conclusions of law however the arbitrator's decision in this case which was adopted in full by the commission did not include a finding of fact there was no real weighing of the evidence or the credibility of the witnesses and so we must rely on the facts discussed in the various sections of the conclusions of law to almost speculate as to what the arbitrator and the commission's findings of fact in their entirety work however when we take a look at the facts that are discussed in the various sections of the conclusions of law is our position that the facts in and of themselves are inconsistent and their conflicting and more importantly they're on supported by the evidence in the record and therefore we submit that because of these conflicting facts that the decision of the commission enough as a whole was against the manifest weight of the other what we have here is a clear undisputed work injury there's immediate pain there's no question of whether or not the accident happened it was a witnessed accident in which my client who had over twenty years of experience as a mechanic was working on a car and a two hundred lb gas tank came off of a car he lost his footing he fell backwards landing on his upper body on his shoulder and his upper back and a two hundred pound gas take fell on top of him crushing him he reported immediate pain he went to the employer's work clinic where he complained immediately that day within hours of pain in his shoulder going down into his are we have some confusing symptoms because pain in the shoulder from the tear that he had and it was a pretty big tear it was a rotator cuff labor and bicep tear and we also have symptoms of radiation and the arm and unfortunately those were properly diagnosed because what happened is he was set right away for an m r i of the shoulder which showed a significant tear and that's what the doctors did they addressed what they thought the main injury w and then within a week of that he goes to his primary care doctor who also notes that there is ten in the entire cervical spine going into the trap is the right area and he orders that x ray between november tw the range of motion in the shoulder is increasing his shoulders getting stronger but yet there's no need weakness in the arm throughout the physical therapy records post operatively and his surgeries in february every single physical therapy record practically shows he has pain in his nap he has pain going down his arm he has seen going into his fingers he has numbness yes tinkling he has problems holding objects that's not consistent with a shoulder injury but how do you  now in his discovery or i'm sorry his absence opposition said that he's not trained to do cervical surgeries never done cervical surgery and he would defer his opinions when he was treating and was actually practicing because he has since retired and doesn't does this on the side ying it's not related but why is it not related there's nothing in either his initial report or has it done enough that explains how it's not related although he says it's oh it's an incidental finding he doesn't know any preexisting condition he doesn't know anything in the challenging the basis for the opinion because you obviously were very well so that it's up to the commission to judge the credibility of witnesses in the way to be given to their opinions that's what they do correct we're just going to say we don't like th opinion and all we see is the cause nation and the arbitrator's decision and the commission taking that decision and saying well this is also our plans with regards to medical and t v is that we have to see what they put in all we have is their opinions on  specifically make blowing things up dropping the findings of doctors worth in gold in the cars ation they do but i think that it's of note that these same opinions that the arbitrator in the commission adopted they then supposedly adopt in their opinions with regards to medical as well as t t v but how do they adopt opinions of dr or for example with regards to cause ation and then that with regards to how do they adopt the opinions of dr goldberg supposedly on proposition as a whole but then don't adopt those with regards to medical or t t d we don't know almost what facts they rely upon because the pinion and in and of itself is completely discourteous as we're not close by here so does that make any difference to what i think it does make it i think it's very important because it's almost if you take a look at the opinions of both of the doctors and dr goldberg originally they say oh there's no injury but then they of them say how how is it that it returns to being a baseline how is it that this condition is now not symptomatic neither of them provide any explanation for that and i would trigger just to say oh yes he's baseline by the time of the irony of dr goldberg just doesn't make any sense there's no medical testimony as to say how did he go from having an acute cervical sprain to not being a surgical can't fifteen from you know questioning the underlying basis of the session as well as in his medical records goes very far in explaining how that acute cervical injury which showed a normal x ray progressed over time he says it's consistent with mr hand sometimes which is another thing that was completely ignored in the record there is nothing here with regards to the petitioners testimony at the time of trial with his increasing symptom which is that linked in the record and more importantly dr lawrence goes very clearly in showing how the x rays the  g s all show a natural progression of this acute cervical injury how the fact that he had a shoulder injury and a cervical injury at the same time kind of mask the symptoms they weren't able to really differentiate between the two but the bottom line  is he helping going into his arm from the beginning the fact that this wasn't diagnosed unfortunately as it is not the traditional fault and the fact that a lot of his treatment wasn't authorized that's the only thing that we can attribute some of the lapse of time to the consistent complaints or there are documents and not only in his testimony but most importantly throughout the medical he has weakness of the arms and let me ask you this putting to decrease you have medical evidence to support the claim or your medical evidence on the other side  first is to adopt an opinion there has to be a medical basis for that opinion there is no medical basis offered and the other is one dr goldberg one doctor or support that says how this is not the natural progression of the acute cervical injury that i on disputed they can explain it so just say it's incidental it can't be and then say that the reason they don't believe that the symptoms or because of their brief fifteen minute examination each they were  they were exaggerated but yet dr goldberg even admitted that dr lorenz's multiple examinations and very detailed notes showed exact weakness and diminished and sensation at the exact  the burden is on them that they proved anything more than full duty work and the arbitrator in conservation opinion and the commission adopted twice twice in causation section says that the petitioner was released  duty by doctor or that's not what that evidence is he conscious he completely retracted that in his evidence deposition and said no you're right he needs light duty they never offered light duty so we've got conflicting the shoulder as of the march two thousand and nine i meet why does the retreat or cutoff t t d in two thousand and seven that's also inconsistent clearly against the manifest weight of the audience it doesn't make sense you can't say i adopt these doctor  and i think that the t t d and the credit issue when looked even by itself really shows that the decision when taken as a whole is clearly against the manifest weight of the evidence it t he gave him medication then he said ok let's try some epidural injections there was increasing intervention on care that was suggested for the petitioner the fact that his condition got worse over time is part of the natural consequence the commission was wrong in saying what was he diagnosed with originally they need to take a look at the natural progression of his entry and that's what was ignored by the commission and what i'm sorry to say was completely with all due respect but ignored by the response and their brief they can't explain what happened to the natural progression they just want everyone to say oh it's incidental let's not look at that and you know for that reason i believe that the decision of the commission should be over raymond chevrolet here standard of review is whether or not the findings of fact of the commission which are contained in the arbitrator's decision are against minute feste weight of the evidence the employer asks at this court review the decision and review the do diagnostic studies and were asked based on a reasonable degree of medical certainty whether or not they had opinions the basis is that medical records history examination which is typical for what  examining physician or treating physician relies upon in formulating opinions i don't understand how there is not a basis when it's clear that both doctors need the medical records and each reached a conclusion at a different cervical conditions he not be an orthopedic expert or a neurosurgeon but he still has the right in this practice we commonly use doctors that are not necessarily in the same field it doesn't need to can't give absolutely correct and to further substantiate dr goldberg's and dr or spinny and as to the need for surgery on this of wedged not related circle condition it's supported by dr lamie he's the treating physician who was referred by the claimants primary care physician in rendered an opinion in two thousand and seven but this was not a surgical condition the kind it is he is asking you to judge the credibility the witnesses fill out a questionnaire no complaints about the arm no complaints of numbness throughout the course of treatment from november twenty ninth and tell the claimant contacted dr polaski on june nineteenth there was no mention by a physician that this claimant had either neck complaints or cervical complaints reflecting that the condition found later the c five c six was possibly related there's three periods you can look at the initial treatment he admitted that he didn't have any treatment to the neck there was no significant treatment given other than one diagnostic study which apparently did not alert talk to pull out to refer the claimant for any further neck treatment the next question is the second period which affects t t d and also the credibility of what was causing his complaints in july of two thousand and seven as to t t d he was released on light duty by dr sujit he returned to the employer and worked for a period of time dr suchi recommended that the claim that happen f c rather than have the f c e r continue to work by duty which was prescribed by dr suchi he chose of his position and then he chose to no longer work and his testimony regarding why he missed some days if you look at the record it's just absolutely not credible he testifies at one point that had missed several days to physical therapy he only had two opinion what he get cites is the history of the incident and then says he has the cervical condition why do you always were slicing and dicing we're parsing the evidence we're doing exactly what the commission's job is they did they state that they review the evidence the arbitrator states the she reviews the evidence she reviews the evidence in the decision it's well reasoned it's not only rational but it is the preponderance of the evidence the commission reviewed it we're thank you thank you counsel  said a lot of things in his argument there's two very key things that he forgot to mention the first is there is no proof that my client was ever released to full duty with regards to his shoulder injury by any doctor and more importantly there's no proof and it's their burden that they gave him anything but will work completely ignore it the issue is that very issue that casts doubt on the entire decision when read as a whole it's against the manifest weight of the evidence you cannot sit and say that you adopt the opinions of doctor or of the doctor lammy and of dr goldberg and cut off the t v in june of two thousand and seven it they're still symptoms the fact that his treatment was confused because of the injury to the cervical spine and the shoulder it's not his fault he made complaints consistent complaints this isn't a case where he shows up at arbitration two years later and starts complaining oh yeah it was hurting the entire time but it's nowhere in the medical it's consistently documented everywhere the fact that the doctors failed to notice that there was a significant cervical injury until he has to the point of where in physical therapy he goes in to work hard and he can't even lift things and he's dropping things that's part of the natural consequence there is nothing here to break the chain there's no argument of a preexisting condition dr goldberg saying that this is an incidental finding that it's not consistent with the m r i findings it's not there and it's very important that dr goldberg doesn't review all of the evidence he runs his opinions without the e m p the e m t is very clear bilateral the ridiculous up at the in both arms completely consistent with dr lawrence's examination dr so tells examination and the petitioner's testimony and symptoms throughout the medical records dr goldberg doesn't explain that goldberg also goes on to say when when we show him as evidence deposition the new m r i which he didn't have a chance to review prior to entering his opinions he goes oh yeah there's definitely changes in there and that would that would probably attribute for his bilateral pain and when asked well do you think it's quite related oh no that's just not possible it's too far away from the injury or do you have any proof that he had any intervening accident or any subsequent accident nothing there's nothing there  and the fact is that my client was taken off of work by dr pepper laski who finally noticed the cervical condition dr suchi all he did was notice the weakness in the arm he said i can't help you lemmy didn't suggest surgery in two thousand and seven and we all know that most cervical and all signs and most spine surgeries are semi a lot more like to there's mary where unless you've got a fracture that someone's going to say we need to operate right away they're going to try to conservative care and that's what happened here we have some confusing symptoms between a shoulder and a cervical spine injury but we have consistent complaints we've got some conservative treatment we've got failure to respond to that conservative treatment and then a surgical recommendation by now well but two doctors a neurosurgeon and an orthopedic surgeon the only two that provided the most detailed examinations and that saw all of the diagnostic tests and they provide a very clear picture of how this acute injury over time got worse and therefore we ask that you reverse the decision of the commission on all accounts but at minimum we ask even if you do decide to uphold the causation opinion which again it is our position that it's also gets ma weight of the evidence the issue with regards to medicals and t t d heard dr goldberg on i me and evidence deposition should be given through his i mediate of march sixteenth two thousand and nine and i also believe that i'm going to be issued per doctor or sticking it with regards to the fact that there is a light duty restriction with regard to the shoulder condition and no proof by the employer that anything other than full duty was ever offered to