got before you in completely different avenues need to take you back to arbitrator cronan he had a hearing there were eight fact witnesses five doctor depositions he rendered arbitrators opinion bursted out the penalties the respondent takes it to circuit court on the causal connection and we also went to the circuit court on the penalties so you've got two separate issues before the circuit court one taken up by the respondent one by titian or the circuit boards basically reverses the commission and causal connection  the causal connection this was very very fact specific there were eight factual witnesses call about how the accident happened if the accident happened how it happened said she said that it hit her in the lower back we showed that it couldn't hit her back it had to be the upper back and therefore doctors your opinions on causal connection are no good well notice this is a factual issue the causal connection is an opinion and the opinion is all based on what facts are presented to the opinion witness to the medical doctors medical doctor can basis opinion on a lot of things if there are facts that are not known to a medical doctor that's room for cross examination dr did you know or would it change your opinion if  witnesses and in his opinion which was affirmed by the commission they found that there was an accident that there was no what is that there was a causal connection all of these after listening to all the witnesses that were testified now the causal connection needs to be based on medical testimony we have five medical doctor depositions in this case four of them were treaters and one of them was the response expert all of them around that the november two thousand and ten accident was the cause of the injury and reversed that now the circuit court of the causal connection issue has to review would manifest weight of evidence and she basically said the circuit court judge that there is no causal connection i'm going to reverse the commission however in her opinion on page four she says the commission's findings regarding causation hinged upon a small fraction of the evidence in the right card and relied on large part credibility but guess what that's enough ok in her own words in her opinion that's manifest weight of evidence in the ability of her relationship to the commission of the sort this is correct by using a small amount of evidence and not all of it demonstrably reliable the commission ignored a significant portion of the record in making his determination that's what the commission to us they make these factual determinations it's not up to the circuit court judge evidence it's the circuit court's standard reviews manifest weight of evidence and in her own words i'm sure she wasn't giving this to us as a an issue to appeal but in our own words it does see of that  she agrees that at least it meets the manifest with evidence that she might not agree with it if she might not agree with what the tear said she may not agree with what the doctors it said but it certainly beats that standard and so we're know the argument in your reply brief what's missing in the record is any medical testimony that would indicate that this injury could not have happened even assuming that it was hard that it was all such a height that it would have hit your client in the upper back and so it was that question ever asked by any one of a doctor then assuming th examination respondent said well what if it hit her in the back and he said that doesn't make a difference to my opinions once again a factual dispute can be the basis of cross examination and testing that medical opinion but it doesn't mean that the pinion is completely invalid so respondent asked the doctors at different times well are you aware that it hit her in the upper back and that's assuming that they proved that it hit her upper back but  dr would that change or union well no it really wouldn't because of the fact she had eight and accepted injury that happened in december of zero nine that she was continuing to treat with she continued to have epidural injections right up until the november two thousand and ten data loss which we're arguing about today and the fact that she had a preexisting herniated disk from the first accepted data loss makes h from the second date of loss tells me that something else changed from the first data loss to the second data loss and meet the respondents i mean i believe that the second date of loss is c connected to her current state of health now once again they're talking about a factual issue here about where it hit her on the back and that's that's that's that's perfect fodder for cross exam nation but it doesn't mean all the doctors in units go out to work and the commission you know weighed the factual testimony reviewed the medical testimony and the basis for the medical opinions and they found causal connection so that the circuit court basically really weighed all that well i disagree with the factual conclusions that the commission made with regards to where it hit her on the back and the credibility of g and if i accept the respondents factual assertions then i think that circuit courts between the circuit court saying that the medical opinions are valid well that doesn't mean they're not valid you can attack the basis for those opinions but it maximum medical improvement no more treatment authorized no more t t v so the first day to last according to the respondent is done the summer nineteenth oh wait till august twenty fourth that i am nice as all the treatment up to august twenty fourth two thousand and nine it is it is medically necessary and related to the first date of loss we have never been able to get those medical bills paid even though there i am we said that it was related  we come up to the second date of loss which is three months later nov fifth of two thousand times she has the second date of loss she continues to treat the second date of loss they send her back to the need october and that i am need outer says the second day to last is the cause for the need for surgery that second date of loss or something different here m r i is different i believe the second data loss is the need for the attorney that they called as a witness there was a difference of about nineteen thousand yes there were so there was they their attorney testified that the bills that we had submitted we submitted one thousand thousand more and the reason was is because some of the bills we submitted were either paid by workers comp war paid by blue cross blue shield of health when were they paid  t in the meantime way interesting these records their contention is they paid all of the outstanding bills that you saw them on november the down in that they were paid by the completion of  submitted and this is as a twelve nine two thousand and ten the nineteen thousand was paid but the remainder remained open and unpaid and the problem that we have with that with the penalties is this is that i think it's because i'm recording in my words words only nineteen thousand one hundred thirty four remained outstanding career i care about the commission the commission turned around and said we're not giving you the medical bills because number one you didn't submit them timely and then when you did sublimate paid it so now the question is is that true enough that's that the commission didn't occur if if i am given this reading in the failed to pay the remainder of the ninety seven thousand dollars worth of bills until august thousand and eleven it was now after the december tenth here's what they say that you never sent in any bills after the trims middle of this ninety seven thousand dollars worth of bills that they pay in january of  firms representing the respondent carl budig our firm picked up the case i forget the exact date but it was sometime after the first me the medical bills were never transmitted to us and we made that clear to opposing counsel and correspondence that is part of the record and we were just on the day we sent a letter  january twenty eighth oh no it november twenty fourth two thousand nine as him for medical bills and records we sent there was a letter opposing counsel sent us a big stack of medical bills but they were commingled it was for the first accident and for the second x of that and a large part of the medical bills were already paid yes my task was to investigate one of these medical bills were paid because opposing counsel was not sending to us updated or separated medical records to send them a letter in november eight hundred twenty  testimony is that only nineteen pounds of bills totally ninety seven thousand dollars were actually to use the earlier period no that is not accurate there was here there was a least a nineteen thousand dollars discrepancy between the amount that opposing counsel sent us which i believe was one hundred to something thousand dollars he said it was due and owing but we found that we guesstimated that ninety seven thousand was was perhaps too annoying i was unable to contact all of the medical providers and get up to date records from all of them because they actually there were a significant portion of them who said that opposing counsel needed to request the records on behalf of his client and that we couldn't get that information we requested this several times of opposing counsel he did not purchase the medical bills the first time that we got medical bills that were differentiated between ac accident two was the day before the proofs were closed and it should be noted i did not bring proof of payment but these medical bills have been satisfied they were satisfied for the first accident  following receipt of these bil s regarding a causal connection if i may jump to that opposing counsel is trying to have it both ways so to speak and in so doing he presents an inherently conflicting argument he says that there was an aggravation to her pre existing condition which is on the spirit but then when we get to the portion where we say ok what aggravated that creek system condition he relies on doctor you're poor he says nonsensically it doesn't matter because she had a preexisting condition in our opinion it skirts the issue i only way that respondent can actually reconcile that is that inductor of your poor's role as her treater it's really doesn't matter his job is to treat the petitioner and not to assess how the petition r got her or you know try to reconstruct the accident well regardless of the role isn't there evidence in the record in the form of dr your words testimony that the location of the hit on her back was and the reason that we're here today and the reason that the circuit court ruled the way it did was that that doesn't make any sense and it just it it's inherently  doesn't make sense about it for one thing let's just go there for a minute what those might sounds what doesn't make sense is that you can't have something that causes a condition of bill being but then say that something is irrelevant there has to be some form something to aggravate her condition when you consider what happened to the petitioner it was clear on august of two thousand and nine she was that am i her m r i which  the commission really ignores shows a very minimal bulging test now i'll fast forward to twenty twelve where there's a very significant this projection and she actually does need to have treatment for this clearly something happened and responded doesn't dispute that something happened but you can't say that something happened but then ignore what that something was and in this elated the claimant tested by this she was struck mechanism of injury he said it's irrelevant even if she was struck in the shoulder it still could have aggravated her preexisting condition in other words it's not impossible that she was struck in the shoulder as you say in the still aggravated her preexisting condition and that's if the condition isn't it would be not the accident where she was struck is a cause in accelerating or aggravating her preexisting condition different condition so fragile that being you know it in the shoulder with this garbage cart were to aggravate her lower back and i mean you know what activity of daily living would not you know make it big injury in a very complicated portion of the body so you know it's not as clear cut i think as you would want it to be here and you do have evidence of the record be a doctor of your pores injury like that and the petitioner doesn't give any proof any any proof to a reasonable degree of medical certainty that this was a cause then you don't have any opinions to rely on there or there is no case there is no causation and and what the circuit court recognize is that when you look at the record when you look at all of the evidence present any credible evidence instead the responded piece by piece person by person took apart all of the testimony and showed that there was no no reasonable degree of medical certain it was all based on a guess even dr you horace was based on a guess and respond i would further argue that dr you poor who was asked only about a causation at his deposition violated the forty eight hour rule in giving causation opinion that was not disclosed in any of his reports accepted this first date of loss was accepted the bills as of the date of the hearing march tenth of two thousand and eleven over two years after the state of loss even we have the letter from their respondents attorneys saying we will pay them they're still not paid women we will pay them if you serve them right and that has shown that that letter sent from prior counsel was may fourth of two was it november essential or maybe two hours we also transmitted a letter on august sixth of two thousand and ten at c one seven two three on nov eighteenth two thousand and ten the new attorney said give us the records and bills for you now this is this is three months after our nineteen b is already started ok our nineteen he starts in august of two thousand and ten and in november of two again december ninth of two thousand and ten and the last transmittal was march tenth of two thousand and eleven now the reason i wanted to touch on the arbitrator's union is because he found b of his opinion which bills were reasonably transmitted which they should have paid and it's in there it shows what the fall bill was what the what the the amount paid and by whom and what amount was