that the ruling on action cause a connection was against the manifest where the evidence i realize there is difficult at this level of people i don't want to dismiss it it is not my primary issue but i do want to comment and ask the court to look at the evidence in realize that just on a few points that this is a woman who claims an injury while assembling small part who said she was her in early december of zero nine for two weeks without  worked a full duty when she first went to the doctor said nothing about being her own work so this really reflects here when we get to the end of the evidence with regard to the mechanism of injury we have to judge you as one of the job she did and a supplemental video showing effectively what she did at the time she says she was her and it's fairly innocuous and i would invite the justices here to to watch that interview coincides with the opinions of and with regard to whether this is an activity that rises to anything greater than our day to day activity that was actually testimony from one of our witnesses saying this is equivalent to opening and already open general here but i think the judge actually ask job did not rise to the level of accident because there was no timely record it was within the forty five days but someone who works full duty without complaint for two weeks ago to the doctrine says nothing about a work injury this isn't prepared from this is a specific event was there any testimony to  because i did present evidence that she complained of a right of return be pain and i believe it was august of the same year so she was prior she had problems now you need so you provided some country medical evidence but were never did give a causal connection opinion pieces and what is it that you think he is she's not doing anything other than what normal people do i'm using the example that i think i believe the claim acknowledge that the little strong stand for this is no greater than opening a jar of peanut butter directly is there over for all how did she come to you he said i don't know that was his answer to the direct question was that he doesn't know there's nothing else in the record and i deployed the court to try to find him i saw nothing in the record that helps the claimant establish a referral i know in this business that we offer a lead to the four referrals when doctors mention other doctors names when they see each other it's often understood that that's probably a referral i do understand that when they discuss each other's opinions we consider that to be perhaps a referral in fact earlier in this case that may have been dr cassell and also dr frank and some of the other doctors they talk about each other and things like that and while i have questions on those are off after the surgery it should've been done and yet we're allowing her here's a testimony to be the only basis that we allow this in if we allow this and i don't mean to engage in slippery slope here but this is a classic case where there's nothing else to demonstrate a referral if we allow things to come in every case and simply say but doctor referred me in the face of the young doctor saying he doesn't know how the patient came there section eight rule into d support for this at all it's very self serving testimony obviously ireland twenty a letter to the claimants attorney it's one of my exhibits citing the fact that this is a serious issue with the claimant exceeding choice of physicians law on this issue of abuse of discretion they look to whether or not there's other evidence that can be relied upon to support what is otherwise you're sick i don't think there's a question this is hearsay this is a statement of another got our court cetera et cetera it's the hearsay rule is this an exception should there be an exception i think is where we get to and when i look at the exceptions in the rules section eight zero three and i look at the case law not on the fifth they're saying what counted i'm sorry hearsay and what context is being offered for the truth of the matter so yes the truth as to whether or not there was a referral there it can be within the confines of the two dr rule under section eight of the worker's compensation so i believe that's the only reason you're saying that we only ever that we've support for this application and again i think you know i don't get into it too much but there's something to be said for the fact that this woman saw five other doctors dr michael malik who is no stranger to this industry who has never hesitated to do surgery when it's needed first this is not hearsay as i said before and even if it were falls under an exception for medical treatment well the medical treatment exception allows the medical care provider to testify to what the patient any question in this case that the reason why she testified that milly told her to consult with her noah was to prove the truth of the statement and it's yours and again it's clear that the commission viewed the testimony as proof of a valid referral so now the question becomes is there sufficient evidence in the record i'm signed over the statement which was hearsay and probably shouldn't have been admitted to establish that there was a referral between malik and no one i think or not his testimony that he accepts a number of referrals from now in a similar circumstances is sufficient i also would respectfully disagree with your statement that it should not have records demonstrate yes and i'm saying that also because the level here i believe changed the review that is appropriate is a piece of discretion there's no evidence of the beast discretion here the commission the arbitrator and the  something in regards to the chain of referral is it your position that the case ought to be remanded to the commission corps determination as to whether or not there was independent evidence supporting when the public courts are allowed latitude to draw them their own conclusions if there's an densher a reversal in whether or not this court can then say because that was hearsay of course i'm making a large assumption here that you're considering this  but if you were to do so can you then say therefore there was no referral and draw factual conclusions of the should be remanded i feel as though sometimes every case lower there's a remand for the commission to do it in other times i feel like a public cour conclusions and i honestly i don't know with respect if you were to ask me the same question justice i don't know but let me get to a few of the points that were raised that constant brought up whether or not the phantom listener exception applies here and at first glance in his mind made a referral we can't let her see testimony declaring that he admitted it is not an exception here so that's the tail end of a deal three b i did cited i would invite the court to look at that because it does not apply and i believe it was mentioned by the court the other exception being medical evidence and that this is somehow testimony with regard to medical evidence that only applies to medical records where there is a presumption of trustworthiness and accuracy and that's why  actually no reference to a doctor in l a at all five days before so you would think if there was an iota of evidence of a referral it would be there somewhere and it's not so defining the guy in the standard is abuse of discretion standard the measure based on the only piping case is whether the ruling materially affected the outcome of the case certainly in this case it affected the outcome it open the door to his treatment so i asked the top of the court to consider