this is a very voluminous record there's a lot of doctors a lot of hospitals a lot of therapists and sometimes you have a record this large things get a little confusing there's really one critical issue in court that the a finding is contrary to the facts and evidence in this case and against man if this way the evidence or did he say that it is or whether this which he testified to your honor was that she was in a trade show in houston texas for a week she was driving a coworker back to the airport on march nineteenth one thousand nine five she was rear ended by a chevy suburban and she sought emergency room treatment at twelve twelve hopes hospital in houston texas on the day of the accident march nineteenth one thousand nine hundred five she then testified that she i continued to notice an increase symptoms over a period of a couple days she was still in houston at this trade show and she testified that she noticed increased pain in our arm earnings incisions nausea stiffness swelling in the arm in the neck area so she three days after the accident on march twenty second one thousand nine hundred five went to the emergency room at methodist hospital she was examined in the emergency room she was given medication and told it was ok for her to return home she testified that she went examination on don't you think in presenting the facts you see that tells them well she did but if you if you take all the facts into account the increase symptoms the fact that she's in houston texas she's over a thousand miles away from chicago her family is in chicago her friends are in chicago or treating physician dr bennett's in his in chicago wasn't on a reasonable for her to go to emergency room a second on a second occasion three days after the ets and i don't think it was an incident they talked about or she was in mexico a lawful horseman in a car accident but i don't believe credibility goes to the facts of the first four days after this incident occurred because like i said earlier on or was it on reasonable for her to go to an emergency room being due to the fact that she was in houston texas i don't think that was unreasonable i don't know what credibility has to do with that now if arbitrator blackfin she was trying she testified just bit when one of the emergency responders at the scene gets there he says this one didn't make it referring to her and yet according to all the other witnesses she climbs out of the car and her own true fuses in the ambulance  medical treatment it doesn't need any assistance so how do you reconcile the testimony about that but that's not the case or this rule is over a thousand miles away from chicago she can't call or a primary physician she can't go see doctor and it's him who works on a northwestern memorial hospital  another doctor murder was an emergency room i think there's a difference between going to another doctor and going to the nearest emergency room in the area she testified that the only reason she went to methodist hospital it was the closest hospital to her hotel room it wasn't like she call them and got a referral to go there i suppose this is a great hospital to go to she went there because it was nearest to real town some urgency room treatment under the facts of this case like i well your honor i don't know if that's really going back to the doctor dr these doctors roff all refer i agree there's a lot of treatment in this case but these are all excellent doctor she went to she went to all basically almost every prust testified that she had a chronic condition and she would need therapy and lists lee for her right shoulder i think it's unfair to hold there against thirty she went to a lot of doctors yes she went to more doctors in the normal claimant does but everybody's pain tolerance is different everybody feels different and everybody's different in terms out press of the are in terms of medical treatment so i don't know what that has to do with the examination that she went to methodist hospital for a second opinion because she was dissatisfied with his services that she had received a few other of the you know this is really what she said on direct i understand if they can they can assume that i circumstances of the case she's a young woman she's she's out of town by herself she had no way of going to rip primary doctor going to a doctor in chicago who would be unreasonable for her to get off a flight go back to chicago food emergency room and then out back on a flying go back to houston texas it's so unusual that you've got to emergency room visits within four days but i don't think it's unusual under the circumstances but if you get around to it usually included that was not her first choice and i took painstaking time in this phase when i tried this case through to show that all of the dr sharp saw in chicago were through a chain of refer either through dr levy or dr bennett's in her primary dr yes there is maybe fifteen twenty doctors that she saw but they all were through a chain a referral specifically through dr levy and the reason it's critical in this case your honor says that there was approximately eighty thousand dollars in medical bills that was that night on based on the finding of her exceeding her to choice limitations it also affects her ability to seek treatment in the future she is treating doctors telling her she needs ongoing treatment the rest of the wife based on this finding she's on are all her employers not responsible that's that's not a basis to reverse the commission  the first to the commission i would argue that i need permanency work isn't adequate under the circumstances she's here extensive treatment she's here for she jer's to her right shoulder be evidence i would point to the testimony of doctor robert levy took his deposition he testified that the condition in the left shoulder was possibly related that opinion was adopted by a manifest way to the evidence and should be affirmed in all respects except one very small one and that it is as mr leck is alluded in closing the issue of the left shoulder and its causation are causal connection to the work accident in march of ninety five it's set out in my grief but i want to highlight just a couple of points the accident occurred in ninety five and there are no complaints in the record until five years later as to the left shoulder until five years later when she sees dr press and at that time she gives a history that she had some sort of an altercation she testified at trial it was it was a run in with an ex boyfriend or something when she was pushed down and then  evidence at trial is that the left shoulder is not causally related the the arbitrator made no award of permanency as to the left shoulder and really there's only one reference where he  work accident ninety five i don't know if that was a typographical error or where an extra asked was included i don't know however to clarify the record i think it's important that we correct that issue  teacher i guess all she could do is and i'm just guessing i guess what she would have to do is go back to one of the doctors in the chair for a while and see if she could get a referral to a doctor to treat that  so i don't really have anything to add other than that issue and it's my position as he said that that one small issue is is the only one that i raised in the only aspect of the decision i criticize  basically somebody who's exhibiting to few symptoms bilaterally both shoulders i think israelis dr levy has the fight it's really the only testimony in the case with respect to the left shoulder that it was related to the spine of the employer he had my client examined by numerous in a kind of medical examiners i don't believe any of them even opinion with respect to which will thank you or