hundred thirty four dollars and seventy two cents in favor of bills issued by a chiropractor by the name of anderson now our reasons is this that dr anderson as a chiropractor was treating through the on our side of the forearm and a little in ring finger now according to dr good name which is our expert on this case dr can extended well ninety degrees from the form scuse me the upper arm is ninety degrees from the body and the forearm extended ninety degrees like you are holding up your hand as a student at school and then you turn the head the opposite entering the arm and the doctor can feel that by taking the person's polls while they're doing it and they do for a minute or so and the doctor determines is the pulse obliterated by the maneuver or is the pulse diminished by the new maneuver that would be a pierce said my way of doing it is the best way to get him said my way of doing it is the best way the commission had competing medical testimony and they chose right while i disagree with ron respectfully first of all as to the east time the reason why it's not useful in this case is that if the person has something wrong with their shoulder itself like a torn way or broom or partially torn rotator cuff they will have symptoms when they do this they will not have a pulse diminish but they will have increased discomfort now this lady she didn't turn out to have surgery by dr richard erickson on august ninth two thousand and ten a nurse and found that she did have a partially torn labor arm spirit aspect to the tonight versus the commission's finding appears eriksson and mark how do we do that ok so answering that question is that the commission basically the arbitrator thought that there was several reasons for her there was some sort of difference between past killer which means compression of the blood vessels and neurologic which is compression of the nurse through the asacol chief thought there was a difference in the doctors were making a distinction that was wrong the commission recognized that that was wrong and they vacated the reasoning by the arbitrator but thing just affirmed her decision for no reason i guess to ask a point well go one by one erickson is an orthopedic his specific role is the treatment of the shoulder itself he was the one that eventually did the surgery to category of doctors that are specifically the paging dr so the shoulder and that was his point that he examined her for specifically understands that anderson the chiropractor right when we found out that she really didn't have any because you know we being all the pain for the first thirty six visits to work and there was no progress in fact there was there and he cried in her abilities by eighty six  explained that the scaling pacu me relieving of the person's pain if the person has a primary shoulder problem which the petitioner claimant mystery turn out to actually have so there's adopted a reasonable interpretation they adopted the arbitrator's decision but they undercut her reasoning and didn't supply anything else also dr pierce if you accepted him he was saying that the petitioner claimant miss truly needed to have physical therapy for the three assoc outlets and i'm no physical therapy for the three ass accountant would try to improve the person's posture so that they would not have a saggy shoulder that would way and anderson is not a physical therapist if you thought that she needed physical therapist to help her recover from the shoulder surgery she had yes she probably did erickson ordered that b dr anderson is not a physical therapist so the commission is ordering us to pay for physical therapy services by somebody he was not a physical therapist with didn't  physical therapist to treat this problem but he hadn't any peers and he didn't know what what anderson's credentials were he thought she was either for the messiah tryst or physical therapist though he said that in his deposition b obviously knew she was a chiropractor because that's what he said his office knows what i mean one of the stroke two thousand and ten in his office notes he wrote that the claimant was also seeing a chiropractor dr anderson who was helping her with their symptoms so he massages to the spine area yes i don't think they do exactly the same type of maneuvers that chiropractors try to do to align the spine it's not really the same no well it seemed to me that under the my point is that she's not licensed to practice physical therapy in illinois and if your justification for awarding the pills is that peers or erikson order physical therapy and they both did then this dr anderson was reason or necessary in a ward of the bills according and as we know where evidence is conflicting for such nature that different inferences can be drawn it is for the commission to make those decisions currently have a wife at home who's seven months pregnant and i understand exactly what it's like to defer to someone else for determination of where hundreds of lies on all the issues in my home so that's kind of like where the commissions on this  had sustained a certain type of fresco syndrome and that wasn't necessarily in the medical evidence and that she was diagnosed with the breast accounts interim generally and that's what the commission decided on a matter of fact in reviewing the competing again dr anderson i almost want to say was hand picked by experts in this matter to perform a physical there she went to doctors appointments she map which a reason i had to to learn what type of physical therapy to do for this condition i think that the commission put a lot of weight behind that in determining that the treatment is tied to the world making the argument under this florida case of other places well that's all well and good but kind of indicated the same thing when we were talking that day maybe there's a stigma with chiropractors versus physical therapy but it's essentially the same old audi's the question isn't whether in addition was qualified to be a physical service the question is a contrary opinion to dr peers after dr pierce and testified so right about the admission they're right about that and that they're just indicating there was conflict of medical evidence on point and then they didn't go a step further and say we believe in manifest where the evidence they failed to produce a reason darkened them is the far more persuasive doctor because he did a much more thorough examination much more careful examination he you know relied on the if he had a torn labor or partially torn rotator cuff which she turned out to have so the scaling test does not prove that she had the racicot wants room all it's not diagnostic whatsoever in this particular case  as to the chiropractor versus the physical therapist issue physical therapist guy doing exercise that's what they do and that's what the rasik out sooner person would be if she were  specific she does need to be treated for through os account but she never had that problem but if she did and she needed physical therapist to treat her the first call therapist would trigger an exercise is to keep her in a good posture so that the racicot that is not compressed by saying shoulder well kristie didn't really have that problem either because she had good posture that's throughout everybody noticed that but if she did she need an exercise therapist an exercise therapist to be a physical therapist that the overlap if any between physical therapist and chiropractors is in the activities what are the patient is passive and the chiropractor is doing something prolong this lady's disability not cure it and i think the proof in that was it pays to seventy four of your records were erickson cleared out to the exercises that anderson was having this lady do were precisely wrong he was having her extend the arm all the way and rotate if you want someone is labeled a her that's what you do that's a replication of the o'brien test which doctors do with no wait to see if they can identify where the lay rooms tore because that's where the person will have the pain so anderson's behavior is totally wrong in this case if she wants to make this lady keep earning she should keep doing what she's doing and that's why she should not do it that's why we want to cure this lady we don't want her to go into a perpetual state of needing to see dr henderson day after day we paid for eighty six visits that was too much we were right to cut her off on