would agree upon as it pertains to this case specifically the manifest weight question deals with whether or not this condition of building that is found in the elbow in two thousand and ten is causing we connected to the petitioner's work accident that occurred on october third two thousand and eight now in order to most distinctly argue why the commission's decision was not against the manifest would be evidence i would like to dissect judge the perilous order in the that he had complaints in two thousand and ten but not prior now when we further dissect judge locus of parents or he says that the arbitrator i'm sorry that the commission misplaced their reliance on the april twenty third two thousand and nine record following the e m t and says that they only took part of it in context and said that it was contrary to the full statement when you read the april twenty third two thousand and nine e without further work up whether or not it was the work accident and the treatment that followed it or whether it was the petitioners insulin diet insulin dependent diabetes that existed for eighteen years prior to even that record so they say without further work up in the very next sentence is my favorite part where they say so it won't be tested the left now the commission in their decision expressly said immediately after reciting that  twenty third two thousand and nine record sentence that without for the work of the commission immediately set so they tested the left now you go back to the full statement of that record in the conclusory statement in that recordset is that it was helpful in determining heller says in his and his records that he suspects that the primary problem is arthritis occurring in the wrist and not actually the carpal tunnel problem he goes on further in that record to actually say that he suspects that the diabetic neuropathy was causing slight hand numbness so that right there between the two treating doctors are the only people that draw any ne fernandes introduced this opinion where he says that the petitioner is complaining of numbness and tingling and then he says i suspect it's related to all of this but he doesn't qualify all of what he doesn't say it's related to the diabetes he doesn't say it's related to the october two thousand and eight accident he doesn't say it's related to any treatment in between and is so vague it is so nonspecific and that is where the commission was proper in saying that there was a their purposes is to actually when you have conflicting medical every evidence right which is what we have we have dr fernandez in december of two thousand and ten say related to all of this without specifying it from the left in my opinion or any big causal connection commission is going to do is they're going to weigh them in and you know as well as i do with as well as house and case law that the purpose of the commission is also to take competing medical evidence inflicting mike of the medical evidence and decide which is the one to be given more weight and that is exactly what he did so we can take back and connect it to the manifestly question why can't the commission have did what the arbitrator said why couldn't they have time that they weighed all of the evidence they win the entire record the record they did not have a single mention of an awful complaint until two thousand and ten now when you look at that further and you look in december of two thousand and ten at the records that you know where he doctors went in the fuse that opinion is very telling  slip what's interesting is the records from the emergency room talk about spiraling as well as transverse fracture i'm not implying that back in roy's can you can help practice i'm suggesting that based upon the different positions he undergoes to search the procedures and then he's released to return to work with significant restrictions but he has continuing complaints i submit to you counsel said that there was no mention of the complaining at the wrist look at the get a lot of cold records of april and may have own name he's good therapy to his shoulder is doing flexion extension exercises on his upper extremity in the records of doctor  garbage he was handling do picking up like the warders i submit to you that the commission when confronted with the decision of this arbitrary or a will reason documented consistent decision with appropriate finding though they took part of the boat out when you land from ten feet then pets the whole arm and we're talking about a neurological problem we're talking about a constant nagin limiting pain what's the remedy for not related because he didn't complain about it for two years is that what we base causal connection on is the law going to be when ever you tell that emergency room shortly after this occurrence this it we're  of at the initial intervention by a medical provider manifest weight those of us who practice in this arena you gentlemen who have to  manifest we has become a cudgel and here's what i mean and i believe in recent years as i me has done a very good effort to try and parse out the definitions in commission changing a prime a fee should case they say i'll be fine calling more credible because it's more detail but is it correct isn't the body of all of this evidence supposed to be considered as his colon says he didn't complain well given all the triana trauma that went on in this wrist i'd be surprised that the guy could distinguish between this and this i think the judge got it right i know it's a huge  and going forward long before dr fernie indices intervention talks about the upper extremity the upper extremity the f c e talks about the upper extremity it doesn't say the hand or the wrist hundred think where i want to start with this but even if we accept the proposition that there was something wrong and that april twenty third two thousand and nine m g as it that one abnormality you have to take that whole phone book and dissect it and look at it under a microscope and we have the hospital records to two different hospital records we have the letter goes records which spare me so i'm not even well even if he's given the classic symptoms where's the opinion that connects it you know this is shifting the burden onto the respondent to prove that it didn't exist yet it is hard and prove to show that it dead you know by a credible medical opinion and he did not be pointed out just now to deal with that distribution that didn't happen until two thousand and and even then when you go between september first two thousand and in december of two thousand and ten that period where now the cubical tunnel after being identified when you get to that point he's even saying make it in that three month time he's experiencing improvement in the symptomology so i mean this just goes to show that they're the owner of the did not exist until two thousand and ten and even when you take it not cute at all if the distribution matched up at that time and was cause for concern you would have seen a lot more treatment and a lot of tension given to the owner distribution given to the elbow and what you did steve manage as a matter of fact as when they providers that if there is a causal connection with the commission pointed out is that nobody gave him that the existence of the specific what the petitioner sad in december of two thousand and ten i am experiencing pain