Opinion
Record No. 1576-92-1
June 1, 1993
FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION.
William C. Walker (Taylor Walker, P.C., on brief), for appellants.
John H. Klein (Robert E. Walsh; Rutter Montagna, on brief), for appellee.
Present: Judges Baker, Barrow and Benton.
Argued at Norfolk, Virginia.
Pursuant to Code § 17-116.010 this opinion is not designated for publication.
In this appeal, an employer contests a finding of the Workers' Compensation Commission that an employee's condition and consequent disability arose out of and in the course of her employment. The employee suffered from bilateral carpal tunnel syndrome, right hand trigger thumb and left hand trigger finger. The commission found that these conditions were ordinary diseases of life but also found, "by clear and convincing evidence, to a reasonable medical certainty," that they arose out of her employment, were characteristic of the employment and caused by conditions particular to her employment. We hold that the testimony of the treating physician credibly supported the commission's finding.
Because the employee's conditions were ordinary diseases of life, the commission was required to make the specific findings it made regarding the causal relationship between her disabling conditions and her employment. See Code § 65.2-401; Holly Farms Foods, Inc. v. Carter, ___ Va. App. ___, ___, 422 S.E.2d 165, 169-70 (1992). Furthermore, the employee had to produce evidence of this causal relationship to a reasonable medical certainty and to persuade the commission by clear and convincing evidence. Code § 65.2-401.
The phrase "reasonable medical certainty" cannot be defined with absolute precision. Westmoreland Coal Co. v. Campbell, 7 Va. App. 217, 223, 372 S.E.2d 411, 416 (1988). An expert medical opinion need not meet any precise or formal requirement. Id. An expert opinion must state at least that it is more probable than not that the condition arose out of the employment, did not result from causes outside of the employment and is characteristic of the employment, and was caused by conditions particular to the employment.
The treating physician testified that in his opinion the employee's right trigger thumb "was probably precipitated because of the repetitious nature of her work." With regard to the trigger finger and her bilateral carpal tunnel syndrome, the same physician said, "I think in this case I feel fairly comfortable in stating I feel that this is work related." This physician was an orthopedic specialist who saw "a lot of patients in similar types of occupations when they're on an assembly line using pneumatic tools or using a lot of repetitive motions with their hands." He knew that this employee in the course of her work did "repetitious work with tools," including air screwdrivers.
This evidence credibly supported the commission's finding of the causal relationship between the employee's condition and her work. The commission's decision as to all questions of fact are conclusive and binding on this court. Code § 65.2-706. Based on our review of the evidence and the commission's findings of fact, we find that the commission had a sufficient basis upon which to conclude that the issue was proved by clear and convincing evidence to a reasonable medical certainty. Therefore, we affirm the commission's award.
Affirmed.