back to the commission for further findings consistent with this decision causation really is the primary and sole issue before you today and why i'm not here to both tell you first i'm not here to ask you to accept dr cohen to opinion over that  because commission someone because the way the two doctors and decide which one is more credible what i am here to ask you to do today is that you examine the evidence within the record specifically dr percs opinion on causation and determine if it supports the commission's finding a causal connection between these two conditions of the accident because dr parks it painted is all that was offered to support a finding of causation and the commission and the employee's attorney would have you view this in a supports the commission's decision so is the strictly relying on one factor as well i believe this is it here's why iran are calling does in fact state that it could have a twisting can cause a tear in the  case there's just nothing there and to be able to sit back and tell you that that twisting injury actually tore something is impossible to do which is in fact exactly what dr park states because even though dr par patient told me he wasn't having any need problems before you by working full time job as an elite problems with his knee he described this injury to me after that he has all these problems right these two men in my examination not a sufficient down days isn't that something doctors do all the time i call you so your i know what i believe they do is they will add conditions and tell us whether there's been aggravation of that ongoing condition because all doctors will really tell you or did right or we tell us this event could work subsequent to the event that work i suffer pain i suffer pain because this happened to me at work and the only way to relieve my pain for me to have this operation what's wrong with this area and the have that says that you have to have a medical opinion as to the mccann's really what i think you're talking about the mechanics of that need that led to an aggravation or celebration based on the  bet you you have to have more than that just a timeline maybe just a temporal association of a person who says they have a problem doubt and the problem didn't exist before something else occurred that it would be a chain of events  don't think that needs so many because he experiences pain and work again rewind back and read to peoria and what the parents said there i don't believe that the mere fact that the person experiences the first symptoms to start a symptoms while i work even if something happened in greater peoria the i believe they go so far as to say even assuming the shoulder was hit okayed that there needs to be proof of aggravation acceleration precipitation they weigh all four factors  a manifest weak case and cohen could have testified maybe didn't testify in effect that the need was like in greater peoria it was like a robbery to go off or whatever the language was they used and the commission could have said acceleration which then makes it a causative factor all the condition i have to assume things and i have the presumed things that to me says speculation now you follow you sit here and that go with in diagnosis there is that they're educated assumptions they're assumptions that are tempered by the doctor's education his knowledge but he's making assumptions just because of thing based upon assumptions doesn't make it speculation it's only when he if you if you assume a and you can be oh it's within the realm of your honor when he tells us he can't say what it is about this accident that it was actually aggravated as a result or or boy part of this condition was actually be aggravated again is getting back to a greater peoria type situation where a person knows his pain at work has an accident but he doesn't need it aggravated or accelerated the underlying conditions like we're back where we start heard little about the standard of review from the litigants this morning but having prevailed at the level of arbitration at the level of commission at the circuit court level why do it necessary to remind all that that is indeed the standard of review when turning specifically to the argument the council chose to address this morning you were probably correct that counsel would impose on time the doctors and the trier fact the necessity of showing some sort of mathematical algorithm as to exactly what was aggravated or accelerated by a trop i dare say there are waiting rooms it worth  offices all over the loop right now that are filled with patients who have degenerative arthritis and are a say in the matter they have no symptoms they're just there to see the doctor of course that's not the case the reason why people go into treatment the reason why people complain of an injury the reason why people lose time from work is because they are sent the manic and while kelso may pose a threat should pending legislation require a litigant before this worker's compensation commission to establish the principle cause that is certainly not the laws  group to another or can they show a millimeter of progression in a minister they cannot when they go based not just on the temple relationship but the credible testimony of  which is part of it is that he was pain free before here had that counsel introduced evidence that this gentleman lived in newark every day and then had this event we would have an additional obstacle if there was asymptomatic and it occurs to me that unless someone can attack the underlying basis for his opinion that's evidence which the commission could consider which i think he did he end we now have becaus