Case Title: CARL SPLETZER V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

Citation: 

Docket Number: 

State: wyoming

Court: Wyoming Supreme Court

Date: 2005-08-09T00:00:00Z

Document:
CARL SPLETZER V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2005 WY 90116 P.3d 1103Case Number: 04-116Decided: 08/09/2005
APRIL TERM, A.D. 2005

 
 
CARL 
SPLETZER,

 
 
Appellant

(Petitioner/Employee-Claimant),

 
 
v.

 
 
STATE OFWYOMING, ex rel., WYOMING

WORKERS' 
SAFETY AND COMPENSATION

DIVISION,

 
 
Appellee

(Objector-Defendant).

 
 

 
 

Representing 
Appellant:

 
 
            
Michael D. Newman of Hampton & Newman, LC, Rock 
Springs, Wyoming.

 
 

Representing 
Appellee:

 
 
            
Patrick J. Crank, Attorney General; John W. Renneisen, Deputy Attorney 
General; Steven R. Czoschke, Senior Assistant Attorney General; and Kristi M. 
Radosevich, Assistant Attorney General.

 
 
 
 
Before 
HILL, C.J., and GOLDEN, KITE, VOIGT, and BURKE, 
JJ.

 
 

 

 
            
VOIGT, Justice.

 
 
[¶1]      Between 1987 and 
1990, the appellant, Carl Spletzer (Spletzer), suffered compensable work-related 
injuries when he inhaled toxic fumes while working as a welder.  From approximately 1990 to 2001, the 
Wyoming Workers' Safety and Compensation Division (the Division) paid medical 
benefits for treatments related to Spletzer's injury.  However, in December of 2001, the 
Division denied three claims submitted by Spletzer finding that they were not 
related to his 1990 work-place injury.  
Spletzer requested a contested case hearing and the matter was referred 
to the Office of the Medical Commission (the Commission).  The Commission found that Spletzer 
failed to meet his burden of proving that his 2001 claims were related to his 
compensable work injury.  Spletzer 
appealed the Commission's decision to the district court.  After the district court affirmed, 
Spletzer filed a timely appeal to this Court.

 
 

 
 
[¶2]      Spletzer presents 
four issues for our review:

 
 

1.                  
Did the 
Medical Commission exceed its subject matter jurisdiction by ruling on an issue 
that was not referred to [it]?

 
 

2.                  
Did the 
Medical Commission follow proper procedure required by 
law?

 
 

3.                  
Did the 
Medical Commission act arbitrarily, capriciously, abuse its discretion, or 
otherwise not act in accordance with law within the meaning of W.S. 
§16-3-114(c), in denying Appellant's medical treatment of chronic respiratory 
and arthritic conditions?

 
 

4.                  
Was the 
Medical Commission's decision denying benefits supported by substantial evidence 
within the meaning of W.S. §16-3-114(c)?

 
 
FACTS

 
 

[¶3]      From 
1987 through 1991, Spletzer was employed by Sunland Services as a welder at a 
Chevron fertilizer plant in Rock 
Springs.  He 
described the work environment as follows:

 
 
I was 
working on a shutdown in the plant where they were taking pipes apart, taking 
equipment apart, replacing equipment.  
They would wash everything down, but there would still be active fumes in 
the plant.  And I was working in the 
plant.  We were working 16, 18-hour 
days five days a week, seven days a week.  
All I would know is I would be working in the plant like maybe two or 
three days and I would wake up the next morning with a terrific sore throat, 
headache, flulike symptoms, real tremendous body aches.  I would have to take a day off work or 
two days off work.  I wouldn't get 
any better.  I would lose my 
voice.  Then I would go to a 
physician and they would prescribe medicine for me.

 
 
As 
a result of those ailments, Spletzer filed a worker's compensation claim on 
March 27, 1990.  On December 5, 
1990, the Division issued a formal determination stating that it would "review, 
audit and pay claims related to bronchitis, but will not allow any claims to be 
paid on conditions related to arthritis."  
The Division paid for treatment and diagnosis of Spletzer's medical 
condition over the course of several years.

 
 
[¶4]      In August of 
2001, the Division requested that Dr. Terry Brown perform an independent file 
review in order to provide the Division with an opinion regarding whether 
Spletzer's ongoing medical conditions were related to or caused by the 1987-1990 
work-related exposure to toxic chemical fumes.  Dr. Brown's review encompassed 
Spletzer's medical records from July 1987 through February 2001.  The Division requested that Dr. Brown 
answer five specific questions, which questions, and Dr. Brown's responses, 
follow:

 
 

1.      
What 
current ailments are directly attributable to the 1990 hazardous materials 
exposures while working at SF Phosphates Fertilizer plant in Rock 
Springs?

 
 

There 
is minimal to no documentation of any incident of significance in 1990.  Virtually all workups from Dr. Goldstein 
in 5/90 to Dr. Kanner in 7/92 all refer back to 1987 exposures while working at 
Chevron.  Nonetheless having the 
luxury of reviewing over a decade of medical records, it is apparent that it is 
not possible to say that any of Mr. Spletzer's medical problems are relatable in 
any way to exposures that occurred while at work, inasmuch as he had had 
persisting symptoms which have been primarily subjective with minimal to no 
objective evidence for his subjective complaints in terms of his pulmonary and 
musculoskeletal workup and examination.  
He has changed employment several times with no change in his symptoms, 
and the medical records appeared to look for documentation of excessive 
exposures and none were able to be documented.  These facts give credence to the 
conclusions drawn as far back as 1990 and 1992 by very thorough physicians that 
it was not possible to attribute his symptoms to any specific event and, in 
fact, fibromyalgia syndrome and/or depression appear to be the most appropriate 
diagnoses and the ones most in keeping with the complaints he has had.  Neither of these would be work 
related.

 
 

2.      
Would 
exposure to such substances in the amounts reported cause the long-term problems 
Mr. Spletzer reports?

 
 
No.

 
 

3.      
Regarding 
his pulmonary status, what is the most likely cause of his continuing 
complaints, and is it directly attributable to the 1990 exposure or to other 
causes?

 
 
Evaluation 
by an excellent pulmonologist, such as Dr. Kanner, who is well known to me, have 
resulted in no definitive conclusions.  
This would be in keeping with the trend through this decade for him to 
have ongoing symptoms despite changing jobs several times.  I would concur with the opinions of the 
evaluators in the records that it is not possible within a reasonable degree of 
medical certainty to establish a causal relationship between his complaints in 
1990, and certainly later, and any exposures that occurred from 1987 to 
1990.

 
 

4.      
Does 
he suffer from arthritis that is attributable to the hazardous materials 
exposure or is it likely due to other causes?

 
 
His 
subjective complaints of arthritic pain that have not been objectified on 
physical examination to any significant extent or on radiographic examinations 
are not attributable, within a reasonable degree of medical certainty, to any 
exposures at work, and in fact have not been definitively attributed to any 
medical diagnosis.  He has had a 
very thorough workup, and as one reads through these records over the years, 
concerns with his psychological status grow in this reviewer's mind, not only 
regarding existing concurrently with all of his complaints, but also perhaps 
providing a cause for his complaints.  
At some point, a very thorough neuropsychiatric evaluation with 
neuropsychological testing would have been of interest.

 
 

5.      
At 
this time, what current medical condition that Mr. Spletzer receives ongoing 
treatment for should be the Division's responsibility, in that the Division is 
responsible for the treatment of work related injuries for the life of the 
claimant?

 
 
None.  As noted, there is no evidence on this 
review, nor did there appear to be any opinion from any of the evaluating 
physicians that a causal relationship could be established within a reasonable 
degree of medical certainty between his complaints and any work related 
exposures.  I feel that while they 
drew these conclusions in 1990 through 1992, given the ongoing symptoms, it is 
even more possible to state in 2001 that it is impossible to establish or 
consider any causal relationship.

 
 
[¶5]      After receiving 
Dr. Brown's evaluation, the Division denied three of Spletzer's claims in 
September and October of 2001.  
Spletzer objected to the Division's denial and, in November of 2001, the 
matter was referred to the Commission for a contested case 
proceeding.

 
 
[¶6]      In June of 2003, 
prior to the contested case hearing, Spletzer contacted Dr. Phyllis Mullenix, 
PhD., whom he discovered while researching on the Internet.  Dr. Mullenix is not a practicing medical 
doctor, but holds a degree in zoology and chemistry, and a PhD. in pharmacology, 
and engages primarily in research and consulting.  Spletzer requested that Dr. Mullenix 
prepare a report assessing the causation of his medical problems.  Dr. Mullenix conducted an extensive 
review of Spletzer's medical history, and summarized her report by answering the 
same questions previously posed to Dr. Brown.  Her assessment of the relatedness of 
Spletzer's current conditions to the original injury differed significantly from 
Dr. Brown's:

 
 

1.      
What 
current ailments are directly attributable to the 1990 hazardous materials 
exposures while working at SF Phosphates Fertilizer plant in Rock 
Springs?

 
 
The 
respiratory, musculoskeletal, neurological, gastrointestinal, dermal and dental 
ailments listed above are directly attributable to the 1990 hazardous materials 
exposures at the fertilizer plant in Rock Springs.

 
 

2.      
Would 
exposure to such substances in the amounts reported cause the long-term problems 
Mr. Spletzer reports?

 
 
Yes.

 
 

3.      
Regarding 
his pulmonary status, what is the most likely cause of his continuing 
complaints, and is it directly attributable to the 1990 exposure or to other 
causes?

 
 
The 
most likely cause of his respiratory complaints is the fluoride exposure he 
experienced at the fertilizer plant.  
That exposure was to intermittent large doses that accumulated a fluoride 
reservoir in his bones that takes years to diminish even when there is no 
subsequent fluoride exposure.  
Although he left the plant in 1990, his fluoride exposure has continued 
through his subsequent jobs as a welder and his consumption of fluoride in food, 
water and pharmaceuticals.  In 
essence, the fluoride exposures after 1990 keep topping off his bone reservoir 
of fluoride.  The 1990 exposures, as 
they built up his total body burden of fluoride, determined that hence forward 
he could not tolerate even small exposures.  But for the workplace exposure at the 
Chevron plant, Mr. Spletzer would not be experiencing his symptoms 
today.

 
 
. 
. .

 
 

4.      
Does 
he suffer from arthritis that is attributable to the hazardous materials 
exposure or is it likely due to other causes?

 
 
Yes, 
he suffers from arthritis attributable to the 1990 exposure.  His medical and employment histories 
indicate that there are no other causes more probable. 

 
 

5.      
At 
this time, what current medical condition that Mr. Spletzer receives ongoing 
treatment for should be the Division's responsibility, in that the Division is 
responsible for the treatment of work related injuries for the life of the 
claimant?

 
 
The 
Division's responsibility includes treatment of Mr. Spletzer's bronchitis and/or 
his developing COPD, his arthritic pain, his crumbling teeth and his problems 
with vision.  If Mr. Spletzer's 
exposure is not stopped, the Division's responsibility will only expand to 
include even more serious health consequences.

 
 
In 
addition to her written report, Dr. Mullenix was deposed on July 16, 
2003.

 
 
[¶7]      On August 1, 
2003, the Commission held a contested case hearing.  Both Spletzer and the Division submitted 
disclosure statements and presented evidence.  The Commission issued its Findings of 
Fact, Conclusions of Law and Order of the Medical Commission Hearing Panel on 
September 15, 2003.  The Commission 
concluded Spletzer was ineligible to receive benefits because he "failed in 
meeting his burden of proof in establishing that his medical treatment after 
Sept 21, 2001 is directly and causally related to his employment at the Chevron 
fertilizer plant from 1987-1990."

 
 
[¶8]      Spletzer appealed 
the Commission's determination and the district court affirmed.  Spletzer then filed a timely notice of 
appeal with this Court.

 
 
STANDARD 
OF REVIEW

 
 
[¶9]                              
We review agency action following contested case hearings in accordance 
with Wyo. Stat. Ann. § 16-3-114(c) (LexisNexis 2003), which provides as 
follows:  

 
 
"(c)  To the extent necessary to make a 
decision and when presented, the reviewing court shall decide all relevant 
questions of law, interpret constitutional and statutory provisions, and 
determine the meaning or applicability of the terms of an agency action. In 
making the following determinations, the court shall review the whole record or 
those parts of it cited by a party and due account shall be taken of the rule of 
prejudicial error. The reviewing court shall: 

 
 

(i)                 
Compel 
agency action unlawfully withheld or unreasonably delayed; 
and

 
 

(ii)               
Hold 
unlawful and set aside agency action, findings and conclusions found to 
be:

 
 

(A)              
Arbitrary, 
capricious, an abuse of discretion or otherwise not in accordance with 
law;

 
 

(B)              
Contrary 
to constitutional right, power, privilege or immunity;

 
 

(C)             
In 
excess of statutory jurisdiction, authority or limitations or lacking statutory 
right;

 
 

(D)             
Without 
observance of procedure required by law; or

 
 

(E)              
Unsupported 
by substantial evidence in a case reviewed on the record of an agency hearing 
provided by statute."

 
 
Furthermore, 
in Hoff v. State ex rel. Wyo. Workers' Safety and Compensation Div., 2002 
WY 129, ¶¶ 5-8, 53 P.3d 107, ¶¶ 5-8 (Wyo.2002), we reiterated the proper 
application of the substantial evidence and arbitrary and capricious standards 
of review:

 
 
"Our 
standard of review when reviewing administrative agency action was recently 
clarified in the case of Newman v. State 
ex. rel. Workers' Safety and Compensation Div., 2002 WY 91, 49 P.2d 163 
(Wyo.2002) . . . .

 
 
In 
appeals where both parties submit evidence at the administrative hearing, Newman mandates that appellate review be 
limited to application of the substantial evidence test.  Newman, 2002 WY 91, [¶] 22, 49 P.3d 163.  This is true 
regardless of which party appeals from the agency decision.  In addition, this court is required to 
review the entire record in making its ultimate determination on appeal.  Newman, at ¶ 19 and ¶¶ 24-26.

 
 
The 
substantial evidence test to be applied is as follows:

 
 
In 
reviewing findings of fact, we examine the entire record to determine whether 
there is substantial evidence to support an agency's findings.  If the agency's decision is supported by 
substantial evidence, we cannot properly substitute our judgment for that of the 
agency and must uphold the findings on appeal.  Substantial evidence is relevant 
evidence which a reasonable mind might accept in support of the agency's 
conclusions.  It is more than a 
scintilla of evidence.'

 
 

Newman, 
at ¶ 12 
(quoting 
State ex rel. Workers' Safety and Compensation Div. v. Jensen, 2001 WY 
51, ¶ 10, 24 P.3d 1133, ¶ 10 (Wyo.2001)).

 
 
Even 
when the factual findings are found to be sufficient under the substantial 
evidence test, Newman further 
concludes this court may be required to apply the arbitrary-and-capricious 
standard as a safety net' to catch other agency action which prejudiced a 
party's substantial right to the administrative proceeding or which might be 
contrary to the other WAPA review standards . . . ."

 
 

Kunkle 
v. State ex rel. Wyoming Workers' Safety and Compensation Div., 2005 
WY 49, ¶¶ 7-8, 109 P.3d 887, 888-89 (Wyo. 2005).

 
 
[¶10]   The Commission found that Spletzer 
was not entitled to benefits because he failed to meet his burden of proof.  We have said:

 
 

When 
the party charged with the burden of proof has failed to meet that burden, we 
review the case under the arbitrary, capricious, abuse-of-discretion, or 
otherwise-not-in-accordance-with-the-law standard.  Brees 
v. Gulley Enterprises, Inc., 6 P.3d 128, 132 (Wyo.2000); Keck 
v. State ex rel. Wyoming Workers' Safety & Compensation Div., 985 P.2d 430, 432 (Wyo.1999).

 
 
"Under 
the arbitrary, capricious and abuse of discretion standard, we are charged with 
examining the entire record. In our examination and review of a hearing 
examiner's determination, we defer to the hearing examiner's findings of 
fact.  We will examine conflicting 
and contradictory evidence to see if the hearing examiner reasonably could have 
made its findings based on all the evidence before it.  The findings of fact may include 
determinations of witness credibility, as the hearing examiner is charged with 
determining the credibility of the witnesses.  In our review, we will not overturn the 
hearing examiner's determinations regarding witness credibility unless they are 
clearly contrary to the overwhelming weight of the 
evidence."

 
 

In 
re Boyce, 2005 
WY 9, ¶ 6, 105 P.3d 451, 454 (Wyo. 2005) (quoting Brees v. Gulley Enterprises, 
Inc., 6 P.3d 128, 132 (Wyo. 2000)).

 
 

[¶11]   Finally, "[w]e afford no deference 
to the agency's legal conclusions. Statutory interpretation raises questions of 
law over which our review authority is plenary. Conclusions of law made by an 
administrative agency are affirmed only if they are in accord with the 
law."  Kunkle, 2005 WY 49, ¶ 9, 109 P.3d  at 889 
(citing Wesaw v. Quality 
Maintenance, 2001 WY 17, ¶ 8, 19 P.3d 500, 504 (Wyo. 2001)).

 
 
DISCUSSION

 
 
Subject 
Matter Jurisdiction

 
 
[¶12]   In the first of Spletzer's four 
appellate issues, he asserts that the Commission exceeded its subject matter 
jurisdiction.  The Commission 
derives its jurisdictional authority from Wyo. Stat. Ann. § 27-14-616(b)(iv) 
(LexisNexis 2003), which statute provides in part:

 
 
Following 
referral by the division, the hearing examiner or medical hearing panel shall 
have jurisdiction to hear and decide all issues related to the written notice of 
objection filed pursuant to W.S. 27-14-601(k).  . . .  When hearing a medically contested case, 
the panel shall serve as the hearing examiner and shall have exclusive 
jurisdiction to make the final administrative determination of the validity and 
amount of compensation payable under this act.

 
 
Spletzer 
argues that in deciding the compensability of his current claims, the Commission 
went beyond its jurisdiction and re-determined the compensability of his 
original work-related injury.  He 
articulates this argument in his appellate brief as 
follows:

 
 
The 
issue before the Commission was not the compensability of the initial claim or 
whether [Spletzer's] initial symptoms were related to his work related chemical 
exposures.  These conditions had 
been previously determined to be work related.  The issue referred to the Medical 
Commission was the relationship of the curr[e]nt treatment to the already 
established compensable injury and chemical exposures.

            

. . 
.

 
 
The 
issue of compensability of [Spletzer's] injuries was not before the Medical 
Commission.  Accordingly, it did not 
have statutory authority to issue a ruling that based its conclusion that the 
evidence failed to show [Spletzer's] initial exposures and injuries were caused 
by the work related exposure to chemicals.  
The Medical Commission lacked subject matter jurisdiction to rule on an 
issue already decided and not properly presented to it by the 
Division.

 
 

[¶13]   Spletzer is correct in his 
assertion that the Commission does not have jurisdiction to decide the 
compensability of previously determined claims.  Hall v. State ex rel. Wyoming Workers' 
Compensation Div., 2001 WY 136, ¶ 14, 37 P.3d 373, 377 (Wyo. 
2001).  However, the Division clearly has 
jurisdiction to challenge and determine the validity of future claims for 
benefits. Id.; Tenorio v. State ex. 
rel.    Wyoming 
 Workers' Compensation Div., 
931 P.2d 234, 239 ( Wyo. 1997).

 
 
The 
statutory language of the Wyoming Workers' Compensation Act confers finality on 
the benefits paid to the employee through uncontested determinations, subject to 
the exceptions found in Wyo. Stat. Ann. § 27-14-605.  . . .  The statutory language, however, does 
not guarantee a claimant future benefits on the basis of a prior award nor does 
public policy favor the payment of an unjustified worker's compensation 
claim.  . . .  Therefore, an employee/claimant must 
prove that he was entitled to receive benefits for all outstanding claims 
despite previous awards for the same injury.

 
 

Hall, 
2001 WY 
136, ¶ 14, 37 P.3d at 377 (citations 
omitted).

 
 
[¶14]   Spletzer's interpretation of the 
Commission's decision as somehow affecting his previously awarded benefits is 
inaccurate.  The Commission's order 
concluded that Spletzer "failed in meeting his burden of proof in establishing 
that his medical treatment after Sept 21, 2001 is directly and causally related 
to his employment at the Chevron fertilizer plant from 1987-1990."  Clearly, this determination had no 
impact on any of Spletzer's prior claims.  
The Commission decided only those issues referred to it and did not 
exceed its jurisdiction in considering and deciding Spletzer's 
claims.

 
 

Procedure

 
 

[¶15]   Spletzer next argues that the 
Commission's decision was not in accordance with the procedure required by 
law.  As a basis for his argument, 
Spletzer again asserts that "[a] careful reading of the Medical Commission's 
findings of fact clearly reveal[s] that their decision was simply another ruling 
on the compensability of the initial injury vers[u]s the relationship of the 
current medical treatment claims to the already established exposure and 
history."  He then concludes that 
"[t]his is explicitly contrary to the statutory procedure setting forth the 
scope of the Medical Commission's review of the issue referred to them."  For the reasons just set forth above, we 
reject this contentionit does not accurately state what the Commission 
did.  Furthermore, Spletzer neither 
supports this argument with specific record references, nor cites legal 
authority, so we will not further consider the issue.  Hicks v. 
State ex rel. Wyoming Workers' Safety and Compensation Div., 2005 
WY 11, ¶ 25, 105 P.3d 462, 472 (Wyo. 2005).

 
 
Arbitrary, 
Capricious, an Abuse of Discretion and Contrary to 
Law

 
 
[¶16]   In Spletzer's third appellate 
issue, he claims that the Commission's decision was arbitrary, capricious, an 
abuse of discretion and contrary to law. Similar to his other arguments, he 
bases this assertion on the premise that the Commission inappropriately 
considered his prior claims.  He 
states:

 
 
The 
Medical Commission's conclusion was that because past medical records . . . do 
not support an injury or exposure, the current treatment claims are not 
related.  This judgment and decision 
process resulted in reweighing the evidence on whether there was a[n] initial 
compensable injury.  The Medical 
Commission reweighed this evidence and came to the conclusion that the current 
treatment was not related.  This is 
an improper consideration and application of the evidence especially in light of 
the fact that a finding of compensability had previously been made.  This is a[n] arbitrary and capricious 
administrative action.  It is also a 
misapplication of the facts to the law.

 
 
[¶17]   This analysis suffers from the same 
defect as Spletzer's previous argument inasmuch as nothing in the record 
supports his assertion that the Commission's determination of his current claims 
was based on a finding regarding the compensability of his prior claims.  The Commission did not conclude, as 
Spletzer contends, that "because past medical records . . . do not support an 
injury or exposure, the current treatment claims are not related."  To the contrary, the Commission 
acknowledges that Spletzer was injured and received benefits.  The Commission's order references a 
"Formal Determination" letter dated December 15, 1990, wherein the Division 
withdrew a prior objection to payment of benefits and stated that it would 
"review, audit and pay claims related to bronchitis . . .."  The Commission made no findings 
regarding Spletzer's prior claims or the extent of his prior 
injuries.

 
 

[¶18]   Spletzer also claims that the 
Commission, by examining his medical history, improperly re-weighed the evidence 
and re-determined his prior claims.  
As previously established, nothing in the record indicates that the 
Commission re-determined Spletzer's prior claims.  Furthermore, any consideration of prior 
medical evidence in Spletzer's case was necessary in order to establish a causal 
link between his current claims and his prior work-related injuries.  When a claimant requests benefits, he 
has the burden of proving all essential elements of his claim by a preponderance 
of the evidence.  Himes v. Petro 
Engineering & Const., 2003 WY 5, ¶ 14, 61 P.3d 393, 398 (Wyo. 
2003) (quoting Snyder v. State ex rel. Wyoming Workers' 
Compensation Div., 957 P.2d 289, 293 (Wyo. 1998)).  One essential element of a claim for 
future benefits is demonstrating that the current medical condition is causally 
related to the compensable work-related injury.  Himes, 2003 WY 5, ¶ 19, 61 P.3d  
at 399.  It would be virtually impossible for a 
claimant to establish such causation without examining his prior medical 
records.  Also, when an agency 
conducts a contested case hearing, Wyo. Stat. Ann. § 16-3-110 (LexisNexis 2005) 
requires that the agency's final order "be accompanied by a concise and explicit 
statement of the underlying facts supporting the findings."  The Commission determined that Spletzer 
failed to establish a causal connection between his current claims and his 
work-related injury.  To support 
that finding, the Commission had a statutory obligation to consider and state 
underlying facts.  Without examining 
Spletzer's medical history, the Commission would be unable properly to fulfill 
its statutory obligation to provide a concise statement of facts supporting its 
determination.

 
 

[¶19]   We will not reverse an agency 
decision for an abuse of discretion so long as the agency considered relevant 
factors in making its decision and the decision is rational.  Morgan v. Olsten Temporary Services, 
975 P.2d 12, 15 ( Wyo. 1999).  Spletzer's medical records and claim 
history were relevant and necessary factors that the Commission was required to 
consider in determining the compensability of his current claims.  The Commission did not abuse its 
discretion in determining Spletzer's claims, nor do we find its decision to be 
contrary to law or arbitrary and capricious.

 
 
Substantial 
Evidence

 
 
[¶20]   Spletzer's final argument consists 
of two paragraphs, wherein he asserts that the Commission's decision is not 
supported by substantial evidence.  
In support of this contention, he argues that the report and analysis of 
his expert, Dr. Mullenix, was the "only competent relevant evidence presented by 
any of the parties."  Spletzer 
concludes that the Commission did not properly consider Dr. Mullenix's decision 
because it became "mired in reweighing the medical and factual evidence from 
prior unsuccessful treatment of the work related injuries . . 
.."

 
 

[¶21]   Spletzer's statement that Dr. 
Mullenix's report was the only competent and relevant evidence before the 
Commission is inaccurate.  In 
addition to Dr. Mullenix's opinion, the Commission relied on Dr. Brown's report, 
which report provided a thorough analysis of Spletzer's medical conditions based 
on the same materials Dr. Mullenix used in making her assessment.  The fact that Dr. Brown and Dr. Mullenix 
reached opposite conclusions does not make Dr. Brown's analysis any less 
relevant or competent.  Where, as 
here, the Commission is presented with conflicting medical opinions, its 
responsibility, as the trier of fact, is to determine relevancy, assign 
probative value, and ascribe the relevant weight given to the evidence 
presented.  Clark v. 
State ex rel. Wyoming Workers' Safety & Compensation Div., 934 P.2d 1269, 1271 (Wyo. 1997).  The Commission is in the best position 
to judge and weigh medical evidence and may disregard an expert opinion if it 
finds the opinion unreasonable or not adequately supported by the facts upon 
which the opinion is based.  
Id.; Matter of Goddard, 
914 P.2d 1233, 1238 ( Wyo. 1996).  With regard to Dr. Mullenix's opinion, 
the Commission stated:

 
 
This 
Panel disagrees with Dr. Mullenix's assumptions regarding Mr. Spletzer's 
exposure.  Using her logic, every 
employee at a phosphate fertilizer plant would be exposed to toxic levels of 
fluoride simply by the nature and location of their employment.  This is an assumption that we are not 
willing to share.  In Mr. Spletzer's 
case there is no evidence of atmospheric fluoride analysis, nor is there 
specific evidence that fluoride had been taken into the body and deposited in 
the bones or excreted in the urine.

 
 

[¶22]   We have said that we will not 
"re-weigh the evidence or re-determine facts or assess the credibility of 
witnesses so long as the decision of the hearing examiner is based on "relevant 
evidence which a reasonable mind might accept in support of the agency's 
conclusions."'"  Morgan, 975 
P.2d at 15 (quoting Clark, 934 P.2d  at 
1272 and Matter of Workers' Compensation 
Claim of Fansler, 914 P.2d 156, 158 (Wyo. 
1996) and Romero v. Davy McKee Corp., 
854 P.2d 59, 61 ( Wyo. 1993)).  Our review of the record reveals that 
the Commission's decision was reasonable and supported by substantial 
evidence.

 
 
CONCLUSION

 
 
[¶23]   The Commission denied Spletzer 
benefits because he failed to meet his burden of proof in showing that his 
current claims were related to his original work-related injury.  The Commission did not exceed its 
subject matter jurisdiction or commit procedural error in deciding Spletzer's 
claim.  Also, the Commission's 
determination was not arbitrary, capricious, an abuse of discretion or contrary 
to law, and its conclusions were supported by substantial 
evidence.

 
 
[¶24]   We affirm the district court's 
decision which affirmed the Wyoming Medical Commission Hearing Panel's 
determination.