Howell Metal Co. v. Adams

• Decision Date: 27 March 2001
• Docket Number: Record No. 1992-00-3.
• Citation: 35 Va. App. 184,543 S.E.2d 629
• Court: Virginia Court of Appeals
• Parties: HOWELL METAL COMPANY/COMMERCIAL METALS COMPANY and Highlands Insurance Group v. Michael Brandon ADAMS.

543 S.E.2d 629

35 Va. App. 184

HOWELL METAL COMPANY/COMMERCIAL METALS COMPANY and Highlands Insurance Group v. Michael Brandon ADAMS.

Record No. 1992-00-3.

Court of Appeals of Virginia, Salem.

March 27, 2001.

Thomas G. Bell, Jr., (Timberlake, Smith, Thomas & Moses, P.C., on brief), Staunton, for appellants. Linda D. Slough (Brian J. McNamara; Chandler, Franklin & O'Bryan, on brief), Charlottesville, for appellee.

Present: BUMGARDNER, HUMPHREYS and AGEE, JJ.

BUMGARDER, Judge.

Howell Metal Company and its insurer appeal the Workers' Compensation Commission's decision that psychiatric treatment for Michael Brandon Adams was causally related to his work injury. We conclude the evidence did not support the finding and reverse the decision.

On October 21, 1998, the employee received chemical burns to his feet, and the employer accepted the claim as compensable. In March 1999, the employee's treating physician referred him to a psychiatrist. The employee filed an application for payment of psychiatric services claiming the need for treatment arose out of his work injury. The deputy commissioner denied the application finding that the employee had not established the psychiatric treatment was "causally connected to his chemical burns of 1998." The full commission reversed and awarded psychiatric benefits for as long as necessary.

The employee's treating physician, Dr. Steven L. Phillips, noted on February 8, 1999: "I think he has more problems with anxiety and depression associated with this injury than he does have physical injury itself. I think the sympathetic response might be tied in with his emotional response to the entire affair and that he might benefit from treatment of anxiety and depression." The doctor prescribed an anti-depressant.

On February 7, 1999, Dr. Phillips assessed the employee's condition: "Bilateral burns to feet with persisting symptoms with some perpetuation probably resulting from anxiety and depression related to the injury." On February 25, 1999, the assessment was similar: "Bilateral foot burns with prolonged symptoms possibly contributed to by anxiety/depression related to the injury."

On March 31, 1999, Dr. Phillips referred the employee to Dr. Jeffrey K. Lightner, a psychiatrist. Dr. Phillips explained that he referred the employee "for a psychiatric evaluation in order to properly define his condition and also to help determine how much of it is related to his work injury. I realize that this latter task may be difficult but may be very important to the patient as well as his employer." In the letter, Dr. Phillips noted, "There may be an element of sympathetically maintained pain involved here..." He concluded, "I felt it wise to have him see a professional for accurate diagnosis and treatment if needed."

Dr. Lightner diagnosed the employee on April 1, 1999 with bipolar paranoid reaction. He never made a narrative report of his diagnosis. The employee's counsel solicited Dr. Lightner's opinion on the causal relation in a one-question letter: "Is it your opinion, to a reasonable degree of medical certainty, that the treatment you are providing Michael Adams is reasonable, necessary, and causally related to his work injury of October 21, 1998?" The letter provided spaces to check either "yes" or "no." Dr. Lightner did not mark one of the two indicated answers. Instead, he interlined, "to some degree, but I don't know patient's mental state prior to the injury," and drew an arrow to the space for indicating the "yes" response.

Dr. Phillips's notes and letter show that he had not reached a decision about the cause of the employee's psychiatric condition. Perplexed by the employee's condition, he referred the employee to a psychiatrist and deferred to that specialist for diagnosis and treatment. Dr. Phillips's note of May 3, 1999, made after Dr. Lightner's diagnosis, stated the disorder was not related to the injury. The employee's "affective disorder itself is not a work related illness[,] however his work injury may have had some effect on it." In his final response to counsel's inquiry, he could only say that the referral itself was "possibly" related to the injury.

The parties argue opposing interpretations of Dr. Lightner's...