incident that occurred in this case is not necessarily in question we know mr pittman is a man working for court shell that tripped and fell to his right knee in january twenty ten i say the incident is not in question but whether or not there was an accident a question i'm sorry i should say whether or not there was an injury we can call the incident an accident a trip to a knee is an exit we'll give you that was he injured and more importantly was he injured to the extent that it caused the need for a knee replacement that was subsequently had about four months later there was quite a bit of debate as to the severity because this is a gentleman when he tripped and fell got up and continued work was toward the end of the workday anyway but he didn't report an accident nobody disputes to this that is not disputed that here preexisting conditions have been null corrected and in fact the commission cited those records the basis for the commission decision was this gentleman had significant stage degenerate arthritis in his right knee and that that needed to be replaced before this incident ever let's assume it's all true right was the claimant asymptomatic before the state he was not he was not not i think that's a get to those in a moment but let me point to something more persuasive i think judge which commission is relying upon those records you need and you need you need a need today you need it in six months whenever you need it it needs to be replaced and relatively innocuous fall to the knee is not the cause for that condition i well let's look at his own testimony mr pittman testified one he has pain every day that's not a symptomatic and this is a seventy six to eighty three the record this is my cross exam pain every day pain getting up out of a chair years before this and was told his knee needs to be replaced that is tremendously significant let's assume he did definitively it could have been two or three years nobody knows right so here's the x and all of a sudden is immediate need for surgery or he didn't before the accident you're you it wasn't no no no he didn't write alone he was he could have been at the beginning of the ship that was conceded by the supervisor that's correct he also didn't acknowledge that he had every opportunity to revise that before he submitted it at the end of the day and he didn't know if you wrote  he had it well before he also testified to swelling after that's true the measure of that swelling i don't know that anyone can determine and or distinguish the difference because that was a symptom that's chronic based on his own testimony that he had chronic swelling in  because it was in such bad shape a name that it well his pain was because he testified it was every day before the incident and that's in the medical records too this isn't just based on a cross exam of a claimant there's several years of records in fox valley orthopedic records that substantiate this that's the basis of the commission decision in large extent they say in black and white that it's based on the medical records and that's why they rely on you need a new knee but a relatively innocuous fa didn't compel you to seek immediate care or report it that day was a mistake i know mr but it's also a mistake i should have changed it well you didn't and at this point we can't we can only go with what we have in evidence and the gentleman said he did not  report in consumer accident that day he felt the pain later that night but frankly this is a man with pain every single day and yet in that misstating work at all that was good right now but you mean because of the knee before that other then in the right until after he fell on his knee ok but wouldn't this gentleman do in the arbitrator's decision it's lighting maintenance but i didn't see anything in the briefs regarding what his actual job was it is a call like maintenance work and anything more detailed he did change a lot of light fixtures so not to over simplify it i'm sure there were some other light maintenance type duties but that was a primary job duty at this facility they were working on site at a custom you know not a lot of bending more standing and replacing overhead light will that is my understanding yes but that is my understanding so but to get back to two points let's remember today we're here on manifest weight reversal and it is not for the circuit court or for any court after the commission level to rehash the facts necessary if there is a reasonable evidence or a basis for the conclusion of the commission it should says this court certainly has restated that rule as well as the supreme court in this case the commission cites a long standing need condition for demonstrating the knee joint needed to be replaced and specifically says dr chadwick who was the more recent treating physician didn't go to the doctor he had for the last ten years he went to a new physician as well his and his opinions supporting causal connection here are not as credible because ron the idea the extent that this gentleman was suffering in dealing with this he was masking the pain with injections that doesn't mean he didn't need a knee replacement and i submit to you that the commission had a reasonable basis based on quite a bit of evidence from fox valley orthopedic this means and he was in really bad shape in to rely on those records to say you know what you had a contusion the file but the need placement was needed long before that and that's their decision and that is a reasonable this means he was so degenerated you would find those in diagnostics regardless and this gentleman did not have any bruising he did not have any of the regimes certainly didn't have any fracture when he fell and he didn't seek immediate care so dr khan bled explains relatively speaking this was not severe enough of an incident to cause this if there were a spiral fracture of the sheen and he got twisted into a pretzel something horrific that we do see sometimes my argument would be much tougher i would probably still be here arguing that what you need a new that he needed a new knee and that normally would say i think you're probably ok but if that's the case it's not whether or not he may someday need a new knee it's whether or not that he could have been replaced at any point since two thousand and six to twenty ten and the answer is yes he himself in that i don't know the doctor chad nick explained it other then all those injections were from dr patricia he's here at fox valley and then after this incident he moved his treatment to dr chadwick and that's when they more quickly moved from i think the oh i'm looking you had corn plants testimony and i wonder if the good testimony really points to the argument there he is accidents condition thus requiring the operation or merely his he always needed the operation but be injections were masking the pain and for and that he had end stage arthritis and he required a total knee replacement prior to the injury that's page fifteen so i'm summarizing what is the essence of this what i'm citing for support for the fact that this man already needed this to be done  statement was the question we don't have is could have continued injections indefinitely probably not could have continued injections for another year oh do we know why do we know why on the recommendation was made by ensued after the accident they took him off the record ok but that's it it's independent of the condition of this need if i was up here in the gentleman had no prior treatment and they recently uncovered a degenerate condition it may be more persuasive for there to have been a revers that says he wasn't doing it right but then again i've been out of the finish i think i've made the points i want to make you understand a position again it's the focus here is whether or not the circuit court judge could've interpreted  not really the measure that i need to meet here i think the measure is whether or not there was a reasonable basis for this decision there is based on the prior treatment records based on the very case i've cited and i asked for a reversal in reinstatement of the replacement when the hell you are in a cast that injections are working and in this patient we had four years of success increasing success i mean the first injection last five months second six third of sub and i think the last was up to nine months that's an was now an issue we have the need to use a cane or a rock or whatever it was using some assisted device that he didn't before correct he was completely functional before the accident for a period of years the fact that a doctor six or better that more on each other down so the fact that they're working is just like an assisted device the fact that someone's using the system devised to get one line why we were least known they were stopped because now we had instability had severe pain reasonable degree of certainty yes but you say it's wrong i know what your point of reference or my point of reference is more likely than not even concedes it because i ask him before i ask what is he applying to this case in this causation analysis i ask him what to stand of that we're dealing with your doctor and he's been around forever you guys have seen him another case you know this more likely than not forty nine fifty one and he tells us still he's applying an eighty to ninety percent of this case yeah yeah well probably windows where he's here's what's the basis of the opinion in your opinion ok with vinnie the follow up to that is that opinion now admissible as a puppet of anything because he's applying a standard which requires me to prove a connection to an eighty ninety the citing they're fighting specifically say the surgery was posed by on the right he was being treated with a series of injections the medical records i quote we feel he was able to live with the pain and discomfort until january twenty incident right and as for that commission decision i don't know that they ignored a standard page the way they did they seem to restate the facts that everybody agrees let me let me read this line because it is important again manifest weight to they have a reasonable basis doesn't necessarily mean it's the cause you already need that treatment it's already necessary but we may be necessary but it may not be necessary to day you mean this is serious for five years but because of an event it becomes necessary was measurably innocuous or but nine type of incident to say that didn't do anything to trigger the treatment that was already needed i think that's a fair summary of the commission decision to reasonable and i think it should be reinstated because it's not against the