you to reverse the finding of the commission in this matter fundamentally what we're asking is that this commission approved perspective medical benefits for my clients indentation in her right forehead right in front of the temporal area  argues is that a doctor garbage who was a neurologist had said there was nothing else that needed to be done for her and his specialty is neurology it's not plastic surgery he's not a skin doctor of any kind so dr guard had said yes  there is something there i observe the death and but it's not going to be a political problem we're not going to be a problem but again the reason for the referral to a doctor guard from dr ricco was because she was having headaches at that time and there's no evidence argument is that look dr lomax from solders from dermatology operates in an entirely different field of medicine and the analogy that i made is let's say you have somebody that suffers some kind of orthopedic injury and a burn injury at the same time just because you send somebody to an orthopedic doctor and the doctor says look there's nothing else i can do for this person's physical orthopedic injuries that doesn't mean there's not still something that can't be done to fix the skin graft problem it's an entirely different issue as did the two cases that are cited by his the main cases supreme court cases are superior mining and corn products and we were lamb corn products but as i was reading the briefs again today on the right up to the  cases really have to do with permanency and the finding of disfigurement and how that relates to each other if we take a step back even further from that though this with this was in one thousand nine hundred eighty a hearing for prospective medical specifically now it could be as they argue that if she were to get this perspective medical it could take out a picture of her ability to even qualify for any disfigurement because of the procedure works it would flatten out the dents in her head and it wouldn't be there so really that the two cases that both of us rely on are not necessarily even on point specifically to this question about perspective medical interestingly in my mind a case that council cites in his brain the university of illinois case just for a general principle of law is the purpose of a day when we think about it is to cure the effects of any injury and that's to cure the effect of an injury my client ms di since this accident has been walking around with a dent in her head and it's described as two centimeters by one centimeter by dr lomax and he specifically he is able to identify a proceed or that the doctor could do to correct the deformity and he specifically calls it a deformity so when we get into well when you look at the disfigurement cases that are cited the supreme court in severe mining said look we're looking at permanency on to save your men the purpose of the act is not to reward every trifling mark is the language that they use but in that specific case they were looking at somebody where where they had their eye open and you couldn't see anything with the naked eye for you to actually observe whatever disfigurement was being alleged you actually had to lift the i would see a little mark and they said that's a trifling mark about that was compared to the the scar across the products which was a three quarter inch scar below the hair line on the forehead and in that case at the commission the the commission had said that qualifies as a dis i he didn't and i think perhaps that is a fault of myself as counselor for not making sure that he did describe it specifically i asked him to take a look at it and he basically has his response was so what you're saying is this procedure w case i do think if we take the rest of the evidence that we have on that issue taking the other trader outside of it you have a two centimeter by one centimeter mark we know that that's there that's an indentation we know that it's serious enough that there is a cosmetic procedure that can be done to fix it if it was that trifling if it was that non serious with there even be a recommendation for a twelve hundred dollars seizure to take fat out of the hip or the leg and injected into that had and in terms of it being observable again it's not even on the opportunity to say anything we have a description in the record that it is in front of the temple hairline you know we know what our temple is it's in front of the temporal hairline that description is in the record would that we don't know from anything in the record where she has to brush her hair back but we do because it's in front of the temporal hairline so it's on her face in this this this is a woman this summer an injury at work that's undisputed she commission there is a photograph because it was so trifling a photograph wouldn't even show the view again as a matter of how these cases would perhaps be handled in the future i think a photograph or a more specific identification from the arbitrator would be useful to everybody clearly but as i point out it was not the arbitrator that made a specific finding this was not an observable disfigure the arbitrator acknowledged to the doctor for the claimant the doctor for the employer in the arbitrator said that indentation everyone who looked at it said there was a dent in her head correct absolutely no doctor that she went to ever said we have to pull back her hair we can't see it we don't know what it is and then dr lomax specifically did the two centimeter by one centimeter you know actually measured it council faults the doctor for not making a depth measurement and then postulates that we don't know from the record but that the arbitrator had a feel around on her head to feel whether there was at that end but again you know that's perhaps reading a little bit too much into the record i would sit that perhaps the simplest explanation tends to be the correct one that the arbitrator looks at it and says as  if there were something that's correct and again the arbitrator was not the one of them to say that there was no mark it was the commission that did not have the opportunity to you but the arbitrator had made the decision based on the two doctors so every single physician that saw her in the record knows the end in taishan and again it's in front of the temporal hairline nobody says that it's it's not observable so if you're strictly looking at the two cases that have been sided on the issue of disfigurement corn products and superior case and you can you look at somebody that did not have this dent before the accident she has an accident that's not disputed she has a dent in her head that she is now expected to walk around with the rest of her life in effect which is what a j is supposed to be there for in effect from an injury that is specific doctor has said this can cure the defect and perhaps that cures her ability to get any disfigurement or war but as they say that's her choice why shouldn't she a least have the right to perspective medical to go in and get a simple injection to flat out the area so that she doesn't have to walk around as a few in our society with a dent in her head for the rest of her life that she didn't ask for that she didn't have before this injury so we looked at this case nazi thought it was a penalty's case and it's odd that the commission actually worded the medical bill the soderstrom dermatology frankly that's inconsistent in and of itself there saying yes it makes sense for you to be able to go to the soderstrom and figure out whether or not there's something that can be done but if somebody tells you that something can be done never mind you can't do it that's inconsistent with the commission's decision anyway so we think we thought this was a penalty such waste and that they haven't approved anything to dr world was really a phantom argument anyway because the specific reforms were in the record and that now there's an argument about the clinic if you go to a clinic that shouldn't mean you can go to every doctor even though as i point out the law and that is that very fact this court has held that if you go to a clinic that is your choice of position not a specific doctor within a clinic frankly that there's not penalties in this case for failure to appear for failure to pay for this bill for solders from should is against the manifestly the evidence not only should this court award the prospective medical we honestly believe there should be a finding of penalties for failure to approve this reasonable necessary treatment recommended by the the cosmetic surgeon so on that basis we do ask that this court overturn the commission on this issue and remain back for the prospective medaled medical to question is is it significant enough well if you require to walk around with a dent in her head for the rest of her life the question is is it is it significant because it isn't since well first of all the industrial commission does the workers compensation see anything i bit differently i'd theoretically if we want to talk about a dent per say yes some circumstances i agree with everything the court just said but now the circumstances i'm not going to and it's going to depend on the facts of the case now the court rather the good question what in this it's about the size of a tennis bar in the military it we don't have any i we pointed out in a brief that it's important to know how deep this is and i think i think this was a very important thing if you look at the snuff box on your hand if you move your hand here how does this court you know when i said when i when i look at this i ask myself if they're coming before you and saying this is against the manifest way the evidence normally your responses will show me hot and what are they saying well we have a doctor says  the commission talked about what they considered to disfigurement and whether this raises to the level they cited in other cases where that did it was a commission case and they cited a case where there was a physical  imperfection that cause tightness it was a scar caused tightness when the person mood and they found there was a physical aspect of it and they said that that was a compensable compensable distributor and they said this case does not rise to that leve disfigurement i think that's crucial it's their burden to come in and present the record i feel like i'm being asked to prove a negative here there's nothing in this record to show that this is a disfigurement as we would like not be court we have to have some evidence to that's very different then i want you to take a look at call doctor and see if there's a time soon as i give you some leeway but i'm not let you go this far if these days it's not observable you show me where there's evidence up some evidence to do what the commission i think was following what the arbitrator found and there's not a serious condition here why didn't the arbitrator make a comment and find this is a disfigurement if we look at the arbitrarily denying penalties address the fact that they didn't think it but there was anything else that needed to be done for this injury and i think what we're looking at this this is a case where this was presented at this was this was presented as a concussion a trauma injury to the head and then we've got this and that that's a side show really to the whole production and i think that there's there's more than of evidence to support what they did i think this is a classic manifest way case it's not as clean as we'd like certainly but ask yourself if they're asking me to affront based on what well show's been opposite result is clearly apparent and i don't see it i just don't see it on this record because it's not here because there's no basis for the commission's users no in mining says that in the handling of the only supreme court decision it says that the act does not provide compensation for every mark or scar and not there nor every disagreement that says it right there and that's what we really don't know here today i don't think that we can make an assumption we're going to have to make as a court the court's going to have to make an inference that this condition this indentation was readily apparent to the doctor he don't do they don't give them any trouble but they're just figuring but there's a difference between a wrong gash and scar that's left it may not have any physical limitations imposed on it but it qualifies as a serious disfigurement under the act and it would be compensable and that's very different than an indication that may or may not have to be strained to see we don't know that in this case they didn't present that case why not lose for failure proof that too i bottle i'd it was obvious all the doctor saw it they didn't say they had to strain to see it the arbitrator didn't say he had to strain to see it i think based on this argument we seem to be moving beyond the point of this question of whether really it was observable because everybody noticed it without saying they had to strain to see it the question wasn't legally is that a disfigurement look at what dr lomax said he specifically said that the injection would cure the disfigurement so we want to look for someplace to find them or disfigure to to make this injury and again it's not it's not trifling if you have a specific doctor that says i have a cosmetic procedure that can fix the problem and they've done this as the answer is over the question he finds it's when he does it does the record reflect the cost of this perspective treatment it is in the record i don't recall it off and the number that's always bounced around my head was like twelve hundred dollars and i did at the time i got that shorten it from indentation but it is it's a dent and we all know what that means nobody call it anything else but a dent and so on that basis we do as that this court overturned the commission and frankly not just on the issue of the perspective medical but also on the