two thousand and eight a neat addition was related to his two thousand and six accident work the accidents under stupid surgeries pay benefits was a when mr beltran returned and received treatment in two thousand and eight that treatment was recommended treatment was denied in this case mr both trains a city of chicago employee of the city chicago sent him to mercy works which is their occupational clinic mercy works speculative well because dr bush joseph primary primarily relies on what dr mike de would have done in january two thousand and seven if mr beltran had been seen in january two thousand and seven that's not an opinion the doctor push joseph can come through for one it's a question i suppose that could have been asked of dr may day and wasn't but in any event it's certainly not something dr who shows of can say there's also the state it was probably related to the workplace there can be fit probably i think what he said was that it could be related and what he said was that he had not fully discovered fully sest him because he was denied additional additional visits but sort of a qualified opinion it wasn't totally supportive of the claim it was a good deposition testimony was qualified his his records said he was treating him for the same condition that the problem we have here is mr bel injury but stated there is a possibility good possibility is not evidence speculating well you know i think we've got a couple of issues there your honor and one is the villages that are throw says first says and the miss going i had his condition was caused by the villains are throwing well and that's your honor there's dr bush josephs isn't opinion isn't so isn't so clear i think because you know that this was tried out on was entirely silent on whether the physical therapy was reasonable necessary and whether any need for physical therapy was would be related to the accident or not he agreed there was  and he never came to any opinion as to whether it was aggravated or accelerated by the trauma and he sees a real medical evidence that it was i'm sorry or didn't he testified that there was no medical evidence there was i don't believe certainly it's the commission's role to address the credibility but they never addressed the fact that a month before dr bush joseph ever saw this employee the comedian finance ordered mercy works to close the case because this employee would be seen for examination by a doctor which shows they already knew the answer they were getting and the commission despite being pointed out didn't address it and the commission also relied on the that in their mind that mr beltran had health insurance and could have gone to see another doctor when the record is indisputable he didn't have any health insurance and again that something that was in the arbitration decision was brought to the attention the commission and the commission chose not to modify that on the commission also relies again on speculation that what would have happened in january two thousand and seven mr bell trend went back to work  that essentially mr beltran was ready to go back to work in december two thousand and six that he wasn't having any problems anymore or was almost done having problems well again this is not the case from the from indisputable evidence he saw a  testified under contradicted that he continued to have problems with his right knee throughout doesn't sixth two thousand and seven testified about contradiction the tried to seek medical attention in may two thousand and seven but see wouldn't allow  him no evidence in the record of any intervening accident or other positive new problems so it although the commission's decisions and tell the difference does have to be based on the facts of the record and i think in this case it's not based on facts in the record i think that the opposite conclusion is clearly there so unless there's any other questions i what point is in this case i'm not going to say that it is any better than the doctor bush chose a friend of his opinion this this conditions independent of the original work accident but to addressing the in the mechanics behind this some page two seventy six in the record he noted that there was a deformity rather congenital or from a fracture was beside the point and he noted that when he was as he put is two thirty seven following they out he was aware of what the job was what the normal job was he was aware there based on his examination at that time in december of two thousand  had recommended an appointment to come back in three weeks because he was going to return him back to work at that point and one reason he didn't write it down on a sheet of paper saying return to work and you have a piece of paper saying return to work is because of the detention you know in texas on his way back to mexico the record dr bush josephs opinion is based on sound medical reasoning it's come back and there's a reason you want him to come back it's because he was still had not met those heavy duty restrictions that were part of that job at the end of the day yes the commission