that he contract to develop couple tunnel syndrome working as a product of paper essentially her job is that she would walk through various aisles in the facility there was a light skin that would light up certain products she would pick those and put those into a least one every eight to twelve seconds exactly the questions that we presented in the brief are simply two parts and what i'd like to do is focus not as much on the manifest way government today but focus on the issues relating to our position that this is this decision should be remanded as a matter of law it's our position here that the commission matured and the arbitrator refused to consider significant evidence that indicated that the claimants bilateral carpal tunnel syndrome was caused by her prior employment and this is considering this with respect to accident causation and credibility in the review pages nine eleven of the commission's decision what you see is it refused to do so because there was no concurrent medical evidence of it indicating that there was a preexisting bilateral couple tunnel condition and it's our position that that's wrong as a matter of law and requires this court to remain on the case for a full consideration of the evidence and i d we're not going to consider a we're not considering that we don't care whether it was true or not we're not considering that at those four witness's testimony because there's no medical evidence to suggest she had any previous diagnosis and w cited to in our brief there are three legal authorities during antecedent westinghouse would indicate that of a formal diagnosis and doubt required in that medical testimony is not necessarily required to establish or to feed causation or disability so the law supports this in this case i think we need to look at this in three three three three aspects here first of all right was the evidence that would indicate that that there were credibility issues or the preakness in carpel tunnel we need to ask ourselves how do we know  fact or an opinion when she says it was caused by my prior employment i think i think honestly you could consider it as you do one but we're i think mrs bush money as a fact in this case because you know this is not want us asking you to take a look i know recently we ask you to look at in our interests and say well she does orthopedic work she should have reasonably intice a paid but this is what she had based on her symptoms and she works with carpal tunnel here we're not asking that what we're saying is that the commission had an opportunity look at testimony where the petitioner says i had carpal tunnel syndrome and it was caused by my pio employment now when you add that to her testimony are the two comments to sandy not and i think and eliot that talked about  even considered here because the commission said we're not going to consider any of that testimony from those four witnesses because we don't have concurrent medical and that's why we're saying this is wrong now if we have to devolve into a discussion of  versus dr pomerantz now we slide into the manifest weight and i know i know exactly where you're going to come from and so hard battle for me to mag but as a matter of law what i'm saying to you today is that this commission majority did not look at the whole ball of evidence it means issue and it only focuses on one ignores the other factors people of course it's across the board that's an abuse of discretion you got to go back as a matter of law and we decide this issue is the same type of thing here but i think it's even stronger because of the cases that we cited show that we did not have to come in with medical evidence it would have been great to have medical evidence but to reject these four witnesses testimony that goes to accident credibility and causation simply because there's not concurrent medical to show  there for them not to consider it absolutely when you're saying this is not harmless or that's correct and i think if the court read you see the testimony or the testimony the trial just called it that but the arguments that were made a circuit court at page fifteen constantly even agrees this is it simply a situation where the commission majority said that we can we look at those four witnesses we don't find credible we're going to find and we're going to follow the petitioners testimony sheet now it is here they just ignored it because there's no medical to support it there was no concurrent medical and so that's why we say stop just me saying this this is counsel saying this at the circuit court this is a situation where the commission ignored a portion of the evidence now ok grant about what constitutes a manifestation and in this case again we're not we're not saying that there was a body of facts ahead of this petitioner and based on those she should have been first she had something we have a definitive statement which could rise to the level of a mission if it's considered as being i had carpal tunnel syndrome and it was related to my prior work but i think that's the difference here she said that but it is true that there is no medical there is no medical  in the record i mean there's there's a three year old medical record where she says she has joint pain in her wrists and you only thing we have is an unexplained reference in the record to some type of brace that nobody could really attribute to where this came from and they sort of court found it was rather interesting that there's a reference to her wearing a night brace but yet none of the doctors that she saw that prescribe tonight brace so when you couple that with this other testimony of these four witnesses it does make sense that perhaps he did have this before him now  the record though i mean she never got any treatment yes on this record you have she never got any treatment nobody ever diagnosed her with as far as we know so kurt is her statement coming from where he says this was caused by  she's just a lay person saying oh yeah i worked in the food industry even if we put in calls to consider include it really it's really relevant for her good she doesn't have to make a formal diagnosis she doesn't i'm making this claim because i need to have this paid for so i have to call a work comp claim and i'm sorry if it the commission finds it to be credible if they consider this and find it to be credible we will and so we can just say well we have some medical evidence in here that says the employment may have contributed to and we can't just look at that and say that because we have this evidence that was ignored because it evidence goes to accident causation incredibility is a very significant body of evidence in this case and it was ignored and the one person who did pay attention to that evidence was a dissenting commissioner and what did he did he said i would i would deny this point based on the d v d the record of the doctor's opinions and the other employees testimony and so i will we're asking you to do here is not really deborah in the manifest way i would read you should this decision looked upon as the commission did not consider valid evidence as a matter wall it needs to go back and have it consider it it can't reject this evidence and say does it matter what it is because there's nothing kind of medical when i don't have a burden to demonstrate that there's concurrent medical and that's why we think this decision has to go back and be arbitra now be interesting when it goes back because in essence you'll be vacating the arbitrator's decision and will really be starting from scratch on this based on the record but i think it has to go back it has to be considered and you cannot just summarily dismiss social people and sound not going to listen to whatever those four people say despite the fact that it impacts accident causation and credibility because those are key issues in this case if she's not credible well this talk about what she did becomes suspect so that's why this is important about is this fact or opinion this is testimony from way witnesses as to in medical conclusions and i think that's what the arbitron and the commission are recognised they're saying that the petitioner said oh this happened at a prior job i develop the symptoms in the that she didn't say that we consider the testimony of the four other witnesses this is  and they said you know basically we've considered all of us this evidence so ours what is a question of essential really matter and so they look at the medical aspect of the case and they point out as counsel of med there is no medical evidence here that she had a preexisting problem there's a two thousand and four note from that which one hour that she was having joint pain in her west joint pain in her elbows there's a reference to a brace that she may have gone to walgreens and bought we don't know if that's on the album we don't know if that's on the forearm we don't know if that had anything to do with an alleged carpal tunnel there was no evidence of an e m t prior to the state there's no evidence of a prescription prior to the it's an issue of medical credibility of credibility of the witnesses and what the arbitrator and the commission essentially said here is we don't have to decide who we believe were considering the testimony of both of them and we're looking at the medical evidence there i'm not i'm not even sure that that was accurate i think for a while she was a waitress  know that we can speculate on the record and i think what the commission did here every day i don't see any basis for de novo review merely because we have a lay witnesses stating something which essentially is a medical medical conclusion that this woman said that her prior employment caused the competent center on is something that they had the right to look at all of the other evidence when they weighed that and this really is an issue of medical credibility ability of the witnesses and the commission the arbitrator have the right to consider all that evidence it the findings of fact it's manifest weight they have the right to consider that they don't have to make a determination i believe her but she didn't say that there's nothing to the contrary so while i appreciate the fact that they are trying to make this id no overall argument i don't see it otherwise i think in every case where you have testimony of someone saying oh reveal because the fact that the commission and the arbitrator and knowledge and consent are that there is no medical evidence of a preexisting condition on the record which essentially is what they did doesn't put an unfair burden on the emp come forward some others to rebook this and that in the response i would say is that's not true i mean you put forth witnesses that said that this happened at a prior job and the commissioners essentially saying ok we're going to take a look at bat and other evidence and we don't see any medical evidence that this happened at a prior job that would affect our opinion on causation are other findings of fact and that doesn't put they have the right if they thought th condition to try to bring forth other mother medical evidence we know that there isn't any on the run so it would have provided a different outcome and essentially it's not putting a burden on them it doesn't  that the respondent had were considering petitioner but really it's irrelevant whether she said it or not because based upon the medical evidence we find an accident and we find causation  consider it but what they're saying is we don't have to bring to tie your own credibility because the shores of what is being testified to we have other evidence to draw the conclusions as to accident and cause a action and a centrally at this stage and how is that de novo review how would that be any different than any other case where there would be a witness presented i mean essentially they didn't look at the credibility of the witness testifying to something that has to do with a medical history here and there is no evidence and i think what the are what you're going commission concluded is even if she that that her prior employment cost us there was no evidence that we would have found any differently based upon what's in the rocker so that's why they say and they go on to medical credibility we're talking about credibility of the witnesses they considered all of the evidence even if you don't believe the the employee i mean essentially there is and i don't have the  this happened from prior employment there is no medical evidence of that and there's no medical evidence of that this is a medical conclusion not being real a person conclusion not an acute accident so the question becomes did this particular job  we have it's a contributory factor no matter what your position we believe whether she said or her she didn't say so they don't just fail to consider what the testimony was out of this new often and of these testimony of the lay witnesses as to the job duties read out today as opposed to the actual video so i would ask you to confirm the decision of the circuit court which affirms the illinois workers compensation commission thank you significant at all i don't think they did and if you look at page seven only where they say we didn't you won't consider the witnesses called the words of that if you look at seven forty eight s are discussing this this other testimony the commission majority or the arbitrator which was adopted by the commission says it is irrelevant to the case at bar whether these conversations are occurred or did not occur the arbitrator does not have to make a determination as to credibility on this issue because any determination is a relevant and even if we were to believe the petitioner told each of these witnesses th development corporate tunnel syndrome were due to crime down positions there's no medical evidence to suggest that she had any pretty quick misdiagnosis but this is telling us is that if you don't have medical we're not going to consider these witnesses the case although we cited s that goose trips trying to catch this type of information now i would like to say this whether this is a factor opinion and i've got an eye conditions called you the ictus and you can i could tell you about that and what caused it and you could say was that your opinion or is that what you were told by a doctor it's a fact and it's an opinion in this case that's why i said what she says is a fact and an opinion we're not asking this court look at the petition and say well this this non benefit person wants her medical opinion about whether somebody has or she has a condition what we're saying is she admitted to somebody that i've had carpal tunnel syndrome and it was caused by something else and i think that's the significant up still going to she said i have a problem but he and i don't think it would make any difference because if you it it just talks about the injury and it's causal into the work i think the fact that there is a evidence in there from some of the witnesses that she said credible tunnel syndrome i think that's makes my case even stronger and again  admission that goes directly to credibility he was asked if she made the statements and she denied it credibility is at the heart of this case and if you're going to throw out any evidence that says that she's not credible because there's not medical records independently backing it up i think accident a the issues that involve medical testimony and the said that the commission here erred as a matter of law by disregarding the testimony of these four witnesses on the sole basis that there was not independent minute i'll do this if agree with your interpretation of the correct i think it can be read plainly from their opinion yes and then at that point the court can back away and let that commission look at it again but they have to be able to consider all of these witnesses testimony on all these issues that we've talked about otherwise they've only decided on a fraction and for only going to look at a fraction of the case look at their doctor and some holes in our doctor's testimony that's not a full evaluation of the issues and i don't think you can say that's a full consideration of the case again in closing the dissent is the only one here who looked at this case in its entirety and he concluded that this is not compensable on the field the burden of proof and we just one opportunity to be able to have a commission to consider all the evidence in this case and that's why we're asking th