filed by a camper seeking prospective medical treatment the issues that were presented in one thousand be hearing before arbitrator fell siani were accidental causation in perspective medical for a bombar fusion surgery every trader fell siani issued a decision finding that the claimants need for fusion surgery was not cross only connected to the may twenty second two thousand and two accident as claimed by the the commission is against the manifest weight of the evidence and analysis of the facts in this case can lead to only one conclusion which was the arbitrator's conclusion and that is that mis that accident she received emergency room treatment and she treated with her family physician receive some visible there and was released back to work and was in fact working and not receiving any more treatment  true there is the case of global versus industrial commission which stands for the proposition of the claimants condition is weakened by a work related accident it's absolutely accident that aggravates a condition does not break the causal chain well first of all we have no evidence that her condition was weak and there's nothing in the record indicating that we don't we don't know if you've been in a doctor baby established early that it was weak and he doesn't say that he didn't make that opinion until the next year  there's a lot of vocal also is that it's a case where the claimant was still treating at the time of the intervening accident this camper was finished treating for this injury distinguishing it from the  case the second reason that the commission's decision must be reversed is that the basis of the commission decision is based on fact or babies opinion which they found more credible  categorising is a minor i don't know what that was based on the claimant is is the one who went to her doctor and was complaining within days about radiating pain quotes his his position on this and i'll read it to the presence of the new disk her nishan and al forth by with the absence of any work or personal incident since the original surgery would seem to connect her back problems with her original back situation and it is my opinion and he goes on he talks about the absence of any other accidents well he didn't know there was another accident so maybe his opinion would have information that the commission decision is is against the manifest weight of the evidence is that the commission fails to address the undisputed evidence that seven years have elapsed from this campers back strain in two thousand and two and the two thousand and nine diagnosis of the new discrimination it gets to be a commonsense analysis of this issue this camper testified at the administration hearing that she worked continuously from two thousand and three until two  years for the need for fusion that is somehow ludicrous i think overlooks a couple of important factors she had the surgery in two thousand and three laminectomy surgery and at that time she had actually discussed with d having a fusion surgery so dr b is on record back in two thousand and three already talking about the possible need for fusion i think this is a situation where they made a decision between doctor and patient to go for a lesser surgery and then see how she would have done a couple goes back and sees dr beatty in two thousand and five and again discuss with him the possible need for fusion surgery if she goes back in two thousand seventy thousand and eight and again now they're talking about doing a fusion surgery so i think it's a bit of a misconception to suggest that she strictly run from the accident until this time in two thousand and eight and i was sudden there's a need for fusion this is been an ongoing discussion between the doctor and patient with respect to this incident that occurred in october i know council classified that my client sought immediate medical care and again the medical records do not support such finding this incident she went and saw a doctor shy on october fifteenth that was eight days after this alleged incident there is no way that can be classified as immediate medical care and just as importantly when counsel indicates that my client was done with her medical treatment and that everything had dissolved that's not exactly correct either because when she saw dr mathur in august that the matter schedules were for follow up in two months time that was going to be october thirty first so she was already scheduled to go back to see dr mather documented had not released her and i think again when you talk about how serious was this incident that occurred october seventh i think that the commission correctly  about tobar she didn't insist that it be moved up so this was a a bit of a red herring at trial my client when asked about it of the testimony actually was was very brief didn't really have knowledge of the event there was no incident report that was filled out so i think the commission looked at all those factors and made the determination that that's why it was very minor also about the record as opposing opinion was he aware of  you know continuing lower back problems i would also point out that we took the deposition of dr b if in fact this was a very significant incident is responded we would claim they certainly had the position that question was never asked respond in this case also secure the opinions of a doctor david spencer and i mean the section twelve exam or this fact that it was never presented  chastised my client quite a bit for being overly dramatic and her peer in her presentation that day subsequent to that is a new m r i taken which showed over the internet that that's in his words he was suggesting that she needed psychiatric help because of her presentation in the i at the at the time of that first i meet subsequent to that a new m r i was order which showed this is central discrimination when that it was produced and given to  back to spence wrote a very different tone second item the report in which he backed away and said this completely explains why she was feeling the way that she was feeling i would draw my comments about her psyche it treatment and i completely agree with the need for surgery now the interesting issue that dr spencer writes is he talks about the length of time between the initial accident in this need for fusion surgery and what he says is in general the longer we get away from an incident from a traumatic incident the more difficult it may be to relate this but then dr spencer never goes that the next up and says in this case that's exactly what's happened we have too much like the time it's transpired here so in their brief they point to doctors much as a penny and a same dr spencer has said seven years is too long and i think that's that's taking that what he said a step too far he just said simply in general and i think dr beatty went through a very lengthy discourse on the the what happens to a disk once you have surgery once you take that bone out it's changed and he cited the studies that suggest that there asian and while it's new in maine it's still very much a part of the ongoing process very much a reaction of what happened from the underlying laminectomy surgery based upon the record we thousand and two thousand and nine there was another m r i done in two thousand and five which is subsequent to the two thousand and two accident dates subsequent to the two thousand and three surgery which didn't show this herniations so this is a whole new issue that doesn't relate back in any way shape or form to either of the accident things so again i