there was a job description included in the in the evidence that's before you and there was is that mr freeh was working in this position for twenty seven years he was working without restrictions he was working full duty in what was clearly a very demanding job and he was not seeking any treatment prior to the accident that occurred his initial accident occurred in december of two thousand and three as you're aware what happened was that he was walking thousand and five the commission and their review determined that it did not result in august on august lows of two thousand and five but instead determined that it had been resolved on january twenty second of two thousand and four which is actually approximately forty five days after the accident took place and one of the reasons we're here and this case is because of because of that finding obviously because if you look at the medical records and look at the history this is a man who's temporary aggravation as a result of the fall he agreed with the ship fracture in the in the in the wrist but he said in regards to the elbow that the petitioner suffered a temporary aggravation of the left elbow that would have resolved in somewhere between looking i mean he didn't examine him in two thousand and four thousand five thousand and six i mean dr kraft didn't examine him until december of two thousand and seven and at that point he went back and said you know i believe that there was a temper aggravation probably a result somewhere in three and that the surgery would not be related to that and i guess i mean it's our it's our position there's really into that and it's also related to the fact that he continued to do this work because it's clear from all of the doctor's notes his ongoing participation in th it i mean clearly all of the evidence and i guess the way i look at it i mean what what what the doctors have said what the evidence shows is that this fall was a factor in the in his pain and his ongoing was his family physician dr paul or actually sent him across the street said hey i don't handle this my brother's office is right next door go see him so he goes across the hallway and sees the other doctor ordered he  a couple times says you know what i know dr dustman i would rather shoot dr just so he exercises his option to go and see his own doctor so his lab he went saw a doctor for a couple of times and then after that he said ok i'm saw him he still has he still has a serious loss of motion loss of range of motion and when he goes it's still having pain he still have a place he goes to see the doctor dustman three weeks later same complaint same problem elbow i mean what he needs is treatment on his left elbow and so all the doctors agree that this fall aggravated that condition and so the question is what is the extent of that aggravation is the surgery related to that aggravation and we would mean if you look at his job description they're living between three and three hundred pounds you know send up tents serve six hundred pounds you know pulling an empty casket seventy five two hundred pounds you know over it devices he has to be able to  podcast it's into a group of the five hundred pound lifting granite up to four hundred pounds i mean this is something we're all day long he's out there doing extremely heavy duty activities said he still has that loss of range of motion of fifty degrees he still has pain in his left elbow that's the same that's the same injury of the same problem that he had in december of two thousand and three camera two ample evidence in the record to support the commission's findings let's go through the medical evidence a little bit first of all dr dustman the trigger the treating physician in this case found that petitioner did have an aggravation of his preexisting left greatest but his opinion is equivocal at best he states that the progression of the arthritis would have happened regardless of the job he then reviews the employers and the pendant medical evaluators opinion dr kraft dr employee the employees saw his own independent medical evaluation with dr nicholson this evidence alone is enough to support the commission's findings with nicholson opined dr nicholson found that the fall was  as needed there was no referral another doctor there was no indication of any further treatment and then after that the claimant went on his own and found doc just been preparing to treat a starter and wanting to get his opinion and started treating  estimate of the evidence as previously noted there was no connection found in this case and therefore the medical benefits should not be the responsibility of the employer and the commission correctly found no causal connection and therefore prescriptions remain the same on january twenty second two thousand and four that those were the work sources but didn't change so that was the same as they were on the date of the entry and his treatment prior to january twenty second of two thousand and four dr gordon his notes do not try to put off the surgery as long as they can just because of the serious nature of this and that's been the approach since day one with all of the doctors if you look through the notes they they have been putting this off and say live with it as long as