but before we began so for everyone who's going to be present in the afternoon your arguments just to start burris is unable to be here due to a conflict and scheduling you will be a full full participation a member of th which removes all nine university based doctors from potential care for mr montgomery as well as specifically removing dr kelly from this case and the rd do you know who issued is th the doctor could treat a doctor could call her nor could you apparently did she have the ability to call the feeding doctor because they never made a connection so why need to schedule the appropriate thing to do was to develop a life care plan that included schedules to code frequency everything and after were treated a number of different places for the last eight years prior to trial anyway and for i think the last five or six years prior for the injury suffered by the time i think it's inappropriate for the commission to say the pardons that met the bill because they are ordering the bills to be that because the medical care was if you will of the issue in the case you're right we could have waited until later on the bills but then there's an argument  leader in the bills if you were seeking payment for medical expenses you had to submit bills to the commission and the commission would he have to rule as to whether those bills were reasonable necessary and whether  meet the criteria the articulations that are given under the statute well  that's what the ordering now to be honest the way i practice if i found a bill that was unrelated i would never require an employer pay it but all those bills were clearly i believe for the c r p s and i think gives based on the fact they a well and again the bills were a bit on the record correct me if i'm arriving now i'm going by memory but i believe the bills were committed without objection except as to liability because they were all bills from providers who had provided treatment for the c r p f that one form or another and like i said there was a trail of bills and i think the commission ordered what it did but i don't think reasonable ness was really an issue there was no doctor saying this bill isn't reasonable this for a longer like with more pain because that's really what we're dealing with shouldn't be the patient's choice that anybody else has because it's a sad situation but when they're talking about these opioids and everything that's the underpinning nature the other thing i think that's very wrong in this case if he's a chronic pain patient now they're treating him to be honest my opinion like a junkie and here's the here's here's the deal so to speak for the jump you can get off the drugs it's wonderful because in the normal person you get the medicine cravings with a chronic pain patient you take away their drugs the pain goes up and they do other things it's not fair to him it isn't and that's basically an important part of our case the other thing is the commission used the wrong standard altogether so they don't get a difference in my opinion because instead of using was this a reasonable choice the use we're going to do what is best for him there is nothing in the statute nothing in precedent that says that any kind of standard the commission uses patients to get to choose as long as the choices are reasonable and according thing which is specifically that the commission's order is very bag as to what portions of the medical introduced into evidence were supposed to pay and there were a lot of disputes going to that and we had asked the case be remanded back to the commission with directions that they tell us exactly which bills they're finding reasonable and related and we should pay especially because when you look at their order they find that the particular that these are not related they're putting dr kelly out of the treatment are they meaning we need to pay the treatment that dr kelly has provided to that point or are they denying that are they only denying it going forward so st and foremost on a cross appeal looking for a really had daughter back to the commission to address yet and i was not involved in the case at that point i have not become involved until it was asked before this and also i'm not sure why that wasn't done but i do know from the perspective of caterpillar looking at this decision there are a lot of questions about what we do and do not so we are looking for a reunion at this point to direct a commission to address the incurred medical liability of the extent of that beyond that issue the question is really one of manifest way that they have that is the commission's determination of what treatment the employer should pay for going forward supported by the manifest weight of the evidence and to get to that the the employee does have a choice but at the same time the choices that the employee made and the treatment that the respondent is responsible for still has to be reasonable appropriate and necessary and what the commission is doing in this case is saying the care that rush the record is replete with doctors that are recommending against that and actually saying it's dangerous you've got doctor stop that layla who refuses to provide care when he comes back from arizona it comes to the act what the employer is responsible for there are limits to that you know if if the claimant came and said i want you to send me on a cruise somewhere yeah that would be great but we're not in this country and this will say that i like some of this if the body gets to improve his quality of life by removing those from the treatment plan and replacing it with other things i mean we're not talking about a case that's going to be cheaper for caterpillar as we move forward by removing those from make a claim because you're still talking about a lot of expense the medical procedures and medical intervention that's going to need to really we didn't choose that program caterpiller didn't choose that program so would the commission was doing in this case was looking at what is reasonable and appropriate care to manage the chronic pain moving forward and yes they're gets mad at dr lynch and goes somewhere else because that's not helping things towards a better quality of life and to a state of well being and help us so from that perspective i don't think the commission authority is to determine what is reasonable necessary and appropriate care mr montgomery came to them and said you need to order some prospective care they looked at all the evidence and they entered an order addressed that and we whatsoever saying that the machine or even implying that the commission has a right to pick what doctor can or cannot treat a particular patient and what happened was that would make if they did have that right given example dr stephens there's a funny thing  dr stevens had he had a military application he would still be away all of treating the plaintiff and we wouldn't even be here but he had a military obligation he left if he james beck comes back opens his private practice he can't treat him because he's not from a major medical university they've actually different franchise most of the doctors in the state of illinois with their order as far as here's the here's the more important question to all these other modalities work as well if you have an issue on the opioids why snecking these other fenton all together which is you know i think about drugs that is the super duper they found the formula if you would that work which was less drugs and that's what was done since and count this claim that dr kelly consistently  reduce pain somewhat basically this is dr black unfortunately basically i think what you do to a degree is is tricked the brain into thinking that you're feeling less pain that's why things like biofeedback help i you're saying these other modellers are not available to you because caterpillar won't pay for it's the only reason they're not available to him dr kelly's prescribe it the life care plan has it all in there which i think should be implemented and here's the thing with the obvious eventually you're not dealing with someone  just started taking him or he say oh it's really we can get him up he's had a tolerance for them for twenty five years and they do reduce pain dr carson said evidence based medicine is the best and he got something is working let it stay working why not so basically as doctor is against it and yet this for human being can't get it with this commission system that basically decides to not address the bills that by the way justice often just for the record i do agree with you that they should have addressed the bill that i would put them in and again just i don't quarrel with that i really don't but i think that in one thousand we're a day when they make an order like that that sufficient compliance with the springfield leak case to make it a final order where you can still make your rulings as they did in for your arguments in this matter will be taking their vitamins this position sh