and the presumption according to the franciscan sisters case is a strong because it's a presided it's a statutory presumption and if there were requires strong evidence to overcome really that car or vascular disease is not well understood such that all we can do is identify risk factors and says there are other risk factors besides to one's best i know  and as we all know for me it is here every doctor in this case agrees that and hypertension hypertension is a presumed condition under the statute the statute presumption that since well but it's an ordinary presumption and so i was just simply contrary evidence that it was necessary so i can you just i think i understand your position that it's a strong presumption but i find that question assumes an ordinary option i don't think it's contrary evidence in this particular factual setting we're there are a number of risk factors no kno causes that can be penned pointing and our earth is only to show that his employer was a cause and your presumption is that one of the risk factors is a pursue condition that seems to be something intertwined with the issue of whether it was a cause why didn't why did the two of them have to be decided together he'd deal with whether or not the evidence was sufficient to rebut the presumption in bend it into the issue as to whether the evidence still shows that the firefighting duties was a causal factor but that may be necessarily the primary mean figure why does it have to be considered together or you seem to have to be considered together i'm not i'm saying that with respect t or if the data expert says does the expert have to testify i don't believe this firefighting duties had anything to do with the cause of the heart attack or could the experts say i believe that the cause the heart attack was being overweight and smoke it the first one has to be the first one yes because no expert test tomorrow testified there is a limit to or latter types of risk factors that were considered by this doctor and coming to his conclusion but your argument is an argument against the credibility of the opinion that was given the who makes the determination as to whether the  ought evidence submitted by the respondent insufficient to overcome the presumption who makes that determination from the arbitrator initially and  says it makes it but the princes who sisters talk about it in the context of a trial judge making a determination as to whether a person should overcome such that you would give a percentage of instructions to the jury but in this particular case the commission not only made their decision but said why they made the decision and they said respond to successfully rebutted the presumption by providing strong evidence through its expert opinions along now if you want to argue that the commission on it should found it to be an incredible statement you can make the argument but we know who judges credibility and it's not up so the problem the idea of his in by as i said arguing that the nature of that evidence did not exclude occupational factors which i think it had to meet the presumption which is there never talked to my client he doesn't know anything about firefighting he never existed in my mind that after weaver is the director of the occupational medicine residency program at johns hopkins number of risk factors for the development of coronary artery disease that were identified as being specific to firefighters dad is a way process i understand but was flawed because he was lacking the essential necessary foundation elements for the get in whereas the other doctor your expert had those considerations as that is where the just ridiculous particularly given the  legislative history could we went over this case three of this particular bill someone wanted to make it a conclusive presumption and the legislature reject it and we've created a rebuttable presumption so in a rebuttable presumption it's nothing contrary evidence must rise to the level of clear and convincing now if you want to make the argument that based upon this presumption the contrary evidence must be something war in the mere preponderance that's a valid argument fortunately the commission found that the evidence that was submitted was strong they didn't really say it was a proponent they said it was strong well and clearly was it that's part known cody osis so just taking your argument here what would be necessary on the part of the employer to rebut that presumption of would be an expert's opinion that the more along the lines of what justice faulkner is describing as a simply that there is contrary evidence as to the cause of it in that case of death in your case  the lap of clear understanding of causation opens up a number of possibilities for causation that the doctors like to use the words risk factors and i'm only suggesting that when there are court the way this would read would be in our case a condition of a firefighter which results directly from vascular disease suggest a reasonable possibility it was causally connected to his from studying this case in cardiovascular diseases i think it's the nature and the type of the evidence that has to be induced to meet the presumption that is lacking here the with all due respect required to rip others of the deed or face which came up from the illinois supreme court says evidence which is contrary to the presumption must be put forth by the in this case the respondent in order to successfully  presumption for instance consistory said wait a minute dietrich we didn't tell you of the strength of the evidence necessary in order to be contrary such could overcome the presumption in franciscan sister in the facts situation they were dealing with they said the evidence had to be clear and convincing your opponent to suggest that the evidence to overcome this presumption cash would be strong evidence i i'm not sure th actually term that we applied the evidence it's either you know the clear and convincing it to be under the pondering to reasonable doubt but in any rate he suggested something more than just some evidence it h relationship between what they were exposed to would work any on of all of these memories literally listed in the statute so this isn't a simple employer employee relationship this is the relationship of firefighters to employee was a cause of their condition and therefore evidence of a contrary would have to be that the employment was not a cause so do you agree or disagree with that  cardiovascular disease so then you agree leave to the opposite way of saying it is then you agree that the presumption is they had his employment was the cause of his condition that's niece has to rise or fall on the question of whether intelligent opinion that on it was not caused by his occupation as a firefighter is sufficient to overcome the presumption and then put the claim back to his bird video always had any way of establishing that it was so the question is i as delineated by the supreme court indeed he gives a lot of reasons but his opinion can be boiled down to a single sentence as such i do not believe the current event was caused or pursued potato by his work as a secure talking about is not evidence and poses the question of the overcoming of the presumption it's the other evidence that the commission wanes after the presumption has been overcome to determine whether there's a causal place on the golf course it doesn't make any difference the harder it is when we can because of the employment so they've protected but the question becomes is the weather the heart attack or the events  related to that employment so the real only only question here is whether there is evidence in this case is number one to rebut the presumption that was created in the argument obvious of those factors is hypertension and hypertension is presumed to be a condition he in this case and so if that condition now and they brought  apart from the cardiovascular disease not words it was a contributor but that's exactly what indirectly causing one of these conditions means in my opinion in the statute in the results that harper tension is directly caused or maybe even directly caused the cardiovascular disease which led to the heart attack and that resume and there's no evidence against it now yes there is the l me included hypertension as a presumed condition and give the answer presumed condition related to his employment it has to be overcome again then we get into the the city he does this all the time and i won't go into the testimony of how much money makes curious whatever but i think it's just sickening case where he came to a conclusion without any specifics