benefits and it's our contention the decision was contrary to the manifest weight of the of it it's now generally the commission gets to make credibility to terminations but it's not allowed to base its decision on speculative information or on reasonable inferences which is what we're contending here now the commission decision was essentially the arbitrator's decision and the very st paragraph of the arbitrator's decision kind of sets the tone for what i would consider to be a sloppy and irrational analysis of very st paragraphs as the claim is based on exposure to six different chemicals which manifested october th two thousand a lot well it was actually based on two chemicals and the manifestation date was changed to november  thousand and eleven so i think it kind of sets the tone for where we're going with this you haven't actually shows the condition manifested itself in mid may of two thousand and eleven which was two months after the claimant stopped working for him  he reported at the end of may of two thousand and eleven that he gained forty pounds in the previous two weeks which means it was an acute condition which developed two months after he stopped working for the employer required to show proof of the amount of time and duration of exposure well st it's a chemical or it's a coal miner case and the claimant in that case had no macone whosis which can only be contracted from coal dust and the supreme court in that case the guy spent thirty three years in the mine he's got coal miners disease they didn't need any more information to establish causation that was enough as it was that doesn't apply here where the condition is a member  time than doctor kind of doctor decide but with that analysis what that criteria dr sparrow by far is the most qualified to render an opinion he was the treating doctor he's a kidney guy he's the one with the opinions with it was provided with the material safety data sheets i can't emphasize enough on two occasions he filled out a claim disability forms where he wrote the condition was not related to the work exposure so didn't that are fletcher acknowledged that the cases he was relying on don't even mention the two chemicals that we're dealing with so i'm just shaking my head at how the commission can find medical literature persuasive when it doesn't even mention our chemicals the commission also pointed to dr fletcher having a better understanding of the plant conditions and chemicals one of the reasons that they say he had a better understanding was that he visited the plant now they didn't visit the plant like dr tapp did where he went inside and to credibility or no information whatsoever the commission pointed to a doctor fletcher's communication with ny ops they're the ones that did the health hazard evaluation that he commissioned is why communication with them was to try to convince them to change their opinion opinion not to mention the two different accident irv claim disability reports that he completed expressly stating there is no causation in its decision in the conclusions of law section for causation the commission didn't even mention the health hazard evaluation which commissioned by dr fletcher you know i kind of equate this to you know if i have an i am a done and it sides against me you know everyone's all up in arms that i would try to argue against my own doctor well it same should apply here this is dr fletcher's chosen expert this is who he went to to get information and they said there's no medical literature that supports a causal connection he said there's no causal connection between any workplace exposures and workers with kidney problems which mr goddard falls into that category there's just no information here whatsoever to rely on that's credible that would  that in rendering these causation opinions you need to know the frequency duration and intensity of exposure well he had no information as to the intensity of exposure there is no evidence as to how frequently exposures were so by his own leaving the body with an insufficient amount of protein well dr fletcher acknowledged at trial that mr goddard had a full complement of protein in his system because he was in remission going back to the end of two thousand and twelve or two thousand and thirteen so any issues that he had isn't from deficient protein levels so it's not from the alleged work related condition so any limitations or symptoms he has can't be related to the alleged work condition which means there can't be any permanent disability so i'm not sure how you can have an application on file before the accident date but that's what we have here so i'm not sure how you can award medical bills or t t d from before the manifestation date which is exactly what happened here so that at the very least has to be and it wasn't i think we have a statue of limitations problem i think there's no jurisdiction figure i think that that's the crux of my arguments i mean obviously the biggest issue here is is causation and there's maybe what can come to you when you're waxing eloquently it's amazing you know we've been doing this case for ten years now i get a brilliant idea thank you i think i'm asking that the decision be denied in its entirety and dismissed and all benefits tonight thank you and the basis of a lack of jurisdiction is that the crux of your argument i'm sure will starting with a lack of jurisdiction and if you think there is jurisdiction then there's no occupational disease and if there's an occupational disease or is no causal connection so strike three occupational disease part of it yes all right the commission talks about well the question incorrectly states that the health hazard evaluation found over exposure to more philine and carbon by sulfide that's not accurate the rest are different if you light a match in a room full of oxygen or rueful hydrogen compared to run lighting imagine room full of water that's the same thing here now exposure to to the cure a powder once a person carcinogen goddard would have been diagnosed with a certain form of cancer we'd be having a different discussion he was diagnosed with members in front of the which is in no way related to the cure rate powder which was the only the only component or in the are saying there's no medical link between those two chemicals in the condition of the claimant that's correct and that's supported by dr convert dr decide dr tap there's no minutes which would make sense because the t t began with the initial manifestation to the commission and change the date from october to november but assuming the date of disablement is is the manifestation date then there's no application on file be within three years of that date of disablement and the statue of limitations in the occupational diseases act is three years from the date of disable evidence to support dr fletcher's opinion all the credible evidence comes from the health hazard evaluation in the main treating doctor dr sparrow i mean course we've got our eye on these who say there's no causal connection she simply relied on which is an experienced occupational medicine doctor and she just relied on the health hazard evaluation so that's just support for the help as an evaluation doctor decides that is a kidney specialist and she reviewed the biopsy which claim prior to the manifestation day does not mean that there's a jurisdictional issue quite frankly the arbitrator and the commission have the power to change the date of stand based upon the evidence presented to it so it has changed in that the station gave it to the date that the claimant sought after pleasure which is really the appropriate date and the flattening the application for a person may experience carpal tunnel syndrome not realizing that they have a work related occupational disease and until they see a doctor ordinarily after an e m t and depending upon the timing of these particular medical visits it may be after the sent to ems and have to time  started missing work it all deals manifestation they usually relates to a date when the claimant has seen a physician who clarifies the  smell that you're exposed to it even with a respirator she agreed with that it is the inadequacy of the personal protective equipment is not disputed as well i think it's important to pura eighteen and even if we look at the nih ashokan and say indicate the over exposure to people because of the dust from the the chemical even even in that document where they had the noted that he said in assessing the occupational disease cause it is very important to look at the frequency and intensity of the exposure for them he did not address his additional testimony with like you said he la sufficient information to determine the intensity of claimants exposure to any specific chemical and specifically said we don't know the intensity because we have limited industrial hygiene data so does that not go to the argument gabbert every exposure based there would never be an explosion or case that could be one might it planes that's what he was missing the industrial hiking gas and he didn't have it but certainly it was sufficient as if the doctor would have testified in said but i relied upon the intensity that was related to me by d m or he'd then leave a foundation but you can't turn around and say it's intensity because he wound up with the condition there's no evidence in this record everybody that winds up with this condition it gets that in my not in my incorrect then in my reading my understanding was that dr fletcher specifically stated he did not have intensive the order ration information when he when he bases all right then what is the foundation for that way that this this this trail sort of spirit actually creates a condition what would what did he base that on willie based upon his experience for this type of condition so there is there is a study there is the particular exposure to more fully and to carbon deisel flight created this can be evidence of secondary so she admitted  if you don't have the facts in the law you just the other attorney used to improper thanks to the biopsy does not show causation you your honor sort of alluded to that it shows a condition which the person at the dr harris i think it was who interpreted the biopsy is the one who was on the report says it's suspicious for a secondary costs well i guess i'm glad the commission doesn't do criminal work because suspicious is generally not enough to make a causation isn't suspicious circumstantial evidence but sensual in this context well i guess it can be but suspicious of what secondary costs you know an occupational said he makes that leap from a suspicious secondary cause to two particular chemicals which by the way are different than the five chemicals he set forth in his nd report and different than the five chemicals he set forth in his rd report which was issued three days before trial so to say that dr fletcher is any sort of an expert he can make up his own mind so i suppose i suppose my problem with that argument is that if you are and i were to make that leap you know it might be a problems medical doctor in his field isn't this what we live on our medical experts to to do for us to explain what the biopsy means while not when it gets to the causation argument where he's relying on this literature which doesn't even mention the two chemicals in question now mr show you mentioned this study that and we switched started off  fletcher testifying why the trial we didn't finish so we went to his office two weeks later and we finished it on rebuttal during the testimony there he comes up with this chinese study which gives the same fatal flaw no information as to the extent of the exposure and now he's saying ok so now there's literature out there well when he said he didn't have the industrial hygiene data that's when he ordered the health hazard evaluation which was conducted and came back with relationship isn't there to be decided by the doctors isn't that to be decided by the commission well the i think it's broader than that of this one particular thing if you're going to say this one chinese study is the evidence to make to say it's not against the manifest way to be honest i just disagree with making that leap you know there are probably what's wrong with making that leap well it doesn't establish causation between de frequency and intensity of the exposure experienced by mr goddard and his condition because it doesn't give that information well what does the study said it's it's basically that there were some but you don't know whether i mean these exposure to or from presumably from leaks we don't know if there was a leak every day every week every month every year don't they so it was a lot but we don't know that's not in the record you know the same with the intensity dr fletcher doesn't have that information but he said yes anyway so the next step is i suppose you're in the position of humans you know us at this point why it is that those experts from ledger's system oh right luck with commissions decision well then i go back to the commission's decision as to the basis for why they adopted dr dr fletcher's opinions and you know standing outside the plant you don't rely on literature that  mention the chemicals in question you know those kinds of things just don't provide a valid support a valid basis for adopting dr fletcher's opinions i don't there's a mention that you know i didn't use any of it it's well it's not my burden of proof