Opinion ID: 2567206
Heading Depth: 1
Heading Rank: 7

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

Text: [¶ 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 Worker's 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.