., 56 Va. App. 104, 691 S.E.2d 517, 2010 Va. App. LEXIS 148 (2010).

    The lone fact that the employer’s insurance carrier had failed to file certain medical reports with the Commission, where the reports were not prepared until well after the end of the 12-month (now 24-month) period, could not possibly have been the cause of the employee’s failure to make application for review within the prescribed time, and there was nothing before the Commission, therefore, upon which to base an estoppel against the employer and the insurer to plead the limitation provisions of this section. Sledge v. Price, 211 Va. 724 , 180 S.E.2d 674, 1971 Va. LEXIS 253 (1971).

    Employer was estopped from asserting this section in defense of its refusal to pay benefits where the combined effect of employer’s nurse’s statement to claimant and a letter from insurer was to induce claimant not to timely file an application for benefits. Nabisco Brands, Inc. v. Jones, 12 Va. App. 1028, 407 S.E.2d 919, 8 Va. Law Rep. 424, 1991 Va. App. LEXIS 195 (1991).

    No error in refusal to receive after discovered evidence. —

    Where surgery for claimant’s necrosis took place in August 1995 and the record on employer’s change in condition application was not closed until January 26, 1996, the commission could reasonably conclude that employer had ample opportunity to doctor’s opinion before the record closed. Therefore, the commission did not err in denying employer’s petition to receive after-discovered evidence. County of Chesterfield v. Scott, 1996 Va. App. LEXIS 790 (Va. Ct. App. Dec. 17, 1996).

    No error in reinstatement and remand. —

    Having found that the claimant could not return to his pre-injury employment, and the evidence showing that he had been terminated from his selective employment, the commission did not err in reinstating the award for temporary total benefits and remanding the claim to the dispute resolution department in order for the claimant to present verification of subsequent earnings for computation of subsequent benefits, whether they be for temporary total or partial, that the claimant may be owed. Preston Trucking Co. v. Barton, 1995 Va. App. LEXIS 469 (Va. Ct. App. May 30, 1995).

    Failure to list injury in agreement to pay benefits. —

    As the parties’ agreement to pay benefits did not mention the employee’s hand injury, which prevented his cooperation with vocational rehabilitation, it was not the subject of an enforceable award. Therefore, the employer, which applied for a hearing to terminate benefits under subsection B of § 65.2-603 , did not have the burden to show that the hand injury was not work-related. UPS v. Ilg, 54 Va. App. 366, 679 S.E.2d 545, 2009 Va. App. LEXIS 329 (2009).

    Claimant did not qualify for tolling under subsection C. —

    Where claimant’s pre-injury and post-injury jobs were virtually indistinguishable, where upon her return to work, claimant continued to have a lifting restriction, but this restriction did not limit performance of her day-to-day work, where claimant’s post-injury job was not light duty or selective employment for the purpose of the tolling provision of this section, and where the policy behind subsection C did not support its application to toll the statute of limitations in this case, claimant returned to her pre-injury work and therefore did not qualify for tolling under subsection C. Nguyen v. Fairfax County Bd. of Supvrs., 26 Va. App. 100, 493 S.E.2d 391, 1997 Va. App. LEXIS 719 (1997).

    Overuse of one member to compensate for injury to other. —

    A claimant was entitled to benefits to compensate for injury to her left arm where the medical records and the claimant’s testimony proved that her left arm symptoms resulted from overuse of that arm due to her favoring her previously injured right extremity; the injury to her left arm flowed as a natural consequence of the compensable right hand injury. Fisherman's Wharf of Am. v. Wolfe, 2001 Va. App. LEXIS 281 (Va. Ct. App. May 22, 2001).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Analysis

  • General:
  • Jurisdiction:
  • Limitations Period:
  • § 65.2-708 (C):
  • Estoppel:
  • Imposition:
  • Rule 1.4 (Previously Rule 13):
  • Procedure:
  • Application:
  • Seeking Additional Benefits:
  • Terminating Awards:
  • Payments Required to Terminate Award:
  • Ability to Return to Work:
  • Curing Refusal:
  • Credit/Correcting Awards:
  • Note: For definition of change in condition and other cases, see § 65.2-101 . For procedures relating to change in condition applications see Commission Rules 1.2, 1.3, and 1.4 (previously Rule 13). For cases on marketing and selective employment see notes to § 65.2-510 .

    General:

    Claim to add shoulder injury barred by res judicata where prior stipulations omitted that injury and agreed that the Order entering the stipulations alleviated the need for a hearing. Hall v. First Care Health Services, Inc., JCN VA00001015991 (Oct. 20, 2017).

    Defendants’ application barred by res judicata where application was based on the same report they omitted at prior hearing. Defendants seek a second bite of the apple as a result of their failure to produce sufficient evidence to prove their application at the prior hearing and is the type of re-litigation of decided matters that res judicata was intended to prevent. James v. Gabriel Brothers, Inc., JCN VA00000972120 (Dec. 6, 2016).

    One year statute of limitations of § 65.2-501 applies when disability is at same level before and after award of permanent partial disability. Section 65.2-708 ’s two-year limitation governed this claim because claimant proved her physical condition deteriorated since award for permanent partial disability was entered. Hernandez v. Mike’s American Grill, JCN VA00000222973 (Sept. 11, 2014).

    The initial claim listed left knee and right hip injuries but the Stipulated Award Order referenced injuries to the left lower extremity. A claim for a right hip filed almost three years after the accident was barred by the statute of limitations. With the entry of the Stipulated Award Order listing only the left lower extremity, the claim for a right hip injury was merged into that award, waived, or abandoned. As distinguished from facts in similar cases, the insurance carrier did not pay benefits for a brief period of treatment to the right hip. Swain v. City of Petersburg Social Services, VWC File No. 214-93-41 (Sept. 4, 2007).

    A majority held that where the initial award was for a left leg injury, a claim for a back injury filed almost nine years after the accident date is barred by the statute of limitations. The payment of medical expense for the back is not sufficient to establish estoppel, imposition, or a basis for a de facto award. Brickley v. Pardee Coal Company, Inc., VWC File No. 186-35-42 (April 4, 1997), aff’d, No. 116-07-3 (Ct. App. of Va., Sept. 11, 2007) (unpublished opinion).

    A majority found that the claimant’s 2005 claim for a shoulder injury was barred by the statute of limitations because the compensable back injury from the 1998 accident was a separate and distinct injury. Moyer v. David A. Nice Builders, VWC File No. 194-62-94 (Mar. 12, 2007). (Dismissed by Ct. of App., June 4, 2007).

    The defendants, by failing to appear at a change in condition hearing, waived the statute of limitations defense. There was no basis for relying on the carrier’s response to Orders because they are non-binding nor is there a basis for a deputy commissioner to find, sua sponte , that the insurer has a defense if it has not appeared to assert one. Huot v. Affiliated Animal Care, L.L.C., VWC File No 201-99-60 (Jan. 31, 2007).

    While under § 65.2-708 a claim for permanent partial benefits must be filed within thirty-six months from the date compensation was last paid pursuant to an award, this section is not jurisdictional and is waived where the defendants fail to challenge the claim on the grounds of statute of limitations. Downing v. Home Depot USA, Inc., VWC File No. 206-81-72 (April 21, 2006).

    De facto awards are appropriate in either an original-award or a change-in-condition claim. While the last payment pursuant to an Award in this case was June 3, 2002, the finding of a de facto award from September 6 to September 21, 2002 made the claim filed on July of 2004 a timely change in condition claim. Dungee v. Virginia Department of Labor & Industry, VWC File No. 207-57-07 (May 11, 2005).

    The limitation provisions of § 65.2-708 do not apply to claims for vocational rehabilitation brought pursuant to § 65.2-603 A 3 because vocational rehabilitation services do not constitute “compensation” as contemplated in the time limitation provisions of § 65.2-708 . Lingenfelter v. Busch Gardens, VWC File No. 186-51-24 (Aug. 18, 2004).

    Employee excused from marketing for approximate 5-week period despite light-duty release; Deputy Commissioner found that claimant, who worked for employer for 30 years, credible; claimant testified he understood he would return to work for employer; claimant had returned to work after earlier injury, and employer stated it could not offer him work at that time. Fleshman v. Weyerhaeuser Co., VWC File No. 202-21-28 (Apr. 29, 2003).

    Employee released to pre-injury work and returned to such work for employer but later voluntarily resigned; employee later restricted to light-duty work and sought partial wage-loss benefits; light-duty restrictions found to be related to compensable accident, and no evidence of offer by employer within new restrictions; voluntary resignation of pre-injury job did not preclude later seeking benefits based on change in condition. Montoya v. Hardees of Little Creek, VWC File NO. 203-33-48 (Mar. 20, 2003).

    A change in condition is one that flows from a progression, deterioration or aggravation of the injury sustained in the original industrial accident. McBride v. Va. Dept. of Transportation, 76 O.W.C. 227 (1997).

    This section applies exclusively to applications for the resumption, increasing, diminishing or terminating of compensation upon the ground of change in condition of employee. It may be invoked only where there has been an earlier award in favor of employee on account of the same injuries, based either upon formal hearing or memorandum of agreement under § 65.1-93 (now § 65.2-701 ) filed with and approved by the Commission. Parker v. Manchester Bd. & Paper Co., 201 Va. 328 , 111 S.E.2d 453, 1959 Va. LEXIS 230 (1959); Allen v. Mottley Constr. Co., 160 Va. 875 , 170 S.E. 412 , 1933 Va. LEXIS 264 (1933).

    The decision in Amp, Inc. v. Ruebush , 10 Va. App. 270, 391 S.E.2d 879 (1990) does not preclude a new application for a change in condition when a period of time not considered in the course of the previous hearing is involved or other evidence about the contested period of disability was not available at the time of the previous hearing. Philpott v. Harris Teeter Super Markets, Inc., 71 O.W.C. 112 (1992).

    Where the employer voluntarily pays compensation for eight months without submitting a Supplemental Memorandum of Agreement, the Commission found a de facto award. Testimony challenging causation was not be allowed. To terminate benefits the employer must comply with § 65.2-708 and Rule 1.4(C). Anderson v. City of Roanoke Fire Department, 73 O.W.C. 34 (1994). [See also Trammel v. Freeman Decorating Co., 73 O.W.C. 37 (1994) discussed below] .

    In order to meet the burden of establishing a change in the physical condition, as well as a change in the condition under which compensation was previously awarded there must be something in the nature of a deterioration or progression of the employee’s condition rather than simply showing that he remains incapacitated for work. Spruill v. Quality Masonry, 67 O.I.C. 22 (1988).

    A change in condition under the Act means a change in the physical condition of the employee as well as any change in the conditions under which compensation was awarded or terminated such as would affect the right to, amount of and duration of compensation. Huffman v. Toney Arey Trucking, 70 O.I.C. 85 (1991).

    It is not necessary for an employee to prove a pathological change in condition. A change in the evidence as to disability is sufficient to establish a change in condition. Ferguson v. Metric Constructors, Inc., 70 O.I.C. 80 (1991).

    Significant clarification of a physician’s opinion as well as a change in the opinion of a treating physician may form a reasonable basis for either reinstatement or termination of compensation. Hall v. Shenandoah Pride Dairy, 64 O.I.C. 155 (1985).

    Where an employee seeks a change in condition with both incapacity and causation in issue after the rejection of a previous application, the new application is barred by res judicata when the only new evidence is a change in the physician’s opinion on the issue of causation. Amp, Inc. v. Ruebush, 10 Va. App. 270, 391 S.E.2d 879, 6 Va. Law Rep. 2321, 1990 Va. App. LEXIS 85 (1990).

    Compensation was denied because there was no proof of disability within the statutory period. Anticipatory applications are not allowed. Baker v. Valleydale Packers, Inc., 54 O.I.C. 7 (1972).

    Though change in condition application was timely filed claim denied because actual work related disability did not occur within applicable 24 month period. Younce v. Clinchfield Coal Company, 60 O.I.C. 478 (1981).

    There is no presumption in Virginia that once disability has been established a claimant is presumed to remain disabled until contrary medical evidence is shown. Medical evidence must prove causally related disability on a continuous basis. Hummel v. Johnson’s Grocery, 67 O.I.C. 102 (1988).

    A suspension of compensation benefits for unjustified refusal of selective employment does not terminate an award but merely discontinues entitlement to benefits during the period of refusal. Once the refusal has been cured benefits are reinstated without the necessity of establishing a change of condition. Section 65.1-99 (now § 65.2-708 ) and Rule 13 (now Rule 1.2) are not applicable. Hercules, Inc. v. Carter, 13 Va. App. 219, 409 S.E.2d 637, 8 Va. Law Rep. 1109, 1991 Va. App. LEXIS 271 (1991).

    A determination that an employee has not suffered a permanent total disability under § 65.1-56 (18) (now § 65.2-503 C) does not preclude the claimant from later re-filing for benefits at the expiration of 500 weeks of temporary total disability benefits. However, the claimant’s evidence must establish a change in condition that would support a finding of permanent and total disability and not merely that his physical condition remains the same as at the earlier hearing. Stratton v. Lynchburg Foundry Company, 69 O.I.C. 129 (1990).

    An open award for a back injury does not preclude a change of condition application for a subsequent facial injury. If the facial injury is found to be disabling, the employee is entitled to an award for the accident which would provide a higher compensation rate. Ensley v. Westmoreland Coal Company, 69 O.I.C. 25 (1990).

    By its express terms, the tolling provision of Va. Code Ann. § 8.01-229 (A)(3) is limited to causes of action accruing against a committee. That section is not applicable to claims brought under the Virginia Workers’ Compensation Act. Whetzel v. Waste Management of Virginia Blue Ridge, 78 O.W.C. 12 (1999).

    The Virginia Workers’ Compensation Act has its own independent tolling provisions in Va. Code Ann. §§ 65.2-528 and 65.2-602 . The presence of these specific provisions included as part of this statutorily-created remedy precludes application of the general tolling provisions of Title 8.01. Furthermore, because the claimant was not incarcerated at the time of his work-related injury, the alleged incapacity would not have existed at the time of the “accrual” of the right to the remedy, thus rendering Va. Code Ann. § 8.01-229 (A)(1) expressly inapplicable. Whetzel v. Waste Management of Virginia Blue Ridge, 78 O.W.C. 12 (1999).

    Jurisdiction:

    The Commission has jurisdiction to hear the claimant’s change of condition application even though the previous award suspending compensation has not become final pending action on appeal to the Supreme Court. Lawson v. Oakwood Mobile Homes, Inc., 62 O.I.C. 287 (1983).

    The suspension of benefits for a specific loss under § 65.1-56 (now § 65.2-503 ) and the entry of an award for temporary total disability, upon a finding of a change in condition, are proper actions and wholly in accord with the authority and administrative responsibility of the Commission as conferred by the Act. Williams v. Commonwealth of Virginia Division of Motor Vehicles, 1 Va. App. 401, 339 S.E.2d 552 (1986), 64 O.I.C. 354 (1985).

    Although Rule 13(C) does not specifically refer to the right of Review before the Full Commission of a Claims Division’s decision not to place a case on the docket, this procedure is allowed recognizing that the claimant’s benefits are suspended pending the hearing, but also noting that if the employer prevails there is no means of recovering payments made during the review process. Shiltner v. Doris Coal Co., 68 O.I.C. 41 (1989).

    Note: Rule 1.6 now specifically sets forth the right of review of a decision accepting or rejecting a claim.

    The 24-month limitation period set out in § 65.2-708 is not jurisdictional, but is only a time limitation and is subject to waiver or estoppel. Carvajal v. Fresh Fields Markets, Inc., 79 O.W.C. 92 (2000).

    Limitations Period:

    The Commission lacks the authority to issue a Rule which expands the time for filing a change in condition claim. As enacted by the General Assembly, Code section 65.2-708 sets the period during which a timely change of condition claim may be filed and a rule of the Commission cannot expand or reduce this time. Thus, claimant cannot use Commission Rule 1.2(B) to relate back ninety days to make timely a change in condition claim which was not filed with the twenty-four month statute of limitations period. Martin v. Central Virginia Training Center, JCN 221-54-07 (Feb. 13, 2013).

    The receipt of permanent partial disability benefits pursuant to an Award is “compensation” and therefore tolls the statute of limitations under section 65.2-708 (A). Phillips v. Hubbell Lighting, Inc., JCN 212-91-89 (Aug. 18, 2011).

    The claimant’s depression that developed from pain relating to injuries incurred in a work accident is a compensable consequence of the original injury and as such is a change of condition governed by § 65.2-708 which requires that a claim be filed within two years from the date compensation was last paid pursuant to an award. Brown v. Ruby Tuesday’s Inc., VWC File No. 215-94-55 (June 11, 2007), On remand deputy commissioner on Oct. 19, 2007 found for claimant. By March 6, 2008 review opinion the commission affirmed. (On remand deputy commissioner on Oct. 19, 2007 found for claimant. By March 6, 2008 review opinion the commission affirmed).

    The removal of an intramedullary rod does not qualify as a replacement or repair of a prosthesis or orthosis such as to invoke the limitations period of § 65.2-708 A (ii). Benson v. Abbit Management, Inc., VWC File No. 192-08-58 (Aug. 2, 2006).

    The Commission found that a claim for permanent total benefits for a brain injury was a change in condition rather than a new claim because the spreading from the lungs to the brain of the histoplamosis for which benefits were initial awarded was a progression of the original condition. Heller v. Powhatan Correctional Center/Commonwealth of Va., VWC File No. 174-73-32 (July 19, 2006).

    While under § 65.2-708 a claim for permanent partial benefits must be filed within thirty-six months from the date compensation was last paid pursuant to an award, this section is not jurisdictional and is waived where the defendants fail to challenge the claim on the grounds of statute of limitations. Downing v. Home Depot USA, Inc., VWC File No. 206-81-72 (April 21, 2006).

    Limitations period set forth in § 65.2-708 , and not § 65.2-601 , applies to claim for benefits arising out of compensable consequence of original compensable injury. Hardy v. Commonwealth of Virginia, VWC File No. 151-08-12 (Jan. 4, 2005).

    Implantation of spinal stimulator found not to be surgical procedure to repair or replace prosthesis; employee last received benefits in February 2000 but was restricted from work in June 2002 because of stimulator implantation and filed claim in November 2002; statute of limitations not enlarged by implantation procedure under provision allowing such enlargement for repair or replacement of prosthesis. Shearin v. Ruan Leasing Co., VWC File No. 198-97-66 (Oct. 3, 2003).

    Employee who initially sought and was awarded benefits for head injury later (within two years of accident) filed claim and sought benefits for hip and back injuries; Deputy Commissioner’s decision that later claim was precluded by employee’s failure to pursue such benefits at first hearing, thereby avoiding piecemeal litigation, found to be incorrect; employee may seek to amend or supplement prior adjudication within two years of accident. Sparks v. Food Lion, VWC File No. 204-28-96 (May 2, 2003).

    The time limit for filing a change in condition claim for additional compensation expires twenty-four months from the day for which compensation was last paid under an award, not from the date on which the compensation award was entered. Broomall v. Page Aviation Supply Co., 74 O.W.C. 135 (1995).

    Where the claimant alleged a change in condition and permanent total disability, the Commission held that the three year limitation period of § 65.2-708 applied. Hayes v. 4 E Corporation, 78 O.W.C. 147 (1999).

    A claimant seeking permanent partial disability benefits must establish a work-related permanent loss or loss of use to an anatomical member specified in Va. Code Ann. § 65.2-503 . The claim cannot be considered unless it is filed within three years from the date for which compensation was last paid pursuant to an award. The commission can retain jurisdiction of a premature claim if the rated degree of permanency and maximum medical improvement are not manifest and established within that time frame. However, the evidence of the claimant must show some permanent functional disability within the statutory period. Pollard v. First General Services, 77 O.W.C. 259 (1998).

    There are two statutes of limitation that could apply after payments of an award for permanent partial disability. If the claimant has undergone a change in condition, the two-year statute of limitation in § 65.2-708 applies. If there has not been a change in condition and the claimant is at the same disability level after the award for permanent loss as before, the one-year statute of limitations in § 65.2-501 applies. Phelps v. Safeway Stores, Inc., 77 O.W.C. 138 (1998).

    The term “compensation” used in this section refers only to compensation paid to the claimant, and does not refer to payment of medical expenses. Broomall v. Page Aviation Supply Co., 74 O.W.C. 135 (1995).

    The limitation provided for in § 65.1-87 (now § 65.2-601 ) has no application to petitions under this section. Wise Coal & Coke Co. v. Roberts, 157 Va. 782 , 161 S.E. 911 , 1932 Va. LEXIS 327 (1932).

    Where employee seeks compensation for injuries not the subject of the original award, § 65.1-87 (now § 65.2-601 ) is applicable. Dorton v. Wharton Coal Co., 48 O.I.C. 68 (1966) (appeal denied).

    Where an employee is originally paid under the LHWCA without an award in Virginia and subsequently files for compensation benefits, it is an original claim and is not subject to the limitation period of § 65.2-501 or § 65.2-708 . Moore v. Virginia International Terminals, Inc., 73 O.W.C. 46 (1994).

    Where there has been an award for medical benefits only, § 65.2-708 is inapplicable because there has been no prior award of compensation. Therefore, disability must occur within two years from the date of the accident. James v. Morton G. Thalhimer Services Corporation, 71 O.W.C. 71 (1992).

    Where an employee files a claim within two years from the date of the accident but establishes entitlement only to a medical award, subsequent disability must occur within two years from the date of the accident rather than the limitations period for a change of condition. Therefore, the tolling provision of § 65.2-708 (C) is inapplicable. Mayberry v. Alcoa Building Products, 18 Va. App. 18, 441 S.E.2d 349 (1994); 71 O.W.C. 67 (1992).

    A claim for initial disability benefits must be filed within two years of the work accident for compensable disability beginning within two years of that accident. The limitation period is not tolled where only medical benefits were initially awarded because disability did not exceed seven days. The change in condition claim for disability had to be filed within two years of the accident. Ashby v. West Point School Board, 74 O.W.C. 90 (1995).

    The claimant was injured in an accident on September 8, 1995, resulting in disability through December 8, 1995, for which he filed a timely claim on September 26, 1995. The claimant filed an additional claim on September 29, 1998, seeking additional benefits beginning September 21, 1998. The initial hearing was held on April 30, 1999, at which time the claimant was awarded benefits for his initial period of disability. The Commission found that the subsequent disability beginning September 21, 1998 was barred by § 65.2-708 , because that period of disability began more than two years after the termination of the initial award. Ma v. Seal & Company, Inc., 78 O.W.C. 213 (1999).

    A claimant cannot file a speculative application and extend the time for which permanent partial disability compensation may be awarded. Therefore, if the employee files a timely application, but does not have evidence of a permanent functional disability within three years from the date compensation was last paid pursuant to an Award, she cannot be awarded compensation for the permanent injury. Choi v. Shoppers Food Warehouse, 76 O.W.C. 183 (1997).

    The statute of limitations is not extended because a diagnosis of work-related disability is delayed until after the expiration of the statutory period. Ma v. Seal & Company, Inc., 78 O.W.C. 213 (1999).

    In an occupational disease claim where there has been a “medical benefits only award”, the claimant cannot file a change in condition application more than two years after the date of communication of an occupational disease. Lacy v. Aerofin Corporation, 68 O.I.C. 120 (1989).

    The definition of “filed” in § 65.1-52 (now § 65.2-406 ) is limited to occupational diseases and does not change time limitations of § 65.1-99 (now § 65.2-708 ). Street v. Island Creek Coal Co., 56 O.I.C. 302 (1974); Bates v. Clinchfield Coal Co., 55 O.I.C. 32 (1973).

    The majority found a de facto award based on the employer’s payment of benefits for 13 months. Therefore, the claimant’s change of condition application was not barred by § 65.2-708 . A dissent noted that an employer is obligated to file a Memorandum of Agreement but disagreed that the failure to file such agreement tolls the statute of limitations. Trammel v. Freeman Decorating Co., 73 O.W.C. 37 (1994). [See also Anderson v. City of Roanoke Fire Department, 73 O.W.C. 34 (1994) discussed above] .

    A claimant is not required to file supporting evidence with the change in condition application in order to toll the statute of limitations if the application specifies a change in condition. Whitehair v. American Industrial Contracting, Inc., 63 O.I.C. 367 (1984).

    Letter from claimant requesting the Industrial Commission to assist him with his worker’s compensation was sufficient to meet the requirements of statute of limitations of § 65.1-99 (now § 65.2-708 ) and Rule 13 (now Rule 1.2) as to the filing of a change in condition application. Cook v. City of Waynesboro, Police Department, 60 O.I.C. 109 (1981).

    Voluntary payment of medical bills is not tantamount to payment of compensation such as to toll the statute. Compensation is the money allowance payable to employee. Meade v. Clinchfield Coal Co., 215 Va. 18 , 205 S.E.2d 410 (1974); Miller v. United Parcel Service, 51 O.I.C. 182 (1969); Nicely v. Daniel Construction Company, 59 O.I.C. 233 (1980).

    In reversing the Commission, the Court held that the employer was estopped from asserting the statute of limitation period of § 65.2-708 where it earlier advised the claimant that medical and disablity benefits would be paid then delayed the surgery procedure by seeking a second opinion until after the expiration of the two year time period. Fernandes v. Handyman Services, Inc., 20 Va. App. 708, 460 S.E.2d 602 (1995) reversing 73 O.W.C. 42 (1994).

    Soldiers’ and Sailors’ Civil Relief Act, Title 50 United States Code, § 525, bars including period of military service in computing statute limitations. Beatty v. Giant Food, Inc., 49 O.I.C. 21 (1967).

    An employee alleging that his release from incarceration is a change in condition, must comply with the requirements of § 65.1-99 (now § 65.2-708 ) by filing an application within twenty-four months from the date compensation was last paid. The Act does not toll the limitation period during incarceration and does not provide that computation of the twenty-four months occurs from the date the change in condition occurs. Mann v. McDaniels Roofing Corporation, 70 O.I.C. 92 (1991).

    Statute of limitations not extended where new diagnostic technique results in diagnosis of work related disability after statutory period has expired. Scott v. Climatemakers Electric Company, 60 O.I.C. 380 (1981).

    A claim for a back injury was time barred when not filed within two years of the accident, where that injury was incurred in the work accident but not listed with the injuries on a memorandum of agreement filed for entry of an award. Williams v. Capital Distributors, 74 O.W.C. 79 (1995).

    § 65.2-708 (C):

    The Commission rejected the assertion that the tolling provisions of § 65.2-708 C starts anew each time the claimant returns to work. The purpose of the section is to prevent an employer from bringing an injured worker back to work in a light duty position at pre-injury wage and then terminating the job after the statute of limitations expired. Where the claimant returned to work on several occasions and received awards for various periods of benefits it cannot be said that she was lulled into a false sense of security causing her to delay filing a claim. Frisk v. Marshall’s, VWC File No. 183-99-55 (June 6, 2007).

    Based on evidence of the claimant’s pre-injury duties, her work restrictions, and the work performed upon her return to work, the Commission found that the claimant was working in a selective employment capacity and the provisions of § 65.2-708 C were applicable to extend her time for filing a change in condition claim. Center v. Food Lion L.L.C. 1229/Delhaize America Inc., VWC File No. 214-92-48 (April 25, 2007), aff’d, No. 0931-07-1 (Ct. App. of Va., Sept. 4, 2007) (unpublished opinion).

    When claimant was last paid compensation pursuant to an award and returned to work for the employer at light duty but earning his full pre-injury wage, the statute of limitations was tolled for the consecutive period that he continued to earn his pre-injury wage while performing restricted duty until he was laid off and began to collect unemployment benefits in an amount less than his pre-injury wage. The claimant had two years from the date of his lay off to file a change in condition claim. Crites v. Slurry Pavers, Inc., VWC File No. 202-99-47 (Feb. 15, 2005).

    The General Assembly enacted § 65.2-708 C to provide an extended limitation period when an injured worker returns to work at a wage rate equal to or greater than pre-injury wage and when disability renders the injured worker unable to return to pre-injury work. This Code section was designed to prevent possible abuse by employers of the two-year limitation period set forth in § 65.2-708 A, to prevent employers from lulling partially disabled workers into a false sense of security during this two-year period by providing employees light-duty work at their pre-injury wage for two years and then terminating the employee without liability for future disability benefits. Phelps v. Safeway Stores, Inc., 77 O.W.C. 138 (1998).

    Section 65.2-708 C applies to the twenty-four consecutive months after a claimant returns to light-duty work without a wage loss, and it is triggered on the date the claimant is provided light duty work. Phelps v. Safeway Stores, Inc., 77 O.W.C. 138 (1998).

    Where an employee has some restrictions but returns essentially to her same pre-injury work and not selective work at wages approximating or greater than prior to the injury, the requirements of § 65.2-708 A and § 65.2-708 C have not been established. Burton v. Fairfax County School Board, 71 O.W.C. 75 (1992).

    Although the accident date and initial award occurred prior to the enactment of § 65.2-708 , the employee was entitled to the benefit of the statute because the twenty-four month statute of limitations period had not expired on the effective date, July 1, 1989. The employee was last paid compensation when she was laid off from her selective employment. Greene v. Gwaltney of Smithfield, Inc., 13 Va. App. 486, 413 S.E.2d 650, 8 Va. Law Rep. 1646, 1992 Va. App. LEXIS 6 (1992).

    The claimant’s change in condition claim was not barred, where she was placed on light duty by the employer at her regular wages within two years of the date on which her claim was filed. Custer v. Wampler Longacre Turkey, Inc., 76 O.W.C. 176 (1997).

    Section 65.2-708 (C) extends the statute of limitations only where an award has previously been entered. Mayberry v. Alcoa Building Products, 18 Va. App. 18, 441 S.E.2d 349 (1994), 71 O.W.C. 67 (1992).

    The tolling provision of § 65.2-708 (C) does not apply to a self-employed claimant who on his own initiative finds selective employment because the work was not “provided” as required by the statute. Scott v. Terry W. Scott, 71 O.W.C. 78 (1992).

    Promotion of an employee under work restrictions to a position with less strenuous physical duties, without more, does not trigger the tolling provisions of § 65.2-708 C. The evidence established that the employer was unaware of the injury, and the effects of the injury on his employment played no role in his promotion to a lighter-duty job. Because the employee failed to file a claim for permanent partial disability benefits within 36 months from the last date for which compensation benefits were paid under an award, his claim was denied as untimely. Reid v. Controlled Conditions Corporation, VWC File No. 150-22-73 (August 2, 2001).

    Estoppel:

    Where the Commission had previously ruled that the treatment of the claimant by a particular physician was not the responsibility of the employer, litigation of subsequent claims seeking payment for medical treatment by the same physician was barred by the doctrine of collateral estoppel because the parties had litigated that issue in an earlier action. Gonzales-Smith v. Ford Motor Company, VWC File No. 210-99-47 (Feb. 11, 2010).

    A majority held that where the initial award was for a left leg injury, a claim for a back injury filed almost nine years after the accident date is barred by the statute of limitations. The payment of medical expense for the back is not sufficient to establish estoppel, imposition, or a basis for a de facto award. Brickley v. Pardee Coal Company, Inc., VWC File No. 186-35-42 (April 4, 1997), aff’d, No. 116-07-3 (Ct. App. of Va., Sept. 11, 2007) (unpublished opinion).

    Employer that agreed to entry of two awards and provided vocational rehabilitation to employee estopped from raising defense to later claim that employee unjustifiably refused light-duty work soon after accident; employer’s defense of refusal barred by agreement to compensation award covering same period. Ricks v. Goodwill Indus., VWC File No. 204-73-56 (Apr. 4, 2003).

    An employee previously received an award for compensation benefits after submitting time slips to her employer. The employer will be estopped from asserting the statute of limitations because the claimant reasonably believed the claim would be processed as in the past. The claimant timely submitted time slips and is not precluded by Rule 13 (B) (now Rule 1.2B) from receiving benefits more than ninety days prior to the filing of her application. Jones v. Nabisco Brands, 69 O.I.C. 37 (1990).

    The employee sustained injury to her right ankle on March 18, 1995. The treating physician recommended surgery on the ankle, and the carrier’s representative wrote on January 12, 1999 that it would authorize the surgery, and appropriate temporary total disability benefits during the claimant’s recovery. The claimant testified that she could not afford to miss time from work in order to have the surgery and would not have scheduled the surgery absent the carrier’s promise to pay wage loss benefits during her recovery period. The Commission held that the carrier’s use of the term “appropriate” referred to the period of time that the claimant would be disabled as a result of the surgery, and was a sufficiently specific statement on which the claimant could reasonably rely. It concluded that the claimant had changed her position and suffered a significant detriment, lost wages for more than five months, when she scheduled the surgery in reasonable reliance on the insurer’s representation to pay wage loss benefits during her recovery. The Commission found that the employer was estopped from invoking the time limitations of § 65.2-708 , and that it had waived such a defense. Carvajal v. Fresh Fields Markets, Inc., 79 O.W.C. 92 (2000).

    An employer is not estopped from pleading a statute of limitations merely because it did not inform the claimant of the limitation. Ma v. Seal & Company, Inc., 78 O.W.C. 213 (1999).

    During initial period of disability, claimant received full wages from the employer and endorsed her compensation check to the employer. During a subsequent period of disability, she was again paid full wages and medical benefits continued, but compensation payments were not renewed. The Commission held that the evidence did not show acts inconsistent with an endeavor to comply with the Act or upon which the claimant naturally and reasonably relied, and that she had previously received a workers’ compensation pamphlet from the Commission explaining her rights and responsibilities under the Act. Accordingly, the doctrines of estoppel and imposition did not apply in this case. Gibbs v. City of Chesapeake School Board, 74 O.W.C. 229 (1995).

    Where an employee was advised that the employer would forward lost time slips to the carrier and compensation would be paid as in the past, the employer is estopped from asserting the limitation period of § 65.1-99 (now § 65.2-708 ) and Rule 13 (B) (now Rule 1.2 B). Nabisco Brands, Inc. v. Jones, 12 Va. App. 1028, 407 S.E.2d 919, 8 Va. Law Rep. 424, 1991 Va. App. LEXIS 195 (1991).

    To prove equitable estoppel, the claimant must show by clear, precise, and unequivocal evidence that she relied upon an act or statement of the employer or its agent in not filing a claim within the statutory period. The claimant must prove that the employer’s conduct did, in fact, induce her to forgo filing a timely claim. Gibbs v. City of Chesapeake School Board, 74 O.W.C. 229 (1995).

    An employer’s voluntary payment of compensation does not estop the employer from asserting that a claimant’s claim is time barred due to the statute of limitations, unless the employer makes representations to the claimant that induces him not to timely file a claim. An employer’s acceptance of a claim and voluntary payment of compensation does not induce the claimant to refrain from filing a timely claim where the acceptance and payment occur only after the statute of limitations has expired. Anthony v. Newport News Shipbuilding, 78 O.W.C. 38 (1999).

    The claimant alleged compensable disability more than four years after he last received compensation pursuant to an award, and the Commission rejected the claim as time barred. The employer subsequently paid temporary total disability benefits to the claimant, but stopped payments after approximately four months, because the payments were time barred. The Commission found that such payments, made after the limitations periods for additional compensation had expired, did not constitute a de facto award from which a new change in condition claim could be measured, nor did it constitute a waiver of the limitations period by the employer. Anthony v. Newport News Shipbuilding, 78 O.W.C. 38 (1999).

    The Court in denying benefits to an employee held that fraud or concealment are the only grounds to estop an employer from asserting the statute of limitations period of § 65.1-99 (now § 65.2-708 ). A mutual mistake by the parties in believing that an outstanding award exists is not a basis for estopping an employer from raising a statute of limitations defense. Niblett v. Piedmont Aviation, Inc., 12 Va. App. 652, 405 S.E.2d 635, 7 Va. Law Rep. 2906, 1991 Va. App. LEXIS 135 (1991).

    Estoppel will prevent a carrier from asserting the statute of limitations of § 65.1-99 (now § 65.2-708 ) where the employee was paid full salary in lieu of compensation and the employer received reimbursement from the carrier for amounts covered by workers’ compensation. Brooks v. County of Dinwiddie, 70 O.I.C. 51 (1991).

    Payment of wages in lieu of compensation is basis for estoppel. Williams v. City of Fairfax, 51 O.I.C. 298 (1969); Sugg v. Commercial Trading Corp., 53 O.I.C. 358 (1971).

    The employer is not estopped to raise a limitations defense because it paid the claimant regular wages during the alleged disability period, where the evidence does not establish that the employer represented it would “handle” her claim for disability benefits. Gibbs v. City of Chesapeake School Board, 74 O.W.C. 229 (1995).

    Defendant’s physician controlled scheduling date of rating examination and time of reports therefore estopped from asserting limitations period. Holland v. Pen-Sim, Inc., 52 O.I.C. 140 (1970); Richardson v. Hygrade Food Products Corp., 52 O.I.C. 205 (1970).

    Agreement with employer was solely to protect claimant’s union status and was not estoppel or fraud. Witt v. Kenrose Mfg. Co., Inc., 55 O.I.C. 381 (1973).

    Finding made that claimant’s change in condition application was not barred by the provisions of this section in case where claimant, who was illiterate, was advised by attending physician that his continuing disability was due to his compensable industrial accident and he believed the payments he was receiving (under health and accident policy) were payments under the compensation law. Wells v. Westmoreland Coal Co., 57 O.I.C. 369 (1977).

    Carrier not estopped from asserting statute of limitations by failure to file medical reports. Sledge v. Price, 211 Va. 724 , 180 S.E.2d 674, 1971 Va. LEXIS 253 (1971).

    The employer is not estopped from raising a limitations defense because it continued to provide medical care for the claimant’s work injury pursuant to the Act. Gibbs v. City of Chesapeake School Board, 74 O.W.C. 229 (1995).

    Imposition:

    A majority held that where the initial award was for a left leg injury, a claim for a back injury filed almost nine years after the accident date is barred by the statute of limitations. The payment of medical expense for the back is not sufficient to establish estoppel, imposition, or a basis for a de facto award. Brickley v. Pardee Coal Company, Inc., VWC File No. 186-35-42 (April 4, 1997), aff’d, No. 116-07-3 (Ct. App. of Va., Sept. 11, 2007) (unpublished opinion).

    The concept of imposition empowers the Commission in appropriate cases to render decisions based on the totality of the circumstances, even in the absence of fraud, mistake, or concealment. Actions inconsistent with an effort to comply with the Act, standing alone, do not require automatic application of the doctrine of imposition. Gibbs v. City of Chesapeake School Board, 74 O.W.C. 229 (1995).

    The doctrine of imposition does not apply where a carrier’s or employer’s acts are consistent with an endeavor to comply with the Act. Gibbs v. City of Chesapeake School Board, 74 O.W.C. 229 (1995).

    The doctrine of imposition should only be used in the rare case where applying the Act’s provision in a technical manner would prevent the Commission from having jurisdiction to do full and complete justice in each case. Gibbs v. City of Chesapeake School Board, 74 O.W.C. 229 (1995).

    During initial period of disability, claimant received full wages from the employer and endorsed her compensation check to the employer. During a subsequent period of disability, she was again paid full wages and medical benefits continued, but compensation payments were not renewed. The Commission held that the evidence did not show acts inconsistent with an endeavor to comply with the Act or upon which the claimant naturally and reasonably relied, and that she had previously received a workers’ compensation pamphlet from the Commission explaining her rights and responsibilities under the Act. Accordingly, the doctrines of estoppel and imposition did not apply in this case. Gibbs v. City of Chesapeake School Board, 74 O.W.C. 229 (1995).

    Rule 1.4 (Previously Rule 13):

    For additional cases see notes to Rules 1.2, 1.3 and 1.4.

    Employer filed an application alleging that the claimant had returned to pre-injury work. Two months later the employer sought to amend the application by asserting that the claimant had been released to return to pre-injury work. A Deputy Commissioner dismissed the employer’s application, finding that it was defective on its face, because when the application was amended from “returned” to work to “released” to return to work, the employer was required to pay the claimant through the date the amended application was filed, and failed to do so. The Full Commission affirmed, ruling that the employer abandoned the allegation in the initial application when it sought to amend it to “released” to return to work. Hayes v. Action Home Construction, Inc., VWC File No. 222-72-36 (Sept. 17, 2010).

    When payment was processed on the Friday that an Employer’s Application for Hearing was filed, but the check was not mailed to the claimant until Monday, it was appropriate to reject the Application because compensation was not paid to the date of filing. Cromer v. Unifirst Corp., VWC File Nos. 218-55-41 & 219-71-37 (July 31, 2006).

    Senior Claims Examiner’s rejection of employer’s April 18, 2003, Application to terminate benefits based on December 3, 2002, release to return to work upheld, when Application certified that employer paid benefits only through December 5, 2002; although employer argued that employee refused to execute agreement forms, there was no evidence that employee actually had returned to work while still on an open award and had refused to execute appropriate agreement forms. Atkinson v. Penske Logistics, Inc., VWC File No. 201-39-53 (July 15, 2003).

    Employer that unsuccessfully litigated application alleging release to return to pre-injury work precluded from later litigating return to light-duty work on same date, followed by alleged unjustified refusal shortly thereafter; employer knew of facts surrounding later application at time of prior application. Barton v. McDonald’s, VWC File No. 196-30-27 (May 27, 2003).

    Rule 1.4(A) requires that a copy of the defendants’ application and supporting documentation must be sent to the employee, and a copy to the employee’s attorney if the employee is represented. Logically, since the defendants do not know the employee’s address, they cannot possibly provide him with a copy of the application. However, because the employee was represented by an attorney at the time of the last hearing on this matter, and the defendants were certainly aware of that representation, the Commission held that the due process rights of the claimant had been violated, and the Commission rejected the Employer’s Application on that ground. Jones v. Goodwill Industries, 79 O.W.C. 1 (2000).

    Rule of the Commission 1.4(B) provides that each change in condition application filed by the employer under § 65.2-708 must be in writing and under oath. Rule 1.4(B) also states that the defendants shall state the grounds for relief as well as the date for which compensation was last paid. However, Rule 1.4(B) applies only to employer’s applications filed under § 65.2-708 , not to those filed under § 65.2-711 for failure to report a change in address. Jones v. Goodwill Industries, 79 O.W.C. 1 (2000).

    The rule was adopted to require prompt payment of compensation to all claimants entitled thereto, and to eliminate the arbitrary discontinuance of compensation by employer and insurer without legal sanction. Parker v. Manchester Bd. & Paper Co., 201 Va. 328 , 111 S.E.2d 453, 1959 Va. LEXIS 230 (1959).

    An application is void ab initio where an employer fails to pay compensation through the date of filing as required by Rule 13 (now Rule 1.4 C). In addition to upholding the validity of then Rule 13, the Court found that the employee was not required to alert the employer to the defect in the application prior to the hearing. Specialty Auto Body v. Cook, 14 Va. App. 327, 416 S.E.2d 233, 8 Va. Law Rep. 2642, 1992 Va. App. LEXIS 120 (1992).

    Rule 1.4(C) requires that compensation shall be paid through the date the application was filed, unless, inter alia , the application alleges a refusal of selective employment or medical attention or examination, in which case payment shall be made to the date of the refusal or 14 days before filing, whichever is later. Campbell v. Perdue Foods, Inc., 76 O.W.C. 157 (1997).

    Compensation must be paid pursuant to Rule 1.4 (C) either before or with the filing of an Employer’s Application For Hearing. Compensation mailed to the claimant three days after the application was filed and eight days after the date through which payment was required does not comply with Rule 1.4 (C). Rule v. Southside Regional Medical Center, 74 O.W.C. 40 (1995).

    Compensation paid “to” the date the claimant returns to or refuses work requires payment through the day before the alleged refusal or return. Payment for the date of alleged refusal or return to work is not required, since that would require payment for a day on which the claimant worked or refused to work. Rule v. Southside Regional Medical Center, 74 O.W.C. 40 (1995).

    Commission’s Rule 13 (now Rule 1.2) precludes an award of compensation for the period more than two weeks (now ninety days) preceding the filing of claimant’s application for temporary total disability. Employer, however, is not permitted to modify an outstanding award for temporary partial benefits absent the filing of a formal application for hearing, under oath, evidencing compliance with the award through the date of filing. Joseph v. European Parts Exchange, 60 O.I.C. 247 (1981).

    A change in condition application may be accepted and docketed without a finding of probable cause when the payment of compensation continues. Hux v. Ball Corporation, 77 O.W.C. 226 (1998).

    Where the application does not contain a request for modification of the outstanding award, but only a request for a credit, the existing temporary partial award will not be modified to reflect an increase in wages until such time as an application specifying the relief sought is filed. An employer is limited to the relief stated in the application. Washington Metropolitan Area Transit Authority v. Pender, 14 Va. App. 100, 415 S.E.2d 239, 8 Va. Law Rep. 2344, 1992 Va. App. LEXIS 75 (1992).

    Procedure:

    Note: For cases on hearing procedures see notes to § 65.2-704 .

    Employer’s Application for Hearing executed by counsel with the statement “I swear to the above” was technically defective because it was not submitted under oath as evidenced by either a notary public’s seal or the certificate prescribed by the Commission. Dimas v. Town & Country Landscaping, Inc., JCN VA00000379161 (Dec. 1, 2014).

    Unpublished decision: Employee required to prove each element of change in condition claim, seeking benefits based on August 1, 2001, release; Commission agreed with Deputy Commissioner that release was prospective, but disagreed that benefits should be awarded through December 2002; employee found to prove disability only through August 31, 2001. Williams v. Reston Interfaith, VWC File No. 203-92-06 (Oct. 14, 2003), aff’d, Ct. App. Record No. 2885-03-4 (Mar. 6, 2004).

    Rule 1.2(B) did not apply to employee’s claim for initial period of disability benefits following accident, when parties agreed that accident was compensable and that a de facto award for a later period was appropriate; Rule 1.2(B) does not apply to an initial period of claimed benefits. Young v. Young’s Welding, Inc., VWC File No. 204-86-50 (Aug. 4, 2003).

    Employee not prevented from filing “protective” claim for benefits, although she was under an open award of benefits at the time of the filing, when employer had filed application to terminate benefits. Simons v. Tartan Textile Serv., Inc., VWC File No. 201-42-52 (July 7, 2003).

    Unpublished decision: Deputy Commissioner properly adjusted rate of claimant’s temporary partial disability award rate downward, although claimant had requested only increase in rate of award; evidence required to prove modification was the same whether modification increases or decreases rate of award, and thus due process satisfied; claimant also required to notify Commission of increase in earnings, and thus no prejudice in adjusting rate downward.).Bradshaw v. United Parcel Serv. of Am., VWC File No. 198-41-96 (June 9, 2003), aff’d, Ct. App. Record No. 1643-03-2 (Oct. 28, 2003).

    Upon the hearing of an application under this section to modify an earlier award, all evidence previously introduced is before the Commission without being reintroduced and all that may be shown is some change in employee’s condition since the former hearing. Allen v. Mottley Constr. Co., 160 Va. 875 , 170 S.E. 412 , 1933 Va. LEXIS 264 (1933).

    Although the claimant suffered a temporary increase in symptoms after a later incident, there was essentially the same degree of effusion and range of motion as before the incident, and there was no change in work restrictions or medical treatment because of that incident. The Commission held that the later incident was not a new accident, but only an aggravation of her earlier work accident. McBride v. Va. Dept. of Transportation, 76 O.W.C. 227 (1997).

    In considering employer’s application for hearing based upon a change in claimant’s condition, Commission may consider medical reports filed prior to hearing which demonstrate a continuation of claimant’s disability. Rogers v. Sky Chefs, Inc., 222 Va. 800 , 284 S.E.2d 605, 1981 Va. LEXIS 376 (1981).

    The Deputy Commissioner may consider medical evidence obtained by either party after the filing of an application but prior to the time of the hearing. Lay v. Baldindos Lock & Key Service, Inc., 71 O.W.C. 110 (1992).

    Where an employer files an application alleging that the claimant is able to return to regular work, medical evidence is not limited to reports available at the time of the application but includes all reports available prior to the hearing. Turner v. Wilson Brothers, Inc., 69 O.I.C. 73 (1990).

    Where an employee files a change in condition application seeking temporary partial disability and at the time of the hearing amends the application to allege temporary total disability, it is appropriate to allow the amendment. Consolidation of claims at hearing is admissible provided the employer has notice of the time, location and subject matter with a reasonable opportunity to be heard. The circumstances of this case provided the employer with sufficient notice of the pending claim, nor was there prejudice by the amendment. Crystal Oil Co. v. Dotson, 12 Va. App. 1014, 408 S.E.2d 252, 8 Va. Law Rep. 410, 1991 Va. App. LEXIS 201 (1991).

    After a Claim or Application is accepted, a Deputy Commissioner should decide the issues based on the entire record. If the record proves the worker was disabled or not disabled on a later date than the date alleged in the Claim or the Application, the Deputy Commissioner should award or deny benefits as of the later date. Braxton v. Hampton Univ. Aux. Enterprises, 76 O.W.C. 223 (1997).

    It is error for a deputy commissioner to award benefits not sought by the claimant. Justus v. Rapoca Sales Company, 77 O.W.C. 223 (1998).

    The limitations periods under § 65.2-708 are not jurisdictional, and may be waived if not raised as affirmative defenses. An employer may raise additional, non-jurisdictional defenses at any time before a case is submitted for a decision by the hearing officer. However, once the record is closed, any non-jurisdictional defenses not already raised are waived. Here, the employee’s claim for permanent partial disability benefits was filed more than 36 months after the last day for which compensation benefits were last paid under an award. The employer failed to raise the limitations defense until after the case was submitted for decision, and the defense was waived. Stewart v. Visador Company, VWC File No. 167-36-98 (June 26, 2001).

    Application:

    Filing with the Commission a copy of claimant’s counsel’s letter to the employer, which did not request any Commission action, did not constitute the filing of a change in condition claim but rather was merely provision of information to the insurance carrier and the beginning of negotiations for benefits. Fehrenbach v. Giant Food, Inc., VWC File No. 204-62-65 (June 2, 2004).

    The principle that the Commission does not adjudicate cases piecemeal does not apply to a medical benefits award entered in response to Commission’s “20-day Order” because such award results from an administrative action, not from a hearing or formal agreement. Therefore, claimant’s original claim, wherein he requested permanent partial disability benefits, was not merged with his medical benefits award, nor had it been waived or abandoned. Sutherland v. Craft Machine Works, Inc., VWC File No. 194-35-92 (May 28, 2004).

    Where an Employer’s Application For Hearing is filed pursuant to § 65.2-712 , the requirements of Rule 1.4(A) apply. However, the application need not be submitted under oath, as is required by Rule 1.4(B) for applications submitted under § 65.2-708 . Nuttall v. Autozone, 79 O.W.C. 195 (2000).

    The requirement that an Employer’s Application For Hearing must be under oath is in Rule 1.4(B)(2). By the terms of that Rule, it only applies to a change in condition application filed by an employer under § 65.2-708 . Nuttall v. Autozone, 79 O.W.C. 195 (2000).

    A change in condition application cannot be substituted for an original claim. An application for compensation based on a “change in condition” cannot be used as a substitute for an original hearing on a new and separate accident.” Pullen v. Stackhouse, Inc., 78 O.W.C. 59 (1999).

    A change in condition is different from the right to recover for the injury itself. It is impossible to have a change in condition without a prior award. A change in condition is based upon an award in a compensable case. Its object is purely remedial, as it enlarges or diminishes the former award to meet the circumstances of a particular case. Pullen v. Stackhouse, Inc., 78 O.W.C. 59 (1999).

    A letter need only apprise the opposite party of the basis or ground for relief. Martin v. Jones Constr. Co., 37 O.I.C. 252 (1955) [ 198 Va. 370 , 94 S.E.2d 202]; Wise Coal & Coke Co. v. Roberts, 157 Va. 782 , 161 S.E. 911 , 1932 Va. LEXIS 327 (1932).

    Letter written at request of injured employee by a disinterested party asking that “she be given extension of time concerning her case” accepted as timely filed change in condition application. The law does not impose upon the claimant the same burden of stating a well-defined cause of action or of a showing of probable cause as it does upon the employer. Brumfield v. The Lane Co., Inc., 57 O.I.C. 60 (1977).

    Rule 1.2(A) of the Rules of the Virginia Workers’ Compensation Commission provides that a change in condition claim must be in writing and state the change in condition relied upon. .Gatling v. Siemen’s Corporation, 77 O.W.C. 95 (1998).

    A letter from an employee advising that her hours had been reduced and inquiring whether she was entitled to compensation was found to be an inquiry and not an application for hearing. Greene v. Gwaltney of Smithfield, Inc., 13 Va. App. 486, 413 S.E.2d 650, 8 Va. Law Rep. 1646, 1992 Va. App. LEXIS 6 (1992).

    A “generic” change in condition claim for “all benefits to which an employee is or may be entitled pursuant to the Virginia Workmens [sic] Compensation Act” is not sufficient to enable the employer to determine the nature of the change in condition for which benefits are sought. It provides no information to which the employer might respond with its defenses, if medical benefits have already been awarded. Gatling v. Siemen’s Corporation, 77 O.W.C. 95 (1998).

    There is no requirement in § 65.1-99 (now § 65.2-708 ) or in Rule 13 (now Rule 1.2) that the claimant’s application for hearing upon a change in condition be signed. Smith v. Interstate Van Lines, 64 O.I.C. 293 (1985).

    When an employee files a change in condition application both the question of capacity and causation are in issue. When an employer files a change in condition application only the question of disability is raised unless other grounds are specifically asserted on the application. Central Virginia Training Center v. Martin, 2 Va. App. 188, 342 S.E.2d 652, 1986 Va. App. LEXIS 258 (1986).

    An employer’s application defines the scope of the issues to be heard. Where an employer’s application merely alleged the employee was able to return to work, the issue of causal connection between the injury and her condition cannot be considered. Johnson v. Celanese Fibers Company, 229 Va. 117 , 326 S.E.2d 687, 1985 Va. LEXIS 181 (1985).

    In order to determine whether probable cause exists to suspend benefits and refer the matter to the docket for a hearing on the merits, the Commission’s claims examiner must make a determination of whether there is a reasonable probability that the employer will succeed on the merits of its claim. The Commission held that a claims examiner could properly find probable cause that the claimant refused selective employment from (1) a medical report releasing the claimant to return to work; (2) a job description approved by the physician; and (3) the employer’s statement under oath in the application that offered employment was refused. Berry v. Aramark Corporation, 78 O.W.C. 22 (1999).

    Where the employer’s application was not based upon a change in condition, but merely sought to modify the average weekly wage and did not seek to suspend compensation payments pending a hearing, the acceptance or rejection of the application would not be based upon the usual probable cause standard. Hux v. Ball Corporation, 77 O.W.C. 226 (1998).

    An elementary and fundamental requirement of due process, in any proceeding that is to be accorded finality, is notice reasonably calculated under all the circumstances to apprise interested parties of the action and afford them an opportunity to present their objections. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Due process requires that an individual be granted an opportunity for a hearing appropriate to the nature of his case before he is deprived of any significant property interest. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Absent agreement of the parties, only claims set forth in the hearing notice may be heard and decided. Justus v. Rapoca Sales Company, 77 O.W.C. 223 (1998).

    Where the employer was not given notice that a change in the treating physician was an issue to be decided by the Deputy Commissioner, that issue was not properly before the Commission at the evidentiary hearing and the finding on that question must be Vacated. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    The Commission remanded the case after finding that the deputy commissioner erred by deciding an issue not raised by the claimant, and by failing to consider the very essence of the claim, i.e. , the employer’s responsibility for the payment of specific past medical bills. Justus v. Rapoca Sales Company, 77 O.W.C. 223 (1998).

    An employer’s application for hearing alleging a change in condition based on an attached medical report is sufficient to raise the issue of causal connection. Suite v. Clinchfield Coal Co., 8 Va. App. 554, 383 S.E.2d 21, 6 Va. Law Rep. 132, 1989 Va. App. LEXIS 104 (1989).

    The employer’s cover letter indicated its application was sent by certified mail, but a postal receipt subsequently filed did not include that portion with the date, nor was any receipt filed that showed it was delivered to the Commission. The Commission held that the cover letter and the partial receipt was insufficient evidence to establish that the application was in fact filed. Hamilton v. Ramada Inn, 76 O.W.C. 74 (1997).

    Where an employer’s application states that a medical I.M.E. by a specified physician advises that the claimant can return to work but fails to incorporate by reference the physician’s medical report or indicate the date or location of the report, the only issue before the Commission is whether the employee can return to work. The issue of causation is not before the Commission because the employer failed to clearly identify the report such as to give the employee adequate notice of the grounds upon which the change in condition allegation was based. Stump Trucking v. Stump, 12 Va. App. 555, 404 S.E.2d 747, 7 Va. Law Rep. 2666, 1991 Va. App. LEXIS 113 (1991).

    When an employer files an application seeking to suspend compensation benefits on the basis that the claimant has refused vocational rehabilitation or medical treatment, the application must specify the dates and nature of such refusal. Phelps v. J. B. Eurell Company, 67 O.I.C. 28 (1988).

    Where compensation benefits have continued through adjudication of the employer’s application alleging refusal to cooperate with job placement efforts, § 65.1-99 (now § 65.2-708 ) requires suspension of benefits as of the hearing date, not the date the application was filed, if the application is granted. Barton v. Mullins Coal Company, 69 O.I.C. 159 (1990).

    The employer properly filed an Application for Hearing on February 12, 1997, seeking suspension of benefits due to the claimant’s refusal of medical care. It subsequently wrote seeking to amend the application by adding two issues. The hearing Deputy Commissioner chose not to hear the new allegations, but indicated that it would be referred to the hearing docket. The senior claims examiner construed the amendment as a new claim and held it to the technical requirements of Commission Rule 1.4. The Commission held that the line between an amendment and a new claim is not always clear, but given that the Deputy Commissioner announced at the hearing that she would send the request to the hearing docket, together with the fact that the amendment was filed with the Commission more than three months before the hearing, it was error to reject the application because it technically did not comply with Rule 1.4. Colindres v. Jay Swigart Construction, 76 O.W.C. 503 (1997).

    Seeking Additional Benefits:

    Compensation awarded for time missed from work following diagnostic tests where the claimant undergoes multiple diagnostic studies during non-work hours, as ordered and scheduled by a treating physician, and the physician excused the claimant from work as a result of those tests. The Commission will not second guess a professional rationale which appears to be a reasonable and necessary medical practice. Brown v. Johnson Memorial Hospital, VWC File No. 233-60-73 (March 8, 2010).

    Claimant who scheduled a required medical appointment on a workday or during work time, may receive temporary total or partial benefits if it is shown that the medical condition required the appointment during work hours, if scheduling the appointment at a non-work time would interfere with obtaining favorable work assignments, or if scheduling the appointment on non-work time would cause substantial hardship. Brightwell v. City of Richmond Police, VWC File No. 190-41-06 (Sept. 30, 2004).

    Senior Claims Examiner’s decision to refer employee’s change-in- condition Claim to hearing docket upheld; in previous proceeding, employee’s marketing efforts, based on restrictions in February 2003 medical report, found to be insufficient; in present proceeding, employee sought benefits based on marketing efforts, and included February 2003 report; employer’s objection to further consideration of February 2003 rejected because present Claim based on continuing restrictions and marketing efforts, and medical report relevant to such inquiry. Beard v. Rogar Int’l Corp., VWC File No. 213-76-96 (Apr. 30, 2004).

    In 1991, the General Assembly amended the definition of “change in condition” to include “any change in the conditions under which compensation was awarded, suspended, or terminated .” The Commission later held that this amendment effectively vitiated the distinction between suspended and terminated, and claimants thereafter were obliged to prove continuing disability, through marketing efforts, in order to have compensation benefits reinstated. Goddard v. Albrite Engine Works, 78 O.W.C. 256 (1999).

    When a claimant becomes partially incapacitated and files a change of condition application seeking compensation benefits, he must prove both his incapacity and a reasonable effort to secure suitable employment during the period of partial disability. Hudson v. Eastern Airlines, 66 O.I.C. 108 (1987).

    Where a medical award has already been entered for the work injury, a change in condition application is the appropriate procedural remedy for the claimant. Given that he already has an award for the subject accident, his claim simply alleges a change from an injury without compensable disability (as opposed to medical expense) to one with compensable disability. Pullen v. Stackhouse, Inc., 78 O.W.C. 59 (1999).

    The claimant was under an open award for temporary partial disability resulting from an October 1990 accident when he filed a claim for permanent partial disability compensation. The Deputy Commissioner limited the award to the difference between the claimant’s statutory entitlement to 500-weeks benefits and the number of weeks’ benefits that the claimant had already received. The Commission modified that award, holding that the claimant’s entitlement to permanent partial disability benefits accrued on the date his application was filed, although the employer was entitled to a credit for temporary partial disability benefits it had continued to pay. Fett v. Waymar, Inc. & Sport Patios of Tidewater, 78 O.W.C. 250 (1999).

    A claimant seeking compensation for increased permanent partial disability must prove that his condition has deteriorated since his disability rating was last determined by the Commission and that his current permanent disability is greater than that previously awarded. Swearingen v. Westvaco Corporation, 74 O.W.C. 36 (1995).

    The Commission awarded additional benefits even though the medical profession was unable to diagnose a basis for the employee’s testicular or scrotal pain because the claim was originally accepted as compensable and the employee’s medical complaints were consistent. Ferguson v. Metric Constructors, Inc., 70 O.I.C. 80 (1991).

    Section 65.2-510.1 provides that compensation benefits for wage loss shall be suspended whenever a partially disabled employee is imprisoned in a jail. Once suspended, a resumption of benefits is not automatic or self-executing upon release from incarceration. The claimant is required to prove that he is entitled to a resumption of benefits. Goddard v. Albrite Engine Works, 78 O.W.C. 256 (1999).

    A claimant who is precluded from receiving temporary partial compensation benefits because of incarceration is not entitled to temporary total benefits when surgery as a result of the industrial accident renders him unable to work. Jones v. D & F Plumbing, Heating and Repair, 67 O.I.C. 220 (1988) (see Garrison v. MSJ Construction Company, Inc., VWC File No. 167-38-59 (June 28, 1996) which makes a contrary holding).

    Claimant is entitled to a continuing award of compensation when medical reports establish she can perform her pre-injury employment but upon return to her former employment, she finds that although the job title remains the same, the physical requirements are different and beyond the medical limitations imposed on her activities. Parham v. Wendy’s International, Inc., 63 O.I.C. 268 (1984).

    Where an employee’s severe injury and its consequences directly caused him to become devoid of normal judgment and to be dominated by a disturbance of the mind which led to suicide, a claim by his dependents was found to be compensable. The post-injury suicide was held to be a change in condition and not a new accident. Confer v. Arban & Carosi, Inc., 63 O.I.C. 66 (1984).

    The claimant, who could not satisfactorily perform selective work because of a pre-accident glaucoma condition, was entitled to resume temporary total benefits upon establishing an attempt to market his remaining capacity. Orange v. Tidewater Construction Corp., 68 O.I.C. 167 (1989).

    An employee’s loss of selective employment through no fault of his own is a change in condition entitling him to a resumption of compensation benefits if he is partially disabled and has made a reasonable effort to market his remaining work capacity. Huffman v. Toney Arey Trucking, 70 O.I.C. 85 (1991).

    The claimant returned to light duty with the employer after sustaining a back injury that left her permanently disabled from her pre-injury work. The employer had created the job for her, but it was not a permanent position and the claimant was encouraged to look for other work. The employer, through a vocational rehabilitation provider, was unable to locate appropriate alternative work. On her own, the claimant located and accepted a position with earnings approximately 10% below her pre-injury average weekly wage. The employer defended the claim for temporary partial disability on the ground that the claimant voluntarily resigned and did not have a compensable change in condition. The Commission held that these facts demonstrated the claimant’s good faith efforts to market her residual capacity and supported the Deputy Commissioner’s award of temporary partial disability. Mannix v. St. Mary’s Hospital, 76 O.W.C. 515 (1997).

    An employee performing restricted work who is dismissed for economic reasons is entitled to additional benefits if a reasonable effort to market remaining capacity is established. Nixon v. Stafford Electrical & Refrigeration Service, Inc., 71 O.W.C. 87 (1992).

    Compensation benefits were reinstated to an employee who was able to perform light duty work but was unable to drive sixty-five miles each way to his pre-injury employment. Desmond v. Republic Claims, 70 O.I.C. 89 (1991).

    Where a claimant was released to light work on a “trial basis” and experienced increased symptomatology upon attempting the work, there was no unjustified refusal of selective employment nor was there a change in condition justifying a termination of benefits when the work attempt was ended. Setliff v. Tultex Corporation, 68 O.I.C. 160 (1989).

    Where claimant sustained injuries during her part-time job as a school bus driver, compensation must be paid during period disabled for driving school bus, although she returned to her full-time job at an earlier date. Chandler v. Christian School Assoc. of Richmond, 51 O.I.C. 45 (1969).

    Although an employee’s physical condition remains constant, a change in condition was established when he was compelled to sell his business because economic deterioration from reduced working hours necessitated by his medical condition is a change of condition within the Act. Harris v. Varina Bi Rite Food Store, 71 O.W.C. 90 (1992).

    Unemployed because his business enterprise failed is not a change in condition within the Act. Harrington v. United Air Lines, Inc., 55 O.I.C. 163 (1973).

    Change of condition not established where claimant’s present disability was due to illness contracted while in military service. Houston v. Sears Roebuck & Co., 57 O.I.C. 176 (1977).

    Aggravating effects of re-exposure to causative agent of dermatitis is not new accident. Durham v. Walker Machine & Foundry Co., 52 O.I.C. 90 (1970); McDaniel v. Folker, 49 O.I.C. 201 (1967); Hawkeye-Security Ins. Co. v. McDaniel, 210 Va. 209 , 169 S.E.2d 582, 1969 Va. LEXIS 225 (1969).

    Once the employee’s respiratory condition returned to normal, he is no longer entitled to benefits merely because of susceptibility to re-contract or reactivate the disease. Castle v. Westvaco Container Division, 69 O.I.C. 118 (1990).

    Terminating Awards:

    Deputy Commissioner properly modified award of temporary total benefits to provide temporary partial benefits, although employer’s Application sought termination of award; employee defended Application and requested entry of partial award; Commission found that employer had burden to prove change in condition and extent of change, and only proved that employee’s total wage loss did not continue and that partial wage loss did continue; thus, entry of partial award appropriate, based on uncontradicted evidence of partial wage loss. Perrin v. Tri Cities Beverage Corp., VWC File No. 210-59-81 (Apr. 29, 2004).

    Employer who proved that employee’s compensation should be terminated because he was able to return to pre-injury work, based on a May 10, 2002, examination by the employee’s treating physician, not entitled to credit for benefits paid to employee between May 10, 2002, and May 29, 2002, the date the employer filed an application to terminate benefits; benefits were owed under the open award until the date the application was properly filed, not the date of the release to pre-injury work. Gillis v. Enterprise Rent A Car Co., VWC File No. 205-20-70 (Aug. 26, 2003).

    Three ways exist to terminate an award: (1) by claimant’s execution of agreed statement of fact, (2) by claimant’s execution of supplemental agreement under § 65.1-55 (now § 65.2-502 ) or § 65.1-56 (now § 65.2-501 ), changing the basis of compensation, or (3) by defendant’s filing application on ground of change in condition. Lee v. Benefit Group Admrs., Inc., 54 O.I.C. 203 (1972).

    The claimant was examined by his treating physician after a functional capacity evaluation. Although the physician reported no significant change from earlier visits, he was disturbed by the FCE evaluation, which suggested nonorganic causes of the employee’s complaints, without any permanent injury, and he found the claimant had reached his pre-accident state. The Commission agreed, determining that the physician had appropriately based his opinion on the totality of his record of treatment over four months, and the reported findings in the FCE, which medical evidence was uncontradicted. Fleming v. Double M Coal Co., Inc., 79 O.W.C. 156 (2000).

    If claimant will not sign the proper forms, defendant should immediately apply for a hearing, paying compensation to date application is received by the Commission. Manchester Board & Paper Co. Inc. v. Parker, 201 Va. 328 , 111 S.E.2d 453 (1959); aff’g Parker v. Manchester Board & Paper Co., Inc., 40 O.I.C. 101 (1958).

    The signing of agreed statement of fact is not a requirement for payment of compensation. Byrd v. Jones Logging Co., 55 O.I.C. 63 (1973).

    Where the claimant is on an outstanding award but has returned to some type of work, the carrier must continue paying benefits until an Agreed Statement of Fact or application to terminate benefits is filed with the Commission. Beaty v. Meadows Nursing Center, 73 O.W.C. 40 (1994).

    Where an employer files an application alleging an employee has returned to work and seeks a credit but does not request that an outstanding award be vacated, a finding that the employee briefly returned to light work at reduced wages does not require that the award be suspended until the claimant files a change in condition application. While a credit may be allowed for the period in which the claimant worked, compensation is reinstated thereafter on the basis that there is no further grounds for suspension under Rule 13 (now Rule 1.5) or § 65.1-100.3 (now § 65.2-712 ). Hill v. Telesystems, Inc., 69 O.I.C. 46 (1990).

    If an award does not specify a precise disability but simply recites an industrial accident, a general injury, and consequent disability, the burden is on the employer seeking to terminate benefits to prove the employee is no longer disabled or that such disability does not result from the accident. It is not the burden of the employee to establish causally related disability. Rossello v. K-Mart Corporation, 15 Va. App. 333, 423 S.E.2d 214, 9 Va. Law Rep. 574, 1992 Va. App. LEXIS 274 (1992).

    An employee, whose compensable back injury could not be treated because of a subsequent non-work related coronary condition, is entitled to a continuance of benefits. This case is distinguished from American Furniture Co. V. Doane , 230 Va. 39 , 334 S.E.2d 548 (1985) where the issue was a refusal of selective employment. Coelho v. Northern Virginia 4-H Educational Center, 71 O.W.C. 95 (1992).

    Section 65.2-510.1 sets forth the provisions for the suspension of benefits when a claimant is imprisoned and is medically released to perform selective employment, upon filing of a proper application to the Commission. A proper application under Code Ann. § 65.2-708 requires compliance with Rule 1.4(C). Campbell v. Perdue Foods, Inc., 76 O.W.C. 157 (1997).

    Where the employer alleges that the employee was released to return to light duty and that he is incarcerated, compensation must be paid through the date the Employer’s Application For Hearing is filed, or it will be rejected. Campbell v. Perdue Foods, Inc., 76 O.W.C. 157 (1997).

    Cure of a claimant’s failure to report a change in address is not self-executing, and is subject to the time limitations provisions of § 65.2-708 . Attia v. W9Y Construction Co., Inc., 76 O.W.C. 332 (1997).

    Payments Required to Terminate Award:

    When payment was processed on the Friday that an Employer’s Application for Hearing was filed, but the check was not mailed to the claimant until Monday, it was appropriate to reject the Application because compensation was not paid to the date of filing. Cromer v. Unifirst Corp., VWC File Nos. 218-55-41 & 219-71-37 (July 31, 2006).

    Senior Claims Examiner’s rejection of employer’s April 18, 2003, Application to terminate benefits based on December 3, 2002, release to return to work upheld, when Application certified that employer paid benefits only through December 5, 2002; although employer argued that employee refused to execute agreement forms, there was no evidence that employee actually had returned to work while still on an open award and had refused to execute appropriate agreement forms. Atkinson v. Penske Logistics, Inc., VWC File No. 201-39-53 (July 15, 2003).

    All compensation due under prior award must be paid to date of receipt in Commission’s office of application for hearing on ground of change in condition. Parker v. Manchester Bd. & Paper Co., 201 Va. 328 , 111 S.E.2d 453, 1959 Va. LEXIS 230 (1959).

    Where the employer mailed a check to the claimant three days after filing to encompass the period up to the date of filing, the Commission in rejecting the application held that Rule 1.4(C) requires that compensation must be paid to the employee at the time of filing. Mullins v. T & J Trucking, 73 O.W.C. 56 (1994).

    Compensation must be paid pursuant to Rule 1.4 (C) either before or with the filing of an Employer’s Application For Hearing. Compensation mailed to the claimant three days after the application was filed and eight days after the date through which payment was required does not comply with Rule 1.4 (C). Rule v. Southside Regional Medical Center, 74 O.W.C. 40 (1995).

    Compensation paid “to” the date the claimant returns to or refuses work requires payment through the day before the alleged refusal or return. Payment for the date of alleged refusal or return to work is not required, since that would require payment for a day on which the claimant worked or refused to work. Rule v. Southside Regional Medical Center, 74 O.W.C. 40 (1995).

    An employer who unilaterally suspends compensation benefits when an employee returns to work without submitting the appropriate signed agreement forms to the Commission must comply with § 65.1-99 (now § 65.2-708 ) by paying compensation benefits within two years from the date which compensation was last paid to have a change of condition application placed on the hearing docket. The employer is also estopped from asserting Rule 13(B) (now Rule 1.2 B) because the employee, who remained under an outstanding award, had no basis for filing an application for additional benefits until the employer filed an application to terminate the outstanding award. Middleton v. Howat Concrete, 69 O.I.C. 40 (1990).

    An employer, who filed a second application for hearing after requesting review of the Claims Division’s rejection of its first application, must comply with Rule 13 [now Rule 1.4 C (4)] when the first rejection is affirmed on Review. Rachel v. Clintwood Garment Company, Inc., 69 O.I.C. 43 (1990).

    While an employer who files a change of condition application under § 65.2-708 must pay compensation to within two years prior to the date of the filing, an allegation of failure to provide a current address pursuant to § 65.2-711 allows for the suspension of benefits until an address is provided and proper notice of adjudication of the claim on the merits can be given. Ross v. Pony Express, 71 O.W.C. 99 (1992).

    An employer who unilaterally suspends compensation benefits when a claimant returns to work without submitting the appropriate signed agreement forms to the Commission must comply with Virginia Code Ann. § 65.2-708 by paying compensation benefits to within two years from the date which compensation was last paid in order to have a change of condition application placed on the hearing docket. Umphlett v. Tidewater Container Corp., 76 O.W.C. 371 (1997).

    Once death has been established, an outstanding award is terminated. While the Employer’s Application For Hearing on the ground that the employee failed to report a change in address in that he was deceased was appropriately dismissed, it is unnecessary to require the employer to submit another application on the ground that the employee is deceased and no longer entitled to benefits. Anderson v. Shenandoah’s Pride Dairy, 76 O.W.C. 255 (1997).

    Ability to Return to Work:

    When an employer files an application to terminate disability benefits, it must establish by a preponderance of the evidence that the claimant has been released to return to pre-injury work or to return to work without restrictions. Bagley v. Imperial Processing Corp., 75 O.W.C. 316 (1996).

    Where the employee is disabled from both physical and psychological disorders, the party alleging capacity to work must prove that the employee is not limited by either condition from returning to her pre-injury work. Pavlicek v. Jerabek, Inc., 76 O.W.C. 17 (1997).

    Where the employer alleges in its Application that the claimant can return to her pre-injury work, but does not allege that any residual disability is unrelated to the work accident, the issue of causation is not before the Commission, only the narrow issue of whether the claimant is able to return to her pre-injury work. Martinez v. Embassy Suites, 76 O.W.C. 126 (1997).

    The threshold test of compensability is whether the employee is “able fully to perform the duties of his pre-injury employment,” not whether he is able to “return to work.” Johnson v. Celanese Fibers Company, 229 Va. 117 , 326 S.E.2d 687, 1985 Va. LEXIS 181 (1985).

    A treating physician’s release to “return to work” without listing any restrictions to be observed at work is sufficient documentation to refer the case to the docket and to suspend compensation payments pending a hearing. Jenkins v. Loundoun Hospital Center, 75 O.W.C. 140 (1996).

    Where the treating physician could not explain the employee’s continued pain and disability and released the employee to return to his pre-injury work, such evidence establishes that the employee is able to return to his pre-injury work without restrictions. Bagley v. Imperial Processing Corp., 75 O.W.C. 316 (1996).

    A physician’s release from medical treatment does not establish an employee has been released to return to regular work, light work or any type of work. Blake v. Banner Constructors, Inc., 69 O.I.C. 71 (1990).

    When claimant is able to return to type of work in which injured, incapacity for work has ceased even though he cannot return to his usual trade which was a different type of work. Robinson v. Consolidated Constr. Corp., 47 O.I.C. 282 (1965).

    Where the claimant’s pre-injury work involved overtime, he remains disabled from the pre-injury work if medical restrictions limit work hours below the level worked before the accident. Clark v. ABS Americas, 75 O.W.C. 7 (1996).

    It is not necessary that an employee recover to the point that no further medical treatment is required before there can be a valid release to return to work. Ross v. Hudson Masonry, Inc., 70 O.I.C. 97 (1991).

    A treating physician’s release to return to work with an understanding of the claimant’s pre-injury duties is a valid release to pre-injury employment, although the claimant may require additional physical therapy treatment. Robertson v. Shoppers Food Warehouse, 74 O.W.C. 93 (1995).

    A release to return to work on a trial basis is not an unequivocal release to return to pre-injury employment and is not a sufficient basis to suspend compensation benefits. At best, it is a tentative release, intended to explore on a trial basis whether the injured employee is physically able to return to his former employment. Langhorne v. Jamerson Brothers Trucking Company, Inc., 70 O.I.C. 94 (1991).

    A physician’s release to return to work on a trial basis is not sufficient to suspend compensation benefits. The physician must state unconditionally that the claimant is able to perform all aspects of his pre-injury employment. Byrd v. Island Creek Coal Company, 74 O.W.C. 45 (1995).

    Prospective releases to return to work are looked upon with disfavor by the Commission. Leech v. G. M. Clements Co., Inc., 77 O.W.C. 10 (1998).

    A release to part-time activity for two weeks followed by a full and unrestricted release to duty is a prospective release and is insufficient to terminate compensation benefits. Counterman v. Providence Electric Corporation, 71 O.W.C. 81 (1992).

    Where the employee was still symptomatic and under lifting restrictions when last examined by the treating physician, his release to regular work ten days later was prospective and did not satisfy the employer’s burden to prove the employee could return to work as of that date. Leech v. G. M. Clements Co., Inc., 77 O.W.C. 10 (1998).

    While a release to return to work accompanied by a precaution to avoid certain activities because of the danger of reinjury is generally a valid release to return to work, an employee who has no control over the manner in which she works or the work environment such as to comply with the medically imposed precautions remains entitled to compensation benefits. Gosnell v. Virginia Baptist Hospital, 71 O.W.C. 83 (1992).

    Communication of a medical release to return to regular work is not necessary if there is proof that the employee is able to do the work. Williams v. Va. Electric & Power Co., 71 O.W.C. 101 (1992).

    In continuing compensation benefits the Commission found that a video tape demonstration that a person is able to drive a car, open a door and lift a bag of groceries of unknown weight with an injured hand does not in itself establish the ability to perform pre-injury repetitive work as a sealer assistant. Hatten v. Westvaco/Liquid Packaging Division, 70 O.I.C. 314 (1991).

    The employer’s application to terminate benefits on the basis that the employee could return to regular work was denied based on medical reports that the employee’s pre-existing hyperthyroidism or Graves disease became symptomatic as a result of the accident and currently precluded him from returning to work. Pena v. Parcom Floor Systems, 70 O.I.C. 77 (1991).

    The claimant accepted light duty work after his accident, but left the job after two hours on the first attempt and after one hour on the second attempt. The employer filed an application seeking to terminate benefits on the grounds that the claimant had returned to work at his pre-injury wage. The Commission held that this evidence did not prove that the claimant had returned to work, only that he had made an unsuccessful two-hour attempt to return to light duty. Martinez v. J & F Services, Inc., 76 O.W.C. 318 (1997).

    An employee able to perform sedentary work who has retired with the employer’s concurrence may continue to receive workers’ compensation benefits under an outstanding award. Bailey v. Arlington County Board of Supervisors, 69 O.I.C. 166 (1990).

    Curing Refusal:

    Where the Commission had found in prior proceedings that the claimant did not refuse selective employment, the claimant had no duty to cure the alleged refusal to be entitled to a resumption of compensation benefits. She also had no obligation to contact the employer and request a light-duty job. For the employer to prove that the claimant abandoned her employment, it had to offer a suitable position after she was able to return to light duty. Thompson v. Newport News, Inc./Spiegel, Inc., 79 O.W.C. 52 (2000).

    The 1991 amendment added to the language of § 65.2-101 “Change in condition” the reference to awards that had been “suspended,” and employees thereafter were required to prove continuing disability as well as a “cure” of an earlier refusal in order to have benefits reinstated. Perrigan v. Clinchfield Coal Co., 75 O.W.C. 324 (1996); Kaya v. Northwest Airlines, 77 O.W.C. 108 (1998).

    Notice of cure made by correspondence may be effective where perfection of the cure requires response and cooperation from the employer [or its workers’ compensation carrier]. Musick v. Pizza Hut, 75 O.W.C. 54 (1996).

    Where it is within the power of the employer to test whether written representations of cure are made in good faith, it cannot by electing to do nothing deprive the claimant of the means to prove the alleged cure and at the same time question her motives or effort. Musick v. Pizza Hut, 75 O.W.C. 54 (1996).

    A claimant who alleges a cure of conduct for which an award had been suspended must also prove current disability in order to have compensation reinstated. Musick v. Pizza Hut, 75 O.W.C. 54 (1996).

    Notice to the carrier is constructive notice to the employer. Musick v. Pizza Hut, 75 O.W.C. 54 (1996).

    Credit/Correcting Awards:

    Note: For additional cases see notes to § 65.2-712 .

    The Commission has the authority to award a credit for payments made from an employer funded short-term disability plan but there must be evidence that the policy contained an exclusion for disability compensable under the Act. Pieters v. Wegman’s Food Markets, Inc., #4007, VWC File No. 227-86-93 (Oct. 4, 2007). (On remand to determine if policy contained an exclusion deputy commissioner on Apr. 2, 2008 found in defendant’s favor).

    Unpublished decision: The Commission’s jurisdiction is limited to compensation matters and does not include authority over the employer’s policies regarding sick leave such as to order reinstatement. However, the employer/carrier is not entitled to a credit for paid time off leave which consists of accrued sick, vacation and holiday time in the absence of evidence of reinstatement of any such deductions. Epps v. Inova Fair Oaks Hospital, VWC File No. 213-55-21 (March 23, 2007), aff’d on other issues, No. 0908-07-4 (Ct. App. Va., July 31, 2007).

    An application requesting a credit for COLA paid based on unilateral or mutual mistake is not a change in condition claim and therefore the provision of § 65.2-708 that precludes a review of an award effecting monies paid except under § 65.2-712 is not applicable. Figgers v. Dept. of State Police/Commonwealth of Va., VWC File No. 160-65-03 (Jan. 9, 2007) (Dismissed by Ct. App. on July 6, 2007).

    Credit is determined on a dollar for dollar basis as opposed to offsetting the number of weeks for which benefits are paid under the Act. Virginia International Terminals, Inc. v. Moore, 22 Va. App. 396, 470 S.E.2d 574, 1996 Va. App. LEXIS 368 (1996), aff'd, 254 Va. 46 , 486 S.E.2d 528, 1997 Va. LEXIS 55 (1997).

    Payment of compensation made under a prior award cannot be credited upon award made under this section. Stinespring v. Houff Transfer, Inc., 36 O.I.C. 187 (1954).

    Since no compensation had been paid, there was no conflict with § 65.1-99 (now § 65.2-708 ) in reforming a Memorandum of Agreement to commence on the date compensation was first due. Seabrook v. American Airlines, Inc., 68 O.I.C. 3 (1989).

    Where an employer files an application alleging that the employee has failed to provide notice of earnings as required by § 65.1-100.3 (now § 65.2-712 ) with benefits suspended pursuant to Rule 13 (C) [now Rule 1.5 C(1)] pending a determination on the merits, it is appropriate to award a credit to the employer for any period in which the claimant worked but to reinstate benefits for periods in which there was no employment without the necessity of the employee filing a change in condition application under § 65.1-99 (now § 65.2-708 ). The language of Rule 13 (C) [now Rule 1.5 C (1)] provides for a suspension of benefits and not a permanent termination. Therefore, the employee is not required to file a change in condition application to obtain reinstatement of compensation benefits. Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    Where the application does not contain a request for modification of the outstanding award, but only a request for a credit, the existing temporary partial award will not be modified to reflect an increase in wages until such time as an application specifying the relief sought is filed. An employer is limited to the relief stated in the application. Washington Metropolitan Area Transit Authority v. Pender, 14 Va. App. 100, 415 S.E.2d 239, 8 Va. Law Rep. 2344, 1992 Va. App. LEXIS 75 (1992).

    The Commission may correct an average weekly wage based on a mutual mistake when the claimant seeks additional compensation benefits because of an underpayment. Spradlin v. Coca-Cola Bottling Company, 67 O.I.C. 4 (1988).

    Where an employer’s application for hearing alleges an employee’s return to part-time work with an unreported change in earnings and only requests relief under § 65.1-100.3 (now § 65.2-712 ), it was proper in the absence of a request to vacate the award to allow a credit for the period worked and reinstate the temporary total award after the employment ceased. Lot Masters v. Gibbs, 11 Va. App. 70, 396 S.E.2d 395, 1990 Va. App. LEXIS 166 (1990).

    Where a new condition was not present when an earlier disability rating to an inferior member [hand] was approved, the employee is entitled to a new rating for the superior member [arm], but the employer is entitled to a credit for permanent partial disability payments made pursuant to the earlier award. Watson v. Kentucky Fried Chicken, 75 O.W.C. 113 (1996).

    Unpublished decision: Where the employer alleges that the employee unjustifiably refused appropriate medical treatment, the employer must submit a change in condition application to suspend payment of compensation benefits under an open award. A change in condition application, seeking suspension of an open award, submitted after the alleged refusal has been “cured,” is moot. If the employer continues to pay benefits under the award during the period of alleged refusal, the Act makes no provision for recovery of such payments by credit. Absent an allegation that the benefits were procured through fraud or misrepresentation pursuant to § 65.2-712 , the employer’s after-the-fact claim is unavailing. Cox v. Tradesmen International, Inc., VWC File No. 200-72-12 (June 11, 2001), aff’d sub nom. Tradesmen International, Inc., Record No. 1726-01-4 (Va. Ct. App. March 19, 2002).

    Compensable Consequence:

    Note: For additional cases see notes to § 65.2-101 .

    It is unreasonable to conclude that degeneration of an injury, or the failure of an injury to heal, is a non-compensable consequence where it results from an employer’s failure to authorize or provide recommended medical treatment as required by the Workers’ Compensation Act. Hall v. Campbell County School Board 26, JCN VA00000189503 (Aug. 29, 2013).

    To apply the consequence of a consequence analysis to medical treatment for the initial injury would dramatically limit the medical treatment available to a claimant for his compensable injury. This would conflict with the claimant’s entitlement under the Act to reasonable and necessary medical treatment related to the compensable injury. Sychev v. S K A Construction, LLC, VWC File No. 228-36-59 (Apr. 14, 2011).

    The claimant’s depression that developed from pain relating to injuries incurred in a work accident is a compensable consequence of the original injury and as such is a change of condition governed by § 65.2-708 which requires that a claim be filed within two years from the date compensation was last paid pursuant to an award. Brown v. Ruby Tuesday’s Inc., VWC File No. 215-94-55 (June 11, 2007), On remand deputy commissioner on Oct. 19, 2007 found for claimant. By March 6, 2008 review opinion the commission affirmed. (On remand deputy commissioner on Oct. 19, 2007 found for claimant. By March 6, 2008 review opinion the commission affirmed).

    Dental problems that result from medication prescribed for the industrial accident are a compensable consequence and the responsibility of the employer. Martin v. Still Water, Inc., VWC File No. 152-51-72 (May 17, 2007).

    Injuries sustained in a motor vehicle accident while going to a medical appointment for the work injury are a compensable consequence of the industrial accident. Jones v. Checkered Flag Toyota, VWC File No. 220-84-93 (Jan. 26, 2007).

    Where a compensable work accident resulted in a fusion at L5-S1 and claimant subsequently felt a loud “pop” while sitting the resulting disc herniation at L4-5 is a compensable consequence of the original injury rather than a new accident because the fusion resulted in a weakening at the L4-5 level. Gaskins v. W. L. McKendree & Company, Inc., VWC File No. 214-82-19 (Sept. 26, 2006).

    In awarding permanent total benefits it was found that the claimant’s brain injury was a compensable consequence of his work injury. While there was no physical trauma to the brain, structural changes as a result of histoplasmosis altered brainwave activity and caused a loss of brain function. Heller v. Powhatan Correctional Center/Commonwealth of Va., VWC File No. 174-73-32 (July 19, 2006).

    The Act does not require that a compensable consequence meet the definition of an injury by accident in order to be compensable. Where there is a direct causal connection to the original accidental injury, a subsequent problem caused by repetitive trauma may be a compensable consequence. Frazier v. Infineon Technologies, VWC File No. 218-88-98 (Feb. 6, 2006).

    Where carpal tunnel syndrome was not caused directly by a work accident but developed as a result of swelling caused by surgery necessitated by the accident, the carpal tunnel syndrome represents a change in condition caused by the accident, rather than the accident itself, or a subsequent accident that is a compensable consequence. Therefore, the limitations period in § 65.2-708 applies rather than limitations period in § 65.2-601 . Charles v. Lite-Tech, Inc., VWC File No. 195-55-69 (Aug. 31, 2004), aff’d, No. 2256-04-1 & 2319-04-1 (Ct. App. Va., March 22, 2005).

    Gradually incurred compensable consequence not subject to notice and limitations provisions of 65.2-601 ; employee gradually developed right-foot condition as a result of off-loading weight onto right foot because of original left-foot injury; claim for right foot not time-barred by 65.2-601 but timely under 65.2-708 . Field v. American Red Cross, VWC File No. 198-54-11 (Mar. 10, 2003).

    For the purpose of establishing the compensability of a subsequent injury, the doctrine of compensable consequences applies to both an aggravation of a previously compensable injury and a new injury. If the subsequent injury is a new injury the provisions of § 65.1-87 (now § 65.2-601 ) are applicable with the limitations period commencing from the date of the new injury. If the subsequent injury is a change in condition the limitations period of § 65.1-99 (now § 65.2-708 ) are applicable. Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    Where a causal relationship between an initial compensable injury and a subsequent injury is established, the doctrine of compensable consequences provides that the subsequent injury is considered to have arisen out of and in the course of the employee’s employment. Bartholow Drywall Co., Inc. v. Hill, 12 Va. App. 790, 407 S.E.2d 1, 8 Va. Law Rep. 1, 1991 Va. App. LEXIS 152 (1991).

    The Stenrich Group v. Jemmott , 251 Va. 186 , 467 S.E.2d 795 (1996) does not bar compensation for cumulative trauma injuries which are the compensable consequence of an injury by accident. Cummings v. Hermitage In Northern Va, 75 O.W.C. 272 (1996).

    § 65.2-709. (Effective until July 1, 2022) Cost of living supplements for total incapacity and dependents of deceased.

    1. In the event that the combined disability benefit entitlement of a claimant or his dependents under this title and the Federal Old-Age Survivors and Disability Insurance Act is less than eighty percent of the average monthly earnings of the claimant before disability or death, cost of living supplements shall be payable, in addition to the other benefits payable under this title, in accordance with the provisions of this section to those recipients of awards resulting from occupational disease, accident, or death occurring on or after July 1, 1975, under § 65.2-500 , subsection C of § 65.2-503 , subdivision A 4 of § 65.2-504 , and §§ 65.2-512 and 65.2-513 . For purposes of determining the monthly amount of combined disability entitlement received by a claimant, the claimant may deduct any monthly amounts paid for Medicare.
    2. The Commission may require the claimant to present evidence of filing for Federal Old-Age Survivors and Disability Insurance benefits in order to establish eligibility under this section and also may require the claimant to furnish the employer with the decision on his claim for such federal benefits.
    3. The amounts of supplementary payments provided for herein shall be determined by using a compounding method of computation annually. The percentage of change shall be determined by reference to the increase, if any, in the United States Average Consumer Price Index for all items, as published by the Bureau of Labor Statistics of the United States Department of Labor, from its monthly average, from one calendar year to another.
    4. Amounts of supplementary payments shall be based on the percentage increase, if any, in the Average Consumer Price Index for all items adjusted annually. Any change in the cost of living supplement determined as of any determination date shall become effective as of October 1 next following such determination date and as the case may be, shall be added to or subtracted from any cost of living supplements previously payable; however, compensation paid the claimant under this section shall at no time exceed the then current maximum weekly amount payable under § 65.2-500 .

    History. 1975, c. 472, § 65.1-99.1; 1981, c. 265; 1986, c. 548; 1991, c. 355; 1997, c. 296.

    Editor’s note.

    The Federal Old-Age Survivors and Disability Insurance Act, referred to above, may primarily be found in 42 U.S.C.S. §§ 401 through 433.

    The 2022 amendments.

    The 2022 amendment by c. 182 rewrote subsection A, which read: “In the event that the combined disability benefit entitlement of a claimant or his dependents under this title and the Federal Old-Age, Survivors, and Disability Insurance Act is less than eighty percent of the average monthly earnings of the claimant before disability or death, cost of living supplements shall be payable, in addition to the other benefits payable under this title, in accordance with the provisions of this section to those recipients of awards resulting from occupational disease, accident, or death occurring on or after July 1, 1975, under § 65.2-500 , subsection C of § 65.2-503 , subdivision A 4 of § 65.2-504 , and §§ 65.2-512 and 65.2-513 . For purposes of determining the monthly amount of combined disability entitlement received by a claimant, the claimant may deduct any monthly amounts paid for Medicare”; substituted “subdivision A 1” for “this section” in subsection B; and made stylistic changes.

    Law Review.

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 42, 58.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-99.1 or prior law.

    Purpose. —

    The manifest purpose of this section is to ensure, as much as possible, that the value of benefits paid under the Act does not diminish due to inflation. Commonwealth Dep't of Hwys. & Transp. v. Williams, 1 Va. App. 349, 338 S.E.2d 660, 1986 Va. App. LEXIS 206 (1986).

    Purpose of 1981 amendment. —

    The 1981 amendment to this statute resulted, not from a desire to state an intention ex post facto, but from recognition of this phenomenon: In the 1978-79 period, the cost-of-living, for the first time since this section was enacted, rose at a greater rate than the average weekly wage of the Commonwealth. Clinchfield Coal Co. v. Anderson, 222 Va. 62 , 278 S.E.2d 817, 1981 Va. LEXIS 275 (1981).

    Assessment of cost of living adjustments remedial in purpose. —

    The assessment of cost of living adjustments under former § 65.1-99 is remedial in purpose; it is designed to ensure that the value of the compensation award is not lessened as a result of inflation. Circuit City Stores, Inc. v. Bower, 243 Va. 183 , 413 S.E.2d 55, 8 Va. Law Rep. 1891, 1992 Va. LEXIS 151 (1992).

    Cost-of-living payments are not compensation within meaning of Workers’ Compensation Act. —

    Cost-of-living payments paid under this section are not compensation within the meaning of the Workers’ Compensation Act. Bishopric Prods. Co. v. Brock, No. 1481-86-1 (Ct. of Appeals June 22, 1987).

    Claimant was not required to reimburse carrier for the cost-of-living supplements paid between July, 1983 through February, 1984, on grounds that his receipt of social security benefits disqualified him from receiving cost-of-living supplements. To permit such a reimbursement would in effect build into the Workers’ Compensation Act an offset provision, which to date the General Assembly has refused to enact. Woody's Auto Parts v. Rock, 4 Va. App. 8, 353 S.E.2d 792, 3 Va. Law Rep. 1822, 1987 Va. App. LEXIS 160 (1987).

    Cost-of-living supplements are not compensation within meaning of Rule 13(B) of the Rules of the Industrial (now Workers’ Compensation) Commission. Commonwealth v. Commonwealth Dep't of Hwys. & Transp. v. Williams, 1 Va. App. 349, 338 S.E.2d 660, 1986 Va. App. LEXIS 206 (1986).

    Rule 13(B) inapplicable to cost-of-living supplements. —

    Rule 13(B) of the Rules of the Industrial (now Workers’ Compensation) Commission does not apply to cost-of-living supplements, because of the distinctions which exist between such payments and the compensation paid for actual disability. Commonwealth Dep't of Hwys. & Transp. v. Williams, 1 Va. App. 349, 338 S.E.2d 660, 1986 Va. App. LEXIS 206 (1986).

    Supplements not determined by average weekly wage. —

    In a given year the availability of cost-of-living supplements is based upon a determination whether there has been an increase in the consumer price index, rather than a change in the average weekly wage of the Commonwealth and, further, once the supplement becomes available, eligibility therefor is tied to a formula in which the average wage of the claimant, rather than the average wage of Commonwealth, is the determinative factor; thus although a supplement has been allowed, it later may be reduced if the consumer price index falls, even though the average weekly wage of the Commonwealth may rise, in the determinative period. Clinchfield Coal Co. v. Anderson, 222 Va. 62 , 278 S.E.2d 817, 1981 Va. LEXIS 275 (1981).

    Beneficiaries’ right to cost of living adjustment not limited to future economic conditions. —

    The beneficiaries’ right to receive a cost of living adjustment under former § 65.1-99.1 is dependent upon the formula set forth therein and is not limited simply to future economic conditions; several other factors must be considered in any computation of cost of living adjustments under former § 65.1-99: Those factors include whether the beneficiaries are eligible for the federal benefits referenced in § 65.1-99, the duration or contingencies to which any such entitlement is subject, and the present and projected amounts of any entitlement. Circuit City Stores, Inc. v. Bower, 243 Va. 183 , 413 S.E.2d 55, 8 Va. Law Rep. 1891, 1992 Va. LEXIS 151 (1992).

    Change of condition application required. —

    The statutory cost-of-living provision is not self-executing, and a claim for a cost-of-living supplement is cognizable only under the change-of-condition sections of the Virginia Workers’ Compensation Act, which require an application and a showing of eligibility by the claimant and an award by the Commission. Jewell Ridge Coal Corp. v. Wright, 222 Va. 68 , 278 S.E.2d 820, 1981 Va. LEXIS 276 (1981).

    When a workers’ compensation claimant sought cost-of-living adjustment benefits because she began receiving Social Security retirement benefits, as opposed to Social Security disability benefits, the Workers’ Compensation Commission had to make adequate factual findings, under subsection A of § 65.2-705 , supporting its award, and its failure to do so required that its award be vacated and the matter remanded for adequate findings. Powhatan Corr. Center v. Mitchell-Riggleman, 40 Va. App. 491, 579 S.E.2d 696, 2003 Va. App. LEXIS 288 (2003).

    But letter may be sufficient application. —

    In an action challenging a decision of the Commission which awarded a worker a cost-of-living supplement and attorney fees after he returned to work from a compensable injury, the plaintiff was not entitled to reversal of the Commission’s decision for the worker’s alleged failure to file an application for a cost-of-living supplement because during oral argument the plaintiff conceded that the worker had sent a letter to the Commission stating that the plaintiff had failed to pay the cost-of-living increase and inquiring about the status of the matter; thus, the letter to the Commission constituted sufficient application for a cost-of-living supplement. Jewell Ridge Coal Corp. v. Wright, 222 Va. 68 , 278 S.E.2d 820, 1981 Va. LEXIS 276 (1981).

    Supreme Court will not give an advisory opinion as to what benefits are properly includible in determining eligibility for cost-of-living supplements under this section. Beatrice Pocahontas Co. v. Shortridge, 229 Va. 80 , 326 S.E.2d 677, 1985 Va. LEXIS 176 (1985).

    Cost of living adjustment benefits denied. —

    Workers’ Compensation Commission did not err as a matter of law by denying a claimant’s request for cost of living adjustment benefits under § 65.2-709 where the claimant received an award of over 80 percent of her monthly average pay. Dominguez v. Hardee's & Travelers Indem. Co. of Am., 2017 Va. App. LEXIS 90 (Va. Ct. App. Mar. 28, 2017).

    No authority to order release of social security records. —

    No authority permitted the Workers’ Compensation Commission to order an employee to sign a release authorizing an employer to get the employee’s records from the Social Security Administration and the commission exceeded its authority ordering the signing of the release. Arvizu v. Gold, 38 Va. App. 641, 567 S.E.2d 592, 2002 Va. App. LEXIS 491 (2002).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    An application requesting a credit for COLA paid based on unilateral or mutual mistake is not a change in condition claim and therefore the provision of § 65.2-708 that precludes a review of an award effecting monies paid except under § 65.2-712 is not applicable. Figgers v. Dept. of State Police/Commonwealth of Va., VWC File No. 160-65-03 (Jan. 9, 2007).

    Section 65.2-520 applies where there has been an overpayment of cost of living benefits. Killen v. Westvaco Corp., VWC File No. 205-29-00 (Nov. 14, 2006).

    The carrier is entitled to a credit for COLA benefits paid when Social Security is awarded retroactively. Radford v. Va. Tech (VPI & SU), VWC File No. 188-44-00 (Feb. 16, 2006).

    Because the Commission has inherent power to do full and complete justice, there was no error in awarding a credit even though an Employer’s Application was not filed. The employer raised the issue of overpayment in response to the claimant’s request for COLA and the claimant acknowledged the request in his letter. Radford v. Va. Tech (VPI & SU), VWC File No. 188-44-00 (Feb. 16, 2006).

    Employer, who overpaid employee for 18 weeks beyond statutory maximum of 500 weeks of benefits, allowed to take credit for the overpayment against unpaid cost-of-living payments, because overpayment was a voluntary payment and COLA payments are subject to statutory provision allowing credit for voluntary payments. Eghbal v. Boston Coach Corp., VWC File No. 167-35-41 (July 11, 2003).

    Section construed. —.Lambert v. Island Creek Coal Co., 57 O.I.C. 217 (1977); Meadows v. Clinch Valley Coal Co., 58 O.I.C. 236 (1978); Ratliff v. Jewell Ridge Coal Corp. (appeal denied), 58 O.I.C. 299 (1978); Anderson v. Clinchfield Coal Co., 59 O.I.C. 1 (1980).

    Cost-of-living benefits do not accrue during the payment of temporary partial compensation. Dehart v. Safeway Stores, Inc., 67 O.I.C. 202 (1988).

    In holding that it is not permissible to apply adjudicated credit to subsequent medical costs, the Commission noted that to do so would equate medical benefits with compensation. Compensation does not include voluntary medical payments and the twenty percent penalty may not be assessed against such payments. In addition, cost-of-living adjustments are not considered compensation. Mabe v. Happy Stores #494, 73 O.W.C. 175 (1994).

    Carrier may not make cost of living increase contingent on claimant’s signing agreement to reimbursement carrier or for payments which duplicate social security disability benefits or exceed limit set out in § 65.1-99.1 (now § 65.2-709 ). Jones v. Griffith Consumers, 60 O.I.C. 236 (1981).

    Claimant not required to execute reimbursement agreement as condition precedent to receipt of cost of living supplement. VanDyke v. R.J.B. Mining, Inc., 61 O.I.C. 386 (1982).

    Cost of living supplements are not subject to the limitation period of Rule 13 (now Rule 1.2 B). They are also not a component in determining whether an employee has reached the “eighty percent limitation” so as to affect eligibility for further supplemental payments. Further the limitation provision of § 65.1-54 (now § 65.2-500 ) does not prohibit an employee’s compensation payment and his cost of living supplement from exceeding his preinjury average weekly wage. Campbell v. Beatrice Pocahontas Company, 63 O.I.C. 43 (1984).

    Once initial eligibility has been determined, the only limitation is that set out in § 65.1-99.1 (now § 65.2-709 ), which limits compensation and cost of living supplement to the maximum compensation rate. Hall v. Conoco, Inc., t/a Kayo Oil Company, 62 O.I.C. 201 (1983).

    An employee who receives only a portion of a cost of living increase commencing on October 1 of a given year as a result of being limited by the maximum compensation rate, is entitled to the remainder of the cost of living increase up to the maximum compensation rate effective July 1 of the following year. Newman v. Branch Electric Supply Company, 62 O.I.C. 340 (1983).

    In cases where it is fair and equitable to both sides the Commission will allow a credit for cost-of-living overpayments. Miller v. Daniel Construction Company, 67 O.I.C. 235 (1988).

    In computing awards for specific loss under § 65.1-56 (now § 65.2-503 ), other than permanent total disability benefits, cost-of-living is not to be included but rather only the basic compensation rate. Taylor v. Sullivan t/a St. Margaret Farm, 66 O.I.C. 157 (1987).

    Social Security Benefits:

    To determine the average monthly earnings for the purposes of determining whether to award cost of living supplements, the claimant’s pre-injury average weekly wage must be multiplied by 52.1429 rather than by just 52, then divided by 12. This more precise method yields a more accurate method of calculation and a just outcome. Fleming v. Pitt Des Moines, Inc., VWC File No. 177-45-29 (Sept. 16, 2009).

    Employee is entitled to no prior or future cost of living supplements so long as his Social Security payment and the basic award equal 80 percent of his average monthly wage. Atchison v. May Dept. Stores, 225 Va. 525 , 304 S.E.2d 640, 1983 Va. LEXIS 251 (1983).

    (On Remand from the Court of Appeals) Receipt of “old-age insurance” benefits, as opposed to “disability insurance” benefits, under social security, does not count towards 80% limitation as provided in § 65.2-709 , and thus employee, who qualified for both types of benefits but chose to receive old-age insurance benefits, met 80% limit and was entitled to COLA during period of receipt of both old-age insurance benefits and workers’ compensation benefits, but did not meet 80% limit and was not entitled to COLA during period of receipt of both disability insurance benefits and workers’ compensation benefits. Riggleman v. Powhatan Corr. Ctr., VWC File No. 149-24-79 (Aug. 4, 2003).

    In determining eligibility for cost of living supplement under § 65.1-99.1 (now § 65.2-709 ), amount of claimant’s cost of living increase shall not be added to state Worker’s Compensation and Federal Old-Age Survivors and Disability Insurance benefits for purposes of computing 80% average monthly earnings limitation. Nakpodia v. Marriott Corporation, 223 Va. I.C. #496-769, Supreme Court Record #810470 January 26, 1982; 60 O.I.C. 322 (1980).

    A claimant’s entitlement to a cost of living adjustment is determined by adding the amount he receives monthly from Social Security, after reduction for medical insurance premiums, to the amount of his original temporary total disability benefits under the Workers’ Compensation Act. The claimant is not entitled to cost of living benefits if this amount exceeds eighty percent of the claimant’s average weekly wage on the date of injury. Garrett v. Adams Company, 77 O.W.C. 147 (1998).

    An employee’s “entitlement” to Social Security benefits, when computing his eligibility for cost-of-living supplements, is the amount he actually receives after the Federal offset by the amount he receives under workers’ compensation. Only in fatal cases are Social Security benefits which are paid to an employee’s dependent included for cost of living purposes. Nicholson v. J. D. Bell Construction Company, 62 O.I.C. 342 (1983).

    The Social Security benefits received by the widow of a deceased employee for a disabling condition suffered by her, cannot be added to benefits she is receiving as a result of the fatal compensable injury suffered by her husband for the purpose of determining her entitlement to cost-of-living supplements. Only those Social Security benefits being paid as a result of the death of the employee can be considered. Pond v. Nelson Electrical Company, Inc., 63 O.I.C. 272 (1984).

    Social Security benefits paid to claimant based upon his age and not his disability are not to be considered in determining his eligibility for cost of living supplement. MacDonald v. Hicks & Ingle Company of Virginia, Inc., 61 O.I.C. 287 (1982).

    Dependents who were not awarded cost of living increases for four-year period during which their Social Security benefits, combined with compensation exceeded 80% of deceased’s average weekly wage, were entitled to cumulative cost-of-living adjustment after reduction in their Social Security entitlement brought their total benefits below 80% of deceased’s average weekly wage. Mason v. Associated General Contractors of America, Inc., 61 O.I.C. 289 (1982).

    The Commission is not empowered to require a claimant to file for Social Security benefits. Hall v. Conoco, Inc., t/a Kayo Oil Company, 62 O.I.C. 201 (1983).

    For the purpose of determining eligibility for cost-of-living benefits the Commission has the authority to require a claimant to present information concerning whether an application for Social Security benefits was filed and the outcome. However, an employer may not require a claimant to sign an authorization to receive federally protected information when no claim has been made for cost-of-living benefits. Singleton v. Fairfax Hospital Association, 68 O.I.C. 226 (1989).

    § 65.2-709. (Effective July 1, 2022) Cost of living supplements for total incapacity and dependents of deceased.

    1. Cost of living supplements shall be payable under this section if:
      1. The combined disability benefit entitlement of a claimant or his dependents under this title and the federal Old-Age, Survivors, and Disability Insurance program is less than 80 percent of the average monthly earnings of the claimant before disability or death; or
      2. The claimant or his dependents are receiving disability payments under this title but not benefits under the federal Old-Age, Survivors, and Disability Insurance program. Such cost of living supplements shall be payable, in addition to the other benefits payable under this title, in accordance with the provisions of this section to those recipients of awards resulting from occupational disease, accident, or death occurring on or after July 1, 1975, under § 65.2-500 , subsection C of § 65.2-503 , subdivision A 4 of § 65.2-504 , and §§ 65.2-512 and 65.2-513 . For purposes of determining the monthly amount of combined disability entitlement received by a claimant pursuant to subdivision A 1, the claimant may deduct any monthly amounts paid for Medicare.
    2. The Commission may require the claimant to present evidence of filing for federal Old-Age, Survivors, and Disability Insurance benefits in order to establish eligibility under subdivision A 1 and also may require the claimant to furnish the employer with the decision on his claim for such federal benefits.
    3. The amounts of supplementary payments provided for herein shall be determined by using a compounding method of computation annually. The percentage of change shall be determined by reference to the increase, if any, in the United States Average Consumer Price Index for all items, as published by the Bureau of Labor Statistics of the U.S. Department of Labor, from its monthly average, from one calendar year to another.
    4. Amounts of supplementary payments shall be based on the percentage increase, if any, in the Average Consumer Price Index for all items adjusted annually. Any change in the cost of living supplement determined as of any determination date shall become effective as of October 1 next following such determination date and, as the case may be, shall be added to or subtracted from any cost of living supplements previously payable; however, compensation paid the claimant under this section shall at no time exceed the then current maximum weekly amount payable under § 65.2-500 .

    History. 1975, c. 472, § 65.1-99.1; 1981, c. 265; 1986, c. 548; 1991, c. 355; 1997, c. 296; 2022, c. 182.

    § 65.2-710. Enforcement, etc., of orders and awards.

    Orders or awards of the Commission may be recorded, enforced, and satisfied as orders or decrees of a circuit court upon certification of such order or award by the Commission. The Commission shall certify such order or award upon satisfactory evidence of noncompliance with the same.

    History. 1976, c. 149, § 65.1-100.1; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    For survey of Virginia workers’ compensation and welfare law, see 62 Va. L. Rev. 1506 (1976).

    Research References.

    Friend’s Virginia Pleading and Practice (Matthew Bender). Chapter 1 Courts. § 1.08 Workers’ Compensation Commission. Friend.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 42, 45.

    CASE NOTES

    Award of credits not reducible to an action at law. —

    Where claimant, through no fraud or misrepresentation, received sums from employer equal to his pre-injury wages while he also received the carrier’s disability benefits, an award of credits against future compensation were not reducible to an action at law under §§ 65.2-710 and 65.2-712 ; the employer’s payments were made in the hope that the claimant would remain loyal and return to work and thus, they were not “earnings” within the meaning of § 65.2-712 . Bay Concrete Constr. Co. v. Davis, 43 Va. App. 528, 600 S.E.2d 144, 2004 Va. App. LEXIS 377 (2004).

    Commission has full authority to enforce its orders and protect itself from deception. While the language of this section is permissive and provides that a party may enforce an award in court, it must be read and considered in pari materia with the Commission’s power pursuant to former § 65.1-20 (now § 65.2-202 ) to punish for disobedience of its orders. Hudock v. Industrial Comm'n, 1 Va. App. 474, 340 S.E.2d 168, 1986 Va. App. LEXIS 226 (1986) (decided under former Title 65.1).

    Authority to issue certificate of authentication. —

    Virginia Workers’ Compensation Commission did not err in finding that a certificate was not issued pursuant to § 65.2-710 because the certificate of authentication was issued pursuant to the general authority of the commission under §§ 8.01-390 and 8.01-391 , and the commission, which was acting pursuant to its legal authority when it entered the award for benefits to a workers’ compensation claimant as the agency responsible for workers’ compensation awards, had authority to issue a certificate without relying on § 65.2-710 ; the interpretation of a Virginia Workers’ Compensation Commission document is not left to the desires of a claimant, and the commission determines the nature of its orders and rulings. Hodnett v. Stanco Masonry, Inc., 58 Va. App. 244, 708 S.E.2d 429, 2011 Va. App. LEXIS 161 (2011).

    Because every agency of the Commonwealth has authority to authenticate its records, the Virginia Workers’ Compensation Commission, likewise, has this authority. Hodnett v. Stanco Masonry, Inc., 58 Va. App. 244, 708 S.E.2d 429, 2011 Va. App. LEXIS 161 (2011).

    Virginia Workers’ Compensation Commission did not err in upholding the deputy commissioner’s decision to decline to recuse herself because the deputy commissioner did not demonstrate bias by denying an employee’s request for § 65.2-710 certification. Urias v. Winkler's, Inc., 2011 Va. App. LEXIS 397 (Va. Ct. App. Dec. 13, 2011).

    Authority to issue certificate for authentication purposes only. —

    As the Virginia Workers’ Compensation Commission is an agency of the Commonwealth, subsection A of § 8.01-390 provides authority for the commission to issue a certificate for authentication purposes only, rather than for enforcement purposes under § 65.2-710 . Hodnett v. Stanco Masonry, Inc., 58 Va. App. 244, 708 S.E.2d 429, 2011 Va. App. LEXIS 161 (2011).

    Court exercises ministerial function. —

    The state courts have construed the enforcement of awards of the Commission as purely ministerial. They do not inquire into whether a claimant’s condition continues to justify compensation. Rather, they simply enforce agreements and awards that have been approved and not formerly rescinded by the Commission. Dillard v. Industrial Comm'n, 416 U.S. 783, 94 S. Ct. 2028, 40 L. Ed. 2d 540, 1974 U.S. LEXIS 143 (1974) (decided under former Title 65.1).

    The order of the court, under former § 65.1-100, in rendering judgment so that execution might be had, was the exercise of a ministerial function. The court was vested with no discretion since the section was mandatory. Richmond Cedar Works & Liberty Mut. Ins. Co. v. Harper, 129 Va. 481 , 106 S.E. 516 , 1921 Va. LEXIS 111 (1921); Parrigen v. Long, 145 Va. 637 , 134 S.E. 562 , 1926 Va. LEXIS 422 (1926) (decided under prior law).

    Interpretation. —

    Plain meaning of the second sentence of § 65.2-710 , the sentence stating, “The Commission shall certify such order or award upon satisfactory evidence of noncompliance with the same,” is that the commission can certify an award for enforcement purposes when satisfactory evidence of noncompliance with that award is presented to the commission. Hodnett v. Stanco Masonry, Inc., 58 Va. App. 244, 708 S.E.2d 429, 2011 Va. App. LEXIS 161 (2011).

    Argument not preserved for review. —

    Where an employee argued that a claim for total disability benefits was erroneously characterized as one for additional compensation, implicating the Va. Workers’ Comp. Comm’n R. 1.2(B)’s 90-day deadline, rather than an enforcement action of an earlier award, the appellate court could not consider the employee’s claim, as the employee did not make argument to the Virginia Workers’ Compensation Commission. Morissette v. Custom Tel. Serv., 2003 Va. App. LEXIS 82 (Va. Ct. App. Feb. 19, 2003).

    Court of appeals could not consider the arguments of a workers’ compensation claimant that the Virginia Workers’ Compensation Commission misinterpreted its rules to allow suspension of an award pending an employer’s application for termination of benefits and that such suspension violates his due process rights because there was no commission ruling on those issues; the commission explicitly declined to rule on those issues, and thus, it did not err in interpreting its rules and did not violate claimant’s due process rights in relation to his award of benefits. Hodnett v. Stanco Masonry, Inc., 58 Va. App. 244, 708 S.E.2d 429, 2011 Va. App. LEXIS 161 (2011).

    Court of appeals could not consider the argument of a workers’ compensation claimant that he presented satisfactory evidence of noncompliance so that the Virginia Workers’ Compensation Commission should have issued a certificate for enforcement pursuant to § 65.2-710 because there was no commission ruling to review on the issue of noncompliance since claimant did not ask the full commission to review the decision, and thus, the commission did not review the decision; also, claimant did not ask for reconsideration after the commission issued its opinion. Hodnett v. Stanco Masonry, Inc., 58 Va. App. 244, 708 S.E.2d 429, 2011 Va. App. LEXIS 161 (2011).

    CIRCUIT COURT OPINIONS

    No right to subrogation against legal malpractice proceeds. —

    Employer and its workers’ compensation insurer were not entitled to a lien against the verdict that an employee obtained in a medical malpractice suit against a doctor because the employer and insurer were compelled to provide workers’ compensation benefits as a result of the on-the-job accident and not as a result of the doctor’s medical negligence; the employer was required to provide compensation benefits to the employee or on his behalf, but the award orders of the Workers’ Compensation Commission conclusively established that those benefits were for the employee’s broken leg, not for damages caused by a third party. Thompson v. Alhadeff, 2011 Va. Cir. LEXIS 137 (Roanoke Oct. 11, 2011).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    There is no requirement that the Clerk or Commission make a finding of “noncompliance” before a certified copy of an award is furnished by the Clerk. Any challenge to a judgment on the grounds of payment and satisfaction must be made in the Circuit Court after entry of judgment. Black v. A. F. B. Contractors, Inc., 63 O.I.C. 14 (1984).

    § 65.2-711. Reporting of address change by employee; suspension of payment of benefits.

    So long as an employee is entitled to payment of compensation under this title, such employee shall have a duty to disclose to the Commission his current residential address and to report any changes of address as they may occur. The failure to disclose or report such address or changes of address without reasonable justification may result in the suspension of compensation payments until the employee complies with this duty. When the Commission is properly notified of the change in the employee’s address, the Commission shall notify the employer when the employer is self-insured, or the employer’s insurer in all other cases.

    History. 1983, c. 416, § 65.1-100.2; 1991, c. 355; 1996, c. 178.

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Where the claimant is not on an award but a claim has been filed though not adjudicated, there is no statutory duty to report a change in address or to provide a current residential address. Heiston v. Pittman’s Tree & Landscaping, Inc., VWC File No. 231-73-43 (May 16, 2007).

    When claimant failed to notify the Commission of a change of address, benefits were appropriately suspended as of date that Commission became aware of faulty address, and not date that employer knew of faulty address; employer may not unilaterally suspend benefits without filing application with the Commission. Hakimi v. K-Mart Corp., VWC File No. 189-35-70 (June 5, 2003).

    Rule of the Commission 1.4(B) provides that each change in condition application filed by the employer under § 65.2-708 must be in writing and under oath. Rule 1.4(B) also states that the defendants shall state the grounds for relief as well as the date for which compensation was last paid. However, Rule 1.4(B) applies only to employer’s applications filed under § 65.2-708 , not to those filed under § 65.2-711 for failure to report a change in address. Jones v. Goodwill Industries, 79 O.W.C. 1 (2000).

    The scope of discovery in a Commission proceeding is determined not only by Commission Rule 1.8 but also by Supreme Court Rule 4:1(b)(1), which in part provides that, “[p]arties may obtain discovery regarding any matter, not privileged, which is relevant to the subject matter involved in the pending action, whether it relates to the claim or defense of the party seeking discovery or to the claim or defense of any other party.” Craft v. Commercial Courier Express, Inc., 78 O.W.C. 270 (1999).

    Claimant’s ongoing award for medical benefits constitutes an “issue” or “proceeding” pending before the Commission as those terms are used in Commission Rule 1.8 and in Virginia Code § 65.2-703 . Also, Virginia Code § 65.2-711 requires a claimant under an open award to inform the employer of his current residential address unless there is reasonable justification for refusing to do so. A residential address is not equivalent to a post office box address. Craft v. Commercial Courier Express, Inc., 78 O.W.C. 270 (1999).

    Failure of the claimant, without reasonable justification, to disclose to the Commission his current address and to report any change of address, may result in the suspension of compensation benefits. Dowdy v. Nuscope, 63 O.I.C. 109 (1984); Anderson v. Shenandoah’s Pride Dairy, 76 O.W.C. 255 (1997).

    When an employee fails to provide the Commission with a current residential address, compensation benefits are suspended until such information is provided. Since the employee is entitled to a notice of hearing, an employer’s change in condition application will not be heard until a current address is obtained. King v. Robert B. Heap, Inc., 69 O.I.C. 59 (1990).

    An employer mailed the payment to an employee’s last known address and filed an application to suspend benefits pursuant to § 65.1-100.2 (now § 65.2-711 ). It is appropriate to accept the application and suspend benefits until such time as the employee provides a current address. At that time the case can be adjudicated on the merits with proper notice to the parties. Penner v. ESG Enterprises, Inc., 70 O.I.C. 72 (1991).

    The Commission has held that an employer’s application alleging the claimant’s failure to report a change of address under Code § 65.2-711 may be made without payment of benefits to the date of application as required by Rule 1.4(C), since the essence of the defendants’ application is to complain that they are unable to locate the claimant in order to pay benefits. Jones v. Goodwill Industries, 79 O.W.C. 1 (2000).

    While an employer who files a change of condition application under § 65.2-708 must pay compensation within two years prior to the date of the filing, an allegation of failure to provide a current address pursuant to § 65.2-711 allows for the suspension of benefits until an address is provided and proper notice of adjudication of the claim on the merits can be given. Ross v. Pony Express, 71 O.W.C. 99 (1992).

    Rule 1.4(A) requires that a copy of the defendants’ application and supporting documentation must be sent to the employee, and a copy to the employee’s attorney if the employee is represented. Logically, since the defendants do not know the employee’s address, they cannot possibly provide him with a copy of the application. However, because the employee was represented by an attorney at the time of the last hearing on this matter, and the defendants were certainly aware of that representation, the Commission held that the due process rights of the claimant had been violated, and the Commission rejected the Employer’s Application on that ground. Jones v. Goodwill Industries, 79 O.W.C. 1 (2000).

    Cure of a claimant’s failure to report a change in address is not self-executing, and is subject to the time limitations provisions of Code § 65.2-708 . Attia v. W9Y Construction Co., Inc., 76 O.W.C. 332 (1997).

    Va. Code Ann. § 65.2-712 requires a dependent to notify the Commission of her status as a student, but neither Code § 65.2-712 nor Code § 65.2-711 , which requires the reporting of an address change by an employee, specifically requires that a dependent notify either the Commission or the employer of an address change. However, the dependent is required to provide a current residential address so that the defendants can make the required payment. Higgins v. Inspection Enterprises, Inc., 77 O.W.C. 273 (1998).

    The employee’s open award of compensation benefits was suspended for failure to report a change in residential address. The Commission noted that Code § 65.2-711 obligates the employee to disclose his current residential address and to advise of any changes in address as they occur. The Commission held that, to the extent that the employee’s failure to participate in the proceedings before Commission resulted from failure to report his change of address to the Commission, the insurer and his attorney, the consequences of such neglect must, of necessity, fall upon him. Hammoudeh v. Carmel Green Houses, Inc., VWC File No. 166-24-47 (April 4, 2001).

    § 65.2-712. Reporting incarcerations, change in earnings, remarriage, change in student status; recovery of payments procured by fraud, misrepresentation, or unreported change in condition.

    So long as an employee or statutory dependent pursuant to § 65.2-515 receives payment of compensation under this title, any such person shall have a duty immediately to disclose to the employer, when the employer is self-insured, or insurer in all other cases, any incarceration, return to employment, increase in his earnings, remarriage or change in his status as a full-time student. Any payment to a claimant by an employer or insurer which is later determined by the Commission to have been procured by the employee or statutory dependent under § 65.2-515 by fraud, misrepresentation, or failure to report any incarceration, return to employment, increase in earnings, remarriage or change in his status as a full-time student may be recovered from the claimant or statutory dependent by the employer or insurer either by way of credit against future compensation payments due the claimant or statutory dependent, or by action at law against the claimant or statutory dependent. The Commission shall provide for notification to the statutory dependent of his obligation under this section.

    History. 1985, c. 453, § 65.1-100.3; 1991, c. 355; 1992, c. 466; 1996, c. 570.

    Cross references.

    As to secrecy of tax information, see § 58.1-3 .

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 40.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-100.3.

    This section is substantive in nature and should not be retroactively applied to accidents which occurred prior to its effective date. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    This section imposes a singular duty upon the employee: He shall have an obligation to immediately disclose to the employer and the insurer any return to employment or increase in his earnings. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    Former § 65.1-100.3 (now § 65.2-712 ) places the burden upon the employee to immediately inform the employer and insurer of any return to work or increase earnings. Once former § 65.1-100.3 (now § 65.2-712 ) was enacted, the burden to monitor the employee’s activity no longer fell upon the employer and insurer. Clark v. Otis Elevator Co., 1993 Va. App. LEXIS 416 (Va. Ct. App. Sept. 14, 1993).

    This section provides in part that “so long as an employee receives payment of compensation such employee shall have a duty immediately to disclose to the employer any incarceration, return to employment or increase in his earnings.” Here claimant failed to give proper notice regarding her increase in net earnings over her pre-injury weekly wages, and thus claimant’s benefits award was suspended. Thomas v. Nordstrom Pentagon City/Nordstrom, Inc., 22 Va. App. 626, 472 S.E.2d 288, 1996 Va. App. LEXIS 464 (1996).

    Although the purpose of this section is to place an affirmative duty on employees to disclose their employment status to an employer or insurer paying compensation, this duty exists only “so long as an employee receives payment of compensation under this title.” Pressure Concrete Constr. Co. v. Coburn, 21 Va. App. 629, 466 S.E.2d 761, 1996 Va. App. LEXIS 99 (1996).

    This statute cannot be read to place on employees the duty to notify an employer of a return to employment subsequent to the period for which the employee seeks benefits. The employer simply has no stake in the employee’s changed circumstances after that point. Pressure Concrete Constr. Co. v. Coburn, 21 Va. App. 629, 466 S.E.2d 761, 1996 Va. App. LEXIS 99 (1996).

    Section creates new substantive right in employer. —

    Since the effective date of this section, the Commission has held that, by reading former § 65.1-99 (now § 65.2-708 ) and this section together, it is clear that this section creates a new substantive right in the employer which could not be asserted before in the Commission. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    This statute creates a substantive right and cannot operate retroactively unless it by express language or necessary implication indicates that the legislature intended a retroactive application. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    The statute grants a substantive right to the employer or insurer which did not exist previously. Any payment to such employee which is later determined by the commission to have been procured by the employee by fraud, misrepresentation or failure to report any return to employment or increase in earnings may be recovered from the employee by the employer or insurer by way of credit taken against future compensation payments due the claimant, or by action at law against the claimant. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    Employer entitled to credit for benefits paid. —

    Employer was entitled only to a credit based on the excess amount that an injured employee received due to the employee’s increased earnings at a dissimilar job because the employee was not required to report the employee’s employment at a dissimilar job as it was not a change of circumstance to what existed when the award of temporary total benefits was entered. The employee worked as a bakery manager for the employer, which was a wholesale club, and concurrently as a custodian at a school. BJ's Wholesale Club, Inc. v. McCarron, 2017 Va. App. LEXIS 97 (Va. Ct. App. Apr. 4, 2017).

    Employer not entitled to credit for benefits paid. —

    Express provisions of §§ 65.2-708 and 65.2-712 governing the termination of an award based on a change in condition controlled the issue of whether the employer was entitled to a credit for workers’ compensation benefits it paid to the claimant for nearly nine months following his return to work after he had sustained a compensable injury and since those provisions did not dictate that the employer was entitled to a credit for the payments it made to the claimant despite its knowledge that he had returned to full-duty work, the workers’ compensation commission erred in finding that under § 65.2-520 , the employer was entitled to a credit for having made such payments, as that statutory interpretation thwarted the legislature’s intention, as set forth in the other two statutes, that an award of benefits only be altered prospectively. McFadden v. Carpet House, 42 Va. App. 302, 591 S.E.2d 708, 2004 Va. App. LEXIS 28 (2004).

    Commission determination that an employer was not entitled to a credit under § 65.2-712 for benefits paid to or on behalf of a worker was proper because the commission resolved any inconsistency in the testimony by crediting the charity motive as the driving force behind the benefits conferred on the worker, and was not persuaded that the allowances made to the worker were truly a substitute for wages. Fairfax Hosp. v. McKaveney, 2007 Va. App. LEXIS 365 (Va. Ct. App. Oct. 2, 2007).

    Award of credits not reducible to an action at law. —

    Where defendant claimant, through no fraud or misrepresentation, received sums from plaintiff employer equal to his pre-injury wages while he also received the carrier’s disability benefits, an award of credits against future compensation were not reducible to an action at law under §§ 65.2-710 and 65.2-712 ; the employer’s payments were made in the hope that the claimant would remain loyal and return to work and thus, they were not “earnings” within the meaning of § 65.2-712 . Bay Concrete Constr. Co. v. Davis, 43 Va. App. 528, 600 S.E.2d 144, 2004 Va. App. LEXIS 377 (2004).

    An award under this section is limited to the amount the employee receives in excess of that which he or she should have received had he or she reported the return to employment or the increase in earnings. City of Fairfax v. Massey, 11 Va. App. 238, 397 S.E.2d 679, 7 Va. Law Rep. 669, 1990 Va. App. LEXIS 188 (1990).

    Relief limited to what requested on application. —

    An employer is limited to the relief stated in its application for change in condition; thus, where employer’s application for change of condition did not contain a request for modification of the outstanding award, the court would not infer a request for modification based on the form’s printed language. Washington Metropolitan Area Transit Authority v. Pender, 14 Va. App. 100, 415 S.E.2d 239, 8 Va. Law Rep. 2344, 1992 Va. App. LEXIS 75 (1992).

    Student status provision applied to statutory dependents. —

    Worker’s compensation claimant was not required by § 65.2-712 to disclose her status as a full-time student to the Virginia Workers’ Compensation Commission as § 65.2-712 applied to statutory dependents. Starbucks Coffee Co. v. Shy, 61 Va. App. 229, 734 S.E.2d 683, 2012 Va. App. LEXIS 396 (2012).

    No restitution authority in commission as to carrier. —

    Even if relief pursuant to this section were available on the ground the employee failed to give the requisite notice, the plain language of the statute limits the available remedies to a credit against future compensation or for an action at law. The section does not give the commission authority to order restitution as requested by the carrier. Pressure Concrete Constr. Co. v. Coburn, 21 Va. App. 629, 466 S.E.2d 761, 1996 Va. App. LEXIS 99 (1996).

    Commission held that disability benefits were not earnings and employer’s claim that they were income was not considered. —

    Employer’s claim that a workers’ compensation claimant failed to report as “income” monies she received as disability benefits was not considered and the appellate court did not decide whether the employer was entitled to a credit pursuant to § 65.2-712 since the Virginia Workers’ Compensation Commission did not rule on whether the claimant failed to report “income,” but ruled that while the claimant’s disability benefits might be a form of “income,” they were not “earnings.” B.P. Solar & Ace Am. Ins. Co. v. Jones, 49 Va. App. 322, 641 S.E.2d 124, 2007 Va. App. LEXIS 57 (2007).

    Payments received under settlement agreement. —

    This section applies to payments received under a settlement agreement. Magic City Motor City Corp. v. Helmick, 10 Va. App. 10, 390 S.E.2d 1, 6 Va. Law Rep. 1725, 1990 Va. App. LEXIS 39 (1990).

    Award created vested right which could not be divested by retroactive application of this section. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    Fraudulent misrepresentation. —

    Where an injured employee has obtained an overpayment of benefits by fraudulently misrepresenting medical mileage, this section empowers the commission to grant relief to an employer. Four L. Ranch v. Towles, 1994 Va. App. LEXIS 237 (Va. Ct. App. Apr. 26, 1994).

    Claim properly before Commission. —

    Under Rule 2(A) of the Rules of the Industrial (now Workers’ Compensation) Commission, the Commission had the discretion to hear petition for review without a specification of each determination of fact or law, and to determine all of the issues involved in the case. Under the circumstances, for the court to grant the prayer of the carrier and dismiss this appeal, or to refer it back to the Commission for further consideration, would be tantamount to the substitution of the court’s discretion for that of the Commission. Accordingly, the issue of the application of this section to claimant’s claim was properly before the Commission. Brushy Ridge Coal Co. v. Blevins, 6 Va. App. 73, 367 S.E.2d 204, 4 Va. Law Rep. 2325, 1988 Va. App. LEXIS 28 (1988).

    Relation to other provisions. —

    This statute did not prevent the Virginia Workers’ Compensation Commission from applying § 65.2-510 as the two statutes did not conflict; therefore, the Commission did not err in applying § 65.2-510 and the firing for cause doctrine. Barton v. Allied Waste Indus., 2013 Va. App. LEXIS 215 (Va. Ct. App. July 23, 2013).

    Purpose of rule which suspends payments. —

    It is manifest from the practical application of Industrial (now Workers’ Compensation) Commission that its obvious purpose is to preserve the status quo ante. A suspension pursuant to Rule 13(C) is simply preliminary and temporary, intended to protect both parties’ interests until the Commission resolves the noticed matter on its merits. Rule 13 is not an authorization for an employer or insurer to suspend payments with assurance that an employee may not have them reinstated. Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    Rule which suspends payments does not require employee to apply for reinstatement. —

    The language of Industrial (now Workers’ Compensation) Commission Rule 13(C) is not to be read as a permanent termination of award payments requiring an employee to apply for reinstatement under former § 65.1-99 (now § 65.2-708 ). Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    Suspension does not deprive employee of payments accruing during pendency of review. —

    Suspension under Industrial (now Workers’ Compensation) Commission Rule 13(C) does not deprive an employee of entitlement to those payments justly accruing during the pendency of the review, and thus, suspension is compatible with the Commission’s authority to make rules not inconsistent with this Act. Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    Preliminary suspension of payments did not become res judicata. —

    Where the decision to suspend payments was merely preliminary to a formal hearing and decision on the merits, nothing in the Act suggests that the preliminary suspension of payments became res judicata, precluding worker from requesting, and the commission from granting, reinstatement of benefits from the point of suspension; thus, the Commission did not err in reinstating the award and granting company credits in accordance with former § 65.1-100.3. Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    Attempt to return to work but failure did not require disability reclassification. —

    Commission did not err in continuing to recognize worker’s temporary total incapacity; that worker attempted to return to light duty work on his own accord, but ultimately failed, did not require a reclassification of his disability from total to partial; the burden remained with the employer to prove an actual change in condition and the extent of change, and the employer had offered no evidence other than the employee returned to work at some unknown wage during the course of his outstanding award. Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    Failure to report wages after returning to work. —

    Because an employee returned to work without reporting wages as required by § 65.2-712 , a deputy commissioner properly refused to reinstate the employee’s worker’s compensation award, and terminated the employee’s outstanding award with modification of the effective date. Dillon v. Auto Truck Transp. & Zurich Am. Ins. Co., 2008 Va. App. LEXIS 390 (Va. Ct. App. Aug. 12, 2008).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    General:

    Where employer’s payments were made pursuant to an award, § 65.2-712 does not prescribe any limitation on recoupment of those payments where claimant has failed to report a return to work. Thus, employer may recoup its credit by reducing claimant’s weekly compensation on a dollar-for-dollar basis.Batzloff v. ASA Airlines, JCN VA00000705988 (Jan. 20, 2015).

    Claims technician improperly rejected employer’s application as not complying with Rule 1.4(E); although employee under outstanding award, and employer stopped payments under award in 2001, and did not file application until 2003, employer submitted evidence that employee returned to work in 2001 and also had been incarcerated since then, but was unable to be located; Commission found that employer unduly prejudiced by Commission’s refusal to hear application because employer cannot determine exact whereabouts of employee. Cowan v. Glass Protection Services, Inc., VWC File No. 205-48-82 (Feb. 23, 2004).

    Where an Employer’s Application For Hearing is filed pursuant to § 65.2-712 , the requirements of Rule 1.4(A) apply. However, the application need not be submitted under oath, as is required by Rule 1.4(B) for applications submitted under § 65.2-708 . Nuttall v. Autozone, 79 O.W.C. 195 (2000).

    The Commission has jurisdiction to do full and complete justice in each case. This authority is plenary, and it includes the power to vacate awards entered by mistake. Sadler v. Middle Peninsula Regional Security Center, 78 O.W.C. 144 (1999).

    This section which allows a credit when an employee fails to report a change in earnings, is substantive and applies only to accidents that occur after July 1, 1985. Baker v. Memco/Lucky Stores, Inc., 70 O.I.C. 243 (1991).

    The burden is on the claimant to report her earnings to the carrier after her return to work. Sterling v. The Supply Room Companies, Inc., 76 O.W.C. 200 (1997).

    A general premise of the Commission is that the amount reported to the IRS is the most accurate reflection of an employee’s earnings. However, that premise does not apply where the origin of the employee’s funds have been mischaracterized. Myers v. Bill Myers Const. Co., Inc., 76 O.W.C. 283 (1997).

    Income derived because the employee is a shareholder in a business, and not because of active participation in the business and because of work performed, is not considered for average earnings purposes. Myers v. Bill Myers Const. Co., Inc., 76 O.W.C. 283 (1997).

    Section 65.2-712 is substantive in nature and cannot be applied retroactively to accidents that occur prior to its effective date. Washington Metropolitan Area Transit Authority v. Pender, 14 Va. App. 100, 415 S.E.2d 239, 8 Va. Law Rep. 2344, 1992 Va. App. LEXIS 75 (1992).

    Credit is determined on a dollar for dollar basis as opposed to offsetting the number of weeks for which benefits are paid under the Act. Virginia International Terminals, Inc. v. Moore, 22 Va. App. 396, 470 S.E.2d 574, 1996 Va. App. LEXIS 368 (1996), aff'd, 254 Va. 46 , 486 S.E.2d 528, 1997 Va. LEXIS 55 (1997).

    Where an employer is aware that a claimant has returned to selective work and fails to execute a Supplemental Memorandum of Agreement, the employer is not entitled to a credit under § 65.1-100.3 (now § 65.2-712 ). Lewis v. Ribco Products, Incorporated, 65 O.I.C. 292 (1986).

    Where an employer unilaterally suspends compensation on the basis that a credit is due without filing an application for hearing the claimant is entitled to an assessment of a twenty percent penalty for all compensation due and unpaid within fourteen days of the due date. Payne v. W. M. Brown & Son, Inc., 66 O.I.C. 173 (1987).

    There is no provision in the Compensation Act for the employer or its insurance carrier to claim a credit for the value of services contributed by claimant without pay. Nelson v. Roanoke Iron & Bridge Works, 60 O.I.C. 324 (1981).

    There is no statutory provision under the Workers’ Compensation Act granting a credit to an employer for funds received by an employee through the Virginia Employment Commission. King v. Rinker-Detwiler and Associates, P.C., 71 O.W.C. 258 (1992).

    Also see notes to § 65.2-708 (1992).

    Change in Earnings:

    Deputy Commissioner properly adjusted rate of claimant’s temporary partial disability award rate downward, although claimant had requested only increase in rate of award; evidence required to prove modification was the same whether modification increases or decreases rate of award, and thus due process satisfied; claimant also required to notify Commission of increase in earnings, and thus no prejudice in adjusting rate downward. Bradshaw v. United Parcel Serv. of Am., VWC File No. 198-41-96 (June 9, 2003), aff’d, Ct. App. Record No. 1643-03-2 (Oct. 28, 2003).

    This section imposes no affirmative duty on the employee to report the status of his earnings if there is no change. Olson v. MMR/Wallace Corp., 75 O.W.C. 26 (1996).

    This section is applicable where an employee fails to disclose to the employer during the negotiations for a settlement that he is currently working. Magic City Motor City Corp. v. Helmick, 10 Va. App. 10, 390 S.E.2d 1, 6 Va. Law Rep. 1725, 1990 Va. App. LEXIS 39 (1990).

    It is an employee’s duty to report any earnings during the time benefits are suspended pending review of the Commission’s decision by the Court of Appeals. Wilkins v. Best Masonry, Inc., 70 O.I.C. 245 (1991).

    Where an employee has failed to notify the employer of a change in earnings, a request for credit is not limited to ninety days before the filing of the application but extends for the whole period of overpayment. Ruffin v. Casey Chevrolet, 70 O.I.C. 247 (1991).

    The claimant suffered an injury that prevented his return to full duty work as the owner-operator of an S-corporation, which ownership the claimant shared with his wife. The claimant did subsequently return and provide valuable services to the corporation in a managerial and supervisory capacity, although he drew no wages. Based on the evidence presented, the Commission found that these services conferred a benefit on the corporation equivalent to $600.00 per week, effective as of the date the employer suspended compensation payments. No credit was allowed to the employer before that date, because the claimant had received no actual payment of wages, so there was no knowing violation of his duty to report an increase in wages; and because the carrier was aware and had knowledge that the claimant was performing limited work activities before and after that date. Davis v. Davis Auto Service, 78 O.W.C. 25 (1999).

    Where the claimant advised the carrier that she was to return to work on a commission basis, following which the carrier reinstated payments appropriate under an earlier temporary partial disability award, the carrier is entitled to a credit for overpayments made when the claimant did not fully disclose her actual earnings. Sterling v. The Supply Room Companies, Inc., 76 O.W.C. 200 (1997).

    Where an employee is able to expand his working hours in a second dissimilar employment as a result of his disability but fails to advise the carrier of this increased earnings, the employer is entitled to a credit under § 65.1-100.3 (now § 65.2-712 ). City of Fairfax v. Massey, 11 Va. App. 238, 397 S.E.2d 679, 7 Va. Law Rep. 669, 1990 Va. App. LEXIS 188 (1990).

    Where an employer’s application for hearing alleges an employee’s return to part-time work with an unreported change in earnings and only requests relief under § 65.1-100.3 (now § 65.2-712 ), it was proper in the absence of a request to vacate the award to allow a credit for the period worked and reinstate the temporary total award after the employment ceased. Lot Masters v. Gibbs, 11 Va. App. 70, 396 S.E.2d 395, 1990 Va. App. LEXIS 166 (1990).

    Where an employer files an application alleging that the employee has failed to provide notice of earnings as required by § 65.1-100.3 (now § 65.2-712 ) with benefits suspended pursuant to Rule 13 (C) [now Rule 1.5 C(1)] pending a determination on the merits, it is appropriate to award a credit to the employer for any period in which the claimant worked but to reinstate benefits for periods in which there was no employment without the necessity of the employee filing a change in condition application under § 65.1-99 (now § 65.2-708 ). The language of Rule 13 (C) [now Rule 1.5 C (1)] provides for a suspension of benefits and not a permanent termination. Therefore, the employee is not required to file a change in condition application to obtain reinstatement of compensation benefits. Telesystems, Inc. v. Hill, 12 Va. App. 466, 404 S.E.2d 523, 7 Va. Law Rep. 2566, 1991 Va. App. LEXIS 98 (1991).

    A claimant who is precluded from receiving temporary partial compensation benefits because of incarceration is not entitled to temporary total benefits when surgery as a result of the industrial accident renders him unable to work. Jones v. D & F Plumbing, Heating and Repair, 67 O.I.C. 222 (1988) (see Garrison v. MSJ Construction Company, Inc., VWC File No. 167-38-59 (June 28, 1996) which makes a contrary holding).

    Change in Student Status:

    The 1996 Amendments to § 65.2-712 impose another singular duty upon the statutory dependent to immediately disclose to the employer a change in his status as a full-time student. Those amendments also grant a substantive right to the employer which did not exist previously, that is, a right to a credit or action at law. Those amendments are substantive and should not be applied retroactively. Boyd v. James River Limestone Company, Inc., 78 O.W.C. 157 (1999).

    The 1996 Amendments to § 65.2-712 impose another singular duty upon the statutory dependent to immediately disclose to the employer a change in his status as a full-time student. Those amendments also grant a substantive right to the employer which did not exist previously, that is, a right to a credit or action at law. Those amendments are substantive and should not be applied retroactively. Boyd v. James River Limestone Company, Inc., 78 O.W.C. 157 (1999).

    The Commission entered an award on November 23, 1998, terminating compensation benefits to the statutory dependent whose student status had changed on June 12, 1997. By the time that award was entered, however, the employer had overpaid benefits through June 7, 1998, and the employer requested a credit for the overpayment. The Commission denied relief, in part because the Commission’s file established that the Commission never notified the statutory dependent of his obligation to report a change in his status as a full-time student, as § 65.2-712 requires. Boyd v. James River Limestone Company, Inc., 78 O.W.C. 157 (1999).

    Section 65.2-712 requires a dependent to notify the Commission of her status as a student, but neither § 65.2-712 nor § 65.2-711 , which requires the reporting of an address change by an employee, specifically requires that a dependent notify either the Commission or the employer of an address change. However, the dependent is required to provide a current residential address so that the defendants can make the required payment. Higgins v. Inspection Enterprises, Inc., 77 O.W.C. 273 (1998).

    Fraud:

    The Commission under § 65.1-92 (now § 65.2-700 ), § 65.1-94 (now § 65.2-702 ) and § 65.1-100.3 (now § 65.1-712) has jurisdiction to determine if voluntary payments made by an employer were procured by fraud even though an award has not been entered. However, the Commission upon a finding of fraud has no authority to order repayment or allow a credit to the employer. Cecil v. Cardinal Construction, 68 O.I.C. 233 (1989).

    An employer alleging fraud has the burden to prove its allegations by “positive and direct evidence which is clear and convincing.” Wright v. Harrison’s Supermarket, 75 O.W.C. 195 (1996).

    The claimant was awarded temporary total disability benefits beginning May 23, 1993, at the weekly rate of $233.33. Because of a “computer error,” the employer mistakenly paid the claimant approximately $5,000 between December 1995 and January 1996. The Commission found that the claimant was aware of the mistaken payment soon after it occurred, and that it would be inequitable to allow the claimant to retain that money. Noting that the Commission is empowered to protect itself and its awards from fraud, imposition and mistake, the Commission concluded that the employer could recover the mistaken payments by way of a credit against future compensation benefits. Sadler v. Middle Peninsula Regional Security Center, 78 O.W.C. 144 (1999).

    § 65.2-713. Costs.

    1. If the Commission or any court before whom any proceedings are brought or defended by the employer or insurer under this title shall determine that such proceedings have been brought, prosecuted, or defended without reasonable grounds, it may assess against the employer or insurer who has so brought, prosecuted, or defended them the whole cost of the proceedings, including a reasonable attorney’s fee, to be fixed by the Commission.
    2. Where the Commission finds that an employer or insurer has delayed payment without reasonable grounds, it may assess against the employer or insurer the whole cost of the proceedings, including a reasonable attorney’s fee to be fixed by the Commission. In such a case where an attorney’s fee is awarded against the employer or insurer, the Commission shall calculate and add to any award made to the claimant interest at the judgment rate, as set forth in § 6.2-302 , on the benefits accrued from the date the Commission determined the award should have been paid through the date of the award.
    3. Where the Commission finds that an employer or insurer has filed an application for a hearing in bad faith, it shall assess against the employer or an insurer an amount up to ten percent of the total amount of the benefits accrued from the date the Commission determined the award should have been paid through the date of the award. This payment shall be in addition to any costs, fees, or awards as set forth in subsection B.

    History. Code 1950, § 65-97; 1958, c. 509; 1968, c. 660, § 65.1-101; 1989, c. 496; 1991, c. 355; 1997, c. 158.

    Editor’s note.

    Effective October 1, 2010, “§ 6.2-302 ” was substituted for “§ 6.1-330.54” to conform to the recodification of Title 6.1 by Acts 2010, c. 794.

    Law Review.

    For note, “Tort Immunity and Workmen’s Compensation,” see 39 Va. L. Rev. 951 (1953).

    For comment on workers’ compensation and negligent third parties, see 17 Wash. & Lee L. Rev. 315 (1960).

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 14 Costs. § 14.01 Items included. Bryson.

    Michie’s Jurisprudence.

    For related discussion, see 5A M.J. Costs, § 3; 6A M.J. Divorce and Alimony, §§ 35, 59, 72.2, 78; 14A M.J. Parent and Child, § 17.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-101 or prior law.

    Authority to award costs. —

    Subsection A of § 65.2-713 grants the appellate court the authority to assess against the employer the whole cost of the appellate proceedings, including a reasonable attorney’s fee, if it finds that the proceedings were brought, prosecuted, or defended without reasonable grounds; the actual calculation of such costs, if awarded, should be fixed by the workers’ compensation commission. Dinwiddie Custodial v. Ferrell, 2003 Va. App. LEXIS 68 (Va. Ct. App. Feb. 11, 2003).

    Assessment of costs and attorney’s fee is not required in every defense of a proceeding without reasonable grounds. Press v. Ale, 1 Va. App. 153, 336 S.E.2d 522, 1985 Va. App. LEXIS 77 (1985); Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 336 S.E.2d 903, 1985 Va. App. LEXIS 84 (1985).

    Assessment of attorney’s fees held proper. —

    Although there may have been some initial confusion as to whether claimant was an employee of the employer in the instant case, that confusion did not exist after January 19, 1993. After the letter was sent establishing the employee-employer relationship on that day, the insurer had no reasonable grounds to defend against claimant’s claim on the basis that he was not an employee. Yet, the insurer continued to do so, delaying payment to claimant and forcing all parties to go through the expense of a lengthy hearing on January 28, 1994. Therefore, the commission did not abuse its discretion in assessing attorney’s fees against the insurer. Joe's Home Imp. Co. v. Allen, 1995 Va. App. LEXIS 139 (Va. Ct. App. Feb. 14, 1995).

    Trial court properly awarded attorney’s fees to an employee pursuant to § 65.2-713 in relation to a workers’ compensation claim, where employer had denied payment of the medical bills at issue, contending that the surgeries and treatment were not pre-authorized, while the Workers’ Compensation Act did not require the employee to obtain pre-authorization from the employer prior to undergoing treatment. Williams Equip. Corp. v. Register, 2002 Va. App. LEXIS 235 (Va. Ct. App. Apr. 16, 2002).

    Claimant was entitled to partial attorney’s fees for the appeal under subsection A of § 65.2-713 , as the employer contested the claimant’s post-traumatic stress disorder diagnosis, which had also been found by the employer’s psychiatrist. Dinwiddie Custodial v. Ferrell, 2003 Va. App. LEXIS 68 (Va. Ct. App. Feb. 11, 2003).

    When an employer unsuccessfully argued a claimant’s request for payment for treatment of traumatic brain injury was time-barred, it was not error to order the employer to pay the claimant’s attorney’s fees incurred in an appeal of the decision of the Virginia Workers’ Compensation Commission because the employer did not defend against the claim on reasonable grounds, since the employer presented no authority supporting the employer’s defense. Philip Morris USA, Inc. v. Mease, 62 Va. App. 190, 745 S.E.2d 155, 2013 Va. App. LEXIS 206 (2013).

    When an employer unsuccessfully argued a claimant’s request for payment for treatment of traumatic brain injury was time-barred, it was not error to order the employer to pay the claimant’s attorney’s fees because, after paying for treatment for the claimant’s traumatic brain injury, the employer unilaterally reduced the number of physical therapy sessions without supporting medical evidence, while the claimant’s medical evidence recommended resumption of the prior number of sessions. Philip Morris USA, Inc. v. Mease, 62 Va. App. 190, 745 S.E.2d 155, 2013 Va. App. LEXIS 206 (2013).

    Virginia Workers’ Compensation Commission did not abuse its discretion in assessing fees and costs against an employer because the employer had ample time to investigate the legitimacy of an employee’s claim, but the employer’s challenge came more than two full years after the employee filed a claim for benefits. Furthermore, employer’s primary evidence was a deposition and an affidavit of the claimant’s ex-wife’s statements that were inherently in conflict and made by someone with an established agenda. Southern Tank Transp., Inc. v. Hoke, 2015 Va. App. LEXIS 99 (Va. Ct. App. Mar. 31, 2015).

    Discretion of Commission. —

    Assessment is left to the sound discretion of the Commission. Press v. Ale, 1 Va. App. 153, 336 S.E.2d 522, 1985 Va. App. LEXIS 77 (1985); Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 336 S.E.2d 903, 1985 Va. App. LEXIS 84 (1985).

    Virginia Workers’ Compensation Commission is not required to assess costs and fees in every case where an employer delayed payment or defended a proceeding, and whether to assess fees or costs rests in the sound discretion of the Commission and is reversed only for an abuse of that discretion; credible evidence supported the Commission’s findings and order that the employer pay $3,000 of the claimant’s attorney’s fees for unreasonably defending and delaying payment. Winchester Golf Club, Inc. v. Schenck, 2003 Va. App. LEXIS 343 (Va. Ct. App. June 17, 2003).

    Appellate court awarded a claimant attorney fees and costs of the appeal with regard to his employer ceasing all medical and attendant care payments to him without notice as the court affirmed the Virginia Workers’ Compensation Commission award that concluded that the employer unreasonably defended its failure to pay outstanding medical benefits under an existing award after having the benefit of reviewing the entirety of the record on appeal, including the finding that the continuing defense by the employer on appeal of what clearly was an unreasonable delay in payment of medical benefits under an existing award. Va. Polytechnic Inst. v. Posada, 47 Va. App. 150, 622 S.E.2d 762, 2005 Va. App. LEXIS 508 (2005).

    Virginia Workers’ Compensation Commission acted within its discretion in denying a claimant attorney fees or, at minimum, reimbursement for the cost of deposing his treating physician because the Commission’s decision was in keeping with its own prior decisions and reflected a reasonable interpretation of its own rules; the physician cooperated in every possible way and provided adequate information via written answers to the questionnaires he was given, as well as extensive opinions. Wells v. Auto. Serv. Garage, 2018 Va. App. LEXIS 43 (Va. Ct. App. Feb. 20, 2018).

    Defense of claim held not unreasonable. —

    Commission, as fact finder, was entitled to accept employer’s explanation for its delay in paying claimant’s medical bills, and thus there was no error in commission’s refusal to assess attorneys’ fees and costs against employer for such delay. Anselmo v. Cherrydale Motors, 1999 Va. App. LEXIS 260 (Va. Ct. App. May 4, 1999).

    Although the Workers’ Compensation Commission properly found that a claimant cured an earlier refusal of selective employment under subsection A of § 65.2-510 , because a reasonable and honest difference of opinion existed as to what legally sufficed as a cure, the claimant was not entitled to attorney’s fees and costs under subsection A of § 65.2-713 associated with the appeal. LPT, Inc./MSS, Inc. v. Voltaggio, 2007 Va. App. LEXIS 165 (Va. Ct. App. Apr. 17, 2007).

    Because the Virginia Workers’ Compensation Commission did not err in finding that an employer’s defense was reasonable, an employee was not entitled to attorneys’ fees and costs; the employee failed to present any principles of law or authorities supporting his assignment of error. Grizzard v. Sonny's Auto. Racing, Inc., 2018 Va. App. LEXIS 60 (Va. Ct. App. Mar. 13, 2018).

    Virginia Workers’ Compensation Commission did not err in declining to award a health care provider attorney fees because the Commission found that, in asserting a laches defense to the provider’s application for payments, a city reasonably defended against the application filed by the provider. Although the defense ultimately proved unsuccessful, there was nothing unreasonable about asserting that laches barred the claim that the provider waited nearly two decades to assert. City of Newport News v. Peninsula Neurosurgical Assocs., 2020 Va. App. LEXIS 83 (Va. Ct. App. Mar. 31, 2020).

    The mere fact that a corporation was granted an appeal from the Commission’s award evidences that the action by the corporation was not without reasonable grounds. SUNOCO v. Lawrence, 213 Va. 596 , 194 S.E.2d 687, 1973 Va. LEXIS 190 (1973).

    Defense may be reasonable even if erroneous. —

    Attorney’s fees may be awarded in a workers’ compensation case only when it is defended “without reasonable grounds.” If an employer refuses to pay a claim, reasonably believing that it is not compensable, and in the course of its investigation the grounds for refusal are not so contradicted as to be shown unfounded, then the subsequent defense is reasonable, even if it is later proven misplaced or in error. Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 336 S.E.2d 903, 1985 Va. App. LEXIS 84 (1985).

    Reasonableness shown by grant of appeal on each ground. —

    Where an employer challenged the Commission’s decisions which awarded an employee a cost-of-living supplement, the employer was not liable for the employee’s attorney fees since the Supreme Court granted an appeal with respect to each of the employer’s grounds of defense and that alone evidenced the reasonableness of the defense. Jewell Ridge Coal Corp. v. Wright, 222 Va. 68 , 278 S.E.2d 820, 1981 Va. LEXIS 276 (1981).

    Defense reasonable where denial of benefits affirmed on appeal. —

    Affirmance of Commission’s decision denying compensation benefits necessarily established that employer had reasonable grounds for defending against employee’s claim, and therefore employee was not entitled to award of interest, penalties, or attorney’s fees and costs. Mubaidin v. Holiday Inn Alexandria, 1999 Va. App. LEXIS 707 (Va. Ct. App. Dec. 28, 1999).

    Failure to request award from deputy commissioners. —

    Where the claimant’s right to recover attorney’s fees under this section was not raised before either of the deputy commissioners who had handled her claim and where there had been no finding that the employer or insurer had defended the proceedings without reasonable grounds, the court would not reopen the issue of whether the claimant was entitled to an award under this section. Jackson v. J. Sargent Reynolds Community College/Commonwealth of Virginia, 2000 Va. App. LEXIS 323 (Va. Ct. App. May 2, 2000).

    Sanctions against guaranty fund. —

    Workers’ compensation commission erred in finding that the guaranty fund could not be ordered to pay sanctions for the guaranty fund’s failure to attempt to pay the employee’s treating physician. The guaranty fund had all the rights, duties, and obligations of the insolvent insurer and no principled reason existed why it should not be subject to the same penalties as an insolvent insurer. Miller v. Potomac Hosp. Found., 50 Va. App. 674, 653 S.E.2d 592, 2007 Va. App. LEXIS 437 (2007).

    As the court had previously ruled that the Virginia Workers’ Compensation Commission had jurisdiction to order the insurance guaranty fund to pay a claimant’s doctor, and that sanctions could be assessed against the fund, its appeal concerning those issues was without reasonable grounds, entitling the claimant to the costs of the appeal under subsection A of § 65.2-713 . Va. Prop. & Cas. Ins. Guar. Ass'n v. Miller, 2009 Va. App. LEXIS 299 (Va. Ct. App. July 7, 2009).

    Facts justifying appeal. —

    Where the question presented was one which had never been decided by the Supreme Court, and was a debatable question, and one about which there might have been a reasonable and honest difference of opinion at the time the appeal was taken from the decision of the Commission, it was error to require the employer or insurance carrier to pay the claimant an attorney’s fee of $150 under this section, in addition to the compensation awarded her under the Act. Honaker & Feeney v. Hartley, 140 Va. 1 , 124 S.E. 220 , 1924 Va. LEXIS 152 (1924).

    It was not unreasonable for special employer to defend a death benefits action by relying on an agreement in which the regular employer had agreed to provide workers’ compensation, when the effect of such an agreement had not been decided in an appellate court. Therefore, attorney’s fees could not be assessed to the special employer. VPI & State Univ. v. Frye, 6 Va. App. 589, 371 S.E.2d 34, 5 Va. Law Rep. 154, 1988 Va. App. LEXIS 85 (1988).

    In a workers’ compensation case in which a claimant requested an award of attorney’s fees and costs arising from an appeal by her employer and insurance company, since the Virginia Workers’ Compensation Commission’s conclusion that, given the claimant’s restrictions, she sufficiently marketed her residual capacity in finding a job was erroneous as a matter of law, the appeal had been brought with reasonable grounds. Plant Ptnrs. & Nationwide Agribusiness Ins. Co. v. Pittman, 2009 Va. App. LEXIS 448 (Va. Ct. App. Oct. 6, 2009).

    Court of appeals declined to award a workers’ compensation benefits claimant the attorney’s fees and costs she incurred in the course of an employer’s appeal of a decision of the Virginia Workers’ Compensation Commission because although the employer did not prevail on appeal, it brought the appeal with reasonable grounds. CVS Va. Distrib. v. Thompson, 2011 Va. App. LEXIS 175 (Va. Ct. App. May 17, 2011).

    Assessment of attorney’s fees held improper. —

    An employer had reasonable grounds to believe that it had no responsibility to pay for a claimant’s medical treatment because the court of appeals had never addressed the issue of whether a cumulative trauma injury incurred after the primary injury falls with the doctrine of compensable consequences and an award of attorney’s fees to the claimant was, therefore, an abuse of discretion. Allen & Rocks, Inc. v. Briggs, 28 Va. App. 662, 508 S.E.2d 335, 1998 Va. App. LEXIS 661 (1998).

    Fees denied. —

    Employer had reasonable grounds for its appeal, and although the court rejected the employer’s argument that the commission erred, the employer’s appeal was not so contradicted as to be shown unfounded, and thus the claimant’s request for attorney fees was denied. City of Charlottesville v. Sclafani, 2020 Va. App. LEXIS 135 (Va. Ct. App. May 5, 2020), aff'd in part, rev'd, 300 Va. 212 , 862 S.E.2d 101, 2021 Va. LEXIS 93 (2021).

    Award of fees upheld. —

    Workers’ Compensation Commission properly awarded a medical provider its unpaid medical fees and attorney fees because the Commission applied the appropriate legal standard, the record did not contain any evidence showing that it was unreasonable as a matter of law for the Commission to consider the medical bills at issue as prima facie evidence of the prevailing community rate, the employer failed to rebut that prima facie evidence by presenting evidence of the amounts the specific medical provider involved in the case normally received for the same procedures, no evidence compelled the contrary conclusion that the charges were excessive, and the way in which the employer attempted to rebut the prima facie evidence was unreasonable. Va. Int'l Terminals, LLC v. Neurosurgical Specialists, Inc., 2021 Va. App. LEXIS 53 (Va. Ct. App. Apr. 6, 2021).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Attorney’s Fees:

    The claimant, who worked three jobs, sustained a compensable injury. The job with his employer entitled the claimant to the minimum compensation rate, which the defendants began paying. After a dispute arose over the claimant’s average weekly wage from all jobs, the defendants stopped all compensation, causing the claimant to seek an award and assessment of attorney’s fees related to the defendants’ termination of voluntary benefits. The defendants’ decision to delay payments unilaterally based on the minimum amount due to the lack of agreement on the amount of his earnings in similar employment was unreasonable and supports the assessment of attorney’s fees. Henry v. Atlantic Protective Services, JCN VA00000562576 (Sept. 11, 2013).

    Assessment of attorney’s fees against employer for failure to appear at hearing vacated; failure to appear at hearing caused by alleged lack of notice of claim, and therefore no unreasonable defense of claim shown. Rodriguez v. Metropolitan Abatement Servs., Inc., VWC File No. 212-94-71 (Mar. 1, 2004).

    Attorney fee assessment appropriate when employer and insurer received notice of hearing but did not appear at hearing, and offered no argument how award entered after hearing was improper or unsupported by evidence; separate notice not required to be sent to claims adjuster. Simons v. Federal Painting, Inc., VWC File No. 210-75-01 (June 20, 2003).

    Deputy Commissioner’s fee assessment inappropriate although insurer failed to appear at hearing; insurer did not issue coverage for employer when notice of hearing received, and notice indicated employer not insured; insurer not notified it did provide coverage until day before hearing; notice sufficient to conduct hearing, but not to assess fees. Broughton v. Craven Hall Adult Home, Inc., VWC File No. 206-25-45 (Apr. 18, 2003).

    If an employer brings or defends a proceeding without reasonable grounds, the Commission is empowered to assess costs, including reasonable attorney’s fees, against the employer. Prince v. E. E. Lyons Const. Co., Inc., 76 O.W.C. 35 (1997).

    Code § 65.2-713 authorizes the assessment of attorney’s fees against the employer or insurer who defends a proceeding without reasonable grounds. Assessment of the fee is left to the sound discretion of the Commission and will not be disturbed unless there is an abuse of discretion. Landrum v. Berglund Chevrolet, 77 O.W.C. 46 (1998); Cook v. Continental Cablevision of Virginia, 78 O.W.C. 267 (1999).

    Where a review is prosecuted without reasonable grounds, the employer shall be liable for claimant’s attorney’s fee for time spent responding to arguments made on review. Ferguson v. Olsten Kimberly Quality Care, 76 O.W.C. 52 (1997).

    Whether the employer defended a proceeding without reasonable grounds is to be judged from the perspective of the employer, not the employee. Myers v. Bill Myers Const. Co., Inc., 76 O.W.C. 283 (1997).

    The Commission at its own discretion may determine that a case was defended unreasonably and assess attorney’s fees without a specific request from counsel. Ridgeway v. Universal Electric Company, 67 O.I.C. 160 (1988).

    Where claimant was required to enlist the aid of counsel in requesting a hearing due to the employer’s failure to comply with the lawful award of the Commission, attorney’s fee was assessed against the self-insured employer. Alsop v. Marriott Corp., 60 O.I.C. 12 (1981).

    Assessment of attorney’s fees against defendants warranted where defendants contested and failed to appear at hearing for a clearly compensable claim; lack of employer’s cooperation is no defense to carrier. Cox v. Sambo’s Restaurants, Inc., 60 O.I.C. 111 (1981).

    Withdrawal of an employer’s application for hearing only minutes before the hearing without prior notice to the claimant or his counsel was tantamount to bringing the case without reasonable grounds. Smith v. Orange Livestock Market, Inc., 75 O.W.C. 129 (1996).

    Attorney’s fee assessed against defendants where carrier unjustifiably suspended payment for medical treatment and then reinstated such payments one day prior to hearing. Nuske v. Campbell County School Board, 60 O.I.C. 332 (1981); Taliaferro v. City of Hampton, 52 O.I.C. 248 (1970).

    The evidence established that medical treatment [testing] of the claimant in January 1997 was reasonable, necessary, authorized, and causally related to his work accident. The carrier was sent a copy of the billing in April 1997, and the claimant, by counsel, requested unsuccessfully in June and September 1997 that the bill be paid. The case was selected for an on the record hearing in February 1999, after which the employer advised that the bill was being reviewed and was “in the process of being paid.” The Commission held that these facts established extreme delay by the employer, necessitating the intervention and efforts of claimant’s counsel to obtain payment of the bill for medical benefits clearly due him under the Act, and it assessed the claimant’s attorney’s fee against the employer. Cook v. Continental Cablevision of Virginia, 78 O.W.C. 267 (1999).

    Where the employer unilaterally and arbitrarily denies responsibility for certain medical treatment prescribed by the treating physician without reasonable grounds, the employer shall be liable for the claimant’s attorney’s fees as to that issue, even though it prevails on other issues raised in the proceedings. Leon v. Lewis-Gale Clinic, 76 O.W.C. 350 (1997).

    Where two of four claims were reasonably defended by the employer, but two were unreasonably defended, the Deputy Commissioner did not abuse his discretion in apportioning the award of attorney’s fees evenly between the employer and the claimant. Landrum v. Berglund Chevrolet, 77 O.W.C. 46 (1998).

    Where the claimant’s treating physician prescribed swimming therapy and deemed it reasonable and necessary to his rehabilitation needs, and the employer offered no medical evidence to the contrary, but argued only about the distance the claimant has to travel and its nonmedical doubts as to whether or not such treatment is useful, the Commission found that there was no reasonable basis for the denial of benefits or the appeal, and it awarded the attorney’s fee against the employer. Prince v. E. E. Lyons Const. Co., Inc., 76 O.W.C. 35 (1997).

    Attorney’s fees were assessed where a hearing was necessitated by the employer’s failure to stipulate to known facts. Malone v. Cisco, 70 O.I.C. 61 (1991).

    Attorney’s fees may be assessed if the employer attempts to withdraw a stipulation without any basis in law. Watson v. Quality Assistance, 70 O.I.C. 65 (1991).

    It is appropriate to assess attorney’s fees where the employer fails to produce any persuasive evidence at hearing in opposition to the treating physician’s recommendation. Slusher v. Shelor Chevrolet Corporation, 70 O.I.C. 272 (1991).

    Where an insurer failed to pay a claim on the basis of having been deprived of an opportunity to present evidence, the assessment of attorney’s fee was warranted after such opportunity was provided. Board of Supvrs. v. Taylor, 1 Va. App. 425, 339 S.E.2d 565, 1986 Va. App. LEXIS 219 (1986).

    Where the supervisor’s report and medical evidence establish a compensable injury by accident, attorney’s fees will be assessed against the employer, even though the employee declined to give a recorded statement to the carrier without a union representative present. Prillaman v. Tultex Corporation, 76 O.W.C. 72 (1997).

    Where an employer withholds a Memorandum of Agreement purposefully and without just cause when there was an agreement as to the injury and a specific period of disability but insufficient evidence to terminate or suspend the award and the employee refuses to sign an Agreed Statement of Fact, the Commission may assess attorney fees. Howard v. Little River Seafood, 71 O.W.C. 293 (1992).

    In declining to assess attorney’s fees incurred by an insured party against the uninsured entity, the Commission held that adjudication of issues between insured and insurers that is unrelated to the employee is appropriately decided in another forum. Speas v. Omega Interiors, Inc., et al., 71 O.W.C. 21 (1992).

    If an employer refuses to pay a claim, reasonably believing that it is not compensable, and in the course of its investigation the grounds for refusal are not so contradicted as to be shown unfounded, then the subsequent defense is reasonable, even if it is later proven misplaced or in error. Myers v. Bill Myers Const. Co., Inc., 76 O.W.C. 283 (1997).

    The questions of whether medical treatment was authorized and whether the employer’s tender of a panel of physicians was untimely are debatable issues, the Commission declined to assess attorney’s fees against the employer on the grounds that the defense was unreasonable. Flanegin v. Hechingers Corp., 75 O.W.C. 275 (1996).

    The employer had legitimate grounds for alleging the claimant had returned to work, where entries in medical records stated that he had returned to work, and tax forms produced during discovery mischaracterized the nature of the claimant’s income. Myers v. Bill Myers Const. Co., Inc., 76 O.W.C. 283 (1997).

    The Commission judges whether a case was defended without reasonable grounds from the employer’s perspective. Nevertheless, the employer has an affirmative duty reasonably to investigate the compensability of the claim after it is filed and before an evidentiary hearing is held. The employer denied the claim on the basis that early medical histories recorded by one physician were factually incomplete. This physician corrected the omission in later documents in the record. The Commission record was held open for receipt of an opinion by the employer’s independent medical evaluator, whose opinion was sought only two days before the hearing. Ultimately, the IME physician causally related the claimant’s medical condition to the accident alleged. Despite a lack of medical evidence to support its position, the employer maintained its defense of the claim. Attorney’s fees were awarded, pursuant to Code § 65.2-713 , because the employer failed to produce any evidence in support of its position, and the Commission found the claim was defended without reasonable grounds. Stallard v. Knox Creek Coal Corp., VWC File No. 198-83-67 (January 19, 2001).

    The Commission found that the employer had no reasonable justification for unilaterally discontinuing payment of compensation benefits. The employer had evidence it believed established that the pre-injury average weekly wage and, by extension, the compensation rate, was erroneous. The employer should have sought relief by filing a proper application for hearing, and borne the burden to prove the allegations by a preponderance of the evidence. Instead, the employer unilaterally withheld payment until the claimant was forced to seek legal counsel to enforce her open award. The Commission found the employer’s actions were without justification, affirming an award of attorneys fees and costs. Murphey v. Xerox Corporation, Inc., VWC File No. 187-61-08 (September 21, 2001).

    Employers and insurers have a right to investigate all aspects of a claim before accepting it, or any aspect of it. However, such investigation cannot take an unreasonably long time. The Commission found that it was unreasonable for the defendants to take five months to investigate the circumstances of the claimant’s case, only to then accept the entire claim, and all periods of disability claimed. The fact that the defendant’s claim file “fell through the cracks” does not justify the period taken to investigate the claim, and an award of attorney’s fees against the employer and insurer was appropriate. Wood v. IDS Trucking, Inc., VWC File No. 202-48-89 (January 4, 2002).

    Code § 65.2-713 (A) does not authorize the Commission to assess attorney’s fees against the employer for an appeal to the Court of Appeals. The statute provides that the court before which “proceedings are brought or defended” is authorized to assess a fee, which is then “to be fixed by the Commission.” In this case, the claimant was successful on appeal, but the Court of Appeals did not award attorney’s fees pursuant to Code § 65.2-713 . The claimant then asked the Commission to assess an attorney’s fee, arguing that the appeal to the Court of appeals constituted a defense of the claim without reasonable grounds. The Commission found that the fee request should have been brought before the Court of Appeals, not the Commission. Campbell v. The Service Master Co., VWC File No. 182-01-78 (February 26, 2002).

    Bad Faith:

    A bank fee incurred when a check was deposited and drawn upon by claimant but insurer’s bank failed to honor it is not a benefit available under the Act. To the extent the employer engages in improper conduct with respect to the payment of benefits, the Commission has the authority to punish such conduct but does not have the authority to order reimbursement of bank fees, which is in the nature of civil damages. Here, there was no bad faith or unreasonable delay of payment. Jordan v. City of Norfolk School Board, VWC File No. 203-40-31 (March 27, 2006).

    Costs:

    “Costs of the proceedings” is limited to such matters as filing fees, appeal bonds or other costs incurred by the Commission or the Court and does not include expenses incurred by the litigant. This section also does not provide for an assessment of attorney’s fee where an applicant or claimant appears pro se . Dunivin v. Prince William County School Board, 66 O.I.C. 165 (1987).

    Other than the statutory penalties and assessment of costs, the Commission does not have the authority to resolve damages. Jeffries v. Southern Iron Works, 64 O.I.C. 181 (1985).

    There is no provision under the Act to provide for the cost of transportation and lodging incurred by parties attending a hearing. Malone v. Cisco, 70 O.I.C. 61 (1991).

    Interest:

    The interest provision of § 65.1-101 (B) (now § 65.2-713 B) is a penalty provision that applies only to accidents occurring after July 1, 1989. Stiltner v. Hermes Abrasives, Ltd., 70 O.I.C. 250 (1991).

    § 65.2-714. Fees of attorneys and physicians and hospital charges.

    1. Fees of attorneys and physicians and charges of hospitals for services, whether employed by employer, employee, or insurance carrier under this title, shall be subject to the approval and award of the Commission. The Commission shall have exclusive jurisdiction over all disputes concerning such fees or charges and may order the repayment of the amount of any fee which has already been paid that it determines to be excessive; appeals from any Commission determinations thereon shall be taken as provided in § 65.2-706 . The Commission shall also retain jurisdiction for employees to pursue payment of charges for medical services notwithstanding that bills or parts of bills for health care services may have been paid by a source other than an employer, workers’ compensation carrier, guaranty fund, or uninsured employer’s fund. No physician shall be entitled to collect fees from an employer or insurance carrier until he has made the reports required by the Commission in connection with the case.
    2. If a contested claim is held to be compensable under this title and, after a hearing on the claim on its merits or after abandonment of a defense by the employer or insurance carrier, benefits for medical services are awarded and inure to the benefit of a third-party insurance carrier or health care provider, the Commission shall award to the employee’s attorney a reasonable fee and other reasonable pro rata costs as are appropriate. However, the Commission shall not award attorney fees under this subsection unless and until the employee’s attorney has complied with Rule 6.2 of the Rules of the Commission. The fee shall be paid from the sum that benefits the third-party insurance carrier or health care provider. In determining whether the employee’s attorney’s work with regard to the contested claim resulted in an award of benefits that inure to the benefit of a third-party insurance carrier or health care provider, and in determining the reasonableness of the amount of any fee awarded to an attorney under this subsection, the Commission shall consider only the amount paid by the employer or insurance carrier to the third-party insurance carrier or health care provider for medical, surgical, and hospital service rendered to the employee through (i) the date on which the contested claim is heard before the Deputy Commissioner, is settled, or is resolved by order of the Commission or (ii) the date the employer or insurance carrier provides written notice of its abandonment of its defense to the contested claim and shall not consider additional amounts previously paid to a health care provider or reimbursed to a third-party insurance carrier. For the purpose of this subsection, a “contested claim” is an initial contested claim for benefits and claims for medical, surgical, and hospital services that are subsequently contested and litigated or after abandonment of a defense by the employer or insurance carrier.
    3. Payment of any obligation pursuant to this section to any third-party insurance carrier or health care provider shall discharge the obligation in full. The Commission shall not reduce the amount of medical bills owed to the Commonwealth or its agencies without the written consent of the Office of the Attorney General.
    4. No physician, hospital, or other health care provider as defined in § 8.01-581.1 shall balance bill an employee in connection with any medical treatment, services, appliances, or supplies furnished to the employee in connection with an injury for which (i) a claim has been filed with the Commission pursuant to § 65.2-601 , (ii) payment has been made to the health care provider pursuant to § 65.2-605.1 , or (iii) an award of compensation is made pursuant to § 65.2-704 . For the purpose of this subsection, a health care provider “balance bills” whenever (a) an employer or the employer’s insurance carrier declines to pay all of the health care provider’s charge or fee and (b) the health care provider seeks payment of the balance from the employee. Nothing in this section shall prohibit a health care provider from using the practices permitted in § 65.2-601.1 .

    History. Code 1950, § 65-98; 1968, c. 660, § 65.1-102; 1982, c. 439; 1985, c. 445; 1987, c. 559; 1988, c. 544; 1991, c. 355; 1994, c. 707; 1995, cc. 214, 266; 2012, c. 543; 2014, c. 670; 2016, cc. 279, 290.

    The 2012 amendments.

    The 2012 amendment by c. 543 inserted the third sentence of subsection A and made a minor stylistic change.

    The 2014 amendments.

    The 2014 amendment by c. 670, in subsection D, inserted “(i) a claim has been filed with the Commission pursuant to § 65.2-601 , (ii) payment has been made to the health care provider pursuant to § 65.2-605.1 , or (iii),” substituted “(a)” for “(i)” and “(b)” for “(ii),” and added the last sentence.

    The 2016 amendments.

    The 2016 amendments by cc. 279 and 290, effective March 7, 2016, are identical, and in subsection A, deleted “In addition to the provisions of Chapter 13 (§ 65.2-1300 et seq.),” at the beginning of the second sentence; in subsection B, inserted the second sentence, substituted “The fee shall be paid from the sum that” for “from the sum which” and “In determining whether the employee’s attorney’s work with regard to the contested claim resulted in an award of benefits that inure to the benefit of a third-party insurance carrier or health care provider, and in determining the reasonableness of the amount of any fee awarded to an attorney under this subsection, the Commission shall consider only” for “Such fees shall be based on,” inserted the clause (i) designation and added clause(ii); and made minor stylistic changes.

    Law Review.

    For 1987 survey of Virginia law as to professional responsibility, see 21 U. Rich. L. Rev. 807 (1987).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 40.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-102 or prior law.

    Constitutionality. —

    The statute is not vague. Indeed, it could not be clearer. Thus, the statute does not violate plaintiff’s rights under the Due Process Clause of the United States Constitution. Hudock v. Virginia State Bar, 233 Va. 390 , 355 S.E.2d 601, 3 Va. Law Rep. 2511, 1987 Va. LEXIS 205 (1987).

    Former § 65.1-88 (now § 65.2-603 ) and this section did not impair hospital’s contract with employee in violation of federal and state Constitutions since they were not intended to impair existing contract of hospital. Fairfax Hosp. Ass'n v. Sines, 1995 Va. App. LEXIS 183 (Va. Ct. App. Feb. 21, 1995).

    Hospital was not deprived of property without due process of law under this section since hospital received notice, made appearance at hearing on attorney’s fees, and made claim that attorney’s fees statute was unconstitutional; fact that attorney’s fees were automatically granted was not denial of due process, but merely reflected legislative balancing of rights of claimants, insurers, health care providers, and attorneys. Fairfax Hosp. Ass'n v. Sines, 1995 Va. App. LEXIS 183 (Va. Ct. App. Feb. 21, 1995).

    This section, which allows the Commission to award attorney fees by administrative process, did not violate Virginia Constitution’s guarantee of trial by jury, since health care providers may preserve their right to jury trial by not accepting payment from workers’ compensation insurance carrier; however, once provider accepts payment from carrier, it waives its right to pursue civil action, and thus, jury trial. Fairfax Hosp. Ass'n v. Sines, 1995 Va. App. LEXIS 183 (Va. Ct. App. Feb. 21, 1995).

    Applicability of section. —

    Workers’ Compensation Commission erred in denying the claimant’s request for a penalty award against the employer and its insurer for their late payment of attorney fees; where the Workers’ Compensation Commission ordered the attorney fees to be paid out of the claimant’s accrued compensation, the fees remained “compensation” within the meaning of the penalty statute, § 65.2-524 , and that was true even where the workers’ compensation commission ordered the employer to pay a particular portion of the penalty to the claimant’s attorney as a reasonable fee pursuant to this section. Roman v. Ondeo Degremont, Inc., 47 Va. App. 773, 627 S.E.2d 539, 2006 Va. App. LEXIS 108 (2006).

    Exclusive jurisdiction with Commission. —

    The Workers’ Compensation Commission has exclusive jurisdiction over all disputes concerning the payment of fees and charges of physicians and hospitals. Combustion Eng'g, Inc. v. Lafon, 22 Va. App. 235, 468 S.E.2d 698, 1996 Va. App. LEXIS 249 (1996).

    Deputy commissioner’s order directing the employer and/or the guaranty fund to pay the employee’s treating physician was within the deputy commissioner’s subject matter jurisdiction since the employee’s claim involved treatment for a work accident. Furthermore, the Workers’ Compensation Commission could not rule on the merits of that order because the guaranty fund did not timely appeal the order once it was entered. Miller v. Potomac Hosp. Found., 50 Va. App. 674, 653 S.E.2d 592, 2007 Va. App. LEXIS 437 (2007).

    Consent to Jurisdiction of Virginia Workers’ Compensation Commission. —

    Deputy commissioner had jurisdiction to assess an award of attorney’s fees against an out-of-state hospital that provided medical care to a claimant because the hospital, by accepting payment of the claimant’s medical bills from the insurer, consented to the jurisdiction of the Virginia Workers’ Compensation Commission and the Virginia Workers’ Compensation law. Town Country Hosp., LP v. Davis, 64 Va. App. 658, 770 S.E.2d 790, 2015 Va. App. LEXIS 138 (2015).

    Jurisdiction of Commission. —

    Virginia Workers’ Compensation Commission did not err in exercising jurisdiction over a health care provider’s application because the Commission had before it a dispute among a medical care provider, an employee, and an employer concerning whether the employer was responsible, pursuant to a settlement order, for payment of the employee’s medical expenses. Northrop Grumman Shipbuilding, Inc. v. Wardell Orthopaedics, P.C., 67 Va. App. 420, 796 S.E.2d 469, 2017 Va. App. LEXIS 51 (2017).

    This section does not impair the hospital’s contract with the patient in violation of either the federal or state constitutions; once a health care provider accepts payment, it also accepts the administrative process used by the Workers’ Compensation Commission. Mary Wash. Hosp. v. Tyler, No. 1846-91-4 (Ct. of Appeals, February 26, 1992).

    This section reflects a legislative balancing of the rights of claimants, insurers, health care providers and attorneys. Mary Wash. Hosp. v. Tyler, No. 1846-91-4 (Ct. of Appeals, February 26, 1992).

    Section was intended to prevent excessive charges. —

    This section was intended to give the Commission the power to pass on attorneys’ fees and physicians’ charges when rendered, in other words, not to allow an attorney or a physician to overcharge for his services. Bee Hive Mining Co. v. Industrial Comm'n, 144 Va. 240 , 132 S.E. 177 , 1926 Va. LEXIS 244 (1926).

    It confers no power to require payment of fees. —

    Whatever control the Commission has over fees of physicians, it gets from this section, which does not confer on the Commission the power to require an employer or its insurance carrier to pay a money award to a physician furnished by them or either of them to an injured employee. Bee Hive Mining Co. v. Industrial Comm'n, 144 Va. 240 , 132 S.E. 177 , 1926 Va. LEXIS 244 (1926).

    Nor does it give to a physician or hospital a right of action against the employer independent of the right of the employee to compensation. Merrimac Anthracite Coal Corp. v. Showalter, 158 Va. 227 , 163 S.E. 73 , 1932 Va. LEXIS 250 (1932).

    It applies only to charges for services to which employee entitled as of right. —

    This section has no application to charges of physicians and hospitals for services to which the injured employee is not entitled as a matter of right under and by virtue of the Act. Merrimac Anthracite Coal Corp. v. Showalter, 158 Va. 227 , 163 S.E. 73 , 1932 Va. LEXIS 250 (1932).

    Prevailing rate in community. —

    Employer that alleged a medical provider’s bill was excessive presented insufficient evidence of the prevailing rate in the community, as the government-mandated reimbursement rate for injured longshoremen or Medicare patients, standing alone, did not establish that rate. The test was what a surgeon and his assistant with the skill and experience of those that operated on the worker’s compensation claimant typically charged for the surgery at the time and in the community that the surgery was performed. Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 722 S.E.2d 301, 2012 Va. App. LEXIS 59 (2012).

    Test for determining whether medical fee is excessive. —

    Virginia Workers’ Compensation Commission did not err by refusing an employer’s request to consider whether a medical bill exceeded the medical provider’s regular rate or some amorphous “reasonable” rate, apart from the prevailing rate in the community for similar medical treatment. Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 722 S.E.2d 301, 2012 Va. App. LEXIS 59 (2012).

    Burden on employer to prove excessive fee. —

    Virginia Workers’ Compensation Commission’s award to a medical provider for a claimant’s surgery was proper, as it was reasonable for the Commission to consider a medical bill as prima facie evidence that the charges were consistent with requirements of the Virginia Workers’ Compensation Act and to place the burden on the employer to prove that the medical fee was excessive. Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 722 S.E.2d 301, 2012 Va. App. LEXIS 59 (2012).

    Fee not reasonable. —

    Virginia Workers’ Compensation Commission’s exercise of its authority and finding that a medical provider’s fees, which included a 40 percent surcharge because an employee was a workers’ compensation patient, were not reasonable and necessary under § 65.2-605 were proper since the provider did not show that the surcharge was reasonable in the employee’s case. Fredericksburg Orthopaedic Assocs. v. Fredericksburg Mach. & Steel, LLC, 62 Va. App. 83, 741 S.E.2d 813, 2013 Va. App. LEXIS 154 (2013).

    In a workers’ compensation case, an amount billed for a back surgery was not paid in its entirety because the employer’s evidence would have rebutted the provider’s billing presumption of reasonableness. It was up to the Virginia Workers’ Compensation Commission to determine the credibility of an insurance industry expert in medical reimbursement, who gave an opinion on the cost per day of such a surgery, the calculations made by the expert relied only upon what the facilities charged, and the Commission was allowed to consider surgery charges in other facilities as additional data. Surgcenter of Silver Spring, LLC v. Michael & Son Servs., 2017 Va. App. LEXIS 24 (Va. Ct. App. Jan. 31, 2017).

    The words “contested claim” in this section simply reflect the legislative requirement that the “dispute, contention, or litigation,” combine with other specified circumstances attending a “claim . . . held . . . compensable,” before attorney’s fees “shall [be] award[ed]” incidental to “benefits for medical services” arising from the claim which “inure to . . . a third party.” Pavlicek v. Jerabek, Inc., 21 Va. App. 50, 461 S.E.2d 424, 12 Va. Law Rep. 168, 1995 Va. App. LEXIS 680 (1995).

    Claim was contested. —

    Where confusion and delay attributable to employer needlessly complicated and protracted the proceedings, leaving claimant without benefits for months while counsel pursued clarification, discovery, and negotiation with employer, and the wage issue remained unresolved and required determination by the commission, under such circumstances, the claim was contested, as a matter of law, by a recalcitrant employer, necessitating the assistance of counsel to successfully obtain benefits both to claimant and the health care providers. Pavlicek v. Jerabek, Inc., 21 Va. App. 50, 461 S.E.2d 424, 12 Va. Law Rep. 168, 1995 Va. App. LEXIS 680 (1995).

    Claim was not contested. —

    In denying counsel’s prayer for attorney’s fees pursuant to subsection B, the commission determined that the underlying claim was not “contested” as contemplated by the statute. It is well established that actual findings by the commission that are supported by credible evidence are conclusive and binding upon this court on appeal. Pavlicek v. Jerabek, Inc., 21 Va. App. 50, 461 S.E.2d 424, 12 Va. Law Rep. 168, 1995 Va. App. LEXIS 680 (1995).

    This section requires attorney’s fees when benefits for medical services are awarded after a hearing on the claim or after abandonment of a defense, but the medical bills in this case were not approved as a result of dispute and litigation and were not before the commission on an initial disputed claim. Beard v. City of Danville Pub. Works, 1996 Va. App. LEXIS 308 (Va. Ct. App. Apr. 30, 1996).

    The control over attorneys’ fees exercised by the Commission promotes the objective of ensuring adequate relief to the claimant and his family. No similar concern exists with regard to employers and the fees they pay for legal services related to workers’ compensation claims. Hudock v. Virginia State Bar, 233 Va. 390 , 355 S.E.2d 601, 3 Va. Law Rep. 2511, 1987 Va. LEXIS 205 (1987).

    Authorizing the Commission to control fees recoverable by claimants’ counsel protects claimants from entering into an improvident fee agreement which might substantially reduce the eventual monetary benefits awarded. Hudock v. Virginia State Bar, 233 Va. 390 , 355 S.E.2d 601, 3 Va. Law Rep. 2511, 1987 Va. LEXIS 205 (1987).

    Attorney fees payment by provider only after reimbursement. —

    This section requires the payment by the health care provider of its pro rata share of an award of attorney’s fees only after the provider has received reimbursement from the employer or its insurer. Danville Radiologists, Inc. Raymond Perkins v. Perkins, 22 Va. App. 454, 470 S.E.2d 602, 1996 Va. App. LEXIS 378 (1996).

    Superior jurisdiction of commission over committees. —

    The exclusive jurisdiction granted to the commission by subsection A overrides the authority of the committees to make such determinations on referral from the commission. This superior jurisdiction is reconfirmed by the language of subsection B of § 65.2-1306. National Linen Service/National Serv. Indus., Inc. v. Parker, 21 Va. App. 8, 461 S.E.2d 404, 12 Va. Law Rep. 133, 1995 Va. App. LEXIS 671 (1995).

    Review of committee determination by commission. —

    When a review of a committee determination is sought, the commission is not exercising an appellate function over the proceedings of the committee. Rather, it is assuming its jurisdiction pursuant to this section to make a final determination of the fees to be awarded for claims payable under the act. That determination must be based on the record as a whole. While the determination of the committee should be given significant weight as informed opinion, it is neither binding on the commission nor the exclusive portion of the record to be considered. National Linen Service/National Serv. Indus., Inc. v. Parker, 21 Va. App. 8, 461 S.E.2d 404, 12 Va. Law Rep. 133, 1995 Va. App. LEXIS 671 (1995).

    When a review of a committee determination is sought, the party seeking the review merely asks the commission to assume its role as final arbiter of the propriety of treatment, services and fees. In that role, the commission may take any action that the statute permits. National Linen Service/National Serv. Indus., Inc. v. Parker, 21 Va. App. 8, 461 S.E.2d 404, 12 Va. Law Rep. 133, 1995 Va. App. LEXIS 671 (1995).

    Review of discretionary action of lower body by court. —

    A reviewing court, in considering the propriety of a discretionary action of a lower body, must not supplant its discretion for that rendered below. The discretionary act should only be reversed where there is clear evidence that the act was not judicially sound. Where the action of the commission was well reasoned and grounded in facts evidenced on the record, there is no abuse of discretion. National Linen Service/National Serv. Indus., Inc. v. Parker, 21 Va. App. 8, 461 S.E.2d 404, 12 Va. Law Rep. 133, 1995 Va. App. LEXIS 671 (1995).

    The question of party status to a health care provider in proceedings before the commission incidental to claims under this section is a matter for determination by the commission in the context of applicable statutes and rules of procedure. Pavlicek v. Jerabek, Inc., 21 Va. App. 50, 461 S.E.2d 424, 12 Va. Law Rep. 168, 1995 Va. App. LEXIS 680 (1995).

    Standard for attorneys’ fees that applies under the Workers’ Compensation Act is ascertainable. The standard is one of reasonableness in furtherance of the beneficent purposes of the Act. Hudock v. Virginia State Bar, 233 Va. 390 , 355 S.E.2d 601, 3 Va. Law Rep. 2511, 1987 Va. LEXIS 205 (1987).

    Reimbursement of carrier where claim later determined to be compensable. —

    This statute supposes a situation in which it is unclear that the injury qualifies for workers’ compensation, and the employee’s insurer pays for medical services. If the Commission decides later that the claim was compensable under the Workers’ Compensation Act, benefits could only “inure to the benefit of a third party insurance carrier or health care provider” if the worker had been found to be entitled to workers’ compensation and the carrier was entitled, because of a non-duplication provision in the policy, to be reimbursed. Hines v. Blue Cross Blue Shield, 788 F.2d 1016, 1986 U.S. App. LEXIS 24530 (4th Cir. 1986).

    Award of fees to claimants’ attorneys is proper. —

    The Commission’s practice of awarding fees to claimants’ attorneys is properly within its statutory and administrative responsibilities. Hudock v. Industrial Comm'n, 1 Va. App. 474, 340 S.E.2d 168, 1986 Va. App. LEXIS 226 (1986).

    And no fee in excess of that approved may be charged to claimant. —

    In a workers’ compensation case, no fee for legal services in excess of that approved by the Commission may be charged to a claimant. Hudock v. Industrial Comm'n, 1 Va. App. 474, 340 S.E.2d 168, 1986 Va. App. LEXIS 226 (1986).

    Nonregulation of fees of employers’ attorneys is not constitutionally infirm. —

    Although this section provides that fees of attorneys employed by claimants, employers or insurance carriers shall be subject to approval and award of the Commission, in practice, the Commission does not undertake to regulate fees of the employer’s counsel. A rational basis exists for such distinction and the Commission’s practice is not constitutionally infirm. Hudock v. Industrial Comm'n, 1 Va. App. 474, 340 S.E.2d 168, 1986 Va. App. LEXIS 226 (1986).

    Even though this section expressly makes all attorneys’ fees in compensation cases subject to Commission control, the commission’s practice of exercising control only over the attorneys’ fees charged to claimants does not violate the Equal Protection Clause of the United States Constitution. Hudock v. Virginia State Bar, 233 Va. 390 , 355 S.E.2d 601, 3 Va. Law Rep. 2511, 1987 Va. LEXIS 205 (1987).

    Effect of agreement between employer and physician or hospital. —

    The fact that the employer or insurer may have agreed to pay a physician or hospital for services to be rendered an injured employee to which the employee is not entitled under and by virtue of the Act, may give the physician or hospital a cause of action at common law against the employer or insurer, as the case may be. But it gives the physician or hospital no rights by virtue of the Act; and the Commission has jurisdiction to give only such relief as may be given by virtue of the Act. It has no jurisdiction to enforce rights existing at law but not by virtue of the Act. Merrimac Anthracite Coal Corp. v. Showalter, 158 Va. 227 , 163 S.E. 73 , 1932 Va. LEXIS 250 (1932).

    Support for limitation of award. —

    Given the absence of significant dispute among the parties, the absence of any appreciable benefit to claimant or his beneficiaries resulting from attorney’s services, and the substantial time expended by attorney on nonlegal matters, there was support for limiting the award of attorney’s fees to $500, instead of the requested $12,000. Flores v. Tito Contractors, No. 0029-95-4 (Ct. of Appeals May 30, 1995).

    Award of fees upheld. —

    Workers’ Compensation Commission properly awarded a medical provider its unpaid medical fees and attorney fees because the Commission applied the appropriate legal standard, the record did not contain any evidence showing that it was unreasonable as a matter of law for the Commission to consider the medical bills at issue as prima facie evidence of the prevailing community rate, the employer failed to rebut that prima facie evidence by presenting evidence of the amounts the specific medical provider involved in the case normally received for the same procedures, no evidence compelled the contrary conclusion that the charges were excessive, and the way in which the employer attempted to rebut the prima facie evidence was unreasonable. Va. Int'l Terminals, LLC v. Neurosurgical Specialists, Inc., 2021 Va. App. LEXIS 53 (Va. Ct. App. Apr. 6, 2021).

    Award of attorney fees upheld. —

    An award of $1,250 to claimant’s former attorney was proper where the voluminous record showed that the attorney addressed multiple issues and represented claimant in a lengthy hearing. Elliott v. Neighbors, 1998 Va. App. LEXIS 286 (Va. Ct. App. May 12, 1998).

    Award of attorney fees denied. —

    Workers’ Compensation Commission properly denied an attorney fee request because the Commission did not err in interpreting the Commission Rule’s “reasonable notice” requirement to contain a temporal component, and the attorney failed to comply with it. Marks v. John Randolph Med. Center/HCA, 2021 Va. App. LEXIS 123 (Va. Ct. App. July 20, 2021).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Note: For cases relating to assessment of attorney’s fees against the employer, see § 65.2-713 .

    General:

    Claimant had standing to pursue the balances of medical bills where the providers whose bills were at issue were not parties to the proceeding and had not pursued payment of the balances. The bills were prima facie evidence of the prevailing community rate when introduced by the claimant independently of the medical provider. Hansen v. TMA Trucking, JCN VA00001001203 (May 28, 2019).

    Health care provider not entitled to direct payments from insurer while claimant’s benefits offset due to a 3rd party settlement. Johnson v. Tidewater Community College, JCN 1991617 (March 30, 2019).

    2012 amendment to 65.2-714 (A) created a new right and does not apply retroactively. Faulkner v. Inova Fairfax Hospital, JCN VA00000495662 (Nov. 2, 2015).

    The Commission has jurisdiction over physician assistant fee disputes. Williams v. Oberthur Technologies of America Corp Appliance, Inc., JCN 2105473 (Nov. 1, 2013).

    The Commission has both subject matter jurisdiction and authority to decide medical providers’ fee disputes although the claimant did not file a claim regarding those fees. Williams v. Oberthur Technologies of America Corp Appliance, Inc., JCN 2105473 (Nov. 1, 2013).

    The Commission is not the proper forum in which to consider medical provider compliance with Board of Medicine regulations. Williams v. Oberthur Technologies of America Corp Appliance, Inc., JCN 2105473 (Nov. 1, 2013).

    Where a carrier pays a medical bill and it is later found that the payment exceeded the prevailing community rate, pursuant to Rule 14, the carrier is entitled to repayment or a credit for the overpayment. Bush v. Sure Kick Battery Co., VWC File No. 156-69-22 (March 5, 2008).

    The Commission has statutory authority to approve the fees of attorneys, whether employed by employer, employee or insurance carrier, although the Commission has consistently applied this provision only against attorneys representing claimants. Moore v. Security Storage Co., 76 O.W.C. 163 (1997).

    A contract between a hospital and an employee for medical services covered under the Act is not a contract which the hospital may enforce against an employee once a claim is found to be compensable. Financial responsibility for hospital services is an obligation of the employer to the hospital. Sines v. Better Homes Realty, 66 O.I.C. 158 (1987) (affirmed by Court of Appeals in unpublished memorandum of March 14, 1989).

    The Commission has the authority to set aside a final award on the grounds of fraud or mutual mistake. When an award is vacated ab initio claimant’s counsel must return to the employer any attorney fee awarded under § 65.1-102 (now § 65.2-714 ) but may collect a fee directly from the client. Gendeloff v. J. & D. Marketing Corporation, 68 O.I.C. 247 (1989).

    Attorney Conflicts of Interest:

    Since medical provider was asserting a claim against payments due claimant via a third party order, claimant’s counsel could not also represent medical provider, even after obtaining written consent from both parties. Farr. v. Lincoln Property Co., JCN VA02000002128 (Jan. 9, 2015).

    Attorney’s Fees:

    The Commission will not approve reimbursement of counsel’s overhead expenses, such as routine postage and photocopying, as it unfairly shifts those costs to the claimant. Smith v. Haverty Furniture Company, Inc., VWC File No. 233-15-93 (July 9, 2009).

    A majority found that it was appropriate in a compromise settlement to award an attorney fee of 15% for that portion that reflected the permanent partial disability and 20% for the remaining part of the settlement. Hilton v. Newport News Shipbuilding and Dry Dock Company, VWC File No. 222-46-43 (Jan. 29, 2007).

    The Commission determined that 10% of the negotiated lien waiver was an appropriate attorney fee in a third party settlement. While the Commission has adopted benchmarks to serve as guidelines for awarding attorney fees such as 20% in compromise settlements, 15% in settlements that resolve permanent partial disability entitlement, and 15% for cases involving permanent partial disability, these amounts are only guides and do not negate the duty to evaluate each case individually and where the fee would be out of proportion to the time, effort, and responsibility of the legal representation to award a lesser fee. Correia v. Stafford County School Board, VWC File No. 215-12-05 (June 5, 2007).

    Where the carrier mistakenly failed to withhold an attorney’s fee previously awarded by the Commission, it was not equitable for the claimant to retain the overpayment and the attorney was entitled to a lump sum rather than payment over time. The carrier was ordered to pay the $1000 fee to the attorney and deduct $50 per week from ongoing payments to the claimant. Robinson v. Union Drill, Inc., VWC File No. 207-70-24 (Dec. 16, 2006).

    Where a dispute arises between an attorney who represented a claimant before the Commission and the law firm with which that lawyer was previously associated during a portion of the representation, the Commission will award the attorney’s fee jointly to the attorneys claiming an interest in them, to be allocated pursuant to the agreement of those attorneys or as determined by a court of competent jurisdiction. Mosby v. Washington Metro. Area Transit Authority, VWC File No. 216-74-28 (June 16, 2004).

    Where a claimant is paid full salary during periods of disability and there was no accrued compensation award attorney’s fees to be paid directly by the claimant. Swanigan v. City of Alexandria School Bd., VWC File No. 213-91-40 (June 15, 2004).

    In determining attorney’s fees the Commission does not use a fee schedule but considers the time spent by the attorney, the necessity of appearance at a hearing or deposition, the ability and skill as reflected by the results of the attorney’s efforts and the actual results which inured to the benefit of the party against whom an attorney’s fee is assessed. Williams v. Philip Morris, Inc., 69 O.I.C. 207 (1990).

    In determining a reasonable attorney’s fee, the Commission does not use a fee schedule or a percentage factor but rather considers the time consumed, the efforts expended, the nature of the services and the results. Marcus v. Foley, 64 O.I.C. 224 (1985).

    As a guideline for administratively awarding attorney’s fees for representation involving awards for permanent partial disability, the Commission has adopted a fee of fifteen percent of the award as being reasonable. This is only a guideline, and the Commission reserves its right to exercise its discretion and award an attorney’s fee that varies from the fifteen percent guideline when circumstances warrant. Down v. Jim Price Chevrolet, 77 O.W.C. 91 (1998).

    The Commission has agreed that a twenty percent attorney fee is an appropriate benchmark attorney fee in matters which are resolved by compromise settlement. King v. Boggs & Sloce Municipal Services, 77 O.W.C. 160 (1998).

    Attorney’s fee fixed by taking into consideration cost of medical attention rendered claimant. McAlpine v. Bristow Improvement & Floors, Inc., 54 O.I.C. 235 (1972).

    Attorney’s inexperience with Virginia Workmen’s Compensation Act is not a valid reason for increase in his fee. Green v. Martin & Gass, Inc., 60 O.I.C. 175 (1981).

    While a contingency fee is not prohibited by law in workers’ compensation cases, it must be approved by the Commission. Dillon v. Holiday Inn, 64 O.I.C. 113 (1985).

    If employee and his attorney carry out an agreement pursuant to which the attorney receives a fee greater than that allowed by the Commission, the former may repudiate the agreement and have the Commission order reimbursement. Saylor v. Old Dominion Veneer Co., 13 O.I.C. 277 (1931).

    The Commission is not bound by contingency fee arrangements and does not take into account any potential award of attorney’s fees under the Longshoremen and Harbor Workers’ Act. Blackburn v. Newport News Shipbuilding & Dry Dock Company, 67 O.I.C. 251 (1988).

    Where claimant employed several attorneys, fee will be awarded to each, to be deducted from compensation. Ashby v. Richmond Community Action Program, Inc., 52 O.I.C. 14 (1970).

    There is no statutory authority or jurisdiction for the Commission to resolve what is essentially a civil dispute between two counsel for the claimant as to a division of fee. Moore v. Security Storage Co., 76 O.W.C. 163 (1997).

    An attorney’s fee agreed to and provided for in a Petition and Order may be reduced by the Commission to comport with the actual work required to reach a compromise settlement in an uncontested compensation case. The change in the attorney’s fee does not reduce the carrier’s liability under the Petition and Order but only increases the proportion of the proceeds that the claimant will directly receive. Smith v. Catron Companies, 68 O.I.C. 245 (1989).

    Attorney Fees From Health Care Providers:

    Note: In addition to the requirements of this section any attorney requesting a fee from a health care provider must comply with Rule 6 (Previously Rule 18).

    25% attorney fee awarded to claimant’s counsel where there was an initial denial of surgery that defendants later abandoned held reasonable. Tucker v. Care Tree Services, LLC, JCN VA00000989639 (Jan. 9, 2020).

    Sum previously paid by Medicare to medical provider was entirely independent of counsel’s efforts or the outcome of the workers’ compensation case and not subject to counsel’s fee under Va. Code § 65.2-714 (B). Rush v. Pennell’s Logging, JCN VA02000016690 (Aug. 24, 2017).

    33% attorney fee awarded to claimant’s counsel from the health care provider was not an abuse of discretion. Aleman v. J. R. Roofing LLC, JCN VA02000014089 (Sept. 4, 2015).

    Attorney fees under this section are due through the date of the hearing before the Deputy Commissioner rather than through the date of a final administrative hearing. Huntt v. Absolute Security Incorporated, VWC File No. 218-21-04 (March 12, 2008).

    Payment by the health care provider of its pro rata share of an award for attorney’s fees can be required only after the provider has received reimbursement from the employer or its insurer. Danville Radiologists, Inc. Raymond Perkins v. Perkins, 22 Va. App. 454, 470 S.E.2d 602, 1996 Va. App. LEXIS 378 (1996).

    Code § 65.2-714 (B) gives an interest in the payment of certain medical bills to a claimant’s attorney since an attorney’s fee may potentially be awarded out of medical bills. Danville Radiologists, Inc. v. Perkins held that fees are not awardable under § 65.2-714 until the medical bills are paid. Thus, the attorney has an interest in having medical bills covered by Code § 65.2-714(B) paid, so that a fee can ultimately be awarded. Brown v. Howmet Corporation, 76 O.W.C. 342 (1997).

    Acceptance by a health care provider of payments made for treatment pursuant to the Workers’ Compensation Act constitutes acceptance of the jurisdiction of the Workers’ Compensation Commission and the Act. Doss v. The ARA Group, Inc., 75 O.W.C. 79 (1996).

    Code § 65.2-714 does not require that the health care provider agree to be represented by the employee’s counsel, and a fee shall be assessed against the health care provider for the attorney’s successful representation of the employee, to the extent that benefits inure to the health care provider. Doss v. The ARA Group, Inc., 75 O.W.C. 79 (1996).

    An award of attorney’s fees under § 65.2-714 (B) may result from a separate procedure or from the initial hearing to determine compensability of the case. Gamble v. PA Coal Company, Inc., 71 O.W.C. 299 (1992) (see also Blackburn v. Adrian Clevinger, VWC # 143-34-32 decided June 12, 1992.).

    In the absence of compliance with Rule 18 (now Rule 6), attorney’s fees may not be charged to medical providers. Begley v. Shaw d/b/a Virginia Chargers Football Club, 64 O.I.C. 39 (1985).

    An attorney who seeks a fee for services from a health care provider must within a reasonable time after entry of a final award or order providing for medical benefits, give notice to the health care provider that he will seek an award for fees for legal services. The notice must state the time and place of hearing on the motion before the Commission, the amount of payment or reimbursement upon which the fee is based, the manner of service and refer to the Commission’s award or order upon which the motion is based. Sines v. Better Homes Realty Inc., 66 O.I.C. 162 (1987).

    An attorney’s request for fees under § 65.2-714 (B) was denied because the case was not “contested”. While there may have been a delay in investigating and providing a Memorandum of Agreement, the case was never denied and any subsequent disagreement involving reasonableness of health care charges did not affect the employee. Gamble v. PA Coal Company, 71 O.W.C. 299 (1992).

    The argument that no benefits inure to the health care provider because payment for medical treatment might have been obtained directly from the employee or her health insurance carrier if not paid by the workers’ compensation insurer is speculative, and also irrelevant. Doss v. The ARA Group, Inc., 75 O.W.C. 79 (1996).

    Where Blue Cross-Blue Shield would have paid a significant part of a medical bill regardless of the outcome of the workers’ compensation case, the assessment of an attorney’s fees against the health care provider is limited only to that portion of the payment which was procured by counsel’s efforts. Williams v. Philip Morris, Inc., 69 O.I.C. 207 (1990).

    Counsel for the employee is entitled to an award of attorney’s fees from the hospital even though Blue Cross/Blue Shield would have paid the bill if compensability were denied. Shelton v. PA Coal Company, 71 O.W.C. 296 (1992).

    An insurance company merely acting as a servicing agency with no funds of its own at risk is not a “third party insurance carrier” contemplated by the Act and is not liable for payment of an attorney’s fee. Eveland v. Commonwealth of Virginia/Department of Transportation, 74 O.W.C. 189 (1995).

    An emergency medical service company providing paramedic and emergency medical technician assistance is not a “health care provider” for purposes of Code § 65.2-714 . Virginia Code § 8.01-581.1 defines a number of specific types of entities and employments that qualify as “health care providers.” The statute also provides that a “health care provider” includes “any other entity . . . which employs or engages a licensed health care provider and which renders health care services.” While the emergency medical service company employed certified paramedics and technicians, the Commission found that it was not a “health care provider” under the statute. The statute is clear and unambiguous, requiring medical personnel with licensure, and not mere certification. Counsel’s request for an attorney’s fee was denied. Harris v. Baxter Healthcare Corporation, VWC File No. 199-40-55 (December 16, 2002).

    Medical Fees/Filing Reports:

    The entry of an order concerning injured employee’s settlement of unadjudicated claim is not the equivalent of a viable award of medical benefits and medical provider’s claim for payment filed after approval of settlement is denied. Riddick v. Newport News Shipbuilding and Dry Dock Co., JCN 2307754 (Feb. 8, 2016).

    An employer, insurer, claimant, and health care provider each have standing to have their responsibility for medical charges related to an injury considered by the Commission. Brown v. Howmet Corporation, 76 O.W.C. 342 (1997).

    The proper forum for the adjudication of disputes over medical expenses in workers’ compensation claims is the Commission. Addison v. Evie Coal Company, 61 O.I.C. 3 (1982).

    Medical bills received by the claimant are prima facie evidence that they are both reasonable and necessary. Blevins v. Williamsburg Pottery, 75 O.W.C. 103 (1996).

    While this section does not specify a definite time for the filing of physicians’ reports required under the Act, they must be filed within a reasonable time. If the physician is in default in this regard, the Commission cannot enter an award directing payment of his bill. Vaughan v. Friend Sand & Gravel Co., Inc., 47 O.I.C. 349 (1965); Gardner v. Stallard-Womack Mining Corp., 47 O.I.C. 135 (1965).

    Physician’s failure to promptly file medical reports discharges defendants from liability for the cost of his treatment. Rich v. Hammond Masonry Corporation, 61 O.I.C. 338 (1982).

    When a physician fails to provide a medical report to an employer/insurer within a reasonable time they are released from responsibility to pay the doctor’s charges and may seek a change in physicians to continue the claimant’s treatment. Parks v. Systems Engineering Associates Corporation, 66 O.I.C. 104 (1987).

    Charges paid to physician by employee must be reimbursed by employer even though the out-of-state physician will not file reports. Evans v. Edwin F. Thompson, Inc., 56 O.I.C. 106 (1975).

    There is no provision in the Compensation Act for the employer or its insurance carrier to claim a credit for the value of services contributed by claimant without pay. Nelson v. Roanoke Iron & Bridge Works, 60 O.I.C. 324 (1981).

    The Commission denied a physician’s demand for fees related to medical “case management.” The physician demanded a fee for telephone communications he had with defense counsel and the insurer’s representatives. In denying the claim, the Commission noted that approved physicians are entitled to reasonable reimbursement for services that provide the claimant with necessary care. An approved physician may be entitled to a reasonable fee for the preparation of any special reports required by the parties, and the costs associated with the time the physician may have to spend offering testimony, whether at a hearing or by deposition. However, the physician may not necessarily be reimbursed for all the time spent related to the employee’s treatment. By statute, certain types of reports must be provided by the physician, the preparation of which constitutes medical “case management.” The costs associated with preparing these reports are subsumed within the totality of the fee paid to the physician and the medical care he is expected to provide. Fox v. Waffle House, VWC File No. 194-57-70 (April 30, 2001).

    § 65.2-715. Providing written information.

    Whenever, in the course of proceedings in connection with awards, the Workers’ Compensation Commission issues any written notice, opinion, order or award regarding a specific case, the Commission shall provide copies to the employee, the employer and the compensation carrier, and, if represented, their counsel, at the same time. The requirements of this section may be satisfied via electronic communications in the manner prescribed by the Commission.

    History. 1998, c. 143; 2010, cc. 159, 274.

    The 2010 amendments.

    The 2010 amendments by cc. 159 and 274 are identical, and added the last sentence.

    Law Review.

    For an article relating to the most significant developments in the law of workers’ compensation since September 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    Chapter 8. Insurance and Self-Insurance.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 3, 10, 53.

    § 65.2-800. Duty to insure payment of compensation; effect of insurance.

    1. Every employer subject to the compensation provisions of this title shall insure the payment of compensation to his employees in the manner hereinafter provided.  While such insurance remains in force he or those conducting his business shall only be liable to an employee for personal injury or death by accident to the extent and in the manner herein specified.
    2. To ensure that all employers who are required to have workers’ compensation insurance under this title have notice of such requirement, the appropriate official of a county, city, or town who licenses employers to conduct business under Chapter 37 (§ 58.1-3700 et seq.) of Title 58.1 or the State Corporation Commission who charters employers to conduct business under § 12.1-12 shall provide employers requesting such licenses or charters on and after January 1, 1989, with information concerning statutory requirements for such insurance coverage.  The Workers’ Compensation Commission shall prepare such information and distribute it to such licensing or chartering officials. The failure of the local official or the State Corporation Commission to give such notice to an employer shall not relieve the employer of the duty of acquiring insurance as required by this title.
    3. As used in this section, the words “those conducting his business” shall include any person whose act results in an injury or death compensable under this title and arises out of and in the course of employment by an employer who is or may be liable for the payment of compensation.  A person other than an employer or statutory employer, or a person employed by either, whose acts result in such injury or death shall be deemed an “other party” within the meaning of § 65.2-309 .

    History. Code 1950, § 65-99; 1968, c. 660, § 65.1-103; 1977, c. 113; 1988, c. 543; 1991, c. 355.

    Cross references.

    As to workers’ compensation requirements for construction contractors and subcontractors on state contracts, see § 2.2-4332 .

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1970-1971, see 57 Va. L. Rev. 1520 (1971).

    For survey of Virginia law on practice and pleading for the year 1971-1972, see 58 Va. L. Rev. 1309 (1972).

    For survey of Virginia law on governmental services and social welfare for the year 1976-77, see 63 Va. L. Rev. 1440 (1977).

    For Essay, “Analyzing the Virginia Workers’ Compensation Act’s Governance of Employer Non-Compliance,” see 51 U. Rich. L. Rev. 193 (2016).

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-103 or prior law.

    Insurance is mandatory. —

    It is mandatory upon every employer subject to the compensation provisions of the Act to insure the payment of compensation to his employees. McCann v. Newport News Shipbuilding & Dry Dock Co., 177 F. Supp. 909, 1959 U.S. Dist. LEXIS 2739 (D. Va. 1959).

    Exclusive remedy. —

    Where the accident sustained by plaintiff arose out of and in the course of his employment, and it allegedly was caused by the negligence of a fellow employee who at the time was acting within the course of his employment, plaintiff’s rights and remedies were exclusively those provided under the Virginia Workmen’s (now Workers’) Compensation Act. Brown v. Reed, 209 Va. 562 , 165 S.E.2d 394, 1969 Va. LEXIS 143 (1969).

    An employer is immune from suit at common law by employees engaged in work which is part of his trade, business or occupation, in accordance with this section and former § 65.1-40 (now § 65.2-307 ). Turnage v. Northern Va. Steel Corp., 336 F.2d 837, 1964 U.S. App. LEXIS 4303 (4th Cir. 1964).

    The effect of former § 65.1-30 (now § 65.2-302 ) is to render the general contractor a statutory employer of all employees engaged in the work. If the general contractor is deemed a statutory employer, he is treated as an employer within the meaning of former § 65.1-40 (now § 65.2-307 ) and this section, and is therefore immune from a common-law action brought by an injured workman. Slusher v. Paramount Warrior, Inc., 336 F. Supp. 1381, 1971 U.S. Dist. LEXIS 10776 (W.D. Va. 1971).

    The “dual capacity” doctrine, under which an employee eligible to receive worker’s compensation benefits is also allowed to sue an employer in tort when the injury is caused by a defective product designed or manufactured by the employer, is inconsistent with the Workers’ Compensation Act. Kast v. PPG Indus., Inc., 664 F. Supp. 237, 1987 U.S. Dist. LEXIS 6438 (W.D. Va. 1987).

    The treatment of compensatory injuries is not a part of the employer’s business. Hence, the attending physician or surgeon does not fall within the category of “those conducting his [the employer’s] business.” Fauver v. Bell, 192 Va. 518 , 65 S.E.2d 575, 1951 Va. LEXIS 199 (1951).

    Negligence action against one who is a stranger to employer’s normal work. —

    The language in former § 65.1-41 (now § 65.2-309 ) and this section has been uniformly interpreted to allow a common-law negligence action for injuries against an “other party,” that, although performing work or providing services for the employer, is a “stranger” to the employer’s normal work. Farish v. Courion Indus., Inc., 722 F.2d 74, 1983 U.S. App. LEXIS 14855 (4th Cir. 1983).

    Merely being in a parking lot utilized by employees is not enough to impose coverage of the Virginia Workers’ Compensation Act. Painter v. Simmons, 238 Va. 196 , 380 S.E.2d 663, 5 Va. Law Rep. 2915, 1989 Va. LEXIS 96 (1989).

    Where the accident occurred at a place and time where employer expected both employees to be for employment purposes, a route of egress and ingress to and between the employer’s facilities and the employee who injured the other employee in an auto accident, clearly was using the lane for no purpose other than to commence his work for the day as anticipated by his employer, therefore the acts which gave rise to employee’s injury “arose out of” and “in the course of” his employment. Painter v. Simmons, 238 Va. 196 , 380 S.E.2d 663, 5 Va. Law Rep. 2915, 1989 Va. LEXIS 96 (1989).

    Statutory employer found. —

    Lawn care provider was not a statutory employer under subsection A of § 65.2-302 because a business owner who had subcontracted all of his lawn care business to the provider and used the provider’s employees retained control of daily operations and oversaw the work to be done at the time of claimant’s accident. The business owner was claimant’s statutory employer and had to comply with its obligation to provide coverage under the Workers’ Compensation Act. Turf Care, Inc. v. Henson, 51 Va. App. 318, 657 S.E.2d 787, 2008 Va. App. LEXIS 104 (2008).

    “Employee” found. —

    Where defendant was hired by employer to locate an ironer, supervise its disassembly, and monitor its installation at company, and where part of company’s trade or business in running its commercial laundry facility was purchasing, installing, operating and maintaining laundry equipment, the court concluded that defendant was a statutory employee and not an other party under the act. Buettner v. Super Laundry Mach., 857 F. Supp. 471, 1994 U.S. Dist. LEXIS 14469 (E.D. Va. 1994), aff'd sub nom. Buettner v. R. W. Martin & Sons, 47 F.3d 116, 1995 U.S. App. LEXIS 2801 (4th Cir. 1995). But see Reibold v. Simon Aerials, Inc., 859 F. Supp. 193, 1994 U.S. Dist. LEXIS 10615 (E.D. Va. 1994).

    Civil penalty properly assessed. —

    Virginia Workers’ Compensation Commission properly assessed a civil penalty on a cab company as: (1) the cab company employed four to six employees, and did not have workers’ compensation insurance due to a dispute with its insurer, (2) § 65.2-800 required every employer subject to the Virginia Workers’ Compensation Act, § 65.2-100 et seq., to have workers’ compensation insurance, (3) subsection A of § 65.2-804 instructed employers to provide proof of that insurance to the Commission annually, or as often as might be necessary, (4) § 65.2-805 stated that employers who failed to comply with §§ 65.2-800 or 65.2-804 were to be assessed a civil penalty, and (5) neither the case law nor the Act included an exception to the insurance requirement based upon a dispute with an insurer. N. End Cab Co. v. Va. Workers' Comp. Comm'n, 2007 Va. App. LEXIS 110 (Va. Ct. App. Mar. 20, 2007).

    Virginia Workers’ Compensation Commission did not abuse its discretion in imposing a $25,000 fine against an employer for the employer’s failure to maintain workers’ compensation insurance coverage, as statutorily required, because the fine imposed by the Commission was below the statutory maximum and the deputy commissioner did not find credible the employer’s testimony that the employer did not believe that the employer was required to have coverage. Am. Transp. v. Mailloux, 2018 Va. App. LEXIS 267 (Va. Ct. App. Oct. 9, 2018).

    CIRCUIT COURT OPINIONS

    Negligence action against one who is a stranger to employer’s normal work. —

    Business’s plea in bar asserting that an injured contractor was its statutory employee at the time of his injury, and thus, he was limited to a claim for workers’ compensation benefits in his personal injury action, was overruled because the work being performed by his direct employer, installing and repairing fire detection and sprinkler systems, was not part of the normal trade, business, or occupation of the business, which primarily involved meat processing; moreover, any plumbing work on the waterlines performed by the business’s 50 to 60 person maintenance team was a de minimis part of the business’s 500-contractor work force. Fose v. Gwaltney of Smithfield, Ltd., 67 Va. Cir. 347, 2005 Va. Cir. LEXIS 47 (Portsmouth May 12, 2005).

    Accident victim’s claim against a contracting elevator company that maintained city elevators was barred by the exclusive remedy provision, § 65.2-307 , of the Virginia Workers’ Compensation Act, § 65.2-100 et seq., as (1) the victim was a statutory employee of the city; (2) the mandate of the city included the improvement, repair, and maintenance of public buildings; (3) the work delegated by the city to the elevator contracting company, and performed by its employees, was part of the trade, business, or occupation of the city; and (4) the elevator contracting company was not an “other party” against whom the victim could maintain a suit in tort, under § 65.2-309 . Brooks v. Blueridge Gen., Inc., 67 Va. Cir. 274, 2005 Va. Cir. LEXIS 46 (Portsmouth May 9, 2005).

    Employer was not an elevator company’s statutory employer. —

    Plea in bar by an elevator company, which contracted with an employer to maintain and repair the elevators at a building that the employer managed, on the basis of the exclusive remedy provision of § 65.2-307 was denied because the employer, which paid workers’ compensation benefits to its employee who was injured when an elevator at the building malfunctioned, was not the elevator company’s statutory employer under § 65.2-302 . While the maintenance of the elevators in the building was clearly an indispensable activity of the businesses of both the employer and the owners of the building, the evidence was insufficient to persuade the court that elevator maintenance and repair was an activity that was normally carried on by employees of either the employer or the building owner. Guardian Realty Mgmt., Inc. v. Otis Elevator Co., 2006 Va. Cir. LEXIS 40 (Fairfax County Jan. 5, 2006).

    Other party. —

    Holding company was not the decedent’s statutory employer because it manufactured and sold tissue paper, and converting a copy paper plant into a tissue paper plant was an essential preliminary step to allow the holding company to manufacture and sell tissue paper, but the business of the decedent’s employer was manufacturing, not converting plants; thus, the holding company was an “other party,” and the exclusivity provision did not apply in the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Whether employees from two separate contractors or subcontractors can sue each other depends on whether they have a common statutory employer; to avoid being an “other party,” you need to be the employee’s actual employer, statutory employer, or a person employed by either the decedent’s actual employer or statutory employer. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    Because contractors did not have an employer in common with the decedent, they were not statutory co-employees, and none of the self-described statutory co-employees were employed by the decedent’s actual employer; thus, the contractors were “other parties,” and the exclusivity provision of the Virginia Workers’ Compensation Act did not apply to the estate’s wrongful death action. Standish Alexander v. St Tissue, LLC, 94 Va. Cir. 426, 2016 Va. Cir. LEXIS 192 (Richmond Oct. 25, 2016).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Notice:

    Pre-Hearing Statement referenced in the Notice of Hearing properly apprised defendants of additional claims being made; those additional claims may be considered at hearing. Dewey v. Cowan Distribution Services, JCN VA00000907306 (Oct. 16, 2018).

    At the hearing, the claimant was permitted to amend his claims to include an additional period of disability over the defendants’ objection because the defendants had sufficient evidence of the additional dates, and included the date the claimant was taken out of work in their medical evidence. The additional period of disability was brief and the defendants were not denied the opportunity to confront and cross-examine the evidence of disability. Saville, Jr. v. Spichers Appliance, Inc., JCN VA00000657794 (Sept. 30, 2013).

    Commission did not violate employer’s due process rights by failing to send hearing notice to its third party administrator where the Commission notified both employer and insurer of scheduled hearing. Hayes v. Cadmus Specialty Publication, VWC File No. 215-94-05 (June 29, 2004).

    Counsel for employee and employee’s own representations that neither received notice of hearing accepted; dismissal for failure to appear at hearing vacated and new hearing ordered. Lewis v. D.A. Foster Co., VWC File No. 191-21-58 (Dec. 30, 2003).

    Attorney fee assessment appropriate when employer and insurer received notice of hearing but did not appear at hearing, and offered no argument how award entered after hearing was improper or unsupported by evidence; separate notice not required to be sent to claims adjuster. Simons v. Federal Painting, Inc., VWC File No. 210-75-01 (June 20, 2003).

    Deputy Commissioner’s fee assessment inappropriate although insurer failed to appear at hearing; insurer did not issue coverage for employer when notice of hearing received, and notice indicated employer not insured; insurer not notified it did provide coverage until day before hearing; notice sufficient to conduct hearing, but not to assess fees. Broughton v. Craven Hall Adult Home, Inc., VWC File No. 206-25-45 (Apr. 18, 2003).

    An elementary and fundamental requirement of due process, in any proceeding that is to be accorded finality, is notice reasonably calculated under all the circumstances to apprise interested parties of the action and afford them an opportunity to present their objections. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Due process requires that an individual be granted an opportunity for a hearing appropriate to the nature of his case before he is deprived of any significant property interest. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Where the employer was not given notice that a change in the treating physician was an issue to be decided by the Deputy Commissioner, that issue was not properly before the Commission at the evidentiary hearing and the finding on that question must be Vacated. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Fees for medical services arising out of compensable injuries are subject to the jurisdiction of the Virginia Worker’s Compensation Commission. Here, the health care provider availed himself of the Commission’s jurisdiction and initiated the proceeding that contested medical expenses. Although the health care provider did not affirmatively file a pleading to join in the proceeding, he was designated a party and was sent copies of correspondence and the final Opinion, and had notice of his right to appeal. The fact that the health care provider elected not to participate in the on-the-record proceeding is not sufficient to prevent him from being bound by the final Opinion. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    The Commission found that there was a compensable accident, and that the claimant’s medical treatment was related to the accident. The claim of the health care provider to recover the cost of its services was denied, because the treatment was not reasonable and necessary. Since the health care provider availed himself of the Commission’s jurisdiction and is bound by that decision denying a recovery, he no longer has a cause of action for the subject charges against either the claimant or the employer/insurer. Selman v. McGuire Group Services, Inc., 77 O.W.C. 18 (1998).

    Law of the Case, Res Judicata:

    Claim to add shoulder injury barred by res judicata where prior stipulations omitted that injury and agreed that the Order entering the stipulations alleviated the need for a hearing. Hall v. First Care Health Services, Inc., JCN VA00001015991 (Oct. 20, 2017).

    The doctrine of res judicata proceeds upon the principle that one person shall not the second time litigate precisely the same question, particular controversy, or issue, which has been necessarily tried and finally determined, upon the merits, by a court of competent jurisdiction, in a judgement in personam in a former suit. The Commission held that res judicata was not applicable to a jurisdictional challenge of whether the claimant was an employee under the Act, where that question had never been litigated, where the employer had simply signed a Memorandum of Agreement, relying on the claimant’s representations that she was legally eligible to work. Quezada v. P M M C Associates, Inc., 79 O.W.C. 46 (2000).

    The “law of the case” doctrine provides that, where there have been two appeals in the same case, between the same parties, and the facts are the same, nothing decided on the first appeal can be reexamined on a second appeal. Right or wrong, it is binding on the trial court and the appellate court, and is not subject to reexamination by either. The rule also applies where the question raised on the second appeal was necessarily involved in the first appeal, whether actually adjudicated or not. Under the doctrine of the law of the case, the issue previously decided must be the basis for the tribunal’s decision. Dictum or closely related statements made about portions of the case not under consideration are not within the rule. Only a particular point urged and considered by the tribunal falls within the doctrine of the law of the case. Hayes v. 4 E Corporation, 78 O.W.C. 147 (1999).

    The claimant suffered compensable injuries on November 5, 1983. The carrier subsequently informed the Commission that the 500 weeks of total benefits expired on June 10, 1993, and that the last payment had been made. On June 1, 1994, the claimant filed an application alleging a change in condition and seeking permanent total disability benefits. In its September 13, 1996 Opinion denying the claim, the Commission reported that the claimant last received benefits under an award on December 13, 1993. The claimant appealed to the Court of Appeals, which affirmed. On November 5, 1996, the claimant filed another application for permanent total disability benefits. The claimant argued that the earlier Opinions reporting that benefits were paid through 1994 was binding in future proceedings in this case, under the theory that these findings were now the “law of the case.” The Commission disagreed, holding that the earlier “findings” were not a conclusion of law or a finding of f act to which the doctrine of the law of the case applies, because the earlier decision did not turn on when payments were last made, and the erroneous statement played no role in the decision denying the 1994 claim, which was based solely on the finding that the claimant failed to prove he was unable to use his right hand and leg to any substantial degree in gainful employment. Hayes v. 4 E Corporation, 78 O.W.C. 147 (1999).

    Pre-Hearing Issues:

    The purpose of a pre-trial hearing is to determine whether the Commission has jurisdiction. Harris v. Va. Elec. & Power Co., 54 O.I.C. 165 (1972).

    Where the employer establishes by clear and convincing evidence that the claimant was not legally eligible to work in the United States at the time of her hire and accident, that the claimant intentionally and fraudulently misrepresented her employment status to the employer, and that the employer reasonably and justifiably relied upon those representations to its detriment when it hired her and later agreed to the entry of an award of compensation benefits, the claimant’s fraud and misrepresentation resulted in an imposition on the Commission, and the Commission lacked subject matter jurisdiction to enter the award of compensation benefits. Quezada v. P M M C Associates, Inc., 79 O.W.C. 46 (2000).

    For the purpose of evaluating work capacity, the employer and insurance representative are entitled to have the benefit of a physical capacities evaluation form executed by the attending physician. Written communication or depositions are the appropriate means for obtaining the physician’s opinion. Carter v. City of Falls Church Public Utilities, 69 O.I.C. 151 (1990).

    An employee is free to gather additional medical evidence prior to a hearing. He is not obligated to notify the employer or seek approval for examinations by other physicians. Pena v. Parcom Floor Systems, 70 O.I.C. 77 (1991).

    It is proper for the Commission to refuse to issue a subpoena duces tecum where the contracts sought were immaterial to the employment status of the deceased employee. Deacon v. Atlantic Lumber Co., 52 O.I.C. 78 (1970).

    Subpoenas of the Commission shall be served by officers designated in this section. Service of process by counsel is not valid service. Thompson v. AMF, Inc., 57 O.I.C. 348 (1976).

    A party seeking to enforce discovery must file a timely motion to compel discovery in the office where the case is assigned to be heard. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    The claimant alleged an injury by accident on February 16, 1995 by claim filed February 13, 1997. On June 24, 1997, the deputy commissioner dismissed the claim for her failure to answer interrogatories and execute medical releases in a timely manner. Claimant moved to vacate the order on July 1, 1997. The deputy commissioner vacated her dismissal order on July 21, 1997. Defense counsel on July 28, 1997 filed a motion to reconsider the order to vacate, simultaneously filing a request for review of that order. The Commission held that the deputy commissioner was without jurisdiction to reconsider, amend, or vacate her June 24, 1997 dismissal order, on July 21, 1997, and the dismissal order was still valid. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    For the purpose of determining eligibility for cost-of-living benefits the Commission has the authority to require a claimant to present information concerning whether an application for Social Security benefits was filed and the outcome. However, an employer may not require a claimant to sign an authorization to receive federally protected information when no claim has been made for cost-of-living benefits. Singleton v. Fairfax Hospital Association, 68 O.I.C. 226 (1989).

    Continuances:

    The Deputy Commissioner did not abuse her discretion in denying the defendants’ continuance request where the hearing notices had been mailed; the insurer was advised to retain counsel; after the letter of representation from defense counsel there was no inquiry of the hearing date or request for a copy of the file; and the claimant’s counsel copied defense counsel on need for a translator, which referenced the date and time of hearing. Nogales-Sanchex v. Forever 21, Inc., VWC File No. 235-99-03 (Aug. 18, 2008).

    It is within the discretionary power of the deputy commissioner to grant or deny motions to continue a case to allow for mediation. Surrett v. Paramont Coal Co., VWC File No. 211-17-53 (May 9, 2007).

    It is within the discretionary power of the Deputy Commissioner to grant or deny motions to continue a case. Leeson v. Washington County School Board, 76 O.W.C. 193 (1997).

    Rule 2 (now Rule 2.2 A), of the Commission relating to continuances is a reasonable one and failure of claimant to appear does not, of itself, constitute a proper ground for continuing the case. Nicholson v. Clinchfield Coal Corp., 154 Va. 401 , 153 S.E. 805 , 1930 Va. LEXIS 222 (1930).

    The Commission is not required to grant a continuance or to allow an employee to withdraw an “Application for Hearing.” Keenan v. Westinghouse Elevator Co., 10 Va. App. 232, 391 S.E.2d 342, 6 Va. Law Rep. 2276, 1990 Va. App. LEXIS 75 (1990).

    Where the claim was filed January 15, 1997, but interrogatories were not propounded by the employer until April 21, 1997, and the Motion to Compel was not filed until May 20, 1997, the Deputy Commissioner did not abuse his discretion in finding that the filing of the motion just ten days before the hearing left him insufficient time to issue an order compelling the claimant to respond and for counsel to receive the answers, and the Deputy Commissioner did not abuse his discretion in refusing the employer’s request for a continuance. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    Nonsuit:

    A nonsuit cannot be used to extend the provision of Commission Rule 1.2(B); the Commission does not follow the provisions of Code § 8.01-229 (E)(3). Reynolds v. Banker Steel Company, LLC, JCN VA00001157598 (Aug. 15, 2018).

    A claimant’s voluntary nonsuit does not toll the statute of limitations of Code § 65.2-601 . Morneault v. Tidewater Temps Inc., VWC File No. 202-31-60 (July 26, 2004).

    There is no provision in the Rules of the Commission regarding a nonsuit. The Commission has followed § 8.01-380 and allowed a party to nonsuit a claim at any time prior to its being submitted for decision. While Code § 8.01-380 states that only one nonsuit may be taken against a party to the proceedings, it also provides that the court may allow additional nonsuits. However, a party may not obtain two nonsuits as a matter of right, and nonsuits are not condoned on the day before hearing. Norman v. Reynolds Metal Co., 75 O.W.C. 353 (1996).

    The Commission has historically conformed to the Civil Nonsuit Section, Virginia Code § 8.01-380 , and allowed a nonsuit any time before the hearing record was closed and the claim submitted to the Deputy Commissioner for a decision. A nonsuit is not allowed after a decision has been rendered. Worrell v. Samax Eggleston, et al., 75 O.W.C. 158 (1996) (see also Emmert v. York International Corporation, VWC File No. 201-28-89 (October 31, 2001)).

    Va. Code Ann. § 8.01-380 (B) provides that a claimant may have one voluntary non-suit as a matter of right. When the claimant petitions for relief to withdraw his claim a second time, it is left to the discretion of the hearing officer to determine whether the dismissal will be with prejudice or without prejudice. Zirkle v. Rocco Farms, 78 O.W.C. 36 (1999).

    The standard for review as to nonsuits is whether the Deputy Commissioner abused her discretion by granting it. Where the record fails to state the reason the nonsuit was requested or the rationale for granting it, the Commission cannot state that discretion was abused. Norman v. Reynolds Metal Co., 75 O.W.C. 353 (1996).

    The claimant sought to withdraw his request for nonsuit 22 hours after it was communicated to the Deputy Commissioner, when he realized that the effect of such nonsuit would be to extinguish his claim. This harsh result is inconsistent with the beneficent purposes of the Act. The purpose of the Workers’ compensation Act is to protect the employee and avoid harsh results inconsistent with such purposes, and the Deputy Commissioner erred in denying the motion to vacate. Leeson v. Washington County School Board, 76 O.W.C. 193 (1997).

    Hearing:

    General:

    Also see Notes to Rule 2 and Rule 3.

    Prior testimony in a criminal proceeding by deceased witness is admissible in a workers’ compensation case if the requirements of Gray v. Graham, 231 Va. 1 , 341 S.E.2d 153 (1986) are met. Campbell v. Campbell’s Ceramic Supply, Inc., VWC File No. 222-30-83 (Feb. 8, 2006).

    Where employer showed blatant disregard for Commission’s discovery orders, deputy commissioner properly struck defense to the compensability of the accident and prohibited testimony of witnesses on this issue. Branham v. Runk & Pratt of Forest, VWC File No. 213-15-02 (Sept. 1, 2004).

    Denial of evidentiary hearing is appropriate in permanent partial disability case where deputy commissioner can make a reasoned and accurate determination of the extent of loss of use by reference to the medical records and depositions of the treating physician. Edeline v. JTE, Inc., VWC File No. 204-28-62 (June 9, 2004).

    The parties are entitled to a fair but expeditious hearing and decision, but the Commission must apply certain constraints to the litigation. Wright v. CBI Na-Con, Inc., 77 O.W.C. 31 (1998).

    A copy of the hearing Opinion sent to counsel satisfied the Commission’s obligation to send copies to “the parties at issue.” Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    Dismissal of a claim, with a condition that a new claim will be accepted only if outstanding discovery interrogatories are answered, is an appropriate sanction where there is chronic failure to file discovery responses. After a claim is dismissed without prejudice, it is treated as if no claim had been filed. Bryant v. Fieldcrest Cannon, Inc., 75 O.W.C. 184 (1996).

    The “Deadman’s Statute,” § 8.01-397 , does not apply in workers’ compensation cases. Armada, Inc. v. Lucas, 2 Va. App. 414, 345 S.E.2d 14, 1986 Va. App. LEXIS 288 (1986).

    Section 8.01-398 , which provides that a spouse shall not testify without the consent of the other “as to any communication privately made by one to the other while married,” even if and after the marriage relation ceases, must be observed in cases before the Workers’ Compensation Commission. The spousal privilege to exclude private communications applies to words and acts intended to be concealed, even if witnessed by a third party. Wright v. Harrison’s Supermarket, 75 O.W.C. 195 (1996).

    Rule 1 (now Rule 2.2) of the Commission releases it from complying with the statutory or common law rules of pleading or technical rules of practice. Therefore, it is not appropriate for the Commission to grant a motion to strike or summary judgment until after the entire record has been reviewed. Francisco v. O’Sullivan Industries, 70 O.I.C. 132 (1991).

    The Commission is not required to provide a language translator at hearings. Doulgerakis v. Captain Georges Seafood Restaurant, 71 O.W.C. 105 (1992).

    The Commission’s on-the-record hearing procedures meet the constitutional due process requirements by giving a party a specific period of time in which to note objections to evidence filed and to request an ore tenus hearing based upon identification of other evidence which would be presented at such hearing. Williams v. Virginia Electric & Power Company, 18 Va. App. 569, 445 S.E.2d 693 (1994); 71 O.W.C. 101 (1992).

    Certain issues, such as those involving medical questions, can be fully and fairly determined from documentary evidence and do not require an evidentiary hearing. Contested matters that involve the credibility of a witness or party are not appropriate for on the record determinations. Where inconsistent medical opinions are based on different assessments of the employee’s subjective statements, the employee’s credibility is in issue and an on the record determination is inappropriate. Stanley v. Westmoreland Coal Co., 75 O.W.C. 91 (1996).

    Whether asthma may be caused by dust and mites and is therefore an ordinary disease of life is not a fact commonly known from human experience, and the Commission may not take judicial notice of such “fact.” Ruiz v. Abbotts Upholstery, 75 O.W.C. 213 (1996).

    The striking of evidence is an extraordinary action taken only in response to an egregious action, such as the failure to comply with Commission orders and directives. Hassell v. Arlington County Human Services, 79 O.W.C. 141 (2000).

    Where an employer’s motion to strike is granted and the Commission subsequently determines that there was a prima facie case of a compensable industrial accident, the proper procedure is to remand the case to the hearing docket in order for the employer to have an opportunity to present evidence on the merits of its position on the claim. U.S. Gypsum Co. v. Searles, 9 Va. App. 488, 389 S.E.2d 177, 6 Va. Law Rep. 1365, 1990 Va. App. LEXIS 35 (1990).

    Where the issue alleged in the Employer’s Application For Hearing was that the claimant had returned to light duty work at earnings less than his pre-injury average weekly wage, the Deputy Commissioner properly terminated the outstanding Award and entered an Award for temporary partial disability. McRea v. Int’l Sewer Service, Inc., 75 O.W.C. 71 (1996).

    A party that alleges material evidentiary fraud in the case presented to the Commission must raise the issue at the evidentiary hearing or within the time allowed for review or appeal. Pollard v. First General Services, 77 O.W.C. 259 (1998).

    Reconsideration, Request for Review or Vacating Decision:

    A request for review of a decision or award of the Commission must be filed in writing by a party within twenty days of the date of such decision or award. Barrett v. University of Virginia, 74 O.W.C. 49 (1995).

    The Deputy Commissioner retains jurisdiction over Orders and Awards for twenty days from issuance, during which time he may vacate, amend, or reconsider his decision. Leeson v. Washington County School Board, 76 O.W.C. 193 (1997).

    A Deputy Commissioner has the authority to reconsider a decision within the twenty days subsequent to an order before it becomes final. Barring a pleading based on fraud or mistake, the Deputy Commissioner loses jurisdiction to vacate an award after twenty days of the entry of that award. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    A Deputy Commissioner maintains control and retains jurisdiction over a claim only for twenty days after issuing an Opinion. However, where the Deputy Commissioner vacates his original opinion, he has jurisdiction to issue a subsequent opinion, even a year later. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    Where the Deputy Commissioner writes that he grants the request for reconsideration and will issue a new opinion on the merits, the effect of such language is to vacate his original decision and to preserve his jurisdiction to issue another opinion. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    Whether an application to set aside an award of the Commission is seasonably presented must necessarily depend upon the facts and circumstances of the particular case. If an application to vacate an award of the Commission is made on the ground of fraud or mistake, the Commission retains authority to act upon any relevant evidence offered in support of the motion. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    A Motion For Reconsideration does not substitute for a request for a review. Ferguson v. Olsten Kimberly Quality Care, 76 O.W.C. 52 (1997).

    The Commission permits parties to file requests for reconsideration. However, requests for reconsideration are different from requests for review. A request for reconsideration does not toll the statute for filing a review request. Hamilton v. Basic Construction Company, 77 O.W.C. 245 (1998).

    An application to vacate is not, strictly speaking, an application for a review. A request that a deputy reconsider to vacate an order does not preserve the claimant’s rights to challenge the deputy’s decision on review if the deputy denies or does not consider the motion within the twenty-day period before the order becomes final. Therefore, unless counsel files a motion for reconsideration or a motion to vacate in the alternative with a petition for review, the Commission’s jurisdiction to act upon its order expires with the passing of the twenty-day period. Asanakis v. Ice Follies & Holiday On Ice, Inc., 76 O.W.C. 278 (1997).

    Representation at Hearing:

    A nonlawyer representative of the carrier may request review of a Commission decision, but arguing the case ore tenus or by brief constitutes the practice of law and will be heard only from licensed attorneys. Smith v. Orange Livestock Market, Inc., 75 O.W.C. 129 (1996).

    Proceedings before the Commission constitute practice before a tribunal, so only attorneys licensed to practice law in Virginia may represent another person before the Commission. A nonlawyer may request a hearing or submit a petition for review for another person, and the provisions of Rule 1.9 of the Rules of the Commission allows nonlawyers to submit arguments for a party in Informal Dispute Resolution proceedings. Pannell v. Gerdy Construction Co., Inc., 75 O.W.C. 219 (1996).

    An employer has standing to file an Application For Hearing to establish its rights and obligations under the Virginia Act. Harrison v. City of Portsmouth School Bd., 75 O.W.C. 305 (1996).

    Representation of parties before the Commission constitutes practice of law and defendant’s representatives will not be permitted to represent the corporation if they are not licensed attorneys. Hewitt v. Norfolk Shipbuilding & Drydock Corp., 51 O.I.C. 121 (1969).

    Representation of parties before the Virginia Workers’ Compensation Commission constitutes the practice of law. A proper person may appear pro se , but a corporate party may appear only through an attorney licensed to practice law in Virginia. A nonlawyer employee/agent of a corporate party may request a hearing or review, and offer written argument in a matter before the Commission’s Informal Dispute Resolution Department, pursuant to Rule 1.9 of the Rules of the Commission. However, nonlawyers may not represent a party in ore tenus proceedings before the Commission, or file written argument or other pleadings in a case referred for review. Washington v. City of Richmond Fire Dept., 75 O.W.C. 347 (1996).

    Illinois counsel advised that he would not associate Virginia counsel regarding this claim, and he refused to allow defense counsel to contact the claimant. The Commission held that the claimant was therefore deemed to be proceeding pro se in Virginia, and the employer was therefore granted permission to contact the claimant directly, until he retained Virginia counsel. Vercoe v. Air Wisconsin, 76 O.W.C. 288 (1997).

    Failure to Appear:

    Attorney fee assessment appropriate when employer and insurer received notice of hearing but did not appear at hearing, and offered no argument how award entered after hearing was improper or unsupported by evidence; separate notice not required to be sent to claims adjuster. Simons v. Federal Painting, Inc., VWC File No. 210-75-01 (June 20, 2003).

    An application may be dismissed with prejudice if a Deputy Commissioner is convinced that a party is abusing the hearing process. If the non-appearance may be the result of failure to receive notice of the hearing or other reasonable explanation, a Show Cause hearing should be scheduled. Green v. Goodwin House, Inc., 70 O.I.C. 68 (1991).

    Notice to counsel of record of a hearing date is proper notice to the employee/client. Where the employee fails to appear at the hearing and sufficient evidence to sustain the burden of proof is not presented, it is proper to dismiss the claim. McGuinn v. National Linen Service, 69 O.I.C. 61 (1990).

    Although application for hearing may make out a case, claim will be dismissed if party fails to appear and offer evidence in support of claim. Loehr v. Seward Lumber Co., Inc., 51 O.I.C. 155 (1969).

    Admissions and Stipulations:

    The initial claim listed left knee and right hip injuries but the Stipulated Award Order referenced injuries to the left lower extremity. A claim for a right hip filed almost three years after the accident was barred by the statute of limitations. With the entry of the Stipulated Award Order listing only the left lower extremity, the claim for a right hip injury was merged into that award, waived, or abandoned. As distinguished from facts in similar cases, the insurance carrier did not pay benefits for a brief period of treatment to the right hip. Swain v. City of Petersburg Social Services, VWC File No. 214-93-41 (Sept. 4, 2007).

    Admissions and stipulations made in good faith should be encouraged. Coley v. Southeastern Tidewater Area Manpower Authority, 221 Va. 859 , 275 S.E.2d 598 (1981).

    While the Commission encourages stipulations to narrow disputed issues and avoid unnecessarily litigious hearings, an employee is not obligated to admit facts not within his personal knowledge. Foster v. Hooker Furniture Corp., 75 O.W.C. 355 (1996).

    Once parties stipulate to the facts of a claim, they are bound by those stipulations. Pinto v. Williams, 75 O.W.C. 255 (1996).

    Stipulations made at hearing regarding the compensability of the claim cannot be withdrawn based on medical evidence developed after the proceeding where the employee had ample opportunity to investigate and develop evidence prior to the hearing. Watson v. Quality Assistance, 70 O.I.C. 65 (1991).

    Burden of Proof:

    While claimant may offer alternative theories of recovery, he may not offer two conflicting sets of facts as to cause of accident. Bruney-Divens v. Community Corrections Administration, JCNs VA000000656197 and VA000000667552 (Sept. 16, 2015), aff’d, No. 1588-15-1 (Va. Ct. App. May 3, 2016).

    In order to recover on a workers’ compensation claim, a claimant must prove (1) an injury by accident, (2) arising out of and (3) in the course of his employment. The burden is upon the claimant to prove the foregoing by a preponderance of the evidence. Morgan v. City of Norfolk School Board, 76 O.W.C. 359 (1997).

    A party’s evidence can rise no higher than his own testimony. Calloway v. Dept. of Corrections, 77 O.W.C. 35 (1998).

    The claimant bears the burden of proving that his injury arose out of his employment. The phrase “arising out of” refers to the origin or cause of the injury. An injury arises out of the employment when there is apparent to the rational mind upon consideration of all the circumstances, a casual connection between the conditions under which the work is required to be performed and the resulting injury. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    The claimant has the burden of proving by a preponderance of the evidence that he suffered a compensable injury by accident on March 6, 1995. A compensable injury is one caused by an accident arising out of and in the course of the employment. To prove an injury by accident, the claimant must establish an identifiable incident that occurred at a reasonably definite time, with a sudden mechanical or structural change in the body, and a causal connection between the incident and that bodily change. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    To prove that the injury arose out of the employment, a claimant must establish a causal connection between the conditions under which the work is required to be performed and the resulting injury. The claimant must show that the conditions of the workplace or some significant work-related exertion caused the injury. The causative danger must be peculiar to the work, incidental to the character of the business, and not independent of the master-servant relationship. In cases where an injury does not follow as a natural incident of the work and does not result from exposure occasioned by the nature of the employment, the injury does not arise out of the employment. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    The burden is on claimant to prove causal connection by a preponderance of the evidence. He need not prove this beyond a reasonable doubt. Rogers v. Williams, 196 Va. 39 , 82 S.E.2d 601, 1954 Va. LEXIS 198 (1954).

    The medical evidence showed that the claimant was able to perform light-duty work, and the issue was whether the light-duty restriction would allow the claimant to perform all the duties of his pre-injury work. Evidence of the claimant’s pre-injury work duties necessary to resolve this issue was absent from the record. Since the employer, as the proponent of the change in condition application, had the burden to supply evidence to prove its claim by a preponderance of the evidence, and since evidence of the claimant’s pre-injury work was not presented, the Commission held that the employer failed to prove the claimant could return to his pre-injury work. Meekins v. Heritage Golf Club, 77 O.W.C. 81 (1998).

    While it is the endeavor of the courts to construe the compensation statute liberally in order to carry out its beneficial purpose, liability cannot be based upon imagination, speculation or conjecture but must be based upon facts established by the evidence. Johnson v. Capitol Hotel, 189 Va. 585 , 54 S.E.2d 106, 1949 Va. LEXIS 202 (1949); Bailey v. Stonega Coke & Coal Co., 185 Va. 653 , 40 S.E.2d 254, 1946 Va. LEXIS 238 (1946).

    Proof of causal connection between accident and claimed disability must go beyond conjecture. Lucas v. Eccon Construction Company, 60 O.I.C. 292 (1981).

    The Commission looks primarily to the medical evidence to determine the mechanism or cause of an injury. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    The claimant has the burden to prove that he is an employee subject to the control of the employer, that he is under a contract of hire that provides an agreed remuneration for services rendered, and that the work being performed is in the business, trade, occupation, or profession of the employer. Eliason v. Boger Construction Company, 76 O.W.C. 385 (1997).

    Where the treating physician has prescribed specific medical treatment for the claimant’s work injury, the employer or its workers’ compensation carrier, not the employee, has the burden to proceed with evidence which would relieve it from the mandate of the act. Leon v. Lewis-Gale Clinic, 76 O.W.C. 350 (1997).

    Claimant may establish his case by circumstantial evidence. Byrd v. Stonega Coke & Coal Co., 182 Va. 212 , 28 S.E.2d 725, 1944 Va. LEXIS 170, limited, Carter v. Hercules Powder Co., 182 Va. 282 , 28 S.E.2d 736, 1944 Va. LEXIS 177 (1944).

    Where the claimant is not inherently incredible, the Commission will look to his testimony and the medical record to determine whether he has met his burden of proving that a condition of the employment caused the accident. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    Testimony that is not inherently incredible, but is consistent, credible, and unimpeached by the records of her treating physicians, is sufficient to establish an injury by accident. Perkins v. Family Health Care Assoc., 76 O.W.C. 84 (1997), aff’d, Nos. 1238-97-3 & 1290-97-3 (Va. Ct. App., Dec. 23, 1997).

    Hearsay Evidence:

    Hearsay evidence, in view of Rule 1 (now Rule 2.2) of the Commission, may be introduced and, if credible and not contradicted, may alone constitute the basis for award. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562 (1958); Derby v. Swift, 188 Va. 336 , 49 S.E.2d 417 (1948); Humphries v. Boxley Bros. Co., 146 Va. 91 , 135 S.E. 890 (1927); Graves v. American Furniture Co., 141 Va. 1 , 126 S.E. 213 (1925); Jenkins v. Bowman Apple Products Co., Inc., 48 O.I.C. 125 (1966); Gray v. East Coast Oil Corp. (appeal denied), 58 O.I.C. 154 (1979).

    Although the Commission is not bound by statutory rules of evidence, it is guided by them. Thus, Rule 2.2 allows the Commission to accept hearsay evidence, but hearing officers may exclude such evidence not considered reasonably reliable. Wright v. Harrison’s Supermarket, 75 O.W.C. 195 (1996).

    The claimant died from unrelated causes prior to the evidentiary hearing. The employer argued that it would be severely prejudiced if the claim was allowed, because it could not cross-examine the claimant. The Commission disagreed that the contested issues could not be decided without the claimant’s testimony, since the Act’s liberal hearsay rule would allow the evidence to be presented through the testimony of other witnesses and other evidence in the record. The Commission acknowledged that the absence of a significant witness would affect the quality of the evidence in the record, but that such an obstacle was not so critical as to render the proceedings fundamentally unfair. Echols v. Rite Aid Corporation, 78 O.W.C. 16 (1999).

    The Commission acted appropriately by refusing to allow evidence concerning racial discriminatory conduct. Claims of race discrimination have never been considered to fall within the generic term “industrial accidents.” A pattern of racial discrimination would not affect the Commission’s determination of whether an injury by accident occurred or whether a compensable ordinary disease of life which arose out of or in the course of employment was present. Teasley v. Montgomery Ward & Company, Inc., 14 Va. App. 45, 415 S.E.2d 596, 8 Va. Law Rep. 2327, 1992 Va. App. LEXIS 77 (1992).

    Medical Evidence:

    Where a physician’s statement as to causation is one of possibility, not probability, and the possibility of a causal connection does not rise to the level of an opinion to a reasonable degree of medical probability, it is insufficient to satisfy the claimant’s burden of proof. The preponderance of evidence must show that work was the cause of the disability under the more probable than not rule. Parker v. Wal-Mart Associates, Inc., JCN VA00000223428 (Aug. 31, 2011).

    A nurse practitioner’s unchallenged opinion concerning causation and disability will be considered. However a contradictory opinion from a physician will be given greater weight than a nurse practitioner. Counts v. Virginia Dept. of Transportation/Commonwealth of Va., VWC File No. 220-85-21 (March 9, 2006) see also Shine v. Teco Energy, Inc., VWC File No. 223-46-12 (April 5, 2006) (nurse practitioner’s notes are admissible) and Patterson-Parker v. Lowe’s Home Centers, Inc., VWC File No. 212-86-74 (Sept. 29, 2006) (release to work by nurse practitioner is sufficient where notes reflect discussed with doctor).

    A physician assistant’s opinion as to diagnosis and disability is admissible but unless a medical doctor has endorsed the conclusion, it will not be given the same weight as a physician’s determination. Austin v. Allstate Insurance Co., VWC File No. 224-68-41 (Aug. 1, 2006).

    A chiropractor’s opinion concerning a thumb and hand condition is beyond the scope of the “practice of chiropractic” as defined by § 54.1-2900 and therefore will not be considered. Fedorko v. Prince William Hospital, VWC File No. 208-77-08 (Feb. 7, 2006) see also Torres v. Maid Brigade, #153, VWC File No. 203-57-08 (April 1, 2004) (chiropractor’s rating to an arm not considered).

    The Commission has authority to exclude medical evidence. However, the employer has the right to see all the medical records, because this information is, or might lead to, admissible evidence. In this case, the Commission found that the Deputy Commissioner erred by allowing the claimant’s treating physician to submit redacted and summarized records relevant to the claimant’s post traumatic stress disorder claim, and that the employer was entitled to review all of the physician’s records for his treatment of the claimant, unredacted and unsummarized. Hassell v. Arlington County Human Services, 79 O.W.C. 141 (2000).

    Non-designated medical reports and records are automatically a part of the hearing record. Lowery v. Globe Iron Const. Co., Inc., 76 O.W.C. 221 (1997).

    A conflict in the testimony of medical experts presents an issue of fact. In such case the Commission may adopt that view which is most consistent with reason and justice, taking into consideration also the lay testimony introduced, in the same manner a jury would. While great weight should be given testimony of the attending physician, his opinion is not binding upon the Commission. Williams v. Fuqua, 199 Va. 709 , 101 S.E.2d 562, 1958 Va. LEXIS 116 (1958); Southall v. Eldridge Reams, Inc., 198 Va. 545 , 95 S.E.2d 145, 1956 Va. LEXIS 240 (1956); Johnson v. Capitol Hotel, 189 Va. 585 , 54 S.E.2d 106, 1949 Va. LEXIS 202 (1949); Baltimore v. Benedict Coal Co., 182 Va. 446 , 29 S.E.2d 234, 1944 Va. LEXIS 194 (1944); Commonwealth v. Hughes, 161 Va. 714 , 172 S.E. 155 , 1934 Va. LEXIS 296 (1934); Bristol Builders Supply Co. v. McReynolds, 157 Va. 478 , 162 S.E. 8 (1932).

    Where there is conflict in medical evidence, greater credence is given to the opinion of the treating physician than to that of another physician of the same medical specialty who has only recently been consulted. Green v. Audley Farms, 57 O.I.C. 143 (1976) (appeal denied); Harding v. Mother Goose, Inc., 57 O.I.C. 159, 1977(aff’d on review) (appeal denied).

    A party has the right to have the entire deposition testimony of a doctor received into the evidentiary record, notwithstanding the requirement in Rule 2.2 (B)(3) that the transcript must be specifically identified by page and line. Lowery v. Globe Iron Const. Co., Inc., 76 O.W.C. 221 (1997).

    Opinions of general practitioners fall short of overcoming view of specialists. Russell v. Wright Mining Co., 49 O.I.C. 284 (1967).

    The Commission will not substitute its own opinion for those of a medical expert where no contrary evidence is presented and the opinion is fully explained. Palmer v. City of Roanoke Emergency Services, 70 O.I.C. 147 (1991).

    Once an accident has been established without consideration of the medical history, medical histories may be considered to determine whether the treatment was for injury related to that accident. Sandra R. Hall v. Spartan Industries/Barnes and Company, Inc., 74 O.W.C. 56 (1995).

    Credible testimony of the claimant may be sufficient to establish an injury by accident unimpeached by the medical records, even if the medical histories refer only to general repetitive tasks the claimant performed when the accident occurred. Mullins v. Dickenson County Medical Center, 74 O.W.C. 176 (1995).

    Historical inconsistencies alone may be insufficient to nullify or compromise a treating physician’s opinion on causation, where he is the spine specialist to whom the claimant was referred, his opinion is not based totally on the precise details of the history, the substance of the history relied upon by the physician is correct, and he is the only physician who expressed an opinion on causation. Smith v. Southeastern Virginia Training Center, 78 O.W.C. 69 (1999).

    Claimant’s bona fide effort to work is better evidence than physician’s opinion. Wills v. Green, 56 O.I.C. 340 (1975).

    A physician’s release from medical treatment does not establish an employee has been released to return to regular work, light work or any type of work. Blake v. Banner Constructors, Inc., 69 O.I.C. 71 (1990).

    A physician’s release to return to work on a trial basis is not sufficient to suspend compensation benefits. The physician must state unconditionally that the claimant is able to perform all aspects of his pre-injury employment. Byrd v. Island Creek Coal Company, 74 O.W.C. 45 (1995).

    A release to return to work one week following an examination is considered a prospective release and does not establish that an employee is able to return to work. Haggins v. American Academy of Otolaryngology, 70 O.I.C. 293 (1991).

    A doctor’s release to return to work more than seven days after the examination is prospective and anticipatory, and is insufficient to establish an ability to work on the future date. Devault v. Virginia Imports, Ltd., 74 O.W.C. 174 (1995).

    Videotape surveillance of the claimant showed him using a piece of cloth to wipe an automobile, lifting a bicycle carrier, attaching the carrier to the vehicle, and thereafter placing a bicycle in the carrier. These actions, at face value, reflect an ability to perform tasks greater than that noted in the medical reports and alluded to in the claimant’s testimony. However, the Commission found that such evidence was insufficient to prove an ability to return to work. Sinkfield v. Aerotech Contract Engineering Serv., 76 O.W.C. 493 (1997).

    Where an employer files an application alleging that the claimant is able to return to regular work, medical evidence is not limited to reports available at the time of the application but includes all reports available prior to the hearing. Turner v. Wilson Brothers, Inc., 69 O.I.C. 73 (1990).

    The medical evidence showed that the claimant was able to perform light-duty work, and the issue was whether the light-duty restriction would allow the claimant to perform all the duties of his pre-injury work. Evidence of the claimant’s pre-injury work duties necessary to resolve this issue was absent from the record. Since the employer, as the proponent of the change in condition application, had the burden to supply evidence to prove its claim by a preponderance of the evidence, and since evidence of the claimant’s pre-injury work was not presented, the Commission held that the employer failed to prove the claimant could return to his pre-injury work. Meekins v. Heritage Golf Club, 77 O.W.C. 81 (1998).

    Mental health records are not admissible without testimony of the counselor unless the care has been rendered by or at the direction of a practitioner of the healing arts licensed under § 54.1-2929 , Code of Virginia. Potter v. Island Creek Coal Co., 69 O.I.C. 67 (1990).

    The report of a clinical psychologist may be admitted as evidence under Rule 1 (now Rule 2.2). Landy v. Eastern State Hospital, 69 O.I.C. 212 (1989).

    A doctor’s office note stating that the claimant failed to attend a medical appointment was admissible as a record of the physician’s care of the patient. Griffith v. Commonwealth Steel Erectors, Inc., 68 O.I.C. 218 (1989).

    The person requesting a witness subpoena for a medical expert must pay the witness fee set by the Commission. Dotti v. Sonco Wholesale Fence Co., Inc., 70 O.I.C. 307 (1991).

    Witness Credibility:

    For cases discussing credibility findings by deputy commissioners and their affect on Full Commission decisions see Goodyear Tire & Rubber Co. v. Pierce, 5 Va. App. 374, 363 S.E.2d 433, 4 Va. Law Rep. 1457, 1987 Va. App. LEXIS 250 (1987); Corestaff Corp. Servs. Group v. Carter, 2004 Va. App. LEXIS 128 (Va. Ct. App. Mar. 30, 2004) (see also the Notes under § 65.2-705 .).

    A deputy commissioner’s determination of a witness’ credibility based on issues such as demeanor and appearance, may not be arbitrarily disregarded, unless it is evident from the record that there existed some basis for the Commission’s different interpretation of the witness’ credibility. When a credibility decision is reversed, it should be evident from the record how the Commission resolved the credibility issue consistent with the deputy’s observations at the evidentiary hearing. When the deputy commissioner’s finding of credibility is based, in whole or in part, upon the claimant’s appearance and demeanor at the hearing, the commission may have difficulty reversing that finding without recalling the witness. On the other hand, if the deputy commissioner’s determination of credibility is based on the substance of the testimony and not upon the witness’ demeanor and appearance, such a finding is as determinable by the Commission as by the deputy. Al-Janabi v. MCI Communications Corp., 76 O.W.C. 290 (1997).

    Post-hearing Evidence:

    The burden is on the moving party to see that the record affirmatively reflects a motion for leave to file post-hearing medical reports. Hayward v. Pep Boys, 1 Va. App. 483, 339 S.E.2d 908, 1986 Va. App. LEXIS 227 (1986).

    Time limit for filing post-hearing evidence is within hearing commissioner’s discretion. Chabot v. Commonwealth of Virginia, Virginia Polytechnic Institute & State University, 60 O.I.C. 85 (1981).

    A request to depose a physician first made at or close in time to the evidentiary hearing is untimely where there was ample time after the physician’s report was issued and before the hearing to cross examine the physician by deposition. Clay v. Ogden Allied Building Services, 75 O.W.C. 83 (1996).

    After Discovered Evidence:

    Employer’s request to admit evidence after the hearing regarding a credit for short-term disability payments made during the period of disability is not subject to the rule governing after-discovered evidence. An employer may seek credit for benefits paid at the hearing or by post-hearing application. Juhl v. Monumental Life, Inc., VWC File No. 217-76-00 (Feb. 1, 2005).

    Since case was still pending a decision by the deputy commissioner when he issued his decision to reconvene the hearing, the case was not “under review” as contemplated by Rule 3.3, and deputy commissioner retained discretion to hear and review additional evidence. Collick v. Batey Enterprises II, Inc., VWC File No. 216-57-38 (Oct. 22, 2004).

    Deputy commissioner’s opinion vacated and remanded for consideration of evidence that claimant and his wife pled guilty to certain federal criminal charges where credibility was central issue in case. Martin v. Groome Transp., Inc., VWC File No. 209-63-38 (Oct. 15, 2004).

    Rule 3 (now Rule 3.3), of the Commission, providing that a petition for reopening of a case to permit the taking of additional testimony will only be acted upon by the full Commission where it appears that such course is absolutely necessary and advisable and also where the party requesting same is able to conform to the rule prevailing in the courts of the State for the introduction of after-discovered evidence, means that such evidence must not be cumulative, corroborative or collateral and must be evidence that could not have been discovered before the hearing by the exercise of due diligence. Defonis v. Clinchfield Coal Corp., 186 Va. 715 , 43 S.E.2d 852 (1947); Nicholson v. Clinchfield Coal Corp., 154 Va. 401 , 153 S.E. 805 (1930); Barsa v. Kator, 121 Va. 290 , 296, 93 S.E. 613 (1940); Brown v. City of Suffolk Police Dept., 59 O.I.C. 39 (1981).

    The petition for leave to introduce additional evidence must be filed before the hearing on review. Baker v. Va. Lee Co., Inc., 12 O.I.C. 1 (1930).

    Employer had ample time to investigate claim prior to hearing; petition to admit new evidence denied. Clark v. Harris Industries, Inc., 58 O.I.C. 61 (1979).

    § 65.2-801. Insurance or proof of financial ability to pay required.

    1. Every employer subject to this title shall secure his liability thereunder by one of the following methods:
      1. Insuring and keeping insured his liability in an insurer authorized to transact the business of workers’ compensation insurance in this Commonwealth;
      2. Receiving a certificate pursuant to § 65.2-808 from the Workers’ Compensation Commission authorizing such employer to be an individual self-insurer;
      3. Being a member in good standing of a group self-insurance association licensed by the State Corporation Commission;
      4. Being a member in good standing of a local government group self-insurance pool licensed by the State Corporation Commission pursuant to § 15.2-2706 to offer workers’ compensation coverage; or
      5. Entering into an agreement with a professional employer organization for professional employer services which includes voluntary market workers’ compensation insurance for coemployees of the professional employer organization and the client company procured from an insurer authorized to transact the business of workers’ compensation insurance in this Commonwealth. A professional employer organization may obtain voluntary market workers’ compensation insurance in its own name for all coemployees which it shares or which are assigned or allocated to it pursuant to the agreement between the professional employer organization and the client company. The client company shall maintain separate voluntary market workers’ compensation insurance insuring any and all employees of the client company not insured through the policy obtained by the professional employer organization.
    2. An employer who satisfies the requirements of this section shall be certified by the Workers’ Compensation Commission as an individual self-insurer and permitted to pay direct the compensation in the amount and manner and when due as provided for in this title. The Commission shall not certify an employer as a self-insurer unless it receives in such form as it requires satisfactory proof of the solvency of such employer, the financial ability of the employer to meet his obligations and the ability of the employer to pay or cause to be paid the compensation in the amount and manner and when due as provided for in this title. The Commission shall establish reasonable requirements and standards for approval of an employer as a self-insurer including, without limitation, the quality and amount of security deposits, bonds or indemnity, the amount of advance payments and reserves required, the investment of such funds, and the form and content of financial information to be submitted by the employer and the frequency of such submissions. For the purposes of any debt/equity ratio (total liabilities to net worth) minimum standard, a ratio of less than 2.2:1 shall be deemed satisfactory. The Commission shall, after notice and hearing, embody such requirements and standards and such other requirements as may be reasonably necessary for the purposes of this section in regulations. The Bureau of Insurance of the State Corporation Commission shall, at the request of the Commission, assist the Commission in establishing the reasonable requirements and standards for approval and certification of an employer as a self-insurer. The Workers’ Compensation Commission may in its discretion require the deposit of a financial instrument of a specified amount from an entity approved by the Workers’ Compensation Commission to secure the payment of compensation liabilities as they are incurred. The form of the instrument to be deposited shall be selected by the employer from the following list of acceptable financial instruments and may include any combination thereof so long as the amount specified by the Workers’ Compensation Commission is deposited and the actual value thereof maintained: corporate surety bonds, certificates of deposit, United States government obligations, letters of credit, and cash.
    3. The State Treasurer shall be the custodian of securities deposited by the employer under the requirements of this section, or under § 65.2-802 , and for such services he shall receive a compensation of one-tenth of one percent per year of the amount of securities deposited with him, payable by or on behalf of such employers.

    History. Code 1950, § 65-100; 1968, c. 660, § 65.1-104.1; 1973, c. 173; 1979, c. 463; 1991, c. 355; 1992, c. 816; 1996, c. 181; 2000, cc. 624, 718; 2004, cc. 44, 173; 2006, c. 265; 2009, cc. 285, 336.

    Editor’s note.

    Acts 2000, cc. 624 and 718, which added subdivision A 4, in cl. 2 provide: “That the provisions of this act shall be effective with respect to any workers’ compensation insurance policy issued to or renewed with a professional employer organization on or after January 1, 2001.”

    The 2000 amendments.

    The 2000 amendments by cc. 624 and 718 are identical, and deleted “or” at the end of subdivision A 2, and inserted “or” at the end of subdivision A 3, and added subdivision A 4. See editor’s note.

    The 2004 amendments.

    The 2004 amendments by cc. 44 and 173 are identical, and in subsection B, substituted “a financial instrument of a specified amount from an entity approved by the Workers’ Compensation Commission” for “an acceptable security, indemnity, or bond” in the seventh sentence and added the last sentence.

    The 2006 amendments.

    The 2006 amendment by c. 265 substituted “2.2:1” for “2:2” in the fourth sentence in subsection B.

    The 2009 amendments.

    The 2009 amendments by cc. 285 and 336 are identical, and added subdivision A 4 and made a related change.

    Law Review.

    For survey of Virginia law on governmental services and social welfare for the year 1976-77, see 63 Va. L. Rev. 1440 (1977).

    For survey of Virginia law on governmental services and social welfare for the year 1978-1979, see 66 Va. L. Rev. 301 (1980).

    For 2006 survey article, “Labor and Employment Law,” see 41 U. Rich. L. Rev. 203 (2006).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 10.

    CASE NOTES

    Legislative intent. —

    Nothing in § 65.2-404 is intended to release employers from the duty of keeping themselves insured as required by this section or to exempt the Uninsured Employer’s Fund when the employer has breached its statutory obligation. Uninsured Employer's Fund v. Mounts, 24 Va. App. 550, 484 S.E.2d 140, 1997 Va. App. LEXIS 242 (1997), aff'd, 255 Va. 254 , 497 S.E.2d 464, 1998 Va. LEXIS 42 (1998).

    ERISA exemption. —

    Even if the challenged provisions of Virginia’s Workers’ Compensation statutes are interpreted to “relate to” an Employee Retirement Income Security Act (ERISA)-covered plan, they are exempt from preemption under § 4(b)(3) of ERISA. Employers Resource Mgt. Co. v. James, 853 F. Supp. 920, 1994 U.S. Dist. LEXIS 7312 (E.D. Va. 1994), aff'd, 62 F.3d 627, 1995 U.S. App. LEXIS 22126 (4th Cir. 1995).

    Where subcontractor was uninsured in Virginia for purposes of the Virginia Workers’ Compensation Act, the statutory employer, the general contractor, was liable for claimant’s benefits. Falls Church Constr. Corp. v. Valle, 21 Va. App. 351, 464 S.E.2d 517, 1995 Va. App. LEXIS 898 (1995).

    Liability of coal company for future claims. —

    Given the statutory mandate to insure and keep insured its liability, coal company, whose employees are susceptible to pneumoconiosis, was required to anticipate that such claims accrue in the future and therefore to secure its liability for such potential claims even when its insurer had been declared insolvent. Since coal company failed to keep itself insured, Uninsured Employer’s Fund was liable for occupational disease benefits of worker whose pneumoconiosis was diagnosed after employer’s insurance lapsed. Uninsured Employer's Fund v. Mounts, 255 Va. 254 , 497 S.E.2d 464, 1998 Va. LEXIS 42 (1998).

    Uninsured Employer’s Fund liable for benefits assessed against insolvent insurer. —

    Uninsured Employer’s Fund was liable for portion of lifetime benefits award originally assessed against insurance company that was solvent on the date coal worker was first awarded compensation benefits but became insolvent after the award was entered. Uninsured Employer's Fund v. Flanary, 27 Va. App. 201, 497 S.E.2d 912, 1998 Va. App. LEXIS 227 (1998), aff'd, 257 Va. 237 , 514 S.E.2d 147, 1999 Va. LEXIS 38 (1999).

    Uninsured Employer’s Fund not liable. —

    Workers’ Compensation Commission properly found that it had jurisdiction to award compensation to a claimant because, the insurer agreed to pay compensation, the claimant did not have to establish coverage, nothing in the record established that employer failed to comply with the statutory requirements, and there was no merit to the insurer’s assertion that the Uninsured Employer’s Fund was responsible for paying compensation where the policy was not cancelled or not renewed. Nationwide Mut. Ins. Co. v. Estate of Harrison, 64 Va. App. 110, 765 S.E.2d 154, 2014 Va. App. LEXIS 396 (2014).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Section 65.2-800 A provides that every employer shall insure payment of compensation for his employees. Code § 65.2-801 (A) provides that the obligations of Code § 65.2-800 (A) can only be accomplished by purchasing a workers’ compensation insurance policy issued through a private insurer, being certified by the Commission as an individual self-insurer, or by becoming a member of a group self-insurance association licensed by the State Corporation Commission. Gulbranson v. C. F. W. Contracting, 77 O.W.C. 234 (1998).

    Acts of authorized agent in issuing binder or certificate of insurance bind its principal even though policy of insurance not in existence. Johnson v. Farlow Const. Co., et al., 56 O.I.C. 188 (1975); Poston v. Evans Const. Co., et al., 56 O.I.C. 253 (1975).

    There is no provision in the Act that permits one employer to satisfy its workers’ compensation insurance obligation by including its employees under another company’s policy. Thus, while a leasing company and employer could contract for the leasing company to pay for the employer’s workers’ compensation policy, Code § 65.2-801 (A) requires that the employer, not the leasing company, be the named insured. Gulbranson v. C. F. W. Contracting, 77 O.W.C. 234 (1998).

    Any claim employer may have against carrier for overpayment of premium not within jurisdiction of Commission. Ward v. Mooreman, 52 O.I.C. 278 (1970).

    Fact that insurer collected premium for coverage afforded by policy does not alter status of partners as employers, not employees. Weisz v. Anne Lee Candy Shop, 55 O.I.C. 372 (1973).

    Where practice of carrier and its authorized agent was to renew automatically expiring policy, and to furnish new policy with a bill for premium, and carrier and agent permitted policy to expire without notice to insured, and without notice that a new policy had not been issued, carrier is estopped to deny coverage. Haid v. Phillips and Co., Inc., 43 O.I.C. 45 (1961).

    Employee unsuccessful in collecting award of Commission against uninsured employer, not barred from resorting to civil action to recover damages from employer. Delp v. Berry, 213 Va. 786 , 195 S.E.2d 877, 1973 Va. LEXIS 232 (1973).

    § 65.2-802. Requirements for licensure as group self-insurance association; annual assessment.

    1. Two or more employers having a common interest may be licensed by the State Corporation Commission as a group self-insurance association and permitted to enter into agreements to pool their liabilities under this title. The members of any such group self-insurance association may also enter into agreements to pool their liabilities for workers’ compensation benefits which may arise under the laws of any other jurisdiction and other types of employers’ liabilities for the death or disablement of, or injury to, their employees. Benefits payable by any such association for such members’ liabilities under the laws of any other jurisdiction shall extend only to employees otherwise eligible for coverage under the provisions of this title.
    2. The State Corporation Commission shall not license a group self-insurance association or grant authorization for an employer to become a member of such group unless it receives in such form as it requires satisfactory proof of the solvency of any such employer, the financial ability of each to meet his obligations as a member, and the ability of the group to pay or cause to be paid the compensation in the amount and manner and when due as provided for in this title and as may be agreed upon with respect to other types of employers’ liabilities which may be authorized and provided hereunder.
    3. Members of a group shall execute a written agreement under which each agrees to jointly and severally assume and discharge any liability under this title of employers party to such agreement. Agreements among the members shall be subject to approval by the State Corporation Commission; however, no such agreement nor membership in a group self-insurance association shall relieve an employer of the liabilities imposed by this title with respect to his employees. In addition to the rights of the association under such agreements, in the event of failure of the association to enforce such rights after reasonable notice to the association, the State Corporation Commission shall have the right independently to enforce on behalf of the association the joint and several liability of its members under this title and the liability of members for any unpaid contributions and assessments. The State Corporation Commission shall be entitled to recover its expenses and attorneys’ fees.
    4. Any person, firm, or corporation desiring to engage in the business of providing services for a group self-insurance association shall satisfy the State Corporation Commission of its ability to perform the services necessary to fulfill the employer’s obligations under this title before it undertakes to provide such services to any group self-insurance association. The State Corporation Commission may from time to time review and alter any decision approving an employer as a member of a group or its approval of a group or of an agency servicing a group. The State Corporation Commission may in its discretion require the deposit of an acceptable security, indemnity, or bond or the purchase of such excess insurance or the ceding of reinsurance on a specific or aggregate excess of loss basis as may be required by the circumstances.
    5. The State Corporation Commission may establish reasonable requirements and standards for the approval of a group self-insurance association and the administration of such associations including, without limitation, the quality, amount and accounting of security deposits, bonds, excess insurance and reinsurance, the membership in any group self-insurance association, the amount of advance payments and reserves required of group self-insurance associations, the investment of such funds, the form and content of financial information to be submitted by a group self-insurance association and the frequency of such submissions, and the terms of agreements between members of a group self-insurance association. The State Corporation Commission may, after notice and hearing, embody such requirements and standards and such other requirements as may be reasonably necessary for the purposes of this section in regulations; however, any group self-insurance association entering into a reinsurance transaction pursuant to the provisions of this section shall be deemed an insurer for purposes of such transaction and shall be subject to Article 3.1 (§ 38.2-1316.1 et seq.) of Chapter 13 of Title 38.2.
    6. Notwithstanding any provision of this title to the contrary, each licensed group self-insurance association shall be assessed annually by the State Corporation Commission in like manner and amount to that provided by Chapter 4 (§ 38.2-400 et seq.) of Title 38.2 and shall pay such assessment in accordance with the aforesaid provisions of law; however, for the purposes of such assessment “direct gross premium income” of a licensed group self-insurance association shall be the aggregate of the amounts determined to be subject to the tax imposed by § 65.2-1006 on each employer member of such association.
    7. Notwithstanding the provisions of § 49-25 , neither the State Corporation Commission nor any other entity or person, as obligee under any surety bond required under this section or any regulation adopted hereunder, shall be required to institute suit against an association as a condition precedent to the surety’s performance under the bond.

    History. 1979, c. 463, § 65.1-104.2; 1988, c. 365; 1990, c. 306; 1991, c. 355; 1994, cc. 333, 408.

    Cross references.

    As to authorization for group self-insurance pools, see § 15.2-2703 .

    Law Review.

    For survey of Virginia law on governmental services and social welfare for the year 1978-1979, see 66 Va. L. Rev. 301 (1980).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 10.

    CASE NOTES

    This section does not alter former § 65.1-29 (now § 65.2-302 ). —

    The fact that all members of the Virginia Coal Producers Group (VCPG) are jointly and severally obligated to each other under this section does not remove from an injured employee the right to proceed against a statutory employer under former § 65.1-29, but rather, the joint and several liability of the members of the VCPG under this section simply operates to give the statutory employer a broader base of possible indemnification, and it does not, and moreover cannot, alter the statutory employer’s obligations which are plainly set forth in former § 65.1-29. Clinchfield Coal Co. v. Coleman, 1999 Va. App. LEXIS 662 (Va. Ct. App. Dec. 7, 1999) (decided under former § 65.1-104.2).

    § 65.2-803. Administrator and service company affiliation prohibited; exception.

    1. No person, firm or corporation, which is engaged as an administrator for a group self-insurance association, shall be an employee, officer or director of, or have a direct or indirect financial interest in any person, firm or corporation which is engaged in the business of providing services for a group self-insurance association as a service company.
    2. No person, firm or corporation, which is engaged in the business of providing services for a group self-insurance association as a service company, shall be an employee, officer or director of, or have a direct or indirect financial interest in, any person, firm or corporation which is engaged as an administrator for a group self-insurance association.
    3. For purposes of this section, the term “firm” or “corporation” shall include any officer, director, or employee of any such firm or corporation.
    4. This section shall not be construed to affect any contract, or extensions or renewals thereof, for services as an administrator or service company entered into by a group self-insurance association and effective prior to January 1, 1989.

    History. 1989, c. 662, § 65.1-104.3; 1991, c. 355.

    § 65.2-803.1. Requirements for registration as professional employer organization; annual assessment.

    1. Any business entity desiring to engage in the business of providing professional employer services shall register with the Commission before any such services may be provided. The Commission may require any business entity having a controlling ownership interest in or sharing common ownership with a professional employer organization providing professional employer services in the Commonwealth to guarantee, in a form prescribed by the Commission, performance of all obligations pursuant to this title, including the payment of workers’ compensation benefits.
    2. Each registered professional employer organization shall notify the Commission and the Bureau of Insurance of the State Corporation Commission within 30 calendar days of all new or terminated, in whole or in part, client companies. Upon registration and annually thereafter, each registered professional employer organization shall notify the Commission and the Bureau of Insurance of the State Corporation Commission of all client companies. Such notice shall be confidential and shall not be disclosed to the public, provided that the Commission may respond to inquiries as to whether a client company has workers’ compensation coverage; however, nothing herein shall be interpreted to prohibit or limit the production of documents containing such information from the professional employer organization pursuant to an otherwise lawful subpoena issued by a court of competent jurisdiction. Each such notification shall indicate, by client company, if the professional employer organization will provide voluntary market workers’ compensation insurance and whether the client company will obtain separate workers’ compensation insurance. The Commission may require such other information as it deems necessary for the administration of this section.
    3. All agreements for professional employer services shall be in writing and shall provide a description of the respective rights and obligations of the professional employer organization and the client company. The professional employer organization shall provide a written summary of such rights and obligations to each coemployee, including information concerning filing for workers’ compensation and unemployment benefits. No agreement for professional employer services shall alter or affect the terms and conditions of any collective bargaining agreement between the client company and its employees without the consent of the parties to such collective bargaining agreement.
    4. A professional employer organization that is registered with the Commission and operating in compliance with the requirements of this section shall be deemed to be an employer of its coemployees and may assume responsibilities as an employer of its coemployees for the term of its agreement with a client company. A professional employer organization may secure and provide all required voluntary market workers’ compensation insurance for its coemployees under a master workers’ compensation insurance policy in the name of the professional employer organization.
    5. A professional employer organization shall notify in writing the client company and coemployees of its intent to terminate any agreement for professional employer services with a client company at the time of or prior to termination. Such notice shall advise the client company of its obligation to secure workers’ compensation coverage. The professional employer organization shall provide a copy of such notice to the Commission and the insurer at the time notice is given to the client company. Workers’ compensation insurance coverage shall continue until termination or for fifteen calendar days after receipt of notice of termination by both the Commission and the client company, whichever is later. This section shall not alter the notice obligations of an insurer seeking to cancel workers’ compensation coverage pursuant to subsection B of § 65.2-804 . If a professional employer organization has received notice that its workers’ compensation insurance policy will be cancelled or nonrenewed, the professional employer organization shall notify the client companies within seven calendar days after receipt of the notice. Failure of the professional employer organization to provide such notice to the client companies subrogates the Commission, upon payment of a claim from the Uninsured Employer’s Fund to any coemployee of a client company that did not receive notice, to any right to recover damages which the injured coemployee or his personal representative may have against the professional employer organization.
    6. This section shall not exempt a client company from any other license requirements imposed under federal, state, or local law, and a coemployee shall be recognized as an employee of the client company for all purposes. For purposes of licensing requirements, a professional employer organization shall not be deemed to be engaged in the occupation, trade or profession of the client company solely through the provision of professional employer services to that client company.
    7. Where a professional employer organization or a staffing service has obtained workers’ compensation insurance to secure its obligations under this title with respect to compensation on account of injury or death by accident, the rights and remedies available to the employee or coemployee under this title shall be exclusive as to both the client company and the professional employer organization or staffing service in accordance with this title.
    8. A professional employer organization that fails to comply with the provisions of this title or with the regulations of the Commission shall be subject to the requirements of Chapter 9 (§ 65.2-900 et seq.) of this title. The Commission is authorized to revoke or suspend any registration hereunder if the professional employer organization fails to comply with the provisions of this title or with the regulations of the Commission. If a registration is revoked as herein provided, the Commission may allow the professional employer organization to reregister upon application therefor if, when and after the conditions upon which revocation was based have been corrected and the professional employer organization has complied with all provisions of this title and applicable regulations. Whenever a registration is revoked or suspended the Commission may request the Office of the Attorney General to petition the circuit court of the jurisdiction in which the professional employer organization is located for an injunction to cause such professional employer organization to cease providing professional employer services. Suspension of a registration shall in all cases be for an indefinite time and the suspension may be lifted and rights under the registration fully or partially restored at such time as the Commission determines that the rights of the registrant appear to so require and the interests of the public will not be jeopardized by resumption of operation.
    9. Notwithstanding any provision of this title to the contrary, each registered professional employer organization shall be assessed annually by the Commission, in addition to any other assessments provided in this title, an assessment in an amount not to exceed the sums necessary for the registration and supervision of all professional employer organizations. The assessment shall be apportioned and assessed and paid in proportion to the aggregate of the annual payroll of all coemployees shared by or assigned or allocated to the professional employer organization.
    10. The Bureau of Insurance of the State Corporation Commission may request and shall receive information filed with the Commission by a professional employer organization. Such information shall be confidential and shall be used solely for informational purposes by the Bureau of Insurance and its staff.
    11. No person shall sell, solicit, or negotiate, as those terms are defined in § 38.2-1800 , contracts of insurance for or on behalf of a professional employer organization unless such person is licensed for that class of insurance as an insurance agent, as defined in § 38.2-1800 .
    12. The Commission may promulgate regulations as it deems necessary for the administration of this section.

    History. 2000, cc. 624, 718; 2001, c. 706; 2002, c. 469; 2005, c. 158.

    Editor’s note.

    Acts 2000, cc. 624 and 718, cls. 2, are identical, and provide: “That the provisions of this act shall be effective with respect to any workers’ compensation insurance policy issued to or renewed with a professional employer organization on or after January 1, 2001.”

    The 2001 amendments.

    The 2001 amendment by c. 706, effective September 1, 2002, substituted “thirty calendar days” for “thirty days” in the first sentence of subsection B; substituted “fifteen calendar days” for “fifteen days” in the fourth and sixth sentences of subsection E; and substituted “sell, solicit, or negotiate, as those terms are defined in § 38.2-1800 ” for “solicit, negotiate, procure or effect” in subsection K.

    The 2002 amendments.

    The 2002 amendment by c. 469, in this section as effective September 1, 2002, substituted “seven” for “fifteen” in the next to last sentence of subsection E.

    The 2005 amendments.

    The 2005 amendment by c. 158, in subsection A, substituted “business entity” for “person”, “any such services may be provided” for “it undertakes to provide,” adds the last sentence, and makes a minor stylistic change.

    Law Review.

    For Essay, “Analyzing the Virginia Workers’ Compensation Act’s Governance of Employer Non-Compliance,” see 51 U. Rich. L. Rev. 193 (2016).

    § 65.2-804. Evidence of compliance with title; notices of cancellation of insurance.

      1. Each employer subject to this title shall file with the Workers’ Compensation Commission, in form prescribed by it, annually or as often as may be necessary, evidence of his compliance with the provisions of § 65.2-801 and all others relating thereto; however, if the employer secures his liability under this title pursuant to subdivision A 1 of § 65.2-801 then the insurance carrier shall make a filing on behalf of the employer, and such filing shall be made electronically in the form as prescribed and to the agent as designated by the Commission, within 30 days of the inception of the policy. Evidence of an employer’s compliance with the provisions of subdivision A 1 of § 65.2-801 shall be deemed to satisfy such provisions if it includes the name and address of the insured, the insured’s federal employer identification number, his policy number, dates of insurance coverage, the name and address of his insurer, and the insurer’s identification number. Every employer who has complied with the foregoing provision and has subsequently cancelled his insurance or his membership in a licensed group self-insurance association shall immediately notify the Workers’ Compensation Commission of such cancellation, the date thereof and the reasons therefor. Every insurance carrier or group self-insurance association shall in like manner notify the Workers’ Compensation Commission immediately upon the cancellation of any policy issued by it or any membership agreement, whichever is applicable, under the provisions of this title, except that a carrier or group self-insurance association need not set forth its reasons for cancellation unless requested by the Workers’ Compensation Commission. A. 1. Each employer subject to this title shall file with the Workers’ Compensation Commission, in form prescribed by it, annually or as often as may be necessary, evidence of his compliance with the provisions of § 65.2-801 and all others relating thereto; however, if the employer secures his liability under this title pursuant to subdivision A 1 of § 65.2-801 then the insurance carrier shall make a filing on behalf of the employer, and such filing shall be made electronically in the form as prescribed and to the agent as designated by the Commission, within 30 days of the inception of the policy. Evidence of an employer’s compliance with the provisions of subdivision A 1 of § 65.2-801 shall be deemed to satisfy such provisions if it includes the name and address of the insured, the insured’s federal employer identification number, his policy number, dates of insurance coverage, the name and address of his insurer, and the insurer’s identification number. Every employer who has complied with the foregoing provision and has subsequently cancelled his insurance or his membership in a licensed group self-insurance association shall immediately notify the Workers’ Compensation Commission of such cancellation, the date thereof and the reasons therefor. Every insurance carrier or group self-insurance association shall in like manner notify the Workers’ Compensation Commission immediately upon the cancellation of any policy issued by it or any membership agreement, whichever is applicable, under the provisions of this title, except that a carrier or group self-insurance association need not set forth its reasons for cancellation unless requested by the Workers’ Compensation Commission.
      2. Every employer who cancels his insurance or his membership in a licensed group self-insurance association shall, prior to cancelling his insurance or his membership, give 30 days’ written notice to his employees covered. Every employer who receives the notice required under subsection B of this section shall immediately forward a copy to his employees covered. Where the employer is a mine owner or operator, the notice or copy of notice required to be given by this subsection shall also be given to the Chief Mine Inspector. The provisions of this subsection shall not apply with respect to a cancellation incident to a change of insurance or membership where no lapse of coverage occurs.
    1. No policy of insurance hereafter issued under the provisions of this title, nor any membership agreement in a group self-insurance association, shall be cancelled or nonrenewed by the insurer issuing such policy or by the group self-insurance association cancelling or nonrenewing such membership, except on 30 days’ notice to the employer and the Workers’ Compensation Commission, unless the employer has obtained other insurance and the Workers’ Compensation Commission is notified of that fact by the insurer assuming the risk, or unless, in the event of cancellation, said cancellation is for nonpayment of premiums; then 10 days’ notice shall be given the employer and the Workers’ Compensation Commission.
    2. The Commission may designate an agent for receipt of any notices required to be given to it pursuant to this section.

    History. Code 1950, § 65-101; 1956, c. 467; 1968, c. 660, § 65.1-105; 1970, c. 470; 1979, c. 463; 1982, c. 383; 1991, c. 355; 1993, c. 725; 2002, c. 812; 2009, c. 150; 2010, cc. 282, 376; 2018, c. 260.

    The 2002 amendments.

    The 2002 amendment by c. 812, in subdivision A 1, in the first sentence, substituted “Each employer” for “Every employer” at the beginning and added “however, any employer who secures his liability under this title pursuant to subdivision A 1 of § 65.2-801 may have his insurance carrier make such filing” at the end, and inserted the second and third sentences.

    The 2009 amendments.

    The 2009 amendment by c. 150, effective March 6, 2009, added subsection C and made minor stylistic changes.

    The 2010 amendments.

    The 2010 amendments by cc. 282 and 376 are identical, and substituted “if the employer secures his liability under this title pursuant to subdivision A 1 of § 65.2-801 then the insurance carrier shall make a filing on behalf of the employer, and such filing shall be made electronically in the form as prescribed and to the agent as designated by the Commission, within 30 days of the inception of the policy” for “any employer who secures his liability under this title pursuant to subdivision A 1 of § 65.2-801 may have his insurance carrier make such filing” in the first sentence of subdivision A 1.

    The 2018 amendments.

    The 2018 amendment by c. 260 deleted the former third sentence in subdivision A 1, which read “Proof of coverage information filed with the Commission by an insurance carrier or rate service organization on behalf of an employer shall in no event be aggregated by the Commission with the proof of coverage information filed by or on behalf of other employers.”

    Law Review.

    For Essay, “Analyzing the Virginia Workers’ Compensation Act’s Governance of Employer Non-Compliance,” see 51 U. Rich. L. Rev. 193 (2016).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, §§ 3, 10, 15.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-105 or prior law.

    Legislative intent of the notice and delay requirements of this section was to protect the worker against a lapse in his employer’s insurance coverage. Hartford Accident & Indem. Co. v. Fidelity & Guar. Ins. Underwriters, Inc., 223 Va. 641 , 292 S.E.2d 327, 1982 Va. LEXIS 248 (1982).

    The notice and delay requirements of this section serve two functions: They give the employer an opportunity to acquire other insurance, and they make it possible for the Commission timely to invoke its enforcement authority under former § 65.1-106 (now § 65.2-805 ). Hartford Accident & Indem. Co. v. Fidelity & Guar. Ins. Underwriters, Inc., 223 Va. 641 , 292 S.E.2d 327, 1982 Va. LEXIS 248 (1982).

    Notice requirement is mandatory. —

    The requirement of this section that notice be given to the Commission is not just an administrative convenience, but a mandatory provision that must be complied with for a carrier to effectively cancel a workers’ compensation policy. American Mut. Fire Ins. Co. v. Barlow, 4 Va. App. 352, 358 S.E.2d 184, 4 Va. Law Rep. 115, 1987 Va. App. LEXIS 188 (1987).

    Workers’ Compensation Commission properly dismissed an insurer as a party defendant in an injured employee’s action against the employer because the insurer was not obligated to provide the employer coverage for the loss event where, while the Commission erred by holding that actual receipt of the notice of cancellation was not required, the employer did not establish that its reliance on an agent’s misrepresentations was justifiable, the employer was fully aware of its insufficient down payment, did not make a single premium payment, and actually received the notice of cancellation 36 days before the employee was injured. Full Circle Concepts II, LLC v. Cherry, 2015 Va. App. LEXIS 32 (Va. Ct. App. Feb. 3, 2015).

    This section demands that the notice be actually received by the Commission to constitute an effective cancellation. American Mut. Fire Ins. Co. v. Barlow, 4 Va. App. 352, 358 S.E.2d 184, 4 Va. Law Rep. 115, 1987 Va. App. LEXIS 188 (1987).

    Thirty-day notice provision applies only where insurer cancels. —

    The thirty-day notice provision in subsection B applies only where insurance is cancelled by the insurer, not where the insurance is cancelled by the employer. Pennsylvania Mfrs. Ass'n Ins. Co. v. Waldron, 16 Va. App. 991, 434 S.E.2d 690, 10 Va. Law Rep. 175, 1993 Va. App. LEXIS 412 (1993).

    Insurer not obligated to provide reasons for employer cancellation. —

    The plain language of this section does not require the insurer to set forth the reasons for cancellation where employer cancels the insurance policy. Pennsylvania Mfrs. Ass'n Ins. Co. v. Waldron, 16 Va. App. 991, 434 S.E.2d 690, 10 Va. Law Rep. 175, 1993 Va. App. LEXIS 412 (1993).

    Obligations between insurance carriers and other parties in collateral undertakings. —

    This section imposes insuring and reporting obligations on individual employers, and the notice requirement of subsection B addresses that regulatory concern; it does not concern obligations which may come into being between insurance carriers and other parties by virtue of collateral undertakings; therefore, subsection B did not require that general contractor be given notice of the cancellations of subcontractor’s insurance coverage. Girdley Constr. Co. v. Widger, 1990 Va. App. LEXIS 241 (Va. Ct. App. May 29, 1990).

    Acceptance of premiums. —

    Statutes such as this section are designed to prevent employees from being left without compensation coverage. However, notification requirement statutes should not extend beyond the reason for their existence, and an insurer who accepted premiums should accept the loss, although strict technical cancellation by another carrier had not been accomplished. Franklin Mtg. Corp. v. Walker, 6 Va. App. 108, 367 S.E.2d 191, 4 Va. Law Rep. 2254, 1988 Va. App. LEXIS 24 (1988).

    Failure to pay premium meant insurer not required to give notice. —

    Insurer was not required to comply with the notice provisions contained in subsection B of § 65.2-804 because the workers’ compensation and employers’ liability insurance policies, which the insurer issued to two employers, were not non-renewed by the insurer as the employers did not pay the insurance premiums that were required to renew the policies. Thus, the insurance policies were not in effect when the employers’ employees were injured so that the insurer was not responsible for the payment of benefits to the employees. Travelers Prop. Cas. Co. of Am. v. Ely, 276 Va. 339 , 666 S.E.2d 523, 2008 Va. LEXIS 98 (2008).

    Uninsured employer’s fund, rather than the carrier, was responsible for medical benefits for the claimant’s compensable injury because the employer had failed to pay a premium when due, and, although the carrier failed to file a form 45H with the Virginia Workers’ Compensation Commission before the claimant’s injury, the carrier had a statutory obligation to file a form 45H only when the carrier opted not to renew, not when the employer opted not to renew. Am. Zurich Ins. Co. v. Amundsen, 2009 Va. App. LEXIS 150 (Va. Ct. App. Mar. 31, 2009).

    Where insurer informed plaintiff employer more than two months before the policy cancellation date that his insurance would be canceled for failure to provide information necessary for an audit, his insurance was effectively canceled under this section. Villwock v. Insurance Co. of N. Am./CIGNA, 22 Va. App. 127, 468 S.E.2d 130, 1996 Va. App. LEXIS 234 (1996).

    Jurisdiction of the Commission. —

    Virginia Workers’ Compensation Commission properly determined that an employer was subject to the Commission’s jurisdiction in a victim’s claim for injuries sustained while working for the employer as a truck driver, as the employer had regularly in service, three or more employees at the time of the victim’s accident. Va. Uninsured Emplr. Fund v. Nunn, 2003 Va. App. LEXIS 156 (Va. Ct. App. Mar. 25, 2003).

    Civil penalty properly assessed. —

    Virginia Workers’ Compensation Commission properly assessed a civil penalty on a cab company as: (1) the cab company employed four to six employees, and did not have workers’ compensation insurance due to a dispute with its insurer, (2) § 65.2-800 required every employer subject to the Virginia Workers’ Compensation Act to have workers’ compensation insurance, (3) subsection A of § 65.2-804 instructed employers to provide proof of that insurance to the Commission annually, or as often as might be necessary, (4) § 65.2-805 stated that employers who failed to comply with §§ 65.2-800 or 65.2-804 were to be assessed a civil penalty, and (5) neither the case law nor the Act included an exception to the insurance requirement based upon a dispute with an insurer. N. End Cab Co. v. Va. Workers' Comp. Comm'n, 2007 Va. App. LEXIS 110 (Va. Ct. App. Mar. 20, 2007).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Section 65.2-805 provides that an employer who fails to comply with the provisions of § 65.2-804 [reporting insurance coverage] “shall be assessed a civil penalty of not less than $500 nor more than $5000. . . . ” This language imposes a mandatory civil penalty, and the Commission does not have authority to assess a penalty less than the minimum amount set by the statute. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Legislative purpose of § 65.1-105 (now § 65.2-105 ) was to have carrier notify both employer and Commission of the issuance of a Workers’ Compensation insurance policy. Hendricks v. USCO Structures, Inc., 60 O.I.C. 201 (1981).

    The Commission has jurisdiction to interpret a workers’ compensation policy to determine the effective dates of the cancellation of policies, and to decide whether an employer has filed the proper information regarding coverage on its employees but will not adjudicate a dispute between a carrier and its agent. Estes v. Cavalier Enterprises of Virginia, 67 O.I.C. 17 (1988).

    Carrier must give statutory notice of cancellation in order to be exempt from liability, and until such notice is given, carrier remains liable with subsequent carrier. Bostick v. Anden Ltd. t/a The Alexion Restaurant, 58 O.I.C. 34 (1979).

    Unless a cancellation notice from the carrier specifically provides that it is for nonpayment of premium which evokes a ten-day waiting period, the insurance department will authorize a thirty-day cancellation period. The procedure of § 1-13.3 [see now § 1-210 ] requires that the date of receipt of notice be included in the days counted and the date of cancellation excluded from the period counted. Widger v. R. A. Purdie Construction, 68 O.I.C. 259 (1989).

    Where NCCI is notified that a policy has been renewed for the next policy period and the policy is subsequently canceled for non-payment of premium, the insurance remains in force until ten days after such notice is received by the Workers’ Compensation Commission. Wright v. Harrison’s Supermarket, 70 O.I.C. 254 (1991). (Affirmed by unpublished Court of Appeals Opinion 3/31/92).

    Notwithstanding statutory violations by both carriers, carrier whose policy was in effect at time of accident is responsible for payment of claim. Hendricks v. USCO Structures, Inc., 60 O.I.C. 201 (1981).

    Where a carrier, by its own negligence accepted a claim as compensable and paid benefits for some two years before discovering that its coverage for the employer had expired prior to the date of the accident, the doctrine of laches precludes shifting the burden of paying the claim to the correct carrier whose right to protect itself from liability had been signed away without its knowledge or agreement. Matthews v. Potomac Insulation, 63 O.I.C. 226 (1984).

    § 65.2-805. Civil penalty for violation of §§ 65.2-800, 65.2-803.1, and 65.2-804.

    1. If such employer fails to comply with the provisions of § 65.2-800 or 65.2-804 , he shall be assessed a civil penalty of not more than $250 per day for each day of noncompliance, subject to a maximum penalty of $50,000. Such employer also shall be liable during continuance of such failure to any employee either for compensation under this title or at law in a suit instituted by the employee against such employer to recover damages for personal injury or death by accident, and in any such suit such employer shall not be permitted to defend upon any of the following grounds:
      1. That the employee was negligent;
      2. That the injury was caused by the negligence of a fellow employee; or
      3. That the employee had assumed the risk of the injury.
    2. Any person who fails to comply with the provisions of § 65.2-803.1 shall be assessed a civil penalty of not less than $500 nor more than $5,000 for each instance of noncompliance, in addition to any other penalties applicable under this title.
    3. The civil penalties herein provided may be assessed by the Commission in an open hearing with the right of review and appeal as in other cases. Upon a finding by the Commission of such failure to comply, and after 15 days’ written notice thereof sent by certified mail to the employer, if such failure continues, the Commission may order the employer to cease and desist all business transactions and operations until found by the Commission to be in compliance with the provisions of this chapter.
    4. Any civil penalty assessed pursuant to this section shall be divided equally between and paid into the administrative fund established in Chapter 10 (§ 65.2-1000 et seq.) and the Uninsured Employer’s Fund established in Chapter 12 (§ 65.2-1200 et seq.). The Commission may add the costs of collection of such civil penalty to the aggregate civil penalty owed, in which event such costs shall be paid into the administrative fund established in Chapter 10 (§ 65.2-1000 et seq.).

    History. Code 1950, § 65-102; 1968, c. 660, § 65.1-106; 1970, c. 470; 1974, c. 314; 1980, c. 443; 1991, c. 355; 1993, c. 378; 2005, c. 69; 2014, c. 204.

    The 2005 amendments.

    The 2005 amendment by c. 69 inserted “65.2-800 or” in subsection A; added subsection B and redesignated former subsections B and C as present subsections C and D; and made minor stylistic changes in subsection C.

    The 2014 amendments.

    The 2014 amendment by c. 204, in subsection A, deleted “less than $500 nor” following “penalty of not” and substituted “$250 per day for each day of noncompliance, subject to a maximum penalty of $50,000. Such employer also” for “$5,000, and he”; and rewrote subsection D, which formerly read “Any civil penalty assessed pursuant to this section shall be paid into the Uninsured Employer’s Fund established in Chapter 12 (§ 65.2-1200 et seq.) of this title.”

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1973-1974, see 60 Va. L. Rev. 1643 (1974).

    For Essay, “Analyzing the Virginia Workers’ Compensation Act’s Governance of Employer Non-Compliance,” see 51 U. Rich. L. Rev. 193 (2016).

    Michie’s Jurisprudence.

    For related discussion, see 12B M.J. Master and Servant, § 78.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-106 or prior law.

    Legislative intent. —

    This section expresses the overriding legislative intent that an uninsured employer shall be liable to his employee injured in an accident arising out of and during the course of his employment. Virginia Used Auto Parts, Inc. v. Robertson, 212 Va. 100 , 181 S.E.2d 612, 1971 Va. LEXIS 300 (1971).

    The notice and delay requirements of former § 65.1-105 (now § 65.2-804 ) serve two functions: They give the employer an opportunity to acquire other insurance, and they make it possible for the Commission timely to invoke its enforcement authority under this section. Hartford Accident & Indem. Co. v. Fidelity & Guar. Ins. Underwriters, Inc., 223 Va. 641 , 292 S.E.2d 327, 1982 Va. LEXIS 248 (1982).

    Liberal construction. —

    Being part of the Workmen’s (now Workers’) Compensation Act, this section is to be liberally construed in favor of the employee. Virginia Used Auto Parts, Inc. v. Robertson, 212 Va. 100 , 181 S.E.2d 612, 1971 Va. LEXIS 300 (1971).

    This section allows the commission to impose a fine where, as here, the employer failed to comply with the requirements of § 65.2-804 . Jim's Home Auto Serv., Inc. v. Nielsen, 1993 Va. App. LEXIS 234 (Va. Ct. App. June 29, 1993).

    Similarity to Longshoremen’s Act. —

    This section contains almost the identical provision as set forth in § 905 of the Longshoremen’s Act. Biggs v. Norfolk Dredging Co., 237 F. Supp. 590, 1965 U.S. Dist. LEXIS 7677 (E.D. Va. 1965), rev'd, 360 F.2d 360, 1966 U.S. App. LEXIS 6654 (4th Cir. 1966).

    This section is penal in nature. Virginia Used Auto Parts, Inc. v. Robertson, 212 Va. 100 , 181 S.E.2d 612, 1971 Va. LEXIS 300 (1971).

    And it provides extraordinary advantages to an injured employee when his employer has failed or refused to comply with the Act. Virginia Used Auto Parts, Inc. v. Robertson, 212 Va. 100 , 181 S.E.2d 612, 1971 Va. LEXIS 300 (1971).

    Every employer must insure employees. —

    This section, taken in conjunction with former § 65.1-103 (now § 65.2-800 ), former § 65.1-104 (repealed), and former § 65.1-105 (now § 65.2-804 ), demands that every employer insure the compensation of employees. Thus, an injured employee of a subcontractor which had not obtained workmen’s (now workers’) compensation insurance as required by law was entitled to bring an action for monetary damages against the subcontractor, even though the general contractor had compensation insurance which might be available to the employee. Baldwin v. Wrecking Corp. of Am., 464 F. Supp. 185, 1979 U.S. Dist. LEXIS 15222 (W.D. Va. 1979).

    Employer, whose son was properly deemed his third employee, was appropriately assessed a fine, pursuant to § 65.2-805 for failing to carry workers’ compensation coverage; evidence showed that the son worked at the employer’s direction, was paid a wage, used the company vehicle to travel to various work sites, and the employer established quitting time and gave workers, including his son, their individual work assignments. Perkey v. Fridley, 2003 Va. App. LEXIS 31 (Va. Ct. App. Jan. 28, 2003).

    This section does not explicitly require the employee to make an election of remedies. Virginia Used Auto Parts, Inc. v. Robertson, 212 Va. 100 , 181 S.E.2d 612, 1971 Va. LEXIS 300 (1971).

    But he is entitled to only one full recovery and can collect only one time. But where he has effected no recovery, he has not received the satisfaction that can come only with payment. Delp v. Berry, 213 Va. 786 , 195 S.E.2d 877, 1973 Va. LEXIS 232 (1973).

    When employee may resort to civil action against employer. —

    Where an employer failed to comply with the provisions of the Act, notwithstanding it was subject thereto, and the employee-claimant has been unsuccessful in collecting the award decreed him by the Commission, the employee-claimant is not barred from resorting to a civil action to recover damages from the employer. Delp v. Berry, 213 Va. 786 , 195 S.E.2d 877, 1973 Va. LEXIS 232 (1973).

    Unsuccessful resort to a civil action will not bar the employee from pursuing his remedy under the Workmen’s (now Workers’) Compensation Act. Virginia Used Auto Parts, Inc. v. Robertson, 212 Va. 100 , 181 S.E.2d 612, 1971 Va. LEXIS 300 (1971).

    Under a statute giving the employee the right to proceed either at law or under the Workmen’s (now Workers’) Compensation Act against an uninsured employer, the employee will not be barred by an unsuccessful action at law. Virginia Used Auto Parts, Inc. v. Robertson, 212 Va. 100 , 181 S.E.2d 612, 1971 Va. LEXIS 300 (1971).

    Circuit court did not err in ruling that the injured employee could not pursue an action at law against his uninsured employer after obtaining a final collectible award of workers’ compensation benefits. Because the employee successfully obtained a final workers’ compensation award, had received some of that award from the employer, and was assured of recovering all the workers’ compensation benefits to which he was entitled, he received the recovery he sought under the Workers’ Compensation Act. Redifer v. Chester, 283 Va. 121 , 720 S.E.2d 66, 2012 Va. LEXIS 6 (2012).

    Imposition of fine upon review of dismissal by deputy commissioner was not double jeopardy. —

    Where the deputy commissioner dismissed the show cause order against the employer, the Commission’s later imposition of a fine when it reviewed the deputy commissioner’s decision was not double jeopardy. This fine, imposed under this section for failure to obtain workers’ compensation insurance, is not a criminal penalty. It is a fine imposed because of an employer’s refusal or neglect to comply with the provisions requiring evidence of insurance. Smith v. Weber, No. 0873-85 (Ct. of Appeals Nov. 5, 1986).

    Civil penalty properly assessed. —

    Virginia Workers’ Compensation Commission properly assessed a civil penalty on a cab company as: (1) the cab company employed four to six employees, and did not have workers’ compensation insurance due to a dispute with its insurer, (2) § 65.2-800 required every employer subject to the Virginia Workers’ Compensation Act to have workers’ compensation insurance, (3) subsection A of § 65.2-804 instructed employers to provide proof of that insurance to the Commission annually, or as often as might be necessary, (4) § 65.2-805 stated that employers who failed to comply with §§ 65.2-800 or 65.2-804 were to be assessed a civil penalty, and (5) neither the case law nor the Act included an exception to the insurance requirement based upon a dispute with an insurer. N. End Cab Co. v. Va. Workers' Comp. Comm'n, 2007 Va. App. LEXIS 110 (Va. Ct. App. Mar. 20, 2007).

    Virginia Workers’ Compensation Commission did not abuse its discretion in imposing a $25,000 fine against an employer for the employer’s failure to maintain workers’ compensation insurance coverage, as statutorily required, because the fine imposed by the Commission was below the statutory maximum and the deputy commissioner did not find credible the employer’s testimony that the employer did not believe that the employer was required to have coverage. Am. Transp. v. Mailloux, 2018 Va. App. LEXIS 267 (Va. Ct. App. Oct. 9, 2018).

    CIRCUIT COURT OPINIONS

    Prima facie case of negligence. —

    Having failed to plead a prima facie case of negligence, plaintiff’s complaint was deficient as a matter of law, and defendant’s demurrer was sustained, although plaintiff was granted leave to replead. Bailey v. Hensley, 93 Va. Cir. 344, 2016 Va. Cir. LEXIS 74 (Roanoke May 6, 2016).

    Subsection A cannot be read to dispense with an injured employee’s need to establish a prima facie case of negligence if the employee chooses to proceed with a suit at law for recovery under the statute. Bailey v. Hensley, 93 Va. Cir. 344, 2016 Va. Cir. LEXIS 74 (Roanoke May 6, 2016).

    Action against co-worker not allowed. —

    Co-worker’s plea in bar was sustained because an injured employee had a cause of action against his uninsured employer, but not against his co-worker where the parties stipulated that the employer was required to obtain workers’ compensation insurance, but failed to do so. Wade v. Scott Recycling, L.L.C., 87 Va. Cir. 112, 2013 Va. Cir. LEXIS 156 (Roanoke Sept. 19, 2013).

    Employer admitted liability. —

    Both the language of Va. Code Ann. § 65.2-805 , as well as the Supreme Court’s interpretation of the statute, necessitated granting plaintiff employee’s motion for partial summary judgment. Because defendant employer admitted to being within the ambit of the punitive section of the Virginia Workers’ Compensation Act, it was liable in a suit instituted by plaintiff to recover damages for personal injury. Wade v. Scott Recycling, LLC, 89 Va. Cir. 319, 2014 Va. Cir. LEXIS 64 (Roanoke Nov. 20, 2014).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    A Show Cause hearing is a proceeding independent from a claim brought by an injured worker. A decision to fine an employer for failure to have insurance is not binding on a non-party and thus is not res judicata as to those parties. The Uninsured Employer’s Fund can raise a jurisdictional defense should a claim be filed and similarly claimant is not barred from bringing a claim if the Show Cause was dismissed. Bowser v. Michael Eugene Boggan, VWC File No. 223-95-20 (June 29, 2006).

    The automatic stay in bankruptcy does not operate to bar the civil fines associated with the failure to carry workers’ compensation insurance and for failure to respond to a subpoena duces tecum and Show Cause Order because the Commission is exercising its regulatory power and is exempt from the stay pursuant to 11 USCS § 3629(b)(4). In re: Old Point Comfort Hotel, L.L.C., VWC File No. E-0301-14326 (Dec. 13, 2004).

    Code § 65.2-805 provides that an employer who fails to comply with the provisions of § 65.2-804 [reporting insurance coverage] “shall be assessed a civil penalty of not less than $500 nor more than $5000 . . . ” This language imposes a mandatory civil penalty, and the Commission does not have authority to assess a penalty less than the minimum amount set by the statute. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    Code § 65.2-804 requires that every employer must file evidence of its workers’ compensation insurance coverage with the Commission. Code § 65.2-805 provides for a civil penalty of not less than $500 nor more than $5,000 for a violation of § 65.2-804 . The Commission agreed in this case that the employer’s size and financial situation did not warrant the maximum penalty, and it imposed a penalty of $2,500. However, it suspended the penalty, on condition that the employer obtain and maintain workers’ compensation insurance coverage as required by the Virginia Workers’ Compensation Act, and also that the employer pay the claimant’s medical bills pursuant to the award of medical benefits. Oden v. Eagle Aviation Technologies, Inc., 78 O.W.C. 141 (1999).

    An employer is not excused for failure to insure workers’ compensation liability because of misinformation about the requirement for insurance coverage or unawareness that coverage was not in force. Montross v. Wm. Melvin t/a Barnacle Bill’s Bait & Tackle, 68 O.I.C. 22 (1989).

    Lack of knowledge that company was uninsured is not an excuse; every employer has an affirmative duty to determine that workers’ compensation coverage is in effect. Hall v. J. & M. Corp., 59 O.I.C. 114 (1980).

    When employer, a partnership created “for the purchase, development, and operation of commercial real property,” hired three to five employees for the purpose of improving a parcel of rental property, it became obliged to obtain workers’ compensation insurance and its failure to do so left it subject to fine under this section. Williams v. Richard Porter t/a Zenith Associates, 61 O.I.C. 421 (1982).

    A statutory employer otherwise exempt from the Act because it has fewer than three employees may be fined for failure to insure its workers’ compensation liability where the collective total of employees, counting those of its subcontractors, is three or more. Taylor v. Stone Builders, 75 O.W.C. 11 (1996).

    Incorporated subcontractors, who are considered employees under the Act, count as statutory employees of the general contractor. Velonza v. Pandell Builders, Inc., 75 O.W.C. 172 (1996).

    Upon a finding that the employer has failed to maintain workers’ compensation insurance coverage in accordance with § 65.1-105 (now § 65.2-804 ), after 15 days’ written notice to the employer, the Commission may order the employer to cease and desist all business transactions until the employer becomes properly insured. Wagner v. Hubbard Cake Company, 61 O.I.C. 391 (1982).

    § 65.2-806. Criminal penalties.

    In addition to the civil penalties assessed pursuant to § 65.2-805 , any employer who knowingly and intentionally fails to comply with the provisions of § 65.2-800 or 65.2-804 is guilty of a Class 2 misdemeanor.

    Venue for the prosecution hereof when there is an injury shall lie in the county or city wherein the injury occurred.

    History. 1977, c. 434, § 65.1-106.1; 1991, c. 355; 2005, c. 69.

    Cross references.

    As to punishment for Class 2 misdemeanors, see § 18.2-11 .

    The 2005 amendments.

    The 2005 amendment by c. 69, in the introductory paragraph, substituted “civil penalties” for “fine”; and inserted “65.2-800 or” and made minor stylistic changes.

    § 65.2-807. Cost of insurance may not be deducted from wages.

    It shall not be lawful for any employer to deduct from the wages of any of his employees any part of the cost of insurance as provided for in § 65.2-801 to insure liability, or to require or permit any of his employees to contribute in any manner toward such cost of insurance. For any violation of the provisions of this section, an employer shall be subject to a fine not exceeding $100 for each offense and shall refund to the individual employee the amount or amounts deducted or contributed. The fine herein provided may be assessed and the refund ordered by the Workers’ Compensation Commission in an open hearing with the right of review and appeal as in other cases.

    History. Code 1950, § 65-103; 1968, c. 660, § 65.1-107; 1991, c. 355.

    CASE NOTES

    When the owners of a business pay their workers’ compensation insurance premiums from business assets, the payment is a business expense they incur as owners rather than a deduction from an employee’s wages. Counts v. Stone Container Corp., 239 Va. 152 , 387 S.E.2d 481, 6 Va. Law Rep. 1109, 1990 Va. LEXIS 8 (1990) (decided under former § 65.1-107).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    An employer must reimburse an employee for all amounts withheld from the claimant’s earnings attributable to the costs of workers’ compensation coverage. Sidam v. Manjac Construction Co., 76 O.W.C. 19 (1997).

    § 65.2-808. Self-insurance certificate.

    Whenever an employer has complied with the provisions of § 65.2-801 relating to self-insurance, the Workers’ Compensation Commission shall issue to such employer a certificate which shall remain in force for a period fixed by the Commission. But the Commission may upon at least thirty days’ notice and hearing to the employer revoke the certificate upon satisfactory evidence for such revocation having been presented. At any time after such revocation, the Commission may grant a new certificate to the employer upon his petition.

    History. Code 1950, § 65-104; 1968, c. 660, § 65.1-108; 1979, c. 463; 1987, c. 343; 1991, c. 355.

    § 65.2-809. Constructive notice to, jurisdiction of, and awards, etc., binding upon insurer.

    All policies insuring the payment of compensation under this title must contain clauses to the effect (i) that as between the employer and the insurer notice to or knowledge of the occurrence of the injury on the part of the insured employer shall be deemed notice or knowledge on the part of the insurer, (ii) that jurisdiction of the insured for the purposes of this title shall be jurisdiction of the insurer, and (iii) that the insurer shall in all things be bound by and subject to the awards, judgments or decrees rendered against such insured employer.

    History. Code 1950, § 65-105; 1968, c. 660, § 65.1-109; 1991, c. 355.

    CASE NOTES

    Due process claim moot. —

    Where insurer was not a party to proceeding in which the full Commission concluded that claimant suffered from a progression of the injury sustained in a previous accident and not from a new accident, but in response to claimant’s request for payment of his medical bills, the insurer raised the due process issue and requested an opportunity to present evidence, which request was granted at a hearing at which the insurer was given a full and fair opportunity to call witnesses, confront the claimant and present any new evidence it deemed relevant, the effect of this hearing was to make moot any argument by the insurer that it was denied due process of law. Therefore, the insurer’s claim that this section and former § 65.1-111 (now § 65.2-811 ) are applicable to cases in which there is a community of interest between the employer and the insurer which sufficiently protects the rights of one where only the other received notice of the proceeding, but that where the interests of the employer and the insurer are adverse, to bind the insurer to a decision resulting from a hearing of which it received no notice nor opportunity to be heard would offend traditional notions of fair play and substantial justice was without merit. Board of Supvrs. v. Taylor, 1 Va. App. 425, 339 S.E.2d 565, 1986 Va. App. LEXIS 219 (1986) (decided under former § 65.1-109).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Notice to the carrier is considered notice to the employer. Stitt v. Install, Inc., 62 O.I.C. 432 (1983) (see also Musick v. Pizza Hut, 75 O.W.C. 54 (1996)).

    A carrier may not avoid assessment of a fine for failure to file a First Report within ten days as required by § 65.1-124 (now § 65.2-900 ) by alleging that the employer failed to promptly provide the carrier with notice of the accident. Relying on § 65.1-109 (now § 65.2-809 ), the Commission held that notice to the employer of the claimant’s injury became constructive notice to the carrier on the same date. Sanderfur v. United Parcel Service of America, 69 O.I.C. 198 (1990).

    § 65.2-810. How formal notice may be given.

    Whenever by this title or the terms of any policy contract notice is required to be given by an employer to any insurance carrier, the same may be given by delivery or by mailing by registered letter properly addressed and stamped to the principal office or chief agent of such insurance carrier within this Commonwealth or to its home office, or to the secretary, general agent or chief officer thereof in the United States.

    History. Code 1950, § 65-106; 1968, c. 660, § 65.1-110; 1991, c. 355.

    § 65.2-811. Liability of insurer.

    No policy of insurance against liability arising under this title shall be issued unless it contains the agreement of the insurer that it will promptly pay the person entitled to the same all benefits conferred by this title and all installments of the compensation that may be awarded or agreed upon and that the obligation shall not be affected by any default of the insured after the injury or by any default in giving notice required by such policy or otherwise. Such agreement shall be construed to be a direct promise by the insurer to the person entitled to compensation, enforceable in his name.

    History. Code 1950, § 65-107; 1968, c. 660, § 65.1-111; 1991, c. 355.

    CASE NOTES

    This section does not in terms require that all policies shall be conclusively presumed to cover all employees and the entire compensation liability of the insured. Coal Operators Cas. Co. v. Smith & Son Coal Co., 192 Va. 619 , 66 S.E.2d 521, 1951 Va. LEXIS 209 (1951) (decided under prior law).

    Due process claim moot. —

    Where insurer was not a party to proceeding in which the full Commission concluded that claimant suffered from a progression of the injury sustained in a previous accident and not from a new accident, but in response to claimant’s request for payment of his medical bills, the insurer raised the due process issue and requested an opportunity to present evidence, which request was granted at a hearing at which the insurer was given a full and fair opportunity to call witnesses, confront the claimant and present any new evidence it deemed relevant, the effect of this hearing was to make moot any argument by the insurer that it was denied due process of law. Therefore, the insurer’s claim that former § 65.1-109 (now § 65.2-809 ) and this section are applicable to cases in which there is a community of interest between the employer and the insurer which sufficiently protects the rights of one where only the other received notice of the proceeding, but that where the interests of the employer and the insurer are adverse, to bind the insurer to a decision resulting from a hearing of which it received no notice nor opportunity to be heard would offend traditional notions of fair play and substantial justice was without merit. Board of Supvrs. v. Taylor, 1 Va. App. 425, 339 S.E.2d 565, 1986 Va. App. LEXIS 219 (1986) (decided under prior law).

    Agreement to pay compensation. —

    Workers’ Compensation Commission properly found that it had jurisdiction to award compensation to a claimant because, the insurer agreed to pay compensation, the claimant did not have to establish coverage, nothing in the record established that employer failed to comply with the statutory requirements, and there no merit to the insurer’s assertion that the Uninsured Employer’s Fund was responsible for paying compensation where the policy was not cancelled or not renewed. Nationwide Mut. Ins. Co. v. Estate of Harrison, 64 Va. App. 110, 765 S.E.2d 154, 2014 Va. App. LEXIS 396 (2014).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    A decree by the Circuit Court declaring an insurance policy as null and void is entitled to full faith and credit by the Commission. Although the carrier is relieved of paying compensation, the Award remains in full force against the employer. Campbell v. William Simmons Construction/William Simmons, 68 O.I.C. 254 (1989).

    Carrier for partnership not liable for compensation to employees of corporation after change of business form. Ratliff v. B & R Ratliff Coal Co., 56 O.I.C. 261 (1974) (writ denied).

    § 65.2-812. Subrogation of insurance carrier to employer’s rights; compromise.

    When any employer is insured against liability for compensation with an insurance carrier, and such insurance carrier shall have paid any compensation for which the employer is liable or shall have assumed the liability of the employer therefor, it shall be subrogated to all the rights and duties of the employer and may enforce any such rights in its own name or in the name of the injured employee or his personal representative; however, nothing herein shall be construed as conferring upon the insurance carriers any other or further rights than those existing in the employer at the time of the injury to his employee, anything in the policy of insurance to the contrary notwithstanding. No compromise settlement shall be made by the insurance carrier in the exercise of such right of subrogation without the approval of the Workers’ Compensation Commission and the injured employee or the personal representative or dependents of the deceased employee being first obtained.

    History. Code 1950, § 65-108; 1968, c. 660, § 65.1-112; 1991, c. 355.

    Research References.

    Bryson on Virginia Civil Procedure (Matthew Bender). Chapter 5 Parties. § 5.03 Multiple Parties. Bryson.

    Michie’s Jurisprudence.

    For related discussion, see 18 M.J. Subrogation, § 1.

    CASE NOTES

    Editor’s note.

    Some of the cases annotated below were decided under former § 65.1-112 or prior law.

    Effect of Act. —

    The Act permits an injured employee the right to recover from a negligent third party full damages for injuries inflicted on him by such party, and the Act further gives to the employer and his insurance carrier the right to recover from such third party whatever amounts they actually had to pay for the benefit of the injured employee. It takes from the employee the right pro tanto to a double recovery, but beyond this it leaves the employee’s right to recover as it was before. Sheris v. Sheris Co., 212 Va. 825 , 188 S.E.2d 367, 1972 Va. LEXIS 278, cert. denied, 409 U.S. 878, 93 S. Ct. 132, 34 L. Ed. 2d 132, 1972 U.S. LEXIS 1673 (1972).

    Effect of proviso to this section. —

    When the entire Workmen’s (now Workers’) Compensation Act is read as a whole, it is clear that the provision that nothing therein should be construed “as conferring upon the insurance carriers any other or further rights than those existing in the employer at the time of the injury to his employee, anything in the policy of insurance to the contrary notwithstanding,” was simply intended to limit the insurance carrier to its subrogated rights formerly vested in the employer, irrespective of any provision of the policy of insurance, which might seem to give to the carrier any other or further rights. Southern Ry. v. United States Cas. Co., 136 Va. 475 , 118 S.E. 266 , 1923 Va. LEXIS 99 (1923) (see also C & O Ry. v. Palmer, 149 Va. 560 , 140 S.E. 831 (1927)).

    The employer’s workmen’s (now workers’) compensation insurance carrier stands in the shoes of the employer. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    And may sue third person whose negligence caused injury. —

    Under this section there can be no doubt of the fact that an insurance carrier who has paid compensation to an injured employee, or assumed the liability of the employer therefor, has a right to institute and conduct an action against a third person whose negligence caused the injury to the employee, either in its own name or in the name of the injured employee. Corrigan v. Stormont, 160 Va. 727 , 170 S.E. 16 , 1933 Va. LEXIS 252 (1933).

    Insurer has no greater rights than injured employee against subcontractor. —

    An employer, or its insurance carrier as subrogee, after payment of the statutory compensation, may not hold a subcontractor or its servants in damages, as the employer and the carrier have no greater rights than the injured employee. Western Contracting Corp. v. Power Eng'g Co., 369 F.2d 933, 1966 U.S. App. LEXIS 4139 (4th Cir. 1966).

    Employer has rights at time of injury to employee. —

    It was contended in the instant case that at the time of the injury to the employee, the employer had no right to assert, as under former § 65.1-40 (now § 65.2-307 ) that right was not called into being until the employee had made claim for compensation, and therefore the insurance carrier, plaintiff in the instant case, had no right vested in him by this section, which subrogated him to “all the rights and duties of the employer” and not the employee. It was held that there was no merit in this contention. If the construction contended for was adopted, the result would be practically to annul this section which was clearly intended to give relief, by subrogation, to insurance carriers. Southern Ry. v. United States Cas. Co., 136 Va. 475 , 118 S.E. 266 , 1923 Va. LEXIS 99 (1923).

    Employee must not prejudice insurance carrier’s right of subrogation. —

    The insurance carrier’s “statutory right of subrogation” must not be prejudiced by the act of the employee, in order to preserve the latter’s right to compensation. Stone v. George W. Helme Co., 184 Va. 1051 , 37 S.E.2d 70, 1946 Va. LEXIS 168 (1946).

    A claimant is not entitled to further compensation under the Workers’ Compensation Act when he settles a tort action, arising from the same work-related accident, without the knowledge or consent of his employer or its insurer. Safety-Kleen Corp. v. Van Hoy, 225 Va. 64 , 300 S.E.2d 750, 1983 Va. LEXIS 192 (1983).

    Burden of proof on employer. —

    Where impairment of employer’s right of subrogation is claimed, to successfully be relieved of its liability to pay compensation benefits, the burden is on the employer to show that the employee prejudiced the employer’s right. Overhead Door Co. v. Lewis, 22 Va. App. 240, 468 S.E.2d 700, 1996 Va. App. LEXIS 243 (1996).

    Agreement between employer and tort-feasor cannot affect rights of insurer and employee. —

    This was an action against a railroad company to recover for injuries to an employee of an independent contractor. The action was brought in the name of the employee and an insurance carrier who had paid the employee compensation, under this section. There was a contract between the railroad and the independent contractor under which the independent contractor was to save harmless the railroad from any damages arising from injuries to mechanics, laborers, or other persons by reason of accidents or otherwise. It was held that in this action the contract under which the independent contractor agreed to save the railroad harmless need not be considered. The contractor and wrongdoer could not by private agreement deprive the employee of his major remedy, and make him bear the burden of an agreement that the contractor would save the railway harmless. C & O Ry. v. Palmer, 149 Va. 560 , 140 S.E. 831 , 1927 Va. LEXIS 196 (1927).

    Employer and insurer as real parties in interest in claim against third-party tort- feasor. —

    An employer and, in turn, his workers’ compensation insurance carrier, are subrogated to the rights of an injured employee who receives workers’ compensation benefits, and they are thus entitled to seek recovery of the amount of the benefits from a third-party tortfeasor. As such, they should be considered “real parties in interest” within the meaning of F.R.C.P. Rule 17(a). Ingram v. Link Belt Power Shovel Co., 94 F.R.D. 196, 1982 U.S. Dist. LEXIS 14023 (W.D. Va. 1982).

    Issue as to who was entitled to credits awarded not addressed. —

    Under § 65.2-812 , plaintiff carrier stood in the shoes of plaintiff employer for purposes of seeking relief under the Virginia Workers’ Compensation Act, and where the carrier and the employer sought review of a decision of the Workers’ Compensation Commission that held that overpayments of disability compensation to claimant entitled the carrier to a credit against any future compensation due and did not entitle it to recover those overpayments from the claimant under §§ 65.2-710 and 65.2-712 , and the Commission actually awarded the credit to the employer, but the procedural history of the case made it clear that it was the carrier that made the disability compensation payments and sought the relief at issue, for ease of reference, the court referred to the appellant as employer as it was unaware of any dispute between the carrier and the employer as to who was entitled to the credit and did not address any such dispute in the appeal. Bay Concrete Constr. Co. v. Davis, 43 Va. App. 528, 600 S.E.2d 144, 2004 Va. App. LEXIS 377 (2004).

    Employee’s settlement with tortfeasor destroyed employer’s right to subrogation. —

    Benefits were properly terminated to workers’ compensation claimant when her injuries were aggravated by an automobile accident and she settled with and released the tortfeasor, thereby destroying employer’s right to subrogation. Barnes v. Wise Fashions, 16 Va. App. 108, 428 S.E.2d 301, 9 Va. Law Rep. 1085, 1993 Va. App. LEXIS 59 (1993).

    Carrier allowed deduction from attorney’s fee. —

    Where the workmen’s (now workers’) compensation insurance carrier benefited by the employee’s suit against the tort-feasor and must pay its share of the attorney’s fee, but where the carrier also had to spend its own money when the employee assumed an adversary position on the issue of subrogation, the district court should allow as a deduction from the fee that the carrier would otherwise owe, the amount it reasonably expended to perfect its right of subrogation to fulfill the mandate of former § 65.1-43 (now § 65.2-311 ) requiring consideration of the interests of both parties. Sheris v. Travelers Ins. Co., 491 F.2d 603, 1974 U.S. App. LEXIS 10098 (4th Cir.), cert. denied, 419 U.S. 831, 95 S. Ct. 54, 42 L. Ed. 2d 56, 1974 U.S. LEXIS 2369 (1974).

    § 65.2-813. Insurance deemed subject to title; approval of forms.

    Every policy for the insurance of the compensation herein provided or against liability therefor shall be deemed to be made subject to the provisions of this title. No corporation, association or organization shall enter into any such policy of insurance unless its form shall have been approved by the Workers’ Compensation Commission.

    History. Code 1950, § 65-109; 1968, c. 660, § 65.1-113; 1991, c. 355.

    § 65.2-813.1. Insurers offering policies with deductibles.

    Every insurer against liability arising under this title offering and making available policies in which the insured pays a deductible, without regard to amount and including such policies with deductibles of $1,000 or less, shall provide in such policies that (i) the insurer shall pay all of the deductible amount applicable to a compensable claim under this title to the person or provider entitled thereto, (ii) the insurer shall then obtain reimbursement from the policyholder for the applicable deductible amount, and (iii) failure to reimburse deductible amounts by the policyholder to the insurer will result in the cancellation of the deductible endorsement.

    History. 1995, c. 237.

    § 65.2-813.2. Premium discounts; drug-free workplace programs.

    Every insurer providing coverage pursuant to this title shall provide a premium discount of up to five percent to every employer instituting and maintaining a drug-free workplace program satisfying such criteria as each insurer may establish.

    History. 1997, c. 410; 2001, c. 280.

    The 2001 amendments.

    The 2001 amendment by c. 280 substituted “a premium discount of” for “for a total of no more than four years, premium discounts,” and inserted “and maintaining.”

    § 65.2-814. Insurer to furnish written evidence of coverage on request.

    Upon request of its insured, every insurer against liability arising under this title shall furnish to such insured, within five working days of receipt of said request, a certificate or other writing evidencing the effective coverage afforded such insured. Any insurer violating the provisions of this section shall be punished by a fine of $500.

    History. 1973, c. 254, § 65.1-113.1; 1991, c. 355.

    § 65.2-815. Group self-insurance association required to furnish written evidence of membership.

    Upon request of any member employer, a group self-insurance association shall furnish to such employer a certificate of membership or other written evidence of membership.

    History. 1979, c. 463, § 65.1-113.2; 1991, c. 355.

    § 65.2-816. Title not applicable to boiler, etc., insurance.

    This title shall not apply to policies of insurance against loss from explosion of boilers or fly wheels or other similar single catastrophe hazards.

    History. Code 1950, § 65-110; 1968, c. 660, § 65.1-114; 1991, c. 355.

    § 65.2-817. Rates; cooperation between State Corporation Commission and Workers’ Compensation Commission.

    Authority is hereby conferred upon the State Corporation Commission to make such arrangements with the Workers’ Compensation Commission as may be agreeable to the Workers’ Compensation Commission, for collecting, compiling, preserving and publishing statistical and other data in connection with the work of regulating workers’ compensation insurance rates and for the division of the expenses thereof, to the end that duplication of work and expenditures may be avoided. Whenever it deems proper, with the consent of the Workers’ Compensation Commission, the State Corporation Commission may appoint members of the Workers’ Compensation Commission, or its employees, as special agents of the State Corporation Commission to take testimony and make reports with reference to any matter involving questions of workers’ compensation insurance rates.

    History. Code 1950, § 65-113; 1968, c. 660, § 65.1-117; 1991, c. 355.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 5.

    § 65.2-818. Minimum standards of service for insurers.

    The State Corporation Commission in cooperation with the Workers’ Compensation Commission shall establish minimum standards of service for insurers writing workers’ compensation policies in this Commonwealth, including but not limited to the servicing of such policies, the establishment of offices within the Commonwealth, and the payment of compensation.

    History. 1970, c. 470, § 65.1-117.1; 1991, c. 355.

    § 65.2-819. Penalty for violation of certain provisions.

    Any person or persons who shall in this Commonwealth (i) act or assume to act as agent for any such insurance carrier whose authority to do business in this Commonwealth has been suspended, while such suspension remains in force, (ii) fail to comply with requirements or standards imposed under §§ 65.2-817 and 65.2-818 or of Chapter 10 (§ 65.2-1000 et seq.) of this title, or (iii) willfully make a false or fraudulent statement of the business or condition of any such insurance carrier, or a false or fraudulent return as therein provided, shall be deemed guilty of a misdemeanor and, upon conviction, shall be punished by a fine of not less than $100 nor more than $1,000 or by imprisonment for not less than ten nor more than ninety days, or both such fine and imprisonment, in the discretion of the court or jury trying the case.

    History. Code 1950, § 65-114; 1968, c. 660, § 65.1-117.1; 1970, c. 470; 1991, c. 355.

    § 65.2-820. Application to State Corporation Commission for assignment of risk; insurer assigned risk to issue policy.

    Every employer subject to the provisions of this chapter who has been unable to obtain a workers’ compensation insurance policy shall have the right to apply to the State Corporation Commission to have his risk assigned to an insurance carrier licensed to write and writing workers’ compensation insurance in this Commonwealth. The insurance carrier, whether stock, mutual, reciprocal or interinsurer or other type or form of organization, to whom any such risk is assigned shall issue a policy of workers’ compensation insurance which will enable such employer to meet the requirements of this chapter.

    History. Code 1950, § 65-114.1; 1956, c. 358; 1968, c. 660, § 65.1-119; 1991, c. 355.

    § 65.2-821. State Corporation Commission to make rules and regulations, and establish rating schedules and rates.

    1. The State Corporation Commission may make reasonable rules and regulations for the assignment of risks to insurance carriers.  It shall establish such rate classifications, rating schedules, rates, rules and regulations to be used by insurance carriers issuing assigned risk workers’ compensation policies in accordance with this chapter as appear to it to be proper.
    2. In the establishment of rate classifications, rating schedules, rates, rules and regulations, it shall be guided by such principles and practices as have been established under its statutory authority to regulate workers’ compensation insurance rates and it may act in conformity with its statutory discretionary authority in such matters.

    History. Code 1950, § 65-114.2; 1956, c. 358; 1968, c. 660, § 65.1-120; 1991, c. 355.

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 5.

    § 65.2-821.1. Payment and reimbursement practices; prohibitions.

    1. As used in this section, unless the context requires a different meaning:“Contracting entity” means (i) a person that enters into a provider contract with a provider or (ii) an intended beneficiary of the rights of such person under the provider contract.“Employer” means the employer; any insurance carrier, group self-insured association, or other person providing coverage for the employer’s obligation to provide medical service to a claimant under this title; or any third-party administrator acting on behalf of the employer.“PPO network” means the multiple provider contracts available to an employer pursuant to a PPO network arrangement.“PPO network arrangement” means an arrangement under which the PPO network arranger sells, conveys, or otherwise transfers to an employer the ability to discount payments or reimbursements to a provider pursuant to the terms of multiple provider contracts to which the PPO network arranger is a direct party.“PPO network arranger” means a person that operates a PPO network arrangement.“Provider,” “transition date,” and “Virginia fee schedule” have the meaning assigned thereto in § 65.2-605 . “Provider” includes a provider’s employer or professional business entity.“Provider contract” means an agreement between a contracting entity and a provider pursuant to which the provider agrees to deliver medical services to a claimant under this title in exchange for payment or reimbursement of an agreed-upon amount.“Third-party administrator” means a person that administers, processes, handles, or pays claims to providers on behalf of an employer.
    2. On and after the transition date:
      1. No employer shall pay or reimburse a provider for medical services provided to a claimant less than the amount provided for in the applicable Virginia fee schedule or other amount determined as provided in subdivision B 2 or 3 of § 65.2-605 unless:
        1. The employer has directly entered into:
          1. A provider contract with the provider;
          2. A contract with a contracting entity that has entered into a provider contract with the provider; or
          3. A contract with a PPO network arranger that authorizes the employer to use a PPO network to derive a benefit from a provider contract; and
        2. The provider has agreed to provide medical services to the claimant for an agreed-upon reimbursement or contractual amount as set forth in a provider contract referenced in subdivision a.
      2. A person with whom an employer has directly contracted as described in subdivision 1 a shall not sell, lease, or otherwise disseminate data regarding the payment or reimbursement amounts or terms of a provider contract without the express written consent and prior notification of all parties to the provider contract; however, the express written request from, and prior notification to, a provider shall not be required if the provider’s identity has been redacted from such data.
      3. If an employer uses or relies on a contract described in subdivision 1 a to discount a payment or reimbursement to a provider, the employer shall notify the provider, at the time it remits the payment or reimbursement, of (i) the name of the provider, contracting entity, or PPO network arranger with whom the employer directly contracted and (ii) how, if other than by a direct contract between the employer and the provider, the employer acquired the right to discount the payment or reimbursement to the provider.
      4. If an employer uses or relies on a contract with a PPO network arranger described in subdivision 1 a (3) to discount a payment or reimbursement to a provider, the employer shall not shop for the lowest discount for a specific provider among the provider contracts held in multiple PPO networks. This prohibition shall not bar an employer that has entered into a PPO network arrangement and selected a provider contract in the PPO network from availing itself of all discounts provided pursuant to the selected provider contract in the PPO network.
    3. Any person who suffers loss as a result of a violation of this section shall be entitled to initiate an action at the Commission to recover actual damages and interest from the date of the violation until entry of the final award. If the Commission finds that the violation resulted from gross negligence or willful misconduct, it may increase damages to an amount not to exceed three times the actual damages.

    History. 2016, cc. 279, 290.

    Editor’s note.

    Acts 2016, cc. 279 and 290, cl. 2, provides: “That the Workers’ Compensation Commission’s adoption of regulations establishing initial Virginia fee schedules for medical services pursuant to subsection C, and its adoption of regulations adjusting Virginia fee schedules for medical services pursuant to subsection D, of § 65.2-605 of the Code of Virginia as amended and reenacted by this act shall be exempt from the provisions of Article 2 (§ 2.2-4006 et seq.) of the Administrative Process Act (§ 2.2-4000 et seq.) of the Code of Virginia, provided that the Workers’ Compensation Commission utilizes a regulatory advisory panel constituted as provided in subdivision F 2 of § 65.2-605 as added by this act to assist in the development of such regulations and provides an opportunity for public comment on the regulations prior to adoption.”

    Acts 2016, cc. 279 and 290, cl. 5 made this section effective March 7, 2016.

    § 65.2-822. Action by State Corporation Commission upon application.

    The State Corporation Commission may, if in its judgment it deems such action to be justified after reviewing all information pertaining to the applicant or policyholder available from its records, the records of the Workers’ Compensation Commission or from other sources:

    1. Refuse to assign an application;
    2. Approve the rejection of an application by an insurance carrier;
    3. Approve the cancellation of a workers’ compensation policy by an insurance carrier; or
    4. Refuse to approve the renewal or the reassignment of an expiring policy.

    History. Code 1950, § 65-114.3; 1956, c. 358; 1968, c. 660, § 65.1-121; 1991, c. 355.

    § 65.2-823. Information filed with State Corporation Commission by insurance carrier to be confidential; exception.

    Any and all information filed with the State Corporation Commission by an insurance carrier or a rate service organization in connection with an assigned risk shall be confidential and solely for the information of the State Corporation Commission and its staff and shall not be disclosed to any person, including an applicant, policyholder and any other insurance carrier.

    However, at the discretion of the State Corporation Commission, such information may be disclosed to any agent or insurer licensed in the Commonwealth for the purpose of procuring coverage in the voluntary market. Such disclosure shall be limited to the insured’s name, address, policy expiration, risk identification number, experience modification factor, governing classification, premium, information pertaining to whether the insured has locations in multiple states, and any other information the State Corporation Commission deems appropriate.

    History. Code 1950, § 65-114.4; 1956, c. 358; 1968, c. 660, § 65.1-122; 1991, c. 355; 1993, c. 985.

    § 65.2-824. Disclosures not required of State Corporation Commission; liability for acts or omissions.

    1. The State Corporation Commission shall not be required to disclose to any person, including the applicant or policyholder, its reasons for:
      1. Refusing to assign an application;
      2. Approving the rejection of an application by an insurance carrier;
      3. Approving the cancellation of a workers’ compensation policy by an insurance carrier; or
      4. Refusing to approve the renewal or the reassignment of an expiring policy.
    2. The State Corporation Commission shall not nor shall anyone acting for it be held liable for any act or omission in connection with the administration of the duties imposed upon it by the provisions of this chapter, except upon proof of actual malfeasance.

    History. Code 1950, § 65-114.5; 1956, c. 358; 1968, c. 660, § 65.1-123; 1991, c. 355.

    Chapter 9. Reports and Records.

    § 65.2-900. Records and reports of accidents.

    1. Every employer shall keep a record of all injuries or deaths of its employees which occur in the course of employment. Within ten days after the occurrence of such injury or death, and knowledge of injury as provided in § 65.2-600 , a report of the injury or death shall be made and transmitted to the Commission by the employer, its representative or, in the case of an insured employer, its insurance carrier, in accordance with regulations adopted by the Commission which may authorize the transmission of such reports in written, magnetic, electronic or facsimile media. The Commission shall provide forms and instructions for reporting as required by this section. The Commission shall provide the Department of Labor and Industry with such reports.
    2. The accident report shall contain the name, nature and location of the business of the employer and the name, age, sex and wages and occupation of the injured employee, and shall state the date and hour of the accident causing the injury and the nature and cause of the injury, together with such other information as may be required by the Commission. However, those injuries deemed minor by the Commission shall be reported in the manner prescribed by the Commission.

    History. Code 1950, § 65-115; 1956, c. 351; 1968, c. 660, § 65.1-124; 1991, c. 355; 1995, c. 86.

    Law Review.

    For 2003/2004 survey of the law of workers’ compensation, see 39 U. Rich. L. Rev. 475 (2004).

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 57.

    CASE NOTES

    Voluntary payments of compensation benefits and filing of reports do not toll statute of limitations. —

    When the first report of accident is filed, and when there is no evidence of fraud or act by employer reasonably calculated to induce the employee from filing a claim with the commission, voluntary payments of compensation benefits and filing of medical reports and records do not operate to toll the limitation. Barnes v. B T R Dunlop, Inc., 1994 Va. App. LEXIS 512 (Va. Ct. App. July 26, 1994).

    “Actual prejudice” must be shown. —

    Workers’ Compensation Commission erred in finding that the employer’s filing of an accident report beyond the two-year statute of limitations “per se” prejudiced the claimant who filed her application for benefits more than two years after she was injured at work. Instead, the claimant had the burden of proving that she was actually prejudiced by the employer’s filing of the accident report beyond the time for filing a claim itself, as the claimant had a previous claim barred on limitations grounds, and, thus, may have known of the need to file a claim within two years of the date the injury occurred. Hall v. Winn-Dixie Stores, Inc., 41 Va. App. 835, 589 S.E.2d 484, 2003 Va. App. LEXIS 642 (2003).

    No prejudice shown. —

    Workers’ compensation claimant’s claim for a large herniated cervical disk was barred by the statute of limitations as: (1) the claimant was not prejudiced by the late filing of the employer’s first report of accident, but even if the limitations period was tolled until the date of the claimant’s first claim for benefits, the claim was filed more than two years later, (2) the doctrine of equitable estoppel did not apply as the employer did not misrepresent or conceal material facts that caused the claimant to refrain from filing her claim, and (3) the doctrine of imposition did not apply because the employer did not mislead the claimant or use superior knowledge of or experience with the Virginia Workers’ Compensation Act to deprive the claimant of compensation. Tuck v. Goodyear Tire & Rubber Co., 47 Va. App. 276, 623 S.E.2d 433, 2005 Va. App. LEXIS 527 (2005).

    Prejudice found. —

    Although a workers’ compensation claim was filed more than two years after the date of injury, the statute of limitations was tolled under § 65.2-602 because the employer failed to file an accident report under § 65.2-900 , and the claimant was unaware of the statute of limitations because no blue letter was sent under subsection D of § 65.2-201 . Falls Church Cabinetry v. Jewell, 60 Va. App. 134, 724 S.E.2d 236, 2012 Va. App. LEXIS 134 (2012).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    An Employer must file an Employer’s First Report of Accident with the Commission, even if it denies the compensability of the reported accident. Ellis v. City of Norfolk, 68 O.I.C. 47 (1989).

    Employer subject to fine for failure to file an Employer’s First Report of Accident form whenever an employee alleges that he or she sustained an accident, whether the employer contests the claim or not. Jones v. Holiday Inn, 61 O.I.C. 253 (1982).

    A deputy commissioner may use the Employer’s First Report of Accident sua sponte to corroborate the testimony of the claimant and his wife that notice of accident was timely communicated to the employer, and to impeach the contrary testimony of the employer. Blankenship v. K E T, Inc., 76 O.W.C. 68 (1997).

    While an Employer’s First Report of Accident is not used to determine how the accident occurred, it is probative as to whether and when an alleged accident was reported. Blankenship v. K E T, Inc., 76 O.W.C. 68 (1997).

    A carrier may not avoid assessment of a fine for failure to file a First Report within ten days as required by § 65.1-124 (now § 65.2-900 ) by alleging that the employer failed to promptly provide the carrier with notice of the accident. Relying on § 65.1-109 (now § 65.2-809 ), the Commission held that notice to the employer of the claimant’s injury became constructive notice to the carrier on the same date. Sanderfur v. United Parcel Service of America, 69 O.I.C. 198 (1990).

    An employer who refused to process a workers’ compensation claim because the employee did not report the incident within the time frame set by company policy, is subject to a fine for failure to file a First Report of Accident within the statutory period. Stiltner v. Hermes Abrasives, Ltd., 70 O.I.C. 250 (1991).

    Where an employer fails to furnish medical reports upon the filing of its application as required by Rule 13 (now Rule 1.4) and Rule 17 (now Rule 4.2), the application is void ab initio . It is also appropriate to assess a penalty under § 65.1-75.1 (now 65.2-524 ) and a fine under § 65.1-124 (now § 65.2-900 and 65.1-127 (now § 65.2-902 ). Marrow v. Addington Beaman Lumber Company, Inc., 69 O.I.C. 195 (1990); Marrow v. Addington Beaman Lumber Co., Inc., 69 O.I.C. 195 (1990).

    Section 65.1-87.1 (now § 65.2-602 ) prevents the tolling of the statute of limitations when a First Report has been filed but does not mandate the tolling of the statute where such a report has not been filed. The remedy for failing to file a First Report of Accident is a mandatory fine provided for in § 65.1-127. Hervey v. Newport News Shipbuilding & Dry Dock Co., 12 Va. App. 88, 402 S.E.2d 688, 7 Va. Law Rep. 1916, 1991 Va. App. LEXIS 43 (1991).

    Section 65.2-900 grants the Commission discretion to promulgate regulations governing the means by which employers report accidental injuries. Pursuant to 16 VAC 30-90-20, an employer must file an Employer’s Accident Report if the injury meets any of seven criteria. If the injury does not meet any of the criteria set out in the regulation, the injury is deemed minor and the employer may file the abbreviated Form 45-A (Report of Minor Injuries). If the employer files either form, whether or not the employer filed the correct form, the statute of limitations is not tolled. Filing either form triggers the Commission to send the claimant an information brochure, informing the claimant about the statute of limitations and the need to file a claim within two years of the accident. Komrowski v. Stafford (County of) School Board, VWC File No. 204-36-96 (April 5, 2002).

    Absent evidence of fraud, concealment or false representation, an employer’s filing of Commission Form 45-A (Report of Minor Injuries) satisfies the requirements of § 65.2-900 , and the two-year statute of limitations for filing an original claim for benefits is not tolled under § 65.2-602 . Selfridge v. Hampton Inn/Holiday Inns, VWC File No. 203-54-72 (January 23, 2002).

    § 65.2-901. Report of number of employees, hours of work, etc.

    Every employer shall upon request of the Commission report the number of its employees, hours of their labor and number of days of operation of business.

    History. Code 1950, § 65-117; 1968, c. 660, § 65.1-126; 1991, c. 355.

    § 65.2-902. Failure to make required reports; civil penalty.

    1. Any employer, insurance carrier, self-insurer, group self-insurance association, or third party administrator who fails to make any report required by the Commission pursuant to this title shall be assessed a civil penalty of not more than $500 for each failure. If the Commission determines that any such failure is willful, it shall assess a civil penalty of not less than $500 and not more than $5,000. The civil penalty herein provided may be assessed by the Commission in an open hearing with the right of review and appeal as in other cases.
    2. Any civil penalty assessed pursuant to this section shall be divided equally between and paid into the administrative fund established in Chapter 10 (§ 65.2-1000 et seq.) and the Uninsured Employer’s Fund established in Chapter 12 (§ 65.2-1200 et seq.). The Commission may add the costs of collection of such civil penalty to the aggregate civil penalty owed, in which event such costs shall be paid into the administrative fund established in Chapter 10 (§ 65.2-1000 et seq.).

    History. Code 1950, § 65-118; 1968, c. 660, § 65.1-127; 1970, c. 470; 1991, c. 355; 1993, c. 378; 2014, c. 203.

    The 2014 amendments.

    The 2014 amendment by c. 203, in subsection A, inserted “insurance carrier, self-insurer, group self-insurance association, or third party administrator” near the beginning of the first sentence and deleted the former last sentence which read “In the event the employer has transmitted the report to the insurance carrier or third party administrator for transmission to the Commission, the insurance carrier or third party administrator failing to transmit the report shall be liable for the civil penalty”; and rewrote subsection B, which formerly read “Any civil penalty assessed pursuant to this section shall be paid into the Uninsured Employer’s Fund established in Chapter 12 (§ 65.2-1200 et seq.) of this title.”

    CASE NOTES

    Sanctions. —

    Court of appeals found no authority to support a claimant’s argument that he was entitled to an award of sanctions, pursuant to § 65.2-902 , because a company that hired him failed to file a first report of accident after he was injured on the job. North Star Home Improvement, Inc. v. Heddings, 2004 Va. App. LEXIS 81 (Va. Ct. App. Feb. 17, 2004).

    Former employee contended that during the pendency of his workers’ compensation claims, the employer’s supervisors and administrators followed neither the employer’s internal policies nor Virginia’s workers’ compensation laws; the employee’s contention seemed to implicate § 65.2-902 because the employer was, in fact, late in filing a notice of the employee’s injury with the Workers’ Compensation Commission. However, the statute itself specified a civil fine as the remedy for a violation. Taylor v. Wal-Mart Stores, Inc., 376 F. Supp. 2d 653, 2005 U.S. Dist. LEXIS 14040 (E.D. Va.), aff'd, 158 Fed. Appx. 446, 2005 U.S. App. LEXIS 28200 (4th Cir. 2005).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    Note: Also see Rule 4 (previously Rule 17), Rules of the Commission.

    Medical Reports:

    Rule 4.2 of the Rules of the Virginia Workers’ Compensation Commission requires that legible copies of all medical reports shall be filed immediately with the Commission. All medical reports relevant to a claim are required reports. Eames v. Williamsburg Soap & Candle Co., 76 O.W.C. 7 (1997).

    Where an employer fails to file a medical report, § 65.1-127 (now § 65.2-127) provides for the assessment of a fine. Meade v. Clinchfield Coal Company, 62 O.I.C. 311 (1983).

    The Commission may assess a fine for failure to file a medical report as required by Rule 17 (now Rule 4). A fine will not be assessed when the medical report in question has no specific bearing on the issues or the outcome of the case. Whitehair v. American Industrial Contracting, 67 O.I.C. 181 (1988).

    Penalty assessed for failure to file medical reports. Haney v. Thyssen Mining Co., 57 O.I.C. 155 (1977); Walker v. Alsage Mgt. Corp., 57 O.I.C. 363 (1976).

    First Reports:

    A carrier may not avoid assessment of a fine for failure to file a First Report within ten days as required by § 65.1-124 (now § 65.2-900 ) by alleging that the employer failed to promptly provide the carrier with notice of the accident. Relying on § 65.1-109 (now § 65.2-809 ), the Commission held that notice to the employer of the claimant’s injury became constructive notice to the carrier on the same date. Sanderfur v. United Parcel Service of America, 69 O.I.C. 198 (1990).

    An employer who refused to process a workers’ compensation claim because the employee did not report the incident within the time frame set by company policy, is subject to a fine for failure to file a First Report of Accident within the statutory period. Stiltner v. Hermes Abrasives, Ltd., 70 O.I.C. 250 (1991).

    Section 65.1-87.1 (now § 65.2-602 ) prevents the tolling of the statute of limitations when a First Report has been filed but does not mandate the tolling of the statute where such a report has not been filed. The remedy for failing to file a First Report of Accident is a mandatory fine provided for in § 65.1-127 (now § 65.2-902 ). Hervey v. Newport News Shipbuilding & Dry Dock Co., 12 Va. App. 88, 402 S.E.2d 688, 7 Va. Law Rep. 1916, 1991 Va. App. LEXIS 43 (1991).

    § 65.2-903. Records not public.

    The records of the Commission, insofar as they refer to accidents, injuries and settlements, shall not be open to the public but only to the parties satisfying the Commission of their interest in such records and their right to inspect them; however, the Commission shall make its records about an injured employee available to the Virginia Employment Commission, the Department of Social Services, or the Virginia Retirement System if any such entity requests such records. The Commission shall promulgate rules to ensure that information for the purpose of determining eligibility for employment shall not be provided without the written consent of the employee.

    History. Code 1950, § 65-119; 1968, c. 660, § 65.1-128; 1991, c. 355; 1993, c. 806; 1996, c. 457; 1997, cc. 796, 895; 2002, c. 693.

    The 2002 amendments.

    The 2002 amendment by c. 693 substituted “the Department of Social Services, or the Virginia Retirement System if any such” for “and the Department of Social Services, if either.”

    Chapter 10. Administrative Fund and Tax Therefor.

    § 65.2-1000. Tax for administrative fund.

    For the purpose of paying the salaries and necessary expenses of the Workers’ Compensation Commission and its assistants and employees in administering and carrying out the provisions of this title, an administrative fund shall be created and maintained in the following manner:

    1. Every person, partnership, association, corporation, whether organized under the laws of this or any other state or country, company, mutual company or association, the parties to any interindemnity contract or reciprocal plan or scheme, and every other insurance carrier, insuring employers in this Commonwealth against liability for personal injuries to their employees or death caused thereby, under the provisions of this title, shall, as hereinafter provided, pay a tax upon the premiums received, whether in cash or notes, in this Commonwealth or on account of business done in this Commonwealth, for such insurance in this Commonwealth, at the rate of 2.5 percent of the amount of such premiums.
    2. However, premiums received for insuring liability which exists concurrently under this title and the Federal Coal Mine Health and Safety Act of 1969, as amended, shall be modified in accordance with an equitable premium modification plan approved by the Commission. Such tax shall be in lieu of all other taxes on such premiums, except as provided in §§ 65.2-1101 , 65.2-1201 , and Chapter 4 (§ 38.2-400 et seq.) of Title 38.2, and shall be assessed and collected as hereinafter provided. But such insurance carriers shall be credited with all cancelled or returned premiums, actually refunded during the year on such insurance, and with premiums on reinsurance assumed.

    History. Code 1950, § 65-120; 1968, c. 660, § 65.1-129; 1975, c. 365; 1977, c. 345; 1984, c. 606; 1991, c. 355; 1996, c. 56.

    Cross references.

    As to levy of license taxes on insurance companies, see § 58.1-2501 .

    Michie’s Jurisprudence.

    For related discussion, see 21 M.J. Workers’ Compensation, § 5.

    § 65.2-1001. Returns.

    1. Every such insurance carrier shall, for the twelve months ending December 31 of each year, make a return verified by the affidavits of its president and secretary, or other chief officers or agents, to the Workers’ Compensation Commission stating the amount of such premiums and credits during the period covered by such return.
    2. The State Corporation Commission shall have access at all times to the records so filed with the Workers’ Compensation Commission by such insurance carriers and may require such additional information as the State Corporation Commission deems necessary for the performance of the duties herein conferred upon it.

    History. Code 1950, § 65-121; 1968, c. 660, § 65.1-130; 1991, c. 355.

    § 65.2-1002. Payment of tax.

    Every insurance carrier required to make such return shall file the same with the Workers’ Compensation Commission within thirty days after the close of the period covered thereby and shall at the same time pay into the state treasury a tax of $2.50 on each $100 of such premiums ascertained as provided in § 65.2-1000 , less returned premiums and reinsurance assumed.

    History. Code 1950, § 65-122; 1968, c. 660, § 65.1-131; 1991, c. 355.

    § 65.2-1003. Failure to file return.

    If any such insurance carrier shall fail or refuse to make the return required by this title, the State Corporation Commission shall assess the tax against such insurance carrier at the rate herein provided for, on such amount of premiums as it may deem just, and the proceedings thereon shall be the same as if the return had been made.

    History. Code 1950, § 65-123; 1968, c. 660, § 65.1-132; 1991, c. 355.

    § 65.2-1004. Withdrawal from business or failure to pay tax.

    If any such insurance carrier shall withdraw from business in this Commonwealth before the tax shall fall due, as herein provided, or shall fail or neglect to pay such tax, the Comptroller shall at once proceed to collect the same and may employ such legal process as may be necessary for that purpose, and when so collected he shall pay the same into the state treasury. The suit may be brought by the Comptroller, in his official capacity, in any court of this Commonwealth having jurisdiction. A reasonable attorney’s fee may be taxed as costs therein and process may issue to any county of the Commonwealth and may be served as in civil actions, or in the case of an unincorporated association, partnership, interindemnity contract or other plan or scheme, upon any agent of the parties thereto upon whom process may be served under the laws of this Commonwealth.

    History. Code 1950, § 65-124; 1968, c. 660, § 65.1-133; 1991, c. 355.

    § 65.2-1005. Tax exclusive of other taxes.

    Any insurance carrier liable to pay a tax upon premiums under this title shall not be liable to pay any other or further tax upon such premiums, or on account thereof, under any other law of this Commonwealth, except as provided in §§ 65.2-1101 , 65.2-1201 , and Chapter 4 (§ 38.2-400 et seq.) of Title 38.2.

    History. Code 1950, § 65-125; 1968, c. 660, § 65.1-134; 1975, c. 365; 1977, c. 345; 1991, c. 355; 1996, c. 56.

    § 65.2-1006. Payroll reports of self-insurers and tax thereon; withholding or providing false or misleading information.

    1. Every employer carrying his own risk under the provisions of § 65.2-801 and every employer member of a licensed group self-insurance association shall, under oath, report to the Workers’ Compensation Commission his payroll subject to the provisions of this title. Such report shall be made in form prescribed by the Commission and at the time herein provided for premium reports by an insurer. No person required to file this report shall willfully withhold information from or knowingly provide false or misleading information to the Commission. As used herein, the term “information” shall include any false statement made for the purpose of avoiding or diminishing the amount of payroll tax imposed pursuant to this section.There shall be no liability on the part of and no cause of action against:
      1. Any person for furnishing in good faith to the Commission information relating to the investigation of any payroll report when such information is furnished under the requirements of law or at the request or the direction of the Commission;
      2. The Commission or any of the Commission’s employees or agents, acting in good faith, for investigating any payroll report required to be filed under this section or for the dissemination of any official report related to an official investigation of any such payroll report.
    2. The Commission shall assess against such payroll a maintenance fund tax computed by taking 2 1/2 percent: (i) of the basic premiums chargeable against the same or most similar industry or business, taken from the manual insurance rate for compensation then in force in this Commonwealth; (ii) in its discretion, of such premiums modified in accordance with an experience rating determined by the records of the Commission; (iii) in the case of self-insurers covered under the Federal Longshoremen’s and Harbor Worker’s Compensation Act, of such premiums chargeable under an equitable premium modification plan approved by the Commission; or (iv) in case of self-insurers who are concurrently covered by this title and the Federal Coal Mine Health and Safety Act of 1969, as amended, of such premiums chargeable under an equitable premium modification plan approved by the Commission. Such tax shall be paid as provided in § 65.2-1002 and, if not so paid, the same shall be collected by the Comptroller in the manner provided in § 65.2-1004 .
    3. The State Corporation Commission shall at all times have access to the reports herein required to be made to the Workers’ Compensation Commission by self-insurers for the purpose of performing the duties imposed upon the State Corporation Commission under this title.
    4. Any person who fails to comply with the requirements of this section or willfully withholds information from or knowingly provides false or misleading information to the Commission shall be deemed guilty of a misdemeanor and, upon conviction, shall be punished by a fine of not less than $100 nor more than $1,000 or by imprisonment for not less than ten nor more than ninety days, or both such fine and imprisonment, in the discretion of the court or jury trying the case.

    History. Code 1950, § 65-126; 1968, c. 660, § 65.1-135; 1979, c. 463; 1984, cc. 568, 606; 1991, c. 355; 1994, c. 947.

    § 65.2-1007. Disposition of fund.

    Upon receiving the payments required by § 65.2-1002 , the Comptroller shall place the whole thereof to the credit of the fund for the administration of this title. Such fund shall not be used for any other purpose, except as hereinafter expressly provided. The Workers’ Compensation Commission shall administer the fund to carry out the provisions of this title and shall disburse the same as hereinafter directed. If the receipts shall exceed the expenditures for any year and a surplus accrue in the fund in excess of one year’s budgeted expenditures, the Commission shall authorize a credit for the ensuing years as provided by § 65.2-1008 . No portion of the fund or any surplus accruing therein shall be paid into the general fund of the state treasury, nor shall the fund be administered, handled or disbursed except as provided in this section. All claims for salaries or expenses, when approved by a majority of the members of the Commission, shall be presented to the Comptroller and audited by him under the provisions of Chapter 8 (§ 2.2-800 et seq.) of Title 2.2, and he shall draw his disbursement warrants therefor on the State Treasurer; however, any claim for $2,000 or less may be approved by the Chairman or his designee. All such claims shall show to whom and for what service, material or other things or reason such amounts are to be paid and shall be accompanied by voucher, checks or receipts covering the same, except as to items of less than one dollar.

    History. Code 1950, § 65-127; 1968, c. 660, § 65.1-136; 1976, c. 603; 1980, c. 554; 1991, c. 355.

    § 65.2-1008. When fund in excess of requirement.

    If it be ascertained that the tax collected exceeds the total chargeable against the maintenance fund under the provisions of this title, the Workers’ Compensation Commission shall authorize a corresponding credit upon the collection for any year or make refunds of taxes collected in such amounts as are necessary to maintain a fund balance not exceeding one year’s budgeted expenditures.

    History. Code 1950, § 65-128; 1968, c. 660, § 65.1-137; 1976, c. 603; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation for the year 1971-1972, see 58 Va. L. Rev. 1376 (1972).

    Chapter 11. Second Injury Fund.

    § 65.2-1100. Fund created.

    There is hereby created a fund to be known as the “Second Injury Fund” to be administered, maintained and disbursed by the Commission as hereinafter provided.

    History. 1975, c. 365, § 65.1-138; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    § 65.2-1101. Funding.

    1. For the purpose of providing funds for compensation for disability as hereinafter defined, medical treatment and vocational rehabilitative services, a tax of one quarter of one percent shall be assessed, collected and paid into the state treasury by the same persons and in the same manner as set forth in Chapter 10 (§ 65.2-1000 et seq.) of this title.
    2. This tax shall be in addition to the tax for the Commission administrative fund and shall be held by the Comptroller of the Commonwealth solely for the payment of awards against such fund.
    3. In any fiscal year in which the Second Injury Fund has to its credit a sum in excess of $250,000, the tax shall be suspended for the ensuing fiscal years and its collection not resumed until the balance in the fund is reduced below $125,000.

    History. 1975, c. 365, § 65.1-139; 1980, c. 599; 1991, c. 355.

    Law Review.

    For survey of Virginia law on workers’ compensation and welfare for the year 1974-1975, see 61 Va. L. Rev. 1862 (1975).

    § 65.2-1102. Disability defined.

    For the purpose of this chapter, disability shall mean: (i) the partial or total loss or loss of use of an arm, hand, leg, foot, eye, finger, toe, or any combination of two or more thereof in an industrial accident and (ii) actual incapacity for work at the claimant’s average weekly wage.

    History. 1975, c. 365, § 65.1-140; 1980, c. 599; 1991, c. 355.

    § 65.2-1103. When awards entered.

    The Commission shall enter awards against the Second Injury Fund in favor of an employer or carrier only upon a finding that: (i) the employee has prior loss or loss of use, supported by medical evidence, of not less than twenty percent of one or more of the members set out in § 65.2-1102 ; (ii) the employee has suffered in an industrial accident an additional loss or loss of use of any one of the members set out in § 65.2-1102 of not less than twenty percent; (iii) the combination of both impairments has rendered the employee totally or partially disabled as defined in § 65.2-1102; (iv) the carrier or employer has paid the compensation due under §§ 65.2-500 and 65.2-502 , and the permanent partial disability due under § 65.2-503 and the medical treatment under § 65.2-603 ; and (v) the employee is entitled to further compensation for disability which has been paid by the employer or carrier.

    History. 1980, c. 599, § 65.1-141.1; 1991, c. 355.

    § 65.2-1104. Award for compensation, medical treatment and vocational rehabilitation.

    Upon a determination by the Commission that an employer or carrier has paid compensation, medical expenses or vocational rehabilitation services on behalf of an employee under circumstances as set forth under § 65.2-1103 and if notice of a claim against the Second Injury Fund was given prior to payment of the benefits, the Commission shall enter an award from the Second Injury Fund in favor of such employer or carrier for: (i) reimbursement on a pro rata basis of the compensation paid for further disability as set forth in clause (v) of § 65.2-1103 , such prorating to be computed according to the number of weeks each impairment is allowed under the schedule in § 65.2-503 ; (ii) reimbursement of reasonable medical expenses on the same basis as set forth in subdivision (i) of this section, provided the second injury is to the same previously impaired member but such reimbursement shall not exceed $7,500; and (iii) reimbursement of reasonable vocational rehabilitation training service on the same basis as set forth in subdivision (i) of this section but said reimbursement not to exceed $7,500.

    History. 1980, c. 599, § 65.1-142.1; 1991, c. 355.

    § 65.2-1105. Payments by fraud, mistake or improper processing of claim; recovery.

    Any payment to the employer or carrier pursuant to this chapter which is later determined by the Commission to have been procured through fraud, mistake or the improper processing of the claim by the carrier shall be recovered from the employer or carrier and credited to the Second Injury Fund. Any subrogation recoveries or other recoveries from a third party or other source shall be shared by the employer or carrier and the Second Injury Fund on a pro rata basis after deducting all reasonable expenses in obtaining the recovery.

    History. 1975, c. 365, § 65.1-144; 1980, c. 599; 1991, c. 355.

    § 65.2-1106. Claims and hearings.

    Claims against the Second Injury Fund and any hearings on the merits of such claims shall be within the time limits and in the manner otherwise provided for workers’ compensation claims. All claims against the Second Injury Fund shall be defended by the Attorney General.

    History. 1975, c. 365, § 65.1-145; 1991, c. 355.

    Chapter 12. Uninsured Employer’s Fund.

    § 65.2-1200. Fund created.

    There is hereby created a fund to be known as the “Uninsured Employer’s Fund” to be administered, maintained and disbursed by the Commission as hereinafter provided.

    History. 1977, c. 345, § 65.1-146; 1991, c. 355.

    § 65.2-1201. Financing; tax.

    1. For the purpose of providing funds for compensation benefits awarded against any uninsured or self-insured employer under any provision of this chapter, a tax not to exceed one-half of one percent shall be assessed, collected and paid into the state treasury by the same persons and in the same manner as set forth in Chapter 10 (§ 65.2-1000 et seq.) of this title.
    2. This tax shall be in addition to the tax for the Workers’ Compensation Commission Administrative Fund and the tax for the Second Injury Fund and shall be held by the Comptroller of the Commonwealth solely for the payment of awards against such fund.
    3. At the end of any calendar year in which the Uninsured Employer’s Fund has to its credit a sum in excess of the next year’s budgeted expenditures, the tax shall be suspended for the ensuing calendar year.

    History. 1977, c. 345, § 65.1-147; 1983, c. 421; 1986, c. 177; 1990, c. 606; 1991, c. 355; 1997, c. 99; 1998, c. 388; 2009, c. 219.

    Editor’s note.

    Acts 2018, c. 249 repealed Acts 2009, c. 219, cl. 2, as amended by Acts 2012, c. 647, and Acts 2015, c. 449, which contained a July 1, 2018, expiration date for the 2009 act. Amendment by Acts 2009, c. 219, did not expire.

    The 1997 amendment, effective March 6, 1997, deleted the “1” designator preceding “a tax not to exceed”; deleted former subdivision A 2 which read: “Beginning January 1, 1995, in lieu of the tax described in subdivision 1 of this subsection a tax not to exceed one-eighth of one percent shall be assessed, collected and paid into the state treasury by the same persons and in the same manner as set forth in Chapter 10 of this title”; and substituted “Employer’s” for “Employers” in subsection C.

    The 1998 amendment, effective April 12, 1998, substituted “one-half” for “one-fourth” in subsection A. For expiration date, see the Editor’s note.

    The 2009 amendments.

    The 2009 amendment by c. 219 substituted “one-half of one percent” for “one-fourth of one percent” in subsection A.

    Law Review.

    For an article relating to the most significant developments in the law of workers’ compensation since September, 1997, see 32 U. Rich. L. Rev. 1421 (1998).

    § 65.2-1202. Defense of claims against fund by Attorney General.

    Upon being notified by the Commission that a claim is pending before it against an employer who has not complied with the provisions of § 65.2-801 , the Attorney General, or his designee, may, in his discretion, appear before the Commission and defend any claim against the Uninsured Employer’s Fund. A decision on the part of the Attorney General not to appear shall be made only after consultation with the Commission. With the leave of the Commission, the Attorney General may enter an appearance in a claim at any stage of the proceedings if he determines that the position of the fund needs to be protected.

    History. 1977, c. 345, § 65.1-148; 1988, c. 545; 1991, c. 355.

    § 65.2-1203. Awards.

      1. Whenever, following due investigation of a claim for compensation benefits, the Commission determines that (i) the employer of record has failed to comply with the provisions of § 65.2-801 or that a self-insured employer or its surety as required by § 65.2-801 is unable to satisfy an award in whole or in part, and (ii) the claim is compensable, the Commission shall make a provisional award of compensation benefits, or any unpaid balance thereof, without further delay. Thereafter, the Commission shall make a final award concerning such benefits or unpaid balance thereof, in accordance with the provisions of this chapter and all applicable provisions of this title. The Commission shall order payment of any award of compensation benefits pursuant to this chapter from the Uninsured Employer’s Fund. A. 1. Whenever, following due investigation of a claim for compensation benefits, the Commission determines that (i) the employer of record has failed to comply with the provisions of § 65.2-801 or that a self-insured employer or its surety as required by § 65.2-801 is unable to satisfy an award in whole or in part, and (ii) the claim is compensable, the Commission shall make a provisional award of compensation benefits, or any unpaid balance thereof, without further delay. Thereafter, the Commission shall make a final award concerning such benefits or unpaid balance thereof, in accordance with the provisions of this chapter and all applicable provisions of this title. The Commission shall order payment of any award of compensation benefits pursuant to this chapter from the Uninsured Employer’s Fund.
      2. After an award has been entered against an employer for compensation benefits under any provision of this chapter, and upon finding that the employer has failed to comply with the provisions of § 65.2-801, or that a self-insured employer or its surety as required by § 65.2-801 is unable to satisfy an award in whole or in part, the Commission shall order the award, or any unpaid balance, to be paid from the Uninsured Employer’s Fund after demand has been made by a claimant upon his employer or other uninsured entity which is responsible to pay the award. Such demand may be waived by the Commission for good cause shown.
    1. For the purposes of this chapter, an employer who is a former member of a group self-insurance association or group self-insurance pool whose license has been terminated by the State Corporation Commission and whose security deposit with the State Treasurer or surety coverage has been exhausted shall be deemed to be an uninsured employer not in compliance with § 65.2-801 . For all such uninsured employers, the Attorney General, or his designee, shall enforce the right of subrogation and recoupment as provided in § 65.2-1204 .

    History. 1977, c. 345, § 65.1-149; 1983, c. 460; 1988, c. 604; 1991, c. 355; 1993, c. 624; 1997, c. 131; 2009, cc. 285, 336.

    The 2009 amendments.

    The 2009 amendments by cc. 285 and 336 are identical, and inserted “or group self-insurance pool” in subsection B.

    CASE NOTES

    The legislative purpose in establishing the fund was to provide compensation for claimants, not to indemnify statutory employers or their carriers. A.G. Van Metre, Jr., Inc. v. Gandy, 7 Va. App. 207, 372 S.E.2d 198, 5 Va. Law Rep. 391, 1988 Va. App. LEXIS 110 (1988) (decided under former § 65.1-149).

    No award against fund where statutory employer is liable. —

    This section makes no distinction between an immediate employer and a statutory employer in the ascending scale. The purpose of the fund is to insure that injured employees will be paid their compensation benefits even though their employer has breached his duty to secure compensation insurance. In most instances there will be no statutory employer and the employee’s remedy will be against the fund, as provided by this section. But in those instances where a statutory employer is liable, a claimant has no right to an award against the fund. A.G. Van Metre, Jr., Inc. v. Gandy, 7 Va. App. 207, 372 S.E.2d 198, 5 Va. Law Rep. 391, 1988 Va. App. LEXIS 110 (1988) (decided under former § 65.1-149).

    Award unclear as to responsible party. —

    Remand to the Virginia Workers’ Compensation Commission was necessary to clarify which party was required to pay interest on an award to a benefits claimant; the order did not specify the party responsible to pay the interest, and the text of the order did not indicate that the procedure in subsection A of § 65.2-1203 was followed. The Uninsured Employer’s Fund did not simply step into the shoes of the employer. Uninsured Employer's Fund v. Carter, 2013 Va. App. LEXIS 16 (Va. Ct. App. Jan. 15, 2013).

    Uninsured Employer’s Fund liable for benefits without apportionment. —

    Workers’ Compensation Commission properly ruled that award of lifetime benefits to coal worker should be paid by Uninsured Employer’s Fund rather than being apportioned between the Fund and the Virginia Property and Casualty Insurance Guaranty Association. The Fund exhibits the indicia of a governmental insurance or guaranty program and therefore falls within the statutory purview of those entities from which recovery must be exhausted before the Guaranty Association is required to make payments. Uninsured Employer's Fund v. Flanary, 27 Va. App. 201, 497 S.E.2d 912, 1998 Va. App. LEXIS 227 (1998), aff'd, 257 Va. 237 , 514 S.E.2d 147, 1999 Va. LEXIS 38 (1999).

    Uninsured Employer’s Fund liable for benefits assessed against insolvent insurer. —

    Uninsured Employer’s Fund was liable for portion of lifetime benefits award originally assessed against insurance company that was solvent on the date coal worker was first awarded compensation benefits but became insolvent after the award was entered. Uninsured Employer's Fund v. Flanary, 27 Va. App. 201, 497 S.E.2d 912, 1998 Va. App. LEXIS 227 (1998), aff'd, 257 Va. 237 , 514 S.E.2d 147, 1999 Va. LEXIS 38 (1999).

    Uninsured Employer’s Fund retroactively liable for benefits assessed against bankrupt insurer. —

    Workers’ Compensation Commission properly ordered a state fund to pay benefits to a worker after the worker’s self-insured employer went bankrupt; the commission properly determined that the 1983 amended version of subdivision A 1 of § 65.2-1203 applied retroactively to require the fund to pay the benefits in question. Uninsured Employer's Fund v. Duffner, 2005 Va. App. LEXIS 299 (Va. Ct. App. Aug. 2, 2005).

    Uninsured Employer’s Fund not proper party to appeal. —

    Claimant’s failure to name a limited liability company (LLC) in his appeal was fatal to the involvement of the Uninsured Employers’ Fund because any involvement of the Fund was predicated on an award entered against an employer for compensation benefits; the Fund was involved because the LLC did not have workers’ compensation insurance, and since no award had been entered against the LLC, it was not required to pay the claimant and was not a proper party. Axelson v. Pifer Constr., Inc., 2017 Va. App. LEXIS 218 (Va. Ct. App. Aug. 22, 2017).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    A Show Cause hearing is a proceeding independent from a claim brought by an injured worker. A decision to fine an employer for failure to have insurance is not binding on a non-party and thus is not res judicata as to those parties. The Uninsured Employer’s Fund can raise a jurisdictional defense should a claim be filed and similarly claimant is not barred from bringing a claim if the Show Cause was dismissed. Bowser v. Michael Eugene Boggan, VWC File No. 223-95-20 (June 29, 2006).

    The 1983 amendment to § 65.1-147, now § 65.2-1201 , did not change the substantive rights of the parties, and therefore can be applied retroactively to allow payment of benefits by the Uninsured Employer’s Fund for a 1978 accident. Duffner v. Montgomery Ward & Co., VWC File No. 633-069 (Sept. 3, 2004).

    If the evidence produced at the hearing makes it obvious that the uninsured employer cannot satisfy the Commission’s award, it is appropriate for an award to be issued against the Fund at the same time that the award is entered against the employer. Lawson v. Joe & Joyce Gunner, t/a Family Restaurant, 63 O.I.C. 215 (1984).

    Deputy Commissioner improperly entered award against Uninsured Employer’s Fund when only evidence of non-satisfaction of award was employer president’s testimony that employer could “probably not” pay award; claimant must demand payment from employer prior to Fund making payment on award. Crockett v. Wayne Seagle, VWC File No. 204-44-71 (May 23, 2003).

    Virginia Code § 38.2-1610 clearly provides that any person having a covered claim against an insolvent insurance carrier must first pursue his recovery through any other solvent carrier. In this case, the claim had been prorated between two employers and carriers. One employer’s self-insurance association later became insolvent, and its liability was assumed by the Uninsured Employer’s Fund. The other employer’s carrier also became insolvent, and its liability was assumed by the Guaranty Fund. Because the claimant was able to pursue his claim through other sources [the Uninsured Employer’s Fund], the Guaranty Fund becomes liable only in the event that the Uninsured Employer’s Fund does not fully satisfy the award. Flanary v. Moose Coal Co., 76 O.W.C. 119 (1997).

    There is no obligation on the Uninsured Employer’s Fund to seek out the bills of medical providers. It is the responsibility of such providers, or the employee or his counsel to submit medical bills as well as medical reports substantiating the treatment to the Fund. Lawson v. Joe & Joyce Gunner, t/a Family Restaurant, 63 O.I.C. 215 (1984).

    The Uninsured Employers’ Fund is not subject to the penalty provision of § 65.2-524 . Morton v. Henry Davis t/a Davis Asphalt, 71 O.W.C. 309 (1992).

    Proceedings by the Commission are exempt from the automatic stay in cases where the uninsured employer has filed for bankruptcy. An award was entered against the employer with direction to the Uninsured Employer’s Fund to pay any compensation and thereafter file a claim in Bankruptcy Court. Fisher v. G. & G. Welding, 63 O.I.C. 119 (1984).

    Since the Uninsured Employers’ Fund was established for the sole purpose of insuring payment of compensation benefits to those employees whose employers have failed to purchase the required insurance and who are otherwise unable to pay the award, an insured statutory employer is not entitled to reimbursement from the Uninsured Employers’ Fund for any sums paid on behalf of its uninsured subcontractor. Furnival v. Boucher Building/M & M Construction Company, 65 O.I.C. 342 (1986).

    Where the President of a corporation would be barred from recovery against the Uninsured Employer’s Fund because of his own nonfeasance in failing to have compensation insurance as required by § 65.1-103 (now § 65.2-800 ), his dependents are not entitled to benefits from the Uninsured Fund when his death results from an industrial accident. Dunlevy v. Hummel Aviation Services, Inc., 69 O.I.C. 13 (1990) (Affirmed by unpublished Court of Appeals Opinion 4/9/91).

    § 65.2-1204. Subrogation and recoupment.

    The Commission shall, upon payment of a claim from the Uninsured Employer’s Fund, be subrogated to any right to recover damages which the injured employee or his personal representative or any other person may have against his employer or any other party for such injury or death.

    The Commission shall, on behalf of the Uninsured Employer’s Fund, refer any unsatisfied claim against an uninsured employer to the Attorney General for collection.

    History. 1977, c. 345, § 65.1-150; 1991, c. 355.

    CASE NOTES

    Fund not in same position as employer. —

    Remand to the Virginia Workers’ Compensation Commission was necessary to clarify which party was required to pay interest on an award to a benefits claimant; the order did not specify the party responsible to pay the interest, and the text of the order did not indicate that the procedure in subsection A of § 65.2-1203 was followed. The Uninsured Employer’s Fund did not simply step into the shoes of the employer. Uninsured Employer's Fund v. Carter, 2013 Va. App. LEXIS 16 (Va. Ct. App. Jan. 15, 2013).

    This section and § 65.2-309.1 distinguished. —

    While § 65.2-309.1 expressly grants the employer the right of subrogation against proceeds recovered by the injured employee under the uninsured motorist coverage of a policy of insurance provided and paid for by the employer, this section, which defines the fund’s right of subrogation, makes no reference to claims arising from uninsured motorist coverage. Jeneary v. Commonwealth, 262 Va. 418 , 551 S.E.2d 321, 2001 Va. LEXIS 106 (2001).

    Applicability of § 65.2-309.1 . —

    The language of this section neither expressly nor by implication places the fund in the same position as an employer; rather, when the fund is ordered to pay compensation benefits, its right of subrogation extends to claims the employee may have against “the employer or any other party.” Accordingly, § 65.2-309.1 is inapplicable to the fund’s subrogation rights under this section. Jeneary v. Commonwealth, 262 Va. 418 , 551 S.E.2d 321, 2001 Va. LEXIS 106 (2001).

    Uninsured employer’s fund was not entitled to a lien against uninsured motorist insurance proceeds paid to estate administrator to settle wrongful death claim, since insurance company was not an “other party,” but instead was merely fulfilling a contractual obligation in paying insurance benefits to estate administrator. Jeneary v. Commonwealth, 262 Va. 418 , 551 S.E.2d 321, 2001 Va. LEXIS 106 (2001).

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    The Uninsured Employer’s Fund is subrogated to any right to recover damages that the injured employee may have against his employer or any other party for such injury. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    The limitation period of § 65.1-87 (now § 65.2-601 ) does not apply to the Commonwealth. Therefore, the Uninsured Employer’s Fund, as part of its subrogation and recoupment authority, may file a workers’ compensation claim against the direct employer or statutory employer more than two years after the date of the accident. McClanahan v. Liberty Coal Corp., 70 O.I.C. 31 (1991).

    Liability for compensation or indemnification as a statutory employer under § 65.2-302 exists without reference to its insured status. When both the immediate and the statutory employer are uninsured, a determination should be made as to the liability of each, and they may both be held jointly and severally liable to pay for compensation. Powell v. Up Front Painting, 76 O.W.C. 55 (1997).

    § 65.2-1205. Notification of change in earnings; change in award.

    The burden shall be upon the claimant to immediately notify the Commission in writing of any increase or decrease in his earnings. After ten days’ notice to the claimant and the Attorney General, the Commission may, upon its own motion or upon the motion of any party in interest, modify or terminate an award as conditions may require.

    History. 1977, c. 345, § 65.1-151; 1991, c. 355.

    § 65.2-1206. Payments procured by fraud, mistake or unreported change in condition; recovery.

    Any payment to a claimant pursuant to this chapter which is later determined by the Commission to have been procured by fraud, mistake or an unreported change in condition, shall be recovered from the claimant and credited to the Uninsured Employer’s Fund.

    History. 1977, c. 345, § 65.1-152; 1991, c. 355.

    NOTES FROM THE WORKERS’ COMPENSATION COMMISSION

    While the Uninsured Employer Fund may seek a credit for payments based on fraud, mistake or unreported change in conditions from future medical costs it is not entitled to a credit against outstanding medical expenses. Morales-Perez v. David Mesemer/Great Falls Lawn & Tree, Inc., VWC File No. 219-70-52 (Oct. 29, 2007).

    The provision of § 65.2-520 limiting an employer’s recovery of voluntary payments to a reduction of ongoing weekly benefits by one-fourth, does not apply to claims for recovery of mistaken payments made by the Uninsured Employers’ Fund (“UEF”). The General Assembly created § 65.2-1206 , which allows the UEF to recover payments made to the employee procured through fraud, mistake or unreported change in condition. The UEF’s recovery of mistaken payments under § 65.2-1206 is not limited to a percentage reduction in weekly benefits, but is to be determined by the Commission. In this case, the Commission allowed the UEF to reduce weekly benefits by thirty percent until the overpayment was fully recovered. Bullington v. Marshall Boy’s Logging, VWC File No. 180-34-06 (March 7, 2001).

    Chapter 13. Peer Review of Medical Costs.

    §§ 65.2-1300 through 65.2-1310. Repealed by Acts 2016, cc. 279 and 290, cl. 3, effective March 7, 2016.

    Editor’s note.

    Former § 65.1-1300, pertaining to definitions, derived from Acts 1980, c. 444, § 65.1-153; 1991, c. 355. Former § 65.2-1301, pertaining to Statewide Coordinating Committee; membership; terms, derived from Acts 1980, c. 444, § 65.1-154; 1985, c. 29; 1991, c. 355; 2004, c. 1000. Former § 65.2-1302, pertaining to compensation and expenses of members of Statewide Coordinating Committee and regional peer review committees, derived from Acts 1980, c. 444, § 65.1-155; 1983, c. 196; 1991, cc. 352, 355; 2004, c. 1000. For § 65.2-1303, pertaining to regional peer review committees, derived from Acts 1980, c. 444, § 65.1-156; 1991, c. 355; 2004, c. 1000. Former § 65.2-1304, pertaining to utilization review program, derived from Acts 1980, c. 444, § 65.1-157; 1991, c. 355. Former 65.2-1305, pertaining to peer review program, derived from Acts 1980, c. 444, § 65.1-158; 1991, c. 355. Former § 65.2-1306, pertaining to corrective action, derived for Acts 1980, c. 444, § 65.1-159; 1991, c. 355; 2013, c. 204. Former § 65.2-1307, pertaining to immunity of Committee members from liability, derived from Acts 1980, c. 444, § 65.1-160; 1991, c. 355. Former § 65.2-1308, pertaining to privileged communications, derived from Acts 1980, c. 444, § 65.1-161; 1991, c. 355. Former § 65.2-1309, pertaining to employment of Committee staff; contracts for services; rules and regulations, derived from Acts 1980, c. 444, § 65.1-162; 1991, c. 355. Former § 65.2-1310, pertaining to funding, derived from Acts 1980, c. 444, § 65.1-163; 1991, c. 355.