payment for medical expenses already incurred yes you're on ari now we've got a look at the commission's decision in the commission's decision says the respond determine amongst other issues there was no t t v and perspective medical care is perspective but they also remanded back to the arbitrator did they not to assess the medical expenses that in therefore the respondent would be legally required under the act to pay those medical expenses but it's not a final determination by the commission and although they use the word it's remand pursuant to thomas it's not a of expenses but he doesn't take into consideration matters that were that were incurred before the arbitration that were the subject of the a i understand your honor i don't waive any jurisdiction arguments at all our understanding today is that it was a final determination as to that issue so you know i have i used would issue the issue that an accident related accident occurred and therefore the respondent would be required to pay medical expenses to the respondent specifically to authorize the surgery the prospective surgery that this commission decision also required the respondent authorize the word credibility used extensively and that's because the fact of this case make one question paramount did the commission have sufficient evidence to evaluate the credibility of the petitioner differently than arbitrator sotto and they say that today because all relevant issues we will discuss are going to lead back to this fundamental question predicated on the unique factual circumstances presented to this court in regard to the testimony supporting causation as well as the documentary evidence and testimony supporting accident having occurred now your honour's briefly in the underlying worker's compensation action after hearing all testimony and carefully reviewing all evidence arbitrator so to correctly determine that the petitioner did sustain is burned prove an accident that petitioner did  honor arbitrator sotto found that petitioners testimony regarding symptomology was not credible he found to be an credibility of the petitioner similarly tainted the opinion of his treating physician dr to a pan doctor to a pain explicitly type those opinions the petitioner self reported change and symptomology the commission there of to reverse the arbitration decision finding that the petitioner did sustain his burn to prove that an accident occurred further that the respondent is responsible for future related medical expenses including the surgery discussed in the underlying arbitration to so far a nd it reversed the arbitrarily arbitrators credibility findings and in regard to petitioners testimony and that of dr to a plan the circuit court there after affirmed the co findings and reversals and it is here we find our errors the commission's threadbare explanation for the credibility reversals flies in the face of the evidence in the record in this case such an error cannot stand if this course agrees with arbitrator appellants that the testimony of the petitioner presents in congress account a previous post accident symptomology when contrasted with the medical record then there is not sufficient evidence in this case to smart the commission's reversal of the credibility findings or its findings on accident and causation here honors turning to the crucial importance of the credibility here in this factual situation the determination of whether at work related accident occurred here revolves almost exclusively around petitioners pre accident post accident symptomology attributable to his right wrist were also on that question for the following reasons he was the sole witness the accident he suffered from severe preexisting conditions that were symptomatic near in time to the date of injury petitioner previously under went three surgeries to his right wrist two of which were treating preexisting conditions and that right wrist and finally dr tulip in explicitly tied his causation opinions to petitioners reported previous post accident evident as the sole witness of the alleged accident in the individual best suited to describe his symptomology the determination of his credibility carries heavy weight as to whether an accident did in fact occur as alleged and further that his current condition of ill being can be attributed to that accident be a change innocent mahler's however its importance is even greater in this case here where the commission relies upon a medical causation opinion that explicitly tied itself to the credibility of the petitioner in regard to his self consistent with a crucial piece of evidence in the rich record your honour's the only pre accident medical record in evidence from which we can object to really gauge pre x in symptomology it is not consistent with the testimony and this one credibility in turn out that appellate does not contend that the commission is bolland by the credibility finding of the arbitrator however when the commission's credibility findings are adverse to those of the arbitrator the court is faced with the obligation of determining whether the commission's credibility findings which are contrary to those of the arbitrator are against the manifest weight of the evidence and further a resolution of that question can only rest upon the reasons given by the commission for the variance your honour's the commission's revers s in this case as the credibility findings were clearly made against the manifest weight of the evidence as they pertain to the petitioner petitioners the commission predicated this reversal on a summary statement which is that just in his testimony was internally consistent and consistent with the medical record drawn as this is clearly not the case in the record his testimony is inconsistent with the only medical record in evidence from which we can verify pre x instant amaldi which we have discussed further when he was he was asked if he had pain in the year before the accident and he denied despite the fact that we know he was reporting continued discomfort in his function in a very importantly iran as we know by that record that he was actually modifying his tool use at work because of his pain predicated on that record and yet he's apparently not sent to magic on that date or was normal purrs testimony finally on and there is simply not enough of there is not sufficient evidence in the record to rehabilitate petitioner's testimony on this issue as a commissioner seems to have found it is a pounds contention that this in and of itself that credibility reversal that finding without sufficient evidence to do so is reversible error in this case but compounding that issue is the young credibility yes your honor the commission is allowed to do that however opponent's position is that there must be sufficient evidence in the record to support a credibility reversal such as that and in this case there is none as such that credibility findings reversal was made against the manifest weight of the evidence know that report is a self reported statement made by the petitioner it's not signed by a medical professional and i'd also like to briefly touch on the ts c c stare which was discussed by the commission in justifying the reversal but there is no medical testimony in this case showing that a tear was not objectively present as the commission states that seems to be just a theory that makes little sense the appellant given the medical evidence before us and finally they point to a of the course was employed others on it finally honors turning to the test one of the causation testimony as to the current condition of ill being that also is completely tainted by the credibility of petitioner and that's because as i have discussed at length because it's so important dr toole pa twice in his deposition explicitly notes that he has explicitly timing his causation opinions and why the rheumatoid arthritis cannot account for all the conditions present because of what the petitioner was reporting to him and regard to solve reported method and if your honour's agree with the balance in the arbitrator that the petitioner is uncredible based on his testimony then clearly we have an issue as well with dr toole pan's causation testimony which specifically is predicated on  sure your honour's dr toole pain especially concedes that his causation opinion is hinged on the credibility of an credible petitioner and contrast dr perls that kills opinions do not rely on such an uncredible basis dr kills opinions jurisdiction you have to admit i didn't give it that much thought in the sudan and the last page by the commission it stated that the case be remanded to the average traitor for further proceedings consistent with this decision but only after playing that the case had to go if it was going to be addressed and if the case was going to be appealed and the decision as to accident cause the connection it was going to go to the court circuit court and particular case we decided that because of the commission uses the magic words of remanded pursuant to thomas and not until certain things are done that  case and the one issue that's problematic is the medical expenses because medical expenses were sought by this petition or before the arbitrat arbitrator denied all benefits it went back up to the commission and the commission had some interesting things to say about this the commission turned around of course reversed the arbitrator and found that it was out of it in the course of there was no t t d to be awarded before the arbitrator arbitrator for an award of medical expenses the commission never calculated the medical expenses and if it's been returned to the arbitrator for administrative determination it's not a final order and that's what supreme catering says in we have thanks what else service dr weil says the same thing in both of those cases it hoffman the only thing i would say all i'm going to argue about the ad is that just as a matter of judicial resource use the issue is this guy needed a surgery and that's the real issue here and the court ruled that he should get it essential or the commission rather ruled that he should get it prospectively and but as i said i didn't i read that one paragraph your honor and i never address the issue of jurisdiction again and let me if i could can i just address briefly this credibility call her or individual employees petitioner alone is testifying contrary to what counsel just said there is a report and it's gas and nurses handwriting and there gene krupa that says virtually identical as to what the petitioner testified to the commission found his testimony internally consistent which makes total sense he gave a detailed explanation of what happened the whole thing boiled down to a prior visit with the actor to his counsel had mentioned that's completely distorted in the by the appellant in this case and quite frankly it's sort of amazing considering they trusted the same employees when they were pulling their plan out of franklin park and taking all their jobs down to tennessee they send the petitioner burnell down there to reinstall his own install these machines but then the record of this man testimony where he says i'm normal i'm doing fine that is not inconsistent with with the actor to a pants record and even if it was the medical evidence complete code totally  immediately after the accident he goes to to to a pan a few days later he now has restricted motion he now has swelling he now has persistent pain none of those symptoms were present before he didn't measure the grip strength no issue of credibility and i quoted one thing in the brief for the average trader said one of his real bases for saying that are now had no credibility was that he didn't quote report immediate pain  any change in conditions and what does that mean he did report immediate pain it's right nurses reporting that's right and doctor to pan's report or records rather and to append records support the dramatic change as well as the  that and then the no and the law is obviously and our site here the the caterpillar tractor case dealt with rheumatoid arthritis which by the way was never diagnosed with her now before but apparently has by his own history but also by the objective finding by the all that actors and including the eye and so you know the evidence is just overwhelming and cause the connection this thing is case been going on you know for years just so this now or how terminated employee as they move the jobs down to tennessee is trying to get a surge you know look what else can i say that the commission is jab to resolve conflicting opinions as we all know and they did it here the feel case that counsel say in his brief supports affirming the average traitors of war affirming the commission excuse me because all the commission if they have a reasonable explanation and an analysis and some evidence to support their decision that's it that's within the province of the commission even at this court so i will maybe that wasn't exactly the o'connor thank you your honor i do have some brief replace here and like to start with again reiterating that appellant fully understands and agrees that it is within the province of the commission to judge credibility however we believe an accurate and fair reading of feel shows that when they make credibility reversals and they give reasons for it then it's a manifest weight of the evidence and alice's was that finding is there evidence to support that finding here as i think that's reasonable if we think about it would it be acceptable for the commission to rate on a decision that we reversed to credibly findings because we wanted to or we felt that way of course that there has to be some kind of evidence or basis here and i think that's a completely a totally appropriate avenue of judicial review just moving back on to the credibility i would say that there i would say that there's evidence an accident didn't occur but there's evidence that explains petitioners symptomology that does not involve a work related accident and any uncredible to incredible testimony testif to the same specifically your honor your honors we had we know he suffered from severe preexisting conditions and we also know that he was then diagnosed with non work related rheumatoid  is why credibility is so key to this case because we do have alternative explanations and therefore we need to determine positions credibility to determine what has the best evidence to support here and as  earlier that's component in this case when you then have a credibility reversal that has no supporting evidence so it's kind of issues within issues here which i hope i've helped elaborate in my briefs than this or are you meant the final note i would address  regard the work note to the dr poorly heard of the day of the accident and might also just like to state that appellant absolutely agrees that a record was created on that day he absolutely did see the altria workers but we would push back on the n that it's for the purposes of workers compensation an investigation it's not a medical record on with that your honour's i appreciate you all for your time thank you so much and