good morning brit has grover period we have the cash family it was the court comes out joan this is a case that involves really two separate questions that i'm going to address here today the very first question that i'd like to talk about is the commission's decision specific page six of their decision where they said if there's one certainty as to whether or not the petitioners husband actually had lung cancer i think that the behaving up or the biggest issue that the commission had with the case is the fact that there was a bit of uncertainty as to whether or not one cancer was the primary cancer in the occupation or exposure  case and i'm going to propose to you that the plaintiff has met their burden of proof by a preponderance of evidence as to this specific allegation the question is whether or not it was one cancer is the primary there's three separate qualified individuals that give opinions on this i think the commission cites a few medical records from not qualified doctors on the issue but the real three main doctors that talk about what they were wrong cancer was the cases in illinois is more probably true than not true quarter might is good enough at the best more likely than not is better the treating physician is on classical note the first concert report the most comprehensive note that he has states actor shows deposition he was asked the question what is the likely cause and if you look at forty five of this deposition he says to this exact question now doctor it's more probably true than not true his cancer was a wrong cancer is that correct answer i think so the defendant's own section twelve examiner states more probably true the natural wrong is the primary the of original line khwaja can know from the treating on palin just says that the most likely primary is one cancer doctor shero to whom the commission found in this case to be the most qualified expert in the case states that one is the primary i think that there is no other way that i could as the water for the petitioner meet the burden that i need to do to prove something is more probably true the not true than to present the three important people to you plaintiffs twelve section twelve examiner defendant strong santa and then the treating oncologist all  you read i read to mean that it's not one hundred percent definitively true that the that the primary cancer was one cancer that there is less than a hundred percent certainty as to the primary bought needing the burden of proof more likely than not it's a wrong answer so the commission is looking at conflicting medical evidence this is within their purview to decide the weight to be given to them i don't think there is conflicting medical evidence but the legal proposition that you cited is true that's a that's a correct legal proposition that if there's conflicting evidence yes but in this particular case if you look at the entire note of  mammograms that are negative that have read show breast cancer that metastasized to the to the lymph nodes just because you can't see it in a diagnostic film doesn't mean that that's not what originates i think that anybody would agree with that could be  but does not say whether it's likely a lung cancer or not likely at one cancer she just says it's debatable and the debate in that case is clear by the people that have given opinions including the section twelve examiner of the defendant or the respondent excuse me dead wrong cancer is the primary cause from there there's an opinion based on or an argument by the commission that essentially they're saying because the plaintiff hasn't met their burden of proof of the woman being the primary cancer that the next step of causation can't be established and i have a hard time understanding why we're at the point of could have done anything more than what was done in the case i know that there is a notation in the commission's decision that states that the specific peer reviewed journals that are discussed in the briefs were not attached as evidence well they could have been attached as evidence if they were been submitted as evidence at the end of the trial there would have been objection hearsay it would never you can't admit it there's no way you could put a peer reviewed journal into evidence as an exhibit it just you have to have an expert proof that exposure chronic exposure to diesel fumes in diesel exhaust is eight increased risk of causing yes he did say that didn't he also say it meant that the origin of the students cancer had quote unquote not been determine think you have the opinion that it would have been a cause based on medical research literature but then he at the end says his cancer has been not been determined i think if you keep reading the next sentence on that says very likely primary was wrong cancer again though the burden of proof is to prove more likely than not bad something was and the problem with this with trying to decide what the primary was in this specific case is a person who is exposed to an occupational hazard such as this individual was by the time he finds the disease it is very rare it is by point where he was at the point of no return so for somebody to say because you can't say this is the primary for absolute certainty because his body was filled with cancer that you can't look at a person that is filled with cancer and decide whether that they came before the chicken or the chicken came before the a because you didn't have the opportunity to have a person who fell down the stairs or broke their wrists so that you can look at the day of the incident after patient all exposure cases are different you have to look at it at a later point these are things that are readily apparent where you a sudden having a disease that occurs instantly sometimes it's true but a lot of the times this is a chronic exposure where by the time the disease process is flawed it's too late there's nothing that you can do it comes down the burden of proof as difficult as the medical oncologist the only one that there's a record of the only person that's really qualified to give you the opinion of what a primary cancer was in this case steve likely was a lung cancer rightly meets the burden of proof it does either he know almost or he doesn't know and i think your honor if you look to his i'm glad you can know the actual note that you're reading from which is found in the record i believe at age  two seventy eight it states the most likely is primary cancer originating seaton's so you're reading a portion of his note that says i'm the only  it most likely is it's long cancer in places in the wrong possibility not in the realm of probability well and i think that if the commission worked at the specific note and they meant the likely cause was the media should we asked him what he meant maybe he should have said within some degree of medical certainty i can say that this me and have lung cancer and when faced with the deposition case that moment the firing i'm not sure there is universe and i don't think the commission was commission says if you feel for one of the evidence that he in fact had lung cancer right that's what they said that  anani allergy i think if anything it gives it more weight that everybody was being honest is that it's not a one hundred percent certainty brought the most likely and probable cause it was a long cancer that everybody agreed with the likely cause and i think that likeliness is the only way that you can prove the case thank you thank you  complex case here before you the issues are very simple did counsel meet the burden of proof he did not this is a case just doesn't make it is likely likely likely carry the day well luckily we don't know what likely means there are thousands of different kinds of cancers like we the likely culprit could be a ten percent chance against one percent chances for all the rest we don't know we simply don't know there was no evidence that there was one cancer or not we had opinions from three doctors who say i don't know uncertain cause most likely maybe likely we don't know to what level they'd agree that that was the cause we just don't which it could have we don't know but i mean there is this speaks directly to the argument that there was a there was a failure of proof here there are many things that could have been done prior to this case going to arbitra that could have identified a provided additional evidence as to one what the cause what the cancer was with your originating cause the cancer was the number two what the cause of that cancer could have been the issue before you is whether it is it a commission decision was against the manifest weight of the evidence that they found that the petitioner did not prove that he had the long there's a secondary issue as to if there was a lung cancer what the cause of that may have been it's simply the fact of the matter that the facts there were facts and arguments on both sides the commission has a right to judge the credibility of witnesses to weigh medical evidence the weight against one another what we have here is a situation where the petitioner simply fail to prove a certain point and evidence that this was a lung cancer and that it was related to work we did which never really got to the second issue i don't believe that they actually did so we don't know what they need to because they found that he didn't establish that he had lung cancer but i don't think they came up with any definitive determination that if it was a long piece or it wasn't caused by the fuel if they didn't then  favor of the respond in this matter and that that question hinges upon whether there was enough evidence for them not not whether there was enough evidence for them to find that the petitioner had lung cancer but there must have been so much evidence for them to that they had to have found him to have lung cancer that's simply not the case the commission waited they looked at all the evidence there's ample evidence in the medical record that this is an adult carcinoma of unknown origin and ideology your honor stated that in questions to petitioners counsel it's clear that the doctors who are treating this man did not know what the cause of his cancer was they didn't know where it originated your honor stated that the medical records identified that there was nothing found on that cat scan in the c negative there it was glandular that's where they found it didn't originate in the lungs we just don't know we don't know but there's no way to find out whether the commission within its rights to find that they did not meet their burden yes they were there is ample evidence there to make that finding on appeal this is a manifest weight issue in order to meet the burden of manifest weight of the evidence the evidence has to be so strongly supported that the opposite conclusion must be true that is simply not the case here there's ample evidence in the record that they did not know what caused where this cancer started and there's ample evidence in the record that there may not even have been cancer in the long term there are opinions that said li possibly but that's not that's that the commission reviewed that medical evidence and they simply they did not agree with it they did not find it either credible or they didn't find it supportive of the fans of the finding that it did sort of their thank you thank you i just want to address the one one question whether an autopsy would have shown us anything and i think the answer to that take it for what it's worth would is that it would not have shown a biopsy of the of a wong tissue mortem may have but i don't know i mean that's it was a pose an issue that just wasn't addressed i just want to be answered the question the real problem that i have with this whole argument and i do agree with you that i think that the commission got hung up on whether or not wrong was the primary and did not get to the second issue and i don't necessarily think that it's i think they have to prove it's up one primary before you get to that second  finally i don't think that second issue was addressed so i don't know how you guys could address that if you were local if i was lucky enough to get you to that point but the i think the fundamental problem that i have with the whole argument is the fact that the respondents on section twelve examiner agreed before we stepped in the trial before we went before the arbitrator in the case in this deposition that one was the primary our expert either probably true the not true one was the primary yes i don't know how you could then come in here before your honor's and say section twelve examiner that we hired to give an opinion definitively saying that this was a wrong cancer is not an opinion that you should give credence to the commission should have and that it's not a good opinion and we don't know the answer they know the answer they paid good money for this expert they paid good money for the opinion and the opinion no not a specific sentence but look at the whole thing