but he doesn't mention lessen the pain is that fatal no it's not but it starts the process of adding kernels of doubt to this case the next critical fact is about a month later he goes to the emergency room he mentions the right flank pain  think i thought of when i think the cases two competing medical opinions but would judge crowded it is she found a sister oh violation she thought my doctor across there was a question and it's in the brief and is my sis partner mr and the doctor then goes on and answers the question the petitioner was the only witness testify there never was any coworkers that came out and said yeah the fact he told us that his pain was worse after this accident so it was a hypothetical question asked on role says you can't do that as do the second step which is that normal daily activity would cause the same diagnosis just because that may be true it doesn't go back and again step number one which is that not a causation was injury had all the employer until three and a half months after the accident occurred although we've testified he had left me a i before he left the hospital examination room i believe the house was workers and that dr wayne that the left knee complaints initially were not that bad but they gradually grew in intensity and they also started affecting him mechanically started having his  he started having it going out it started affecting his ability to do our job as a repairman at this plant where he had to do a lot of climbing and kneeling and crawling and activities which placed a lot of stress on the meat while he didn't have an issue of complaints that were very strong in his knee rather in his back and he testified that that he was mostly concerned about his back complaints at that point because he had had prior back surgery and so that was the initial focus that he had he did not seek immediate medical treatment and he testified to that he testified as to the reason why he testified that at this particular plant there is a  procedure that they stress with their with their employees that if you have some kind of an injury sprain or string type of injury you should self treat it you rest ice compression  that the the commission should believe that if it's on or about it testimony right that that's my position i mean if if if there's any any anybody to come forward and say oh yeah we saw we saw mr hargrove before this accident he was hobbling around and he was he was having trouble with his knee but no he reported both to dr wayne and to dr regards he that he was totally asymptomatic with this knee prior to the accident treatment the need complaints started to grow he started having mechanical complaints he wasn't and this is also part of the delay in treatment he did not have a primary care physician so his only recourse was to go into a walk in advised that my client was asymptomatic prior to the accident but yet he totally disregarded that and said in my opinion this man's need was so bad after the two thousand and five surgery that he would have pain with any  with regard to something that did affect the system case and that is the standard on causation having to be a cause in the resulting condition of ill being as opposed to a primary cause are derangement well it was internal derangement when doctors see chris reeve did surgery on this knee and in two thousand and five it was on a torn meniscus and by the way in two thousand and five when he went in for that surgery he was able to kneel he was and the able to crawl he was unable to squat and he had it and he had an intelligent case he was limping after that surgery he was able to return without restrictions to that job and without opinion is the one that's that is supported by the manifest weight of the evidence not by speculation or conjecture and then furthermore dr wayne said that he would have expected that this nee would a look that way right after that two thousand and five surgery will not stack based on that spacetime nothing he looked at in operative report and said he would have expected that that m r i that was done after the accident were to look exactly the same after the two thousand and five surgery but did you look at the arthroscopic films from that surgery to make their pronouncement did you look at an m r i that was done shortly after that two thousand and five surgery to make that two thousand and five medical report following what he had available to him your honor was the operative report as well as i believe there was a history of physical when he went into all memorial if i there was no  your honor no m r i whatsoever after the surgery there may have been an m r i prior to the certainty that would have showed the miniscule tear but after that tear was repaired there was no there was no m r i showing the condition of the need after the surgery until after the accident in two thousand and ten and that's what i'm saying his opinion is without foundation it's based on speculation and conjecture the commission can not base a causation opinion on speculation conjecture and an opinion without foundation and so that's why it's it's our position to judge crowder did get this right in saying not only was also our position that she was correct in finding that finding that the overwhelming evidence supported a finding that causation was proved by my case based on dr wayne subpoena being full of holes being full of know why he did report left the pain when he went to the emergency room a month later and we talked about right flank it wasn't just a bed of us which was now i was there was a survivor who was in the mix credibility of the position was in the mix in terms of him  you know trying to say he didn't go to the doctor sooner because he didn't have one that he had mentioned to the e r doctor that he had left the pain but the records absolutely silent and left me and he goes yeah he talks about right flank pain which is in the actual report should not be an accident report should there be some evidence of an injury to the left knee and there just wasn't in this case regarding the basis for dr wayne i supplied to him the treatment records i supplied to him the m r i film taken after the accident and i supplied him the records associated with the old five earlier left knee surgery including the operative report orthopedic surgeons rely on those type of documents and forming opinions the left knee operative report  two thousand and five is probably the best evidence of what the surgeon found in that he itself when he opened it up so when he saying this man has advanced generation back in zero five he's basing that on an actual medical record which is the operative report