Integrative Pain Specialists v. Whole Foods

CourtCourt of Appeals of Virginia
DecidedFebruary 17, 2026
Docket0167251
StatusUnpublished

This text of Integrative Pain Specialists v. Whole Foods (Integrative Pain Specialists v. Whole Foods) is published on Counsel Stack Legal Research, covering Court of Appeals of Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Integrative Pain Specialists v. Whole Foods, (Va. Ct. App. 2026).

Opinion

COURT OF APPEALS OF VIRGINIA

Present: Chief Judge Decker, Judge AtLee and Senior Judge Humphreys UNPUBLISHED

Argued at Williamsburg, Virginia

INTEGRATIVE PAIN SPECIALISTS MEMORANDUM OPINION* BY v. Record No. 0167-25-1 JUDGE RICHARD Y. ATLEE, JR. FEBRUARY 17, 2026 WHOLE FOODS, ET AL.

FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION

Philip J. Geib (Philip J. Geib, P.C., on brief), for appellant.

Rachel Hussein (Robert McAdam; Kalbaugh, Pfund & Messersmith, PC, on brief), for appellees.

On January 14, 2025, the Workers’ Compensation Commission issued an opinion

denying Integrative Pain Specialists’s (provider) claim for reimbursement for medical services

on the grounds that it was invalid under Code § 65.2-605.1(F). On appeal, the provider assigns

error to the Commission’s interpretation and application of Code § 65.2-605.1(F). For the

following reasons, we affirm.

I. BACKGROUND

“In reviewing a decision of the [C]ommission, we view the evidence in the light most

favorable to . . . the party prevailing below.” Starbucks Coffee Co. v. Shy, 61 Va. App. 229, 238

(2012).

On May 7, 2016, Tamela Majors was injured while working for Whole Foods

(employer), resulting in an award for lifetime medical benefits. The provider rendered medical

care to Majors for the injuries she sustained in the accident. On March 17, 2020, the provider

* This opinion is not designated for publication. See Code § 17.1-413(A). filed a claim with the Commission pursuant to Code § 65.2-605.1(F) seeking reimbursement

from the employer for the medical services it provided to Majors. In its claim, the provider

expressly stated that it “d[id] not request a hearing on [its] claims . . . at [that] particular time.”

The provider filed a second claim pursuant to Code § 65.1-605.1(F) on December 1, 2022, again

indicating that it did not wish to pursue an evidentiary hearing at that time.

In March 2023, the provider requested an evidentiary hearing on its previously filed

claims.1 Following the evidentiary hearing in May 2024, a deputy commissioner issued an

opinion denying the provider’s March 2020 claim for lack of standing. The deputy

commissioner based its determination on two management services agreements that the provider

entered into with third-party companies.

In the first agreement, which the provider entered into in 2014, the provider assigned its

rights to bill and collect on its workers’ compensation claims to Ancillary Medical Solutions,

LLC. In 2016, Ancillary Medical Solutions assigned its interest in the provider’s workers’

compensations claims to another third-party company, StreamCare, LLC. The provider then

entered the second management services agreement in March 2020, directly assigning

StreamCare the rights to bill and collect on its workers’ compensation claims. StreamCare

retained the provider’s collection rights until November 2021.2 Relying on these assignments,

1 Prior to the evidentiary hearing, the parties stipulated that the employer made its last payment to the provider on April 23, 2021. This stipulation effectively established that the provider’s December 2022 claim was not timely filed. See Code § 65.2-605.1(F) (requiring claims to be filed within one year of the date of the last payment). Thus, the only claim in dispute at the evidentiary hearing was the March 2020 claim. 2 The provider terminated its agreement with StreamCare in November 2020 and, pursuant to the terms of the agreement, the assignment expired twelve months later. -2- the deputy commissioner found that the March 2020 claim was void because, when it was filed,

the provider had no right to receive payment on its workers’ compensation claims.3

The provider appealed the deputy commissioner’s opinion to the full Commission. After

reviewing the record and the parties’ written statements, the Commission issued an opinion in

January 2025. The Commission found that the provider’s March 2020 claim was a “non-specific

claim” that sought to “preserve all potential rights,” and, thus, it was neither valid nor

enforceable under Code § 65.2-605.1(F). The Commission acknowledged but expressly declined

to adopt the deputy commissioner’s finding that the provider lacked standing to file the March

2020 claim. The provider now appeals.

II. ANALYSIS

The provider argues that the Commission erred in determining that the March 2020 filing

was not a valid “claim” within the meaning of Code § 65.2-605.1(F). The provider contends that

Code § 65.2-605.1(F) is unambiguous and requires only that a provider must file an assertion of

rights to contest the sufficiency of payment for services rendered within the prescribed statutory

period. We agree.

“Decisions of the [C]ommission as to questions of fact, if supported by credible evidence,

are conclusive and binding on this Court.” Shy, 61 Va. App. at 238 (quoting Manassas Ice &

Fuel Co. v. Farrar, 13 Va. App. 227, 229 (1991)). “However, the [C]ommission’s legal

determinations are not binding on appeal and will be reviewed de novo.” Id. (quoting

Wainwright v. Newport News Shipbuilding and Dry Dock Co., 50 Va. App. 421, 430 (2007)); see

also VACORP v. Young, 298 Va. 490, 494 (2020) (“[A]n issue of statutory interpretation is a

3 The deputy commissioner also found that, even if the provider had a right to receive payment on the claim, Code § 65.2-605.1(F) does not allow providers to file “protective claims.” -3- pure question of law which we review de novo.” (alteration in original) (quoting Conyers v.

Martial Arts World of Richmond, Inc., 273 Va. 96, 104 (2007))).

Code § 65.2-605.1(F) provides that a health care provider must “submit a claim to the

Commission contesting the sufficiency of payment for health care services rendered . . . within

one year of the date the last payment is received by the health care provider.” The provider

contends that the statute only requires that a claim be timely filed to be valid. It argues that

“claim” merely means an assertion of rights and that it is immaterial whether the claim

immediately requests an evidentiary hearing. The employer argues that, because the provider

expressly stated in the March 2020 claim that it declined to pursue an evidentiary hearing at that

time, the provider was attempting to indefinitely toll the statute of limitations and the claim was

thus invalid. Thus, we are tasked with interpreting the term “claim” within the context of Code

§ 65.2-605.1(F).

“[S]tatutory interpretation must begin with the text itself to determine the intent of the

legislature.” Williams v. Commonwealth, 84 Va. App. 99, 111 (2025) (alteration in original)

(quoting Davenport v. Util. Trailer Mfg. Co., 74 Va. App. 181, 196 (2022)). “When determining

that intent, words are ‘given their ordinary meaning, unless it is apparent that the legislative

intent is otherwise.’” Davenport, 74 Va. App. at 196 (quoting Cox v. Commonwealth, 73

Va. App. 339, 344 (2021)). “In finding the plain meaning of a word, we will not ‘isolate

particular words or phrases’; instead, we examine ‘[the] statute in its entirety.’” Williams, 84

Va. App. at 112 (quoting Ducharme v. Commonwealth, 70 Va. App. 668, 677 (2019)). Where,

as here, a word is not defined by the statute, “courts can look to dictionary definitions to supply

[the word’s] ordinary meaning.” Davenport, 74 Va. App. at 196.

As we have recognized, “‘[c]laim’ can mean different things depending on the context in

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Related

Perry v. Com.
701 S.E.2d 431 (Supreme Court of Virginia, 2010)
Bolden v. Com.
654 S.E.2d 584 (Supreme Court of Virginia, 2008)
Conyers v. MARTIAL ARTS WORLD OF RICHMOND
639 S.E.2d 174 (Supreme Court of Virginia, 2007)
Mitchem v. Counts
523 S.E.2d 246 (Supreme Court of Virginia, 2000)
Union Recovery Ltd. Partnership v. Horton
477 S.E.2d 521 (Supreme Court of Virginia, 1996)
Wainwright v. Newport News Shipbuilding & Dry Dock Co.
650 S.E.2d 566 (Court of Appeals of Virginia, 2007)
MANASSAS ICE AND FUEL CO. v. Farrar
409 S.E.2d 824 (Court of Appeals of Virginia, 1991)
Timothy Ducharme v. Commonwealth of Virginia
830 S.E.2d 924 (Court of Appeals of Virginia, 2019)

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