and she claimed that this this particular job she had again she had worked several here at this particular job she started in january of two thousand and nine and that's when she started having symptoms not only in her hand at the arbitrated term and that all of her claims we're barred by the statute of limitations and by failing to give proper notice in september of two thousand because she had many of these upper extremity conditions prior to evidently treated with several doctors believe you at at a family practice plan and she did see a doctor will tell you in two thousand and seven he did reference in his office note that she had a positive now si right but her only complaint at that time was that she had these symptoms when she was sleeping so there wasn't any connection with work and there wasn't any diagnosis at that time tunnel but again it's just the right hand that was in bar in two thousand and six she went back to see a doctor bill you she had fallen on the ice and she was complaining of not being able to close the third and fourth fingers on her right hand the doctor diagnosed tendinitis and it didn't affect her work until there wasn't any other treatment and again it only affected the right hand not the left hand was there company got he did a job a valuation he did not speak with my client about her job he did not observe her performing her job he may have picked up a tool that she did that didn't are engag believed she worked on more like eight to twelve railcars per day as opposed to the average of eight or so i think dr ludwig to say with regard to grading the record shows that indians were not based upon the complete review of the claimants medical history to her job duties he had discussion with her about her job duties there was also a hypothetical presented to him during his deposition about her job duties and he testified that they her job can at least cause carpal tunnel and i don't think really think that there was much said in john dr barnes report with regard to the impact that her work which she said at least with regard to the shoulders when she did work that was at  regard to the carpal tunnel though in this case there was no there was no testimony that some other outside condition was the sole cause of her condition and under it only has to be a causal factor in the resulting condition of bill being and i think dr dr gradings testimony quite clearly sets forth that it was at least eight cars  aggravating preexisting condition or causing sleep this lady didn't have any shoulder problems or elbow problems prior to september prior to working in the alcohol department starting in january two thousand there was a medical record of her having shoulder complaints in her right shoulder back in ninety two when she was in high school but the the name left shoulder problem in this book the main shoulder problem in a record in this case before september of two thousand and nine she did not have died she did not have a fiery condition she she did not have hypertension all of starting in january two thousand and nine and it wasn't until after dr barnes center for electro diagnostic studies when when she reported the accident in september of two thousand and nine that she actually had  did not have did not even speak with my client about her job duties or or what it was about her job duties that that caused her to have these complaints and dr grading did dr grading was also a board certified orthopedic surgeon and stuck to him or is using us commissioner mason noted that that kind of credential was not found are presented in evidence with regard to dr barnes with regard to the statute of limitations are our position is that especially with the left hand there was there was no treatment prior to september of two thousand and nine so  arbitrator in the commission to find that the statute of limitations alone not on the left hand it it's just not there is just nothing in the record to to substantiate that with regard to  there's there's nothing in the medical records to indicate that she had any kind of problems with the elbow prior to starting this job which she said initiated the complaints that she had her hands shoulders and  with the shoulder the left shoulder was the problem that had the most problem and the only medical treatment she had prior to this point in time was her right shoulder and that was back in ninety nine two she only had seen the doctor once for that  decision and remand the case to the commission for consideration of my client's requests for medical benefits under section eight and also for the prospective surgical treatment to the left elbow in the left shoulder that was recommended that there was a failure of accident there for all of us that there was a failure notice because there was no notice and all this that because it's no accident there's no causation they came to their decision by listening to the claimants detailed testimony as to what her job   does get it somewhat causation opinion but that is also say in his testimony and believe that four parts would be a repetitive enough up into eight cars and he wasn't even quite sure what the number of cars repetitive to actually actually in the record or not i'm not sure those credentials were actually put into the record but i still still that is a function of the commission to review the doctor's testimony and to weigh their credibility in still they felt that dr parts of testimony she was driving the engine she was driving at a mobile track i think she was also unloading and loading these rail cars which did require her to do a sixty point inspection before she ever got to the point where she would get on top of the real car and use the brass wrench to undo the bolts and i think they're about six or eight bolts and it really seemed from her testimony that that was where she was complaining that there was a causative factor with her but that was only diane you know four time possibly four times a day up to twelve times a day and some days you know times if she wasn't and when after she took the top of the real car up she would attach a hose and she would put this out in it and then she would wait in the new paperwork so her her job duties were particularly very throughout the day and i think that that was also part of what the commissioner heard in conjunction with dr barnes's opinion that he did not believe that those job stat the fact that and employees work duties are very during the day does not negate the fact that it can be a rip type job in that particular case the employee had a lot of different jobs also says that there is no legal requirement that a certain percentage of the work day be spent on a test in order for the work duties to to negate a finding of repetitive trauma and the issue is was were the work duties very large ranch on the bottom of the cars this is the ranch that dr torrance held but didn't use to to simulate this particular job duty she also had to drive a bobcat she had to i think when you look at her testimony as a whole when you look at dr gratings testimony at a whole despite the fact that this lady's job duties were very in the working on these average a real cars per day you you will there is sufficient evidence and in my opinion overwhelming evidence that this lady's job was repetitive and when you couple that with her testimony that it wasn't till she started doing this particular job in january of zero nine that the symptomology the extreme symptomology that she hadn't had prior to this point in time was initiated then i think dr gratings opinion on causation should be entirely too much more weight than either the arbitrator or the commission majority gave it and for that reason we would ask that you would reverse the commission maturity and send it back down to the commission for consideration of awards