Van Buren v. Augusta Cnty.

Decision Date19 July 2016
Docket NumberRecord No. 1975–15–3
Citation66 Va.App. 441,787 S.E.2d 532
PartiesRobert Van Buren, Sr. v. Augusta County and Virginia Association of Counties Group Self Insurance.
CourtVirginia Court of Appeals

Bradford M. Young, (HammondTownsend, PLC, on briefs), Charlottesville, for appellant.

Richard D. Lucas (Lucas & Kite, PLC, on brief), Roanoke, for appellee.

Present: PETTY, O'BRIEN and ATLEE, JJ.

ATLEE

, Judge.

Robert Van Buren, Sr. appeals a decision of the Virginia Workers' Compensation Commission (“the Commission”). He asserts that the Commission erred when it found his injury was “not the result of an identifiable incident which occurred at a reasonably definite time” but rather was “gradually incurred” and “the result of repetitive or cumulative trauma.”1 We reverse.

I. Background

“On appeal, this Court views the evidence in the light most favorable to the prevailing party below.” Town & Country Hosp., LP v. Davis , 64 Va.App. 658, 660, 770 S.E.2d 790, 791 (2015)

. In this case, Augusta County and the Virginia Association of Counties Group Self Insurance (collectively “employer”) prevailed below. “Factual findings by the commission that are supported by credible evidence are conclusive and binding upon this Court on appeal.” Nurses 4 You, Inc. v. Ferris , 49 Va.App. 332, 339–40, 641 S.E.2d 129, 132 (2007) (quoting S. Iron Works, Inc. v. Wallace , 16 Va.App. 131, 134, 428 S.E.2d 32, 34 (1993) ). The following facts are supported by credible evidence.

A. Injury

At the time of his injury, Van Buren was fifty-two years old and working as a firefighter. While on duty on July 25, 2014, he responded to a call requesting assistance for an elderly man who had fallen in the shower. The man weighed approximately 400 pounds and had broken his leg

during the fall. When Van Buren arrived, the man was crumpled awkwardly in the shower, his broken limb crushed under the weight of his body. For the next thirty to forty-five minutes, Van Buren and his colleagues used a combination of improvisation, brute strength, and equipment to rescue the injured man.

Initially, Van Buren and another firefighter used a sheet as a sling, balancing on the ledge of the shower, looping the sheet under the injured man's arms, then elevating and holding the man to relieve pressure on his leg. From there, Van Buren helped maneuver the man onto a towel, then onto a flat-bottomed, flexible stretcher. Van Buren and the others slowly dragged and pushed this stretcher the length of the hallway, along the floor. Van Buren testified: “I had stabilized his broken leg

with my left arm and had to pull down the hallway towards the cot with my right arm.” At the end of the hallway, Van Buren helped hoist the man off the flat-bottomed stretcher and onto a wheeled stretcher

. Van Buren and the other firefighters then hauled the wheeled stretcher out of the house and down a hill. At the bottom of the hill, Van Buren helped heave the wheeled stretcher into the back of the ambulance.

Once Van Buren had dealt with the crisis and loaded the injured man into the ambulance, he noticed for the first time “a pain on the outside [o]f [his] arm.” At the hearing in front of the deputy commissioner, in response to a question about whether he ever felt a sudden onset of pain while helping the man, Van Buren testified that he had not initially noticed the pain because the injured man was “hollering” and because of “the adrenaline with the call and everything.” However, “as soon as [he] closed the door and got ready to go and walk[ed] around the unit to drive,” Van Buren noticed the pain in his arm. He then drove the injured man to the hospital.

B. Treatment

Four days after the rescue, Van Buren called an employee hotline and reported that he was experiencing pain in his right shoulder. Over the next several months, he visited various medical professionals: a nurse practitioner at his family doctor's office, a physical therapist, his family doctor, and doctors at a hospital affiliated with the University of Virginia. In each instance, Van Buren described being hurt while assisting the man during the rescue on July 25, 2014. Ultimately, an MRI revealed a disc herniation at C5–6. Doctors at the University of Virginia surgically removed the herniated disc

material in October of 2014 and performed both a hemilaminotomy and a foraminotomy.

C. Commission Proceedings

Van Buren filed an initial claim for benefits with the Commission on September 11, 2014, and an amended claim several months later. A hearing before the deputy commissioner occurred in March of 2015. Van Buren testified at the hearing, and both parties introduced exhibits. Among the evidence introduced by employer was a letter signed by Dr. James LaGrua, Van Buren's physician. In that letter, Dr. LaGrua affirmed that it was his opinion, “to a reasonable degree of medical probability,” that Van Buren suffered a cervical herniation “as a result of the twisting, lifting, awkward movements and exertion required to extract the gentleman from the shower, into the bathroom, down the hall, onto the gurney and into the ambulance.”

In April of 2015, the deputy commissioner awarded Van Buren temporary total disability, lifetime medical benefits, and attorney's fees. Employer appealed that award to the full Commission. In November of 2015, a divided Commission reversed and vacated the deputy commissioner's decision. Van Buren then noted his appeal to this Court.

II. Analysis
A. Standard of Review

Van Buren and employer disagree as to the standard of review in this case. Van Buren asserts that, because the Court is reviewing “the Commission's application of the law to undisputed facts,” the standard is de novo . By contrast, employer asserts that the standard of review “is based on factual findings and not de novo .” Neither party is entirely correct. Rather, reviewing the Commission's determination that Van Buren did not suffer an “injury by accident” presents a mixed question of law and fact, because it involves both factual findings and the application of law to those facts. The Commission's factual findings bind us as long as credible evidence supports them. Stillwell v. Lewis Tree Serv. , 47 Va.App. 471, 477, 624 S.E.2d 681, 683 (2006)

. But “whether those facts prove the claimant suffered an ‘injury by accident’ is a question of law.” Goodyear Tire & Rubber Co. v. Harris , 35 Va.App. 162, 168, 543 S.E.2d 619, 621 (2001). Therefore, we review that portion of the Commission's decision de novo .

Nelson Cty. Sch. v. Woodson , 45 Va.App. 674, 677–78, 613 S.E.2d 480, 482 (2005)

. Additionally, [t]o the extent we must interpret a statute, that is a question of law that we review de novo.” Powell v. Commonwealth , 289 Va. 20, 26, 766 S.E.2d 736, 739 (2015).

B. Commission's Findings of Fact

In addition to the facts recited in Part I, supra , the Commission found that “the medical record fully substantiated that [Van Buren] suffered a cervical herniated disc

,” but that “the mere existence of a medical condition does not establish that an identifiable, work-related incident transpired and caused the physical problem.” The Commission went on to observe that “the medical record establishes that [Van Buren] had been experiencing right shoulder symptoms prior to July 25, 2014 and that he had “informed health care providers of at least a two-week history of shoulder complaints when he began seeking medical treatment.” It is true that the injury hotline notes stated: “Caller states that he started with right shoulder pain about 2 weeks ago. Caller states that it is getting worse due to him lifting patient's [sic] all day at work.” Furthermore, evaluation notes from Van Buren's visit to a physical therapist two days later indicated, in part, that he complained of “slight R shoulder pain that has been ongoing, but has noticed an increase in R shoulder/lateral arm pain since helping lift a 400lb load for work.”

The Commission's findings of fact continued:

Notably, [Van Buren] described his general, work-related heavy lifting requirements and the development of pain, at some vague point, following the lifting of the 400–pound patient. (emphasis added). Dr. Lagrua similarly agreed that the disc herniation occurred “at some point” while [Van Buren] performed multiple physical acts which included twisting, lifting, moving awkwardly and removing the patient from the shower and house.
... At most, the evidence showed that [Van Buren] suffered a herniated disc

at some point, perhaps as a result

of one of [sic] more of the strenuous activities he performed over an approximate 40–minute period. ...
... At no point in the hearing transcript did [Van Buren] testify or even claim that his injury occurred at a moment in time when he lifted a patient. ... At no point did [Van Buren] testify or even claim that his injury occurred while lifting a patient, or while performing any of the other strenuous and awkward activities in which he was engaged in extricating the 400-pound patient from the shower and transporting him to the emergency vehicle.

Ultimately, the Commission took the approach that, even assuming that the injury occurred on July 25, 2014, the causation was too vague to trigger coverage of the Workers' Compensation Act. The Commission did not make a conclusive finding as to the actual date of the injury, however to the extent the Commission found that the injury occurred before July 25, 2014, that conclusion was clearly erroneous and unsupported by the evidence.

Van Buren noted that he had experienced pain in his shoulder for several weeks prior to July 25, 2014. However, all of his reports to various health professionals indicated that it was the heavy lifting required of him on July 25, 2014 that caused an actual injury and that such injury was to his cervical spine, not to his shoulder. These reports tied his pain and injury directly to the actions he took assisting the injured man on July 25, 2014. Most importantly, Van Buren's own treating physician, Dr....

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