of yes i will dr anderson offers an opinion he sees the climate and april of two thousand and ten he takes one line from dr fletcher's january two thousand and ten office now which he says there is no substantial change in mr todd's condition from when he had previously seen it was so not two months earlier see any substantial change in his condition notwithstanding that he says i want to do cervical x rays i want him to have as a goal therapy he is hopeful it wishful thinking that perhaps this is just a temporary setback because it takes  a hell of a long time to get this guy back to work after his prior injury a lot of therapy a lot of treatment so we look at jump ahead to february when fletcher sees him again by this point he's recommending an m r i scan lumbar spine he's recommending happy girl sterrett injections he also injects the sky shoulder dr anderson didn't look at anything other than fletcher's november two thousand and nine office now is there a little bit they found there was a conflict in pleasures test i don't think there's a conflict fletcher even and if you look at his february out lectures saying he is back to work they've accommodated this restrictions he's got a pretty substantial permanent work restrictions as of november two thousand and nine he's working at that point i think the point you're also except lectures in that the claimants depression increased as a result of the december twenty his approach to that is three isn't we keep the sky working the reason he didn't want to put him back in the treatment mode in january two thousand and ten was because of his depression you know this guy needs to keep working that's the best therapy for the depression  people's mind off his problems and that's you know i think that's pretty logical there's no conflict and pleasures testimony there yes the guy's depression and traces if he's off work yeah that's quite clear i mean he sees the guy in a role he doesn't have any notes after that january doesn't have fletcher's february two thousand and ten no he doesn't have the therapy records from that period of time if you look at it that the shoulder a part of this case was accepted by the city primarily because a different section twelve examiner had found the shoulder to be related to this december two thousand and nine injury if you look at fletcher's january note he says i don't see any substantial change condition that's you know look at anderson's report that's what he relies on ok but there's no change he's back to his baseline status maybe had an injury in december but by january he's back to his baseline status we can take that same always symptomatic i he does have a preexisting condition there's no pressure no question about that he has ongoing treatment he has although in november of two thousand and  is stable lumbar riddick allow the features stable fletcher again is trying not to treat the sky he wants a guy back at work which will help this depression help everything else the guy is back at work ok than the fact that he does have all these prior problems of clearly to landing a good record so i agree i think whatever must have happened has run its course while it hasn't with the shoulder so why do you know and again  january is doesn't even talk much about the shoulder but a month later he and jacks that the guy ends up with a bunch of treatment very hopeful in january that the guy isn't going to get back in the treatment mode but he does for the shoulder that's a that's clear so the same accident where he falls and rips up the shoulder so then conceivable that the low low back was aggravated well absolutely the question is as a temporary or permanent aggravation anderson says a temporary one based on that one noti more testing and order more treatment on the low back he wasn't suggesting any of that back in november of two thousand and nine he was saying the guy's done follow up with me in three months the guy comes back two and two months because of this new andrea and that the sets off the course of a long period of treatment began andersen's i would encourage you to look at anderson's note it's taking something out of a vacuum it's like me saying i heard this any testing at that time to determine what was causing those that and produce and cervical compliance other than ordering the physical therapy in the cervical spine x rays however a month later because of the continued shoulder problems and doesn't hold power does not entitle weight because he looks at these things in a purposeful vacuum so i'm i don't want to hear anything else other than that no substantial change why again the subject of compliance or what the doctors start treating them they run the diagnostic studies to determine what's the basis for the subjective claims and here we have an m r i showing the rotator cuff problems later on showing lumbar problems and we think that's why anderson's of kenyan you know significantly flawed and whether should be the sensual are sufficient whether sufficient to support the manifest way and tell us why it is i believe that dr anderson's report and his deposition testimony which is part of this record is sufficient for to support the arbitrator's and the commission's finding of no causation in this matter on those body parts the shoulder set aside because that was found because of the related illness because it relies on the records he had at the time which was based on the medical history of this petitioner which is extraordinarily extends multiple multiple work done to his to his back he's had six multiple workers compensation claims he went through those records and he looked at the contemporaneous record the most contemporaneous medical record we have which is dr fletcher report office visit from january of two thousand and ten about one month after the accident date in december of e that's not a worsening of conditions it's not an aggravation certainly not a permanent aggravation dr anderson says it could be a temporary aggravation but at that point in time fletcher was focused on he's focused on petitioner's depression and then he referred out the shoulder work to darker pro weapon which eventually the petitioner underwent shoulder shoulder surgery excuse me so in this case their entire argument hinges on whether fletcher's initial office visit where he stated there was no significant the tissues condition is is sufficient for this court to to be sufficiently flawed with for this court to arrive at a conclusion that is that that would have been clearly apparent opposite from that of the arbitrator or the commission and i submit and i submit that it's not whether or not it was the evidence was there to support this decision this court is not charged with three weighing the facts or judging which expert v i b e or the treating physician or multiple experts which one should should carry the day this is not that's true to certain extent but we have to reweigh the evidence in order to term whether it's against the man in this way there is a way process so i say that we that's that's kind of actually true here for the sports ask is you look at the the facts in the record in the in this balloon this record that you have for this case and you have to look at it and decide is there sufficient evidence here to say that three years plus after this accident when with this petitioners history and also let's let's look at the need the necessity for that treatment that was subsequently done there's a push dr pleasures report ties in a lot of it but dr smucker's report he makes no mention of any causal causation for the necessity for that treatment relating back to some proton taxes and i think that supports dr anderson's position of a temporary exacerbation as a worst case scenario i think that anderson's reports and his testimony as we're going to arbitration petitioner gets his deposition he said no no no doctor push no no i that's not what i meant he misinterpreted me well i mean obviously that's somewhat self serving in fact wants you to completely reweigh it and completely discard anderson's opinion which is not the purview of the sport unless it's clearly a pair which is a high standard a high degree that this court must come to and it's simply not present in this case dr anderson stuff position testimony is sufficient enough in this matter for the to the supporters of the art of the commission's decision such that the petitioner has not met the manifest weight stated in an opposite conclusion is not and that time all this other treatment had occurred the shoulder treatment and the m r i and fletcher subsequent records you would think that the city were presented to dr anderson the head of that you know i could take issue with counsels of characterization of fletcher's later comments about this but you look at his his actual office now that first day no substantial change other than subjective compliance ok wasn't handling it but yes i was for the argument listen to the argument and didn't the interview well there are several things in the arbitrator's decision that are a little bit disturbing to me but again he that and it's going to continue to follow the guy there's no question from a accident report which blew this part of the transcript that the guy reported that he hurt his back neck and shoulder in this accident when he saw fletcher three weeks after the accent know anderson three years later isn't given anything else ok he's just we were going to stick with the story that we we came up with that this one line from fleischer is our that's our saving grace here you