v.
Janis R. Cooper
Present: Chief Judge Huff, Judges Russell and AtLee
UNPUBLISHED
Argued at Richmond, Virginia
GENE FORBES ENTERPRISES
d/b/a McDONALD’S OF TAZEWELL
AND ARCH INSURANCE COMPANY
MEMORANDUM OPINION* BY v. Record No. 2320-14-2 JUDGE WESLEY G. RUSSELL, JR. JUNE 9, 2015 JANIS R. COOPER
FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION
Steven T. Billy (Billy & Seli, P.C., on briefs), for appellants.
Mark T. Hurt (The Law Offices of Mark T. Hurt, on brief), for appellee.
Appellants, Gene Forbes Enterprises d/b/a McDonald’s of Tazewell and Arch Insurance
Company (employer), appeal the decision of the Workers’ Compensation Commission awarding benefits to appellee. On appeal, employer presents the following eleven assignments of error:
1. The [commission] erred, as a matter of law, in affirming the [d]eputy [c]ommissioner’s decision excluding and refusing to consider the January 19, 2014 questionnaire responses of Dr. James Vascik.
2. The [commission] erred, as a matter of law, in affirming the [d]eputy [c]ommissioner’s decision to admit [claimant’s] exhibits #3-5 into the evidence.
3. The [commission] erred, as a matter of law and fact, in finding that [claimant] suffered a compensable injury by accident that arose out of her employment on September 3, 2013.
4. The [commission] erred, as a matter of law and fact, in finding that [claimant] suffered a compensable injury by accident that
* Pursuant to Code § 17.1-413, this opinion is not designated for publication. occurred in the course of her employment on September 3, 2013.
5. The [commission] erred, as a matter of law and fact, in finding that [claimant] suffered a sudden mechanical or structural change to her neck on September 3, 2013.
6. The [commission] erred, as a matter of law and fact, in finding that [claimant’s] medical treatment and alleged disability were causally related to the alleged accident of September 3, 2014.
7. The [commission] erred, as a matter of law, in awarding [claimant] lifetime medical benefits for body parts for which no claim had been filed.
8. The [commission] erred, as a matter of law and fact, in awarding [claimant] disability benefits for periods when she did not have a legally sufficient statement of total disability and in awarding [claimant] ongoing disability.
9. The [commission] erred, as a matter of law, in failing to make a ruling on [employer’s] asserted defense that [claimant] failed to market her residual work capacity.
10. The [commission] erred, as a matter of law, in failing to correct the employer’s name in the proceedings from McDonald’s of Tazewell d/b/a Gene Forbes Enterprises to its proper legal name, Gene Forbes Enterprises d/b/a McDonald’s of Tazewell.[1]
11. The [employer] challenge[s] the legal conclusions of the [commission] and the sufficiency of the evidence to support the [c]ommission’s decision in this case.[2]
For the reasons stated below, we affirm the decision of the commission.
[*2]BACKGROUND
On appeals from the commission, “we review the evidence in the light most favorable to
the prevailing party[,]” here, claimant. R.G. Moore Bldg. Corp. v. Mullins, 10 Va. App. 211, 212, 390 S.E.2d 788, 788 (1990). Moreover, “[f]actual findings of the commission will not be disturbed on appeal unless plainly wrong or without credible evidence to support them.” Ga.
Pac. Corp. v. Dancy, 17 Va. App. 128, 135, 435 S.E.2d 898, 902 (1993) (citation omitted).
So viewed, the record establishes that claimant is a former employee of Gene Forbes
Enterprises, a business that operated several McDonald’s restaurants, including one in both
Bluefield and Tazewell, Virginia. Claimant, a forty-three-year-old female, worked for the company at various store locations for 23 years. In 2008, she was serving as store manager at the Bluefield, Virginia store. In June 2013, the business decided to close the Bluefield location for renovations, and claimant was transferred to Tazewell, where she remained a manager, but was subject to the direction of that location’s store manager. Claimant admits she was displeased by her reassignment. Her duties in these positions, which usually entailed nine-hour shifts, included
serving customers, frequent cleaning of all parts of the store, regular loading and unloading of supply trucks, and lifting of equipment and product weighing up to 40 pounds.
On October 8, 2013, claimant filed with the Virginia Workers’ Compensation
Commission a claim for benefits for a neck injury she claimed to have sustained while working
at the Tazewell McDonald’s drive-thru window on September 3, 2013.3 According to claimant, on the date of her injury, she was manning the drive-thru by herself when, in fulfilling an order, a
bag of french fries slipped from her hands. When she impulsively bent over quickly to catch the bag, claimant “heard and felt a tear” down her neck and shoulder and felt a shooting pain that caused her to cry. She reported the injury to her supervisor the same day and informed her that the pain would not allow her to work late. Claimant acknowledges that she had issues with neck and back problems before this incident, however she had no history of absences from work based
[*3]on those issues and stated that the previous pain was different in that it was more sporadic and felt more like a tingling or numbing sensation rather than pain.
Hoping that the injury was minor and that the pain would be temporary, claimant did not immediately seek medical treatment. Not having recovered after two days, however, she sought treatment from a family nurse practitioner, Ms. Walker, on September 5, 2013. The nurse practitioner’s records note that claimant was working when she “felt a pop in her posterior left
neck followed by a burning like pain [in] the muscle with no radiation” and that “[s]ince [the incident claimant] has continued her activities and work to the point that both the upper back and neck pain have become worse and unbearable causing her not to be able to walk, bend, stand, breathe, lift, sleep, work or perform ADL’s normally.” Nurse Practitioner Walker instructed claimant to refrain from work until her follow-up appointment on September 9, 2013.
After claimant’s follow-up appointment, claimant still experienced pain on the left side of her upper trapezius and also in the left scapula trapezius area.[4] During a subsequent visit, she cried because of the pain and the inability to continue providing for her family. Based on claimant’s irregular gait, bent-over posture, and continued negative results on the straight leg raise exam, Nurse Practitioner Walker referred claimant for a cervical MRI, which was conducted on September 20, 2013. Based on the MRI results, claimant was then referred to a neurosurgeon, Dr. James M. Vascik. Claimant also was referred to physical therapy, and she was advised to remain out of work.
[*4]Dr. Vascik examined claimant on October 1, 2013. Notes from that visit reveal that claimant came to the office “bent over at the waist with her head cocked over to the right.”
According to Dr. Vascik’s analysis of the recent MRIs, claimant had bulging disks from C3-C7, but those disks were not touching her spinal cord or the nerve roots. Dr. Vascik concluded, “I do not see a surgical problem on any of her studies. I don’t see that an ESI would be of value as I believe her problem is musculoskeletal in nature, not from a nerve root compression problem.”
The following day, claimant returned to Nurse Practitioner Walker, where she
complained of continuing and exasperated pain due to the car ride to the neurosurgeon and the physical therapy. Claimant was then referred to an orthopaedic physician and, a short time
thereafter, another neurosurgeon. When claimant attempted to make an appointment with the orthopaedist, she was informed that he did not treat neck and back injuries, and she did not see the neurosurgeon, despite arriving for her appointment, because she could not afford the co-pay.
Claimant also started seeing a pain specialist, Dr. Marc Swanson, whose office claimant
first visited on October 30, 2013. Claimant’s continued pain, which she described as tightness in her left neck and shoulder muscles, caused her to continue visiting Dr. Swanson, despite not being able to afford much treatment. She visited Dr. Swanson on a monthly basis and received several brachial plexis block injections to alleviate her muscle spasms. This treatment afforded her temporary pain relief of three to five days. Dr. Swanson found that although claimant may have had a pre-existing injury, the September 3, 2013 incident “escalated her pain and added to
the functional impairment over and above and beyond what she experienced up until the injury, to the point of injury[,]” and he linked her present condition to the event to a reasonable degree of medical certainty.
[*5]In January 2014, Dr. Swanson noted that claimant could not safely or reliably return to work and advised that she remain out of work until the end of February. Dr. Swanson commented that, while claimant was demonstrating some improvement, she would not be employable “when she struggles with neck and arm pain, radicular symptoms, symptoms that really limit her ability to function during the day.” Claimant testified that she could no longer engage in hobbies such as hunting and fishing and could not perform routine tasks, such as house and yard work, grocery shopping, or extended driving without straining her injury. Dr. Swanson ultimately concluded that claimant “is not currently able to return to work.”
After claimant filed her claim for benefits, a hearing was scheduled before the deputy commissioner for January 21, 2014. After granting two continuances based on claimant’s motions, the matter was reset for May 13, 2014. Claimant filed her designation of medical
records on May 9, 2014. Employer filed its designation of medical records on the evening of May 12, 2014, the day before the rescheduled hearing. The designation included questionnaire responses that employer previously had received from Dr. Vascik on or about January 19, 2014.
Arguing that employer’s designation failed to comply with Rule 4.2, claimant moved to strike the questionnaire responses. In response, employer filed a motion to continue and an objection
to the motion to strike. The deputy commissioner denied employer’s motions and excluded the questionnaire. After the evidentiary hearing, employer unsuccessfully twice sought reconsideration of this issue.
During the proceeding on the merits of the case, claimant offered as an exhibit three text messages of the claimant discussing her injuries with others. Employer objected to their consideration on hearsay grounds, but the deputy commissioner accepted them, noting, “I will
allow them for whatever worth, evidentiary weight I think they deserve.” During the hearing, the deputy commissioner realized that the claim had been filed with an incorrect name of the employer, and counsel agreed to amend the claim to reflect the proper party. The deputy commissioner also noted a potential further discrepancy in claimant’s claim: in her pre-hearing statement she had asserted both a neck and left shoulder injury, but her formal claim included only the neck injury. Claimant sought to amend her claim, but the deputy commissioner denied
[*6]her request, and the claimant proceeded on her neck claim only. After the evidentiary hearing, the record was held open to receive a de bene esse deposition of Dr. Swanson, who failed to appear at the hearing despite having been served a subpoena.
On June 19, 2014, the deputy commissioner issued an opinion finding that claimant had suffered a compensable injury of her neck. Specifically, the deputy commissioner determined
that claimant sustained an injury by accident to her neck on September 3, 2013, arising out of and in the course of her employment. The deputy commissioner found the employer responsible for the cost of her treatment with Nurse Practitioner Walker, Dr. Vascik, and the other
neurosurgeon. The treatment by Dr. Swanson was deemed reasonable but unauthorized. The deputy commissioner then awarded claimant compensation of $635.64 per week temporary total
disability for the periods of September 3, 2013 through November 15, 2013 and January 23, 2014 until otherwise modified. Employer timely filed a request for review of the deputy commissioner’s opinion by the full commission, raising twenty assignments of error. The full commission issued an opinion on November 24, 2014, affirming the ruling of the deputy commissioner. This appeal followed.
ANALYSIS
At the outset, we note that the decisions of the commission are “presumed to be
correct . . . [and that if] this [C]ourt determines that the evidence is sufficient to support the finding of the . . . [c]ommission, the order of the [c]ommission will be affirmed.” Humphries v. Newport News Shipbuilding & Dry Dock Co., 183 Va. 466, 476, 32 S.E.2d 689, 694 (1945).
[*7]Having disposed of employer’s tenth and eleventh assignments of error above, we turn to the remaining nine assignments of error.[5]
Exclusion of Dr. Vascik’s Questionnaire Responses
Employer contends that the exclusion of Dr. Vascik’s questionnaire constituted an abuse of discretion because, under Code § 65.2-902 and Rule 4.2 of the Rules of the Commission, such a document constitutes a “required report” and because Rule 2.2(B)(4) provides that designated records “will be admitted into evidence.” Employer further argues that these documents “are automatically part of the hearing record,” and therefore the deputy commissioner was not free to exclude the questionnaire and the commission should have considered it. Because this argument
amounts to a challenge to the commission’s interpretation of its own rules, we review the commission’s action deferentially and will only reverse the commission if its action is arbitrary and capricious. Jenkins v. Webb, 52 Va. App. 206, 211, 662 S.E.2d 633, 635 (2008) (citation omitted).
Although employer’s recitation of these provisions may be correct, the cited Rules cannot be read in isolation. Rather, they must be read in context and in relation to the other Rules.
Commission Rule 1.12 expressly authorizes the commission “to enforce its rules and the provisions of the Workers’ Compensation Act . . . upon its own motion . . . [by excluding]
evidence from the record . . . .” This power is “[i]n addition to the statutory authority of the [c]ommission to levy fines, to assess attorney fees and punish contempt . . . .” Accordingly, although Rule 4.2 provides that the civil penalty established by Code § 65.2-902 applies to medical records, such penalty is not the sole means by which the commission can enforce Rule
[*8]4.2’s requirement that “[e]ach party shall promptly provide the other parties with copies of any
medical records they receive as they receive them.” Further, nothing in Rule 1.12 limits the commission’s power to exclude evidence after it has become part of the record. We, therefore, conclude that the commission’s discretion to exclude evidence under Rule 1.2 is not curtailed by
Rule 4.2 or Rule 2.2(B)(4).
Here, employer sent Dr. Vascik a questionnaire on January 15, 2014. Prior to sending it, employer noted that, in reserving “the right to obtain questionnaire responses from the claimant’s treating physicians,” it “will provide copies of any such reports as soon as they are received,” as required by Rule 4.2. Dr. Vascik completed, signed, and returned the questionnaire to employer
on January 19, 2014, but employer did not disclose the questionnaire until 7:18 p.m. on May 12, 2014, the eve of the scheduled hearing, and almost four months after receiving the document from the physician. The deputy commissioner found that this delay violated Rule 4.2’s
requirement to “promptly provide” copies of medical records as they are received. The commission adopted the deputy commissioner’s resolution of the issue.
As we previously have stated, “Rule 1.12 sets forth methods by which the commission may enforce the Act and its rules, expressly allowing the commission in the exercise of its
discretion to act sua sponte to exclude evidence from the record.” Jenkins, 52 Va. App. at 211, 662 S.E.2d at 635. Accordingly, because the commission determined there had been a violation
of its rules, and because generally, “[t]he commission, in order to do full and complete justice in each case, must be able to protect itself and parties from discovery abuse[,]” Jeff Coal, Inc. v.
[*9]Phillips, 16 Va. App. 271, 278, 430 S.E.2d 712, 717 (1993), we find the commission did not abuse its discretion in excluding the questionnaire responses of Dr. Vascik.[6]
Admission into Evidence of Claimant’s Exhibits 3-5
Claimant’s exhibits 3-5 were reproductions of text messages that claimant either sent or received after the injury. Claimant sought to introduce the reproductions in her rebuttal case to demonstrate prior consistent statements in an effort to counter testimony adduced in employer’s case that suggested she had made statements inconsistent with her hearing testimony.
Employer correctly notes that the commission properly may receive hearsay evidence in determining the substantial rights of the parties. See Rule 2.2, Rules of the Virginia Workers’
Compensation Commission. This Court has repeated that rule, explaining that “the commission is not bound by common law rules of evidence, but may adopt whatever procedures it sees fit so
long as they ‘protect the substantial rights of the parties.’” Ceres Marine Terminals v. Armstrong, 59 Va. App. 694, 702, 722 S.E.2d 301, 305 (2012) (quoting Rios v. Ryan, Inc. Cent., 35 Va. App. 40, 44-45, 542 S.E.2d 790, 791-92 (2001)).