you believe in the evidence is sufficient to show that it a different opinion from a different conclusion was clearly parents so what i'd like to do is talk a little bit about the facts pretty accidental and than he did when he had a preexisting hernia he had a hernia surgery back in two thousand and one the accident occurred on july twenty second two thousand and ten three weeks prior to that he goes to his doctor his primary care physician dr pickett on july second two thousand and ten he complained he was there chiefly for some sinus infections but he also complains of a pain with no falls in the right side of his abdomen the doctor diagnosis him doing heavy manual labor he's putting in foundation walls he's left in fifty sixty pounds a day he's working and then on july twenty second two thousand and ten he's bending down to pick up a railroad tie like a football player a three point stance he goes pick this r off and he testifies that he feels like a blow out sensation in his stomach in his abdomen area so that happens on july twenty second july twenty sixth he goes again back to his primary care physician dr pick now this time the diagnosis has changed it went from a reducible ventral hernia to an incarcerated hernia also he then goes and sees politic hernia which is a hernia that and according to the operative report let me see if i can find it  twenty second two thousand and ten this man had a one resection in june of two thousand and nine he had diverticulitis and they did a colon surgery on him they didn't find any of that act holing up in his chest so he had a normal well not normal but he had diverticulitis and they resection this hole in a year earlier and it was not up in his chest now he has this accident and he's got ten inches of this hole and up inside his diaphragm so there's clearly a change in he said he felt like he lost his crap so we have a call in surgery a colon resection surgery here earlier that didn't have any of this colon and size of the diaphragm and now when he goes with these new complaints to the surgeon after the accident the hernia the one that was found two weeks earlier was aggravated by it was reduceable three weeks earlier and that it became incarcerated as a result of the accident there's two variance and there is a change of ok it's been aggravating better but it didn't cause the need for surgery i didn't respond to that number while i would disagree it did cause a need for surgery on july second three weeks prior to his work accident he goes the doctor says i got this pain on the right side the doctor says it's reduceable ventral hernia and as a as standard practice of a physician he says on july second go see a surgeon so the recommendation for surgery was made prior to the work accident but it was an elective surgery it became a mandatory and in need in an emergency surgery as a result of the work accident he went from having a reduced faria to an incarcerated hernia that needs to have surgery right away that that's what happened though here is we have a man pre work accident who had one hernia the venture a hernia that reduced after the work accident becomes incarcerated his need for surgery became immediate mandatory when it became rich  doctors so they can be mostly caused by birth but it can also be traumatically induced and that's what happened in this case when you have a surgery here before nothing's there and then you have a work accident ten inches of it is up in your diaphragm i think the work accident had already had the surgical referral he was planning on going so that's our position on that that's the that's why the patent but she didn't change what happened was time passed as far as a doctor l a i don't know if i'm pronouncing that right generally congenital there is no evidence and any of the medical records that it was anything but in general i think that the assertion that the prior surgeries or do you guys could have discovered this is unsupportive so that's not much time before the work accident i also think some of them all those who i believe that doctor  ten record confirming this prior diagnosis of a hernia and he says that it would have absolutely no impact on his opinion would have changed anything i don't understand how he can look at that and say it wouldn't even have impact because he's looking at back and then looking at pickett's records on twenty then twenty five looking at farms kind of trying to sex work it's back to being incarcerated hernia how can not not have an effect on pain so you're saying in some way words even though you can point some of it into the re credibility he was found to be not credible by the arbitrator and the commission it's clear that he specifically left information out to all of the treatment providers he has although i am a physician wasn't even aware of the prior and he depended on it but in short i recently received a file i mean i knew on the file i didn't write the briefs so i was a fresh set of eyes when i read this file last couple weeks and when i was reading it and evaluating everything and taking notes huge file i looked through it and i came to the same conclusion that the arbitrator did the commission and the supreme court there was no medical consultation proven by this  truth was he should have been when he went to barnes care because in this past medical history he did talk about having a prior hernia well the issue was is he did not believe you have ever experienced this kind of pain before it wasn't a hernia that he's ever had like this he did talk about his prior abdomen problems but he he didn't talk about having a prior and when he was asked about that at trial he didn't consider this thing on the right side of his abdomen to be a problem or cause or related to the work accident so i think i think it's said of this being a credibility problem was more of a misunderstanding number one number two when they talk when she says there is no and then he gets opened up a month later they find that it is incarcerated and then they find the valedictory as well which was also incarcerated so there was a change in power gee that occurred after the work accident and the last thing she talked about is dr myers said that he he didn't see he didn't view the july second no and that you know that didn't change his opinion one way or the other will both doctors so the say that you know dr meyer had it has a credibility issue or he didn't view all the evidence they both had that no they both missed it both of them thought causation lied with the plaintiff in this case the injured so for purposes of today i will assume that whatever he did preexist and dr meyer when he talked about it he said if that is the same hernia has he said i don't know if it is but if it is it one from