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COURT OF APPEALS OF VIRGINIA
Present:    Judges Willis, Annunziata and Senior Judge Cole
Argued at Richmond, Virginia
DOLLAR GENERAL STORE, ET AL.
v.                                                                     Record No.  0747-95-2   OPINION BY
JUDGE ROSEMARIE ANNUNZIATA
BEATRICE V. CRIDLIN                                                    MARCH  26,  1996
FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
Ralph L. Whitt, Jr.  (Jennifer G. Marwitz;
Sands, Anderson, Marks & Miller, on brief),
for appellants.
No brief or argument for appellee.
Beatrice V. Cridlin  ("claimant") filed a claim for benefits
with the Virginia Workers' Compensation Commission alleging an
injury by accident she sustained in March  1994 while working for
Dollar General Store  ("employer").    The deputy commissioner
awarded temporary total disability for a one-week period at a
rate of  $140.01.    The full commission affirmed.    Employer
appeals, contending the commission erred in its finding that
claimant had sustained an injury by accident arising out of and
in the course of her employment.    Finding no error, we affirm.
I.
On appeal, we construe the evidence in the light most
favorable to the party prevailing below.    R.G. Moore Bldg. Corp.
v. Mullins,  10 Va. App.  211,  212,  390 S.E.2d  788,  788  (1990).
The commission's findings of fact on the issue of causation will
be upheld if supported by credible evidence.    James v. Capitol




Steel Constr. Co.,  8 Va. App.  512,  515,  382 S.E.2d  487,  488
(1989); Ingersoll-Rand Co. v. Musick,  7 Va. App.  684,  688,  376
S.E.2d  814,  817  (1989).
As an assistant manager for employer, claimant's duties
included running the cash register, helping on the floor, and
helping with stock.    On March  28,  1994, claimant helped unload a
delivery truck, removing boxes from a waist-high conveyor belt
extending from the truck.    The unloading began at approximately
10:00 a.m. and lasted three to four hours, during which time
claimant estimated she unloaded close to  1000 boxes.    Claimant
testified that between  11:30 a.m. and  12:30 p.m., after she had
unloaded several hundred boxes, she felt "the muscles pulling in
[her] neck" upon lifting a box of ironing boards from the
conveyor belt.    The box contained four ironing boards, was taller
than claimant, and was the heaviest box she had unloaded that
day.    Although claimant immediately felt the "pull," she did not
feel any pain until the following day.
In reports to her treating physicians and supervisor, in her
claim for benefits, and in a conversation with the insurer's
claims representative, claimant described her injury as occurring
while unloading boxes.    She did not specifically state that it
occurred when she unloaded a box of ironing boards.    Claimant's
condition was diagnosed by medical personnel at the hospital as
an "overuse injury/bursitis right shoulder" and by her physician
as a "trapezius strain" and "tendinitis of the right shoulder."
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"Injury by accident" is defined, within the context of the
Workers' Compensation Act, as "an identifiable incident or sudden
precipitating event  [that results] in an obvious sudden
mechanical or structural change in the body."    Morris v. Morris,
238 Va.  578,  589,  385 S.E.2d  858,  865  (1989).    By contrast, a
gradually incurred injury is not an injury by accident within the
meaning of the Act.    Middlekauff v. Allstate Ins. Co.,  247 Va.
150,  154,  439 S.E.2d  394,  397  (1994).    Though an injury by
accident must be "`bounded with rigid temporal precision,'  .  .  .
[a]n injury need not occur within a specific number of seconds or
minutes  .  .  . but instead, must occur within a  `reasonably
definite time.'"    Brown v. Caporaletti,  12 Va. App.  242,  243-44,
402 S.E.2d  709,  710  (1991)  (quoting Morris,  238 Va. at  589,  385
S.E.2d at  864).
Employer argues that the commission erred in finding
claimant's condition to be an injury by accident.    It contends
that claimant's testimony that the injury was caused when she
unloaded a box of ironing boards is insufficient when weighed
against other evidence in the case, which fails to reflect such
an event.
Claimant did not report until the hearing that unloading a
box of ironing boards caused her injury.    The commission weighed
that factor and resolved the issue in favor of claimant.    We will
not substitute our judgment for that of the trier of fact, which
had an opportunity to observe the witnesses and evaluate their
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credibility.    Goodyear Tire & Rubber Co. v. Pierce,  5 Va. App.
374,  382,  363 S.E.2d  433,  437  (1987), appeal after remand,  9 Va.
App.  120,  384 S.E.2d  333  (1989).
II.
Next, employer contends that claimant's medical records
indicate she suffered from cumulative trauma rather than an
identifiable injury.    Citing Reserve Life Insurance Co. v. Hosey,
208 Va.  568,  159 S.E.2d  633  (1968), employer argues that the
commission violated the well settled rule that it "must look to
the medical evidence to ascertain the cause or mechanism of
claimant's injury."
Hosey, however, does not support employer's assertion.
Although Hosey found causation in that case based on claimant's
medical records, id. at  570,  159 S.E.2d at  634-35, the Court's
ruling does not support employer's argument that medical evidence
is dispositive, or required, to establish causation.
"Medical evidence is not necessarily conclusive, but is
subject to the commission's consideration and weighing."
Hungerford Mechanical Corp. v. Hobson,  11 Va. App.  675,  677,  401
S.E.2d  213,  215  (1991)  (addressing evidence used to establish
percentage of incapacity suffered by employee).    The testimony of
a claimant may also be considered in determining causation,
especially where the medical testimony is inconclusive.    See
Morris v. Badger Powhatan/Figgie Int'l, Inc.,  3 Va. App.  276,
281,  348 S.E.2d  876,  878  (1986).    As noted in  2B Arthur Larson,
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The Law of Workmen's Compensation  §  79.51(a)  (1995):
To appraise the true degree of
indispensability which should be accorded
medical testimony, it is first necessary to
dispel the misconception that valid awards
can stand only if accompanied by a definite
medical diagnosis.    True, in many instances
it may be impossible to form a judgment on
the relation of the employment to the injury,
or relation of the injury to the disability,
without analyzing in medical terms what the
injury or disease is.    But this is not
invariably so.    In appropriate circumstances,
awards may be made when medical evidence on
these matters is inconclusive, indecisive,
fragmentary, inconsistent, or even
nonexistent.
Id.  (citations omitted).
The commission clearly considered claimant's medical
records.    It gave the records little weight in its determination
of the legal cause of claimant's injury, finding that the
treating physicians were primarily interested in treating
claimant's condition and not in establishing the cause of the
injury.    The reports reflect only the results of claimant's
physical examinations and do not purport to establish the cause
or causes of her injury.    See Morris,  3 Va. App. at  282,  348
S.E.2d at  879.    Indeed, neither doctor was asked to give an
opinion as to the causal relationship between claimant's work and
her disability.    See id. at  281-82,  348 S.E.2d at  878-79.
In short, the commission was free to credit claimant's
testimony at the hearing as a basis for its finding of causation.
The fact that contrary evidence may appear in the record "is of
no consequence if there is credible evidence to support the
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commission's finding."    Wagner Enters., Inc. v. Brooks,  12 Va.
App.  890,  894,  407 S.E.2d  32,  35  (1991).
III.
Employer next argues that claimant is precluded from
receiving benefits because her injury was expected.    It contends
claimant lifted the box in contravention of her physician's
direction to lift nothing heavy because of her breast cancer
surgery.
An injury by accident must be unexpected to be compensable.
See, e.g., Hosey,  208 Va. at  570-71,  159 S.E.2d at  635  (injury
to knee while making door-to-door survey unexpected); Lynchburg
Foundry Co. v. Irvin,  178 Va.  265,  270-71,  16 S.E.2d  646,  648
(1941)  (pinching of "safety shoe" causing toe injury unexpected);
Ellis v. City of Norfolk,  68 O.I.C.  47,  52  (1989)  (finding injury
expected therefore noncompensable).    However, claimant's injury
cannot be considered an "expected" result of a deviation from the
heavy lifting restriction placed on her activities because of her
breast cancer surgery; her shoulder injury was not one the
restriction was intended to avoid.    Cf. Miller v. Dixon Lumber
Co.,  67 O.I.C.  71,  73  (1988); Bragg v. Buchanan General Hosp.,  59
O.I.C.  30,  32-33  (1980); Dobbins v. Contractors Equip. & Supply
Co.,  58 O.I.C.  104,  106  (1979).
Accordingly, the decision of the commission is affirmed.
Affirmed.
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