to the work injury that caused her to break the arm of the arbitrator claimant spinal condition does not relate to her work injury in the commission erred when it reversed their findings i know we possess a heavy burden in this appeal but in this case it is clearly apparent the conclusion opposite that reached by the commission on this issue is the only outcome possible based on the evidence it is clearly apparent the commission erred it reversed the arbitrator and found the commission's lumbered condition related to the work injury and appears no in before i go further nothing about petitioners upper extremities is at issue in this appeal only  and the condition the commission's decision provides no explanation how the claimants final condition can relate to an occurrence of april two thousand and seven when the medical records prove the condition that she brought to trial in two thousand after july two thousand and nine were not present three months after the commission that's where the crux of the error lives in the commission reversed the arbitrator by finding dr more credible than the claimants treating doctor and more credible than respondent section twelve physician and the only justification they did so they gave for finding dr lorenz more credible is that he possessed one m r i report that the other two possessed only one medical record at the m r i that he had performed when he evaluated her in july two thousand and nine dr brady and dr soriano possessed all of the medical records for the several you have t could make the argument of the you know the chain of events you've heard there are given to that somebody with health prior to the fall that they ended up having problems after that but wasn't there also you know if it's some diagnostic testing that showed that there but when you compare that spondylolisthesis those are those are the conditions that he wants to treat which the first one is significant is basically that's right yes and she has severe arthritis two a half years later and the  specifically can from properly vertebra vertebra alignment so by the time we get to trial that the wrens is examining her for a condition that he thinks existed in two thousand and seven but didn't based on the diagnostics because in correct absolutely and it is borne out not just by the diagnostics that i have through just now which truly show completely different shows trauma or packed allergy in two thousand and nine that didn't exist and was shown not to exist in two thousand and seven there would be attributable to what well we don't necessarily know and i don't have to establish what it is as long as i can establish a new condition which i can't because a coup going to  this claimant in april of two thousand and nine and in april april sixth two thousand and nine she presents with new and different symptoms of bi lateral leg and foot pain present for the previous several weeks which means we get into the area of march of two thousand and nine and something new and different has happened we know based on the diagnostics of july of two thousand and nine she has new path out we know based on her treatment records with dr ak and improved two thousand and nine that she has new symptoms she has a new condition with new pain symptoms and a new half and worked for roughly a year to see if i can make sure i find those dates correctly but tween june two thousand and seven in may of two thousand and eight she would turns to work she performs full work to those that do lorenz is diagnosing her with a condition that requires complete restriction and claims that she is completely restricted until she has this fusion surgery she has a condition in two thousand and nine and thereafter with significant pap allergy requires returns to work for approximately a year between june two thousand and seven and may of two thousand and eight and that's the period where she had the epidural steroid injections she had some injections to return to work she was able because she didn't have a fusion and by the way epidural steroid injections not be performed to a level that requires even surgery it's what you perform to test for non operative non operative conditions that can be treated with pain management essentially this claimant had some of the drug stored injections and was made to work for a year as no complains least now that she's registering two or treating physicians no treatment until she goes back to doctor back in april two thousand and nine says something something happened in march of two thousand and nine when my symptoms with him it's new and different she doesn't say something else but something changes in around march of two not only is it disproven by the diagnostic evidence the object of scientific medical evidence that shows us what's wrong with this woman spine in two thousand and nine that wasn't wrong with it in two thousand and seven but there's a runs true doesn't have any basis to wonder opinion as to what the claim his condition was prior to his involvement in july of two thousand and nine he literally didn't possess any of the treatment records he testified he didn't possess any of the treatment records and he saw the woman who he did address what is the source of this claim is condition after two thousand and nine states that this is the progression of her of her arthritic condition and her degenerative spine for a woman the only one who disagrees with anybody in this case is dr the wrens and we know he that that case wrong we know he didn't have any of her medical records i submit intentionally didn't have any of her medical records because if either he wanted them aboard the plane wanted him to have them h ave i've gone over the diagnostics which show the error of his opinion but that the rents confirmed that that's a lie two thousand and seven m r i revealed no traumatic i'm sorry no trauma no indication of any injury but claimed that condition is the same as a condition that now requires fusions or he also found her found the claimant possessed a condition significant enough that she was restricted in to she has a fusion but can't explain how it was that she didn't require these work restrictions until he got on her case or at least until april two thousand and nine when she complains of new and different symptoms how did she work a full year between april two thousand and seven and ma two thousand and nine if she exhibited a condition of wired spinal fusion and for restriction she didn't and i would submit to you there's curiosity as to why we're even talking about doctor the rams dr lawrence works and paige illinois had to travel some two hundred please the court counsel jennifer kids went around the half of the defendant to record here and i'm here today to obviously ask you to uphold the decision of the workers compensation commission really the same as a case of manifest weight of the evidence and medical credibility the commission's decision is based upon the petitioners credibility and the medical credibility here now counsel points out the difference in these two ahmadis and what i would point out to  them in council admitted that and said well the other doctors couldn't because it wasn't done until later in two thousand and nine world i don't see any with reason doctor story at all couldn't have reexamined time after the two thousand and  we have a condition that is connected to the workplace accident according to the evidence and bet is what the commission adopted here for two thousand and seven well first of all the two thousand and seven and two thousand and  review both m r i teachers didn't have all of the medical records showing her injections and her therapy he was aware of them but he didn't have every visit but he was aware of her treatment and he is the only doctor who actually viewed both  the difference between most of the girls who i don't i don't think there's any evidence that there was this quantum difference in the backyard there's nothing to support that other argument other than council substituting insults as mad as a medical expert saying look at these they're different learn to sing no they're really not we have a degenerative condition here medical credibility with their support for the commission decision through the medical records through the day gnostics and through doctor lines of testimony that they i would ask you to affirm the commission thank you did review them arrives but he didn't review the two thousand and seven m r i until he was sitting for testable until he had already issued his reports and so he had already found that the claimant needed the treatment which i don't dispute that she probably needs to treat but it's for a condition that didn't exist and wasn't caused by two thousand and seven injury and we know that because the condition wasn't present in july two thousand and seven three months after it was going to set in setting within three months but that the rens reviewed the m r i because it was shown to him during testimony because it was brought out by myself that his knowledge was completely deficient because prior to that point he had never seen so much as a single one of her treatment records which he conceded now were guarding the end that persona did address the relevancy of the two thousand and nine m r i he didn't have the opportunity to see it when he provided his opinions but he did tell it he did testify to it and what he said about it is that an m r i in july of two thousand and nine would be irrelevant for diagnosing a condition stemming from unable to thousand and seven injury when you have a to know that it's irrelevant we now have the m r i that shows what was wrong with her three months after the injury because soriano's focus is causal connection and the renters focus is just she doesn't need the treatment he simply says whatever is a building in july of two thousand and nine m r i is irrelevant concerning what cause was received from an injury in april of two thousand and seven when we have the diagnostics in two thousand and one in two thousand and regarding a medical opinion as to the differences you don't need a medical opinion the documents speak for themselves they say and to all this this is in two thousand and nine and they didn't say that thousands of they sa two thousand and seven when the m r i specifically indicates no acute injury dr lorenz reviewed one piece of prior treatment record that's the m r i of two thousand and seven and he only did so because he was asked to do so during testimony it had no bearing on the opinions that he had rendered prior to them and that's where i was was headed by saying that dr renz is the least informed as to what condition she received in april of two thousand and seven stand before you today if you see me tomorrow with a debilitating back condition you'll know it wasn't caused yesterday because i stand yesterday that's claims case april two thousand and seven she breaks around july of two thousand and seven maybe in july of two thousand and seven they run bag gnostics which still no injury we don't know what happens to her but in april or march or april of two thousand and nine new and different symptoms new path knowledge is shown in july of two thousand and nine it is impossible it is clearly apparent that the opposite conclusion must be the case