specifically focus on the issue of reasonableness and the subsidy as it pertains to the physical therapy treatment marking medicos a petitioner received just a quick summary position i was employed for about two months there was a slip and fall accident on his back sought treatment immediately and eventually went to see dr paratus and marking medicals and that's when he started physical therapy treatment and treatment from november thirtieth of two thousand and nine through december thirtieth of two beginning in january of two thousand time was not reasonable or necessary to cure and relieve his affects the venturing on appeal the majority of the commission this was not a decision where all three commissioners agree eight a and employer is required to approve and pay for all the necessary first day medical or surgical services as well as necessary medical treatment but only to that which is reasonably required to cure or relief reading pain levels and his pain is simply getting higher and higher as each of these physical therapy sessions continue finally the doctors decided that this also wasn't working and in order to help him with this pain recommended injections and that's what petition side was that there should be an active formal conditioning program they sayd if that's what dr bernstein sideband we think the record supports that but it was active and i believe they even discussed that he was doing squats and what not whatever it is that the most traders do or morse firecrackers do but he specifically said was no more marked to medical treatment but you have been undergoing no more chiropractic treatment but you have been undergoing no more passive modalities formal physical here but you were reported certified sixteen of the national sessions through the end of december non certified the rest of dr bernstein side no more after december i want you want to different physical therapy program different not morkie medical different than on top of that the records completely show that there was no improvement dr fisher himself i feel the same there's no improvement that's four types of evidence testimony records you are and i me all stating no improvement this is not working so it wasn't inconsistent and yes it isn't in their purview to weigh those options but all the evidence showed one thing and that's that it was not causing him to feel any better that physical therapy simply wasn't doing american medical treatment from january first of two thousand times through february nineteenth two thousand times and the subsequent twenty two thousand eight hundred thirty five dollars and sixty nine cents in total charges for the treatment at that portion  with respect to counsel you were arguing a manifest weight case under terms of the tamil both standard and just changing the words i think that your honor hit on that road counsel keeps is a significant condition the argument seems to be but we don't think so and i've had a hard time trying to figure out how to argue this because i keep getting sucked into it as don't tend to no carrot issue which is no mission the council has made with regard to the evidence that's on the table they knew that he was improving and then regressing they knew the response to asia and they still recommended additional care they stepped it up and recommended because it was a serious matter and required additional care to hear counsel argue it would be as though all they did was p t t p t and then we get into a conversation of whether or not it was active passive formal or back not being drawn into that perhaps you can things one the injury was november twenty third two thousand and nine you were looking at things approximately four months later this is not to say that this was a fifteen month course of never ending care there wasn't prove board you take that are out of medicine and make it into pure science and not some goals if somebody is looking at an injured party and says ok well all the facts indicate that you were getting better now you're increasing a little bit you've got to make a judgment a scenario other than just saying ok you immediately go to a surgeon and we will cut you open tomorrow the only evidence flows that have to be taken in context of that would be exactly my argument your honor and i think that's what we're looking at and i most certainly do not believe that it rises level of a manifest weight question here i think that the preponderance the preponderance of the evidence very clearly demonstrated what was going on here that the treatment was reasonable that everything thereafter was appropriate and all the other issues were properly awarded and to be honest with you with all possible due respect to counsel i'm not sure why we're here today even the argument of dr bernstein which t t d in cause or based on this matter is the speculation that four weeks later after or some other kind of therapy he would be better so we're here on a manifest way question based would ask this panel do he's not going to see dollar one until like two and a half almost three years later what do i tell my clients from a public policy standpoint when i try case that i've got already ready to go with conflicts and evidence which was done long ago there's nothing funny about this there's no rule of the fact of significant degree in the petitioners evidence it's not it's nothing more than a black and white case and it was decided as it was i believe that from a pop public policy standpoint as far as the judicial economy standpoint we're going to be back in front of this animal panel which i enjoy doing many many times arguing over whether or not the second  exercises the same chiropractic care and it was no longer working that's the point it did regress how can treatment be reasonable how can it be necessary when it's not improving someone's condition you're essentially going to to seem to be working ok the point of any fell back on me rest maybe within the professional opinion of the doctors if you stayed with it again for a period of time to get better again i mean is this an absolute science judge and i would agree with that except that none of the record indicate there's no opinion here from any treating physician saying we're going to give us another shot because we think that he's going to start improving again that's not happening what they're saying is just continue this continue this continue this for what you know what it's not helping let's do injections and that's what happened records showing that he's not improving we believe that that's pretty direct evidence on the fact that the commission to not look at the facts here what they did was they had made up their own issue passive versus active side it was active and call them day opposite