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ROBERT J. GLADWIN, Judge h The Arkansas Workers’ Compensation Commission' (Commission) denied appellant Cheri Stoker’s claim for additional medical testing and treatment, finding that they were not reasonably necessary for the compensable medical injuries Stoker sustained on December 5, 2014. In making its decision, the Commission relied on Dr. Steven Cathey’s report of the independent medical examination (IME) he performed. Stoker contends on appeal that the IME should not have been admitted into evidence and that the Commission erred by relying on it. We affirm. I. Facts Stoker worked as a driver and .trainer for appellee Thomas Randal Fowler, Inc., a trucking company in Texarkana., Arkansas, when she sustained compensable injuries to her neck, back, and right knee on December 5, 2014. Her injuries were the result of her truck being hit from behind after she had unbuckled her seat belt in preparation for delivering a package. Stoker was treated over the, course of- ¡a year, received an IME, and was. seen by |2Pr. Pierce Nunley after the Commission granted her change-of-physician request. When Dr. Nunley recommended additional testing and treatment on December 17, 2015, appellee controverted Stoker’s claim. At the June 2, 2016 hearing before the administrative law judge (ALJ), Stoker’s counsel objected to the admission of the IME report prepared by Dr. Cathey. Counsel argued that Stoker had not been informed that Dr. Cathey was to perform an IME and that Stoker went to the appointment under the assumption that she would be medically treated. Counsel argued that Dr. Cathey’s report should be excluded because Stoker did not give proper or informed consent. Counsel further argued that Stoker was not provided through discovery the introductory letter mentioned in Dr. Cathey’s report. At the close of the hearing, the ALJ posed more questions concerning the IME, including whether appellee’s counsel had seen the introductory letter mentioned in Dr. Cath-ey’s report. Counsel stated that he had tried to obtain the letter but that his “adjusters had changed up,” and he had never received it. Stoker’s counsel also stated that had he been given notice, he would have objected to his client’s seeing Dr. Cathey. The ALJ took under advisement the issue of the report’s admissibility. The ALJ also noted for the record that Respondent’s exhibit 2 was a surveillance video of Stoker that he would view following the hearing, Stoker testified about the circumstances of the automobile accident that resulted in her compensable injuries on December 5, 2014. She said that she had not been having any neck problems before the accident; but since the accident, she could not turn her head I «“right all the ,way to turn to look back” when driving. She also said that she gets “really bad headaches” three to four times a week and that she had to “sleep kind of cock-eyed” at night. She said that since the wreck, she had muscle spasms down her arms and legs, in the front of her legs, and in her back and neck. She complained that she did not “have a grip” in her left hand. Stoker said that after she went to the emergency room following the wreck, she was sent to a company doctor for follow-up care — Healthcare Express (HCE). She was prescribed medication and given some restrictions' for work, but no light-duty work was available. She said that HCE prescribed physical therapy along with medication, and an MRI was ordered, after which HCE “wanted [her] to see a neurosurgeon,” She said, however, that she was sent to an orthopedist, Dr. Dwayne Daniels. Stoker said that Dr. Daniels ordered a nerve-conduction study and that he also talked about “some injections.” She testified that Dr. Daniels’s progress note was incorrect in stating that she had previously had an MRI of her neck and back, and she stated that the MRI was done only on her neck. She stated that Dr. Daniels recommended that she see a neurosurgeon for her neck and that he had recommended many times that she receive epidural steroid injections. She said that she had never received any injections in her neck and claimed that as she received therapy and used the TENS unit, her symptoms where somewhat relieved but were not totally resolved. In spite of the therapy and the TENS unit, she said that she still had continuing headaches, pain, and spasms and was unable to use her left arm and hand. She explained that when she tried to use her left arm or hand, she dropped anything over ten pounds and her hand shook and spasmed. | ¿Stoker testified that after the functional capacity evaluation (FCE), she followed up with Dr. Daniels, and he “thought [she] still needed to see a neurosurgeon and to continue with additional therapy.” She said that there was an appointment scheduled with Dr. Cathey, and she believed that she would receive from him the epidural steroid injections that Dr. Daniels had suggested. She received a letter from Dr. Cathey “on Friday to be there on Monday morning at 8:00.” Along with the letter was a form for her to fill out that asked for her height, weight, address, and the like. When she arrived at Dr. Cathey’s office, she was not told she was' there for any reason other than for medical treatment. She said that Dr. Cathey 'examined her for eight to ten minutes, that his hand “was shaking just as bad as mine was,” and that he touched her left hand and put his hand on the back of her neck for a second. She said that he then showed her the MRI of her neck and talked about it. He told her that he was not recommending any treatment. She said that she had understood that the FCE gave her a ten-pound weight limit and no lifting above her head — sedentary restrictions. She .testified that when she was discharged by Dr. Cathey, she was given no restrictions or limitations and was told that she. could return to full-duty work. She said that she did not agree with that. She also said that she signed papers on her way out of Dr., Cathey’s office, but she did not read them first. She said that she had not been aware at that time that Dr. Cathey had performed an IME. She said that she understood she was to return to Dr. Daniels after seeing Dr. Cathey. While she was driving to Dr. Daniels’s office, his nurse called and canceled her appointment. She said that even though her. .physical therapy had not been completed, Dr. Daniels had placed her . at maximum medical improvement (MMI). She said that she continued to | ¿receive physical therapy after Dr. Cathey’s appointment and that she completed that therapy. However, she claimed that when she tried to go back to work, she failed the company physical. ■ Stoker said that after she learned that Dr. Daniels had placed her at MMI, she obtained a change of physician and saw Dr. Nunley one time. She said that he examined her and that she was there about forty-five minutes. She said that he performed tests-and took measurements. She stated that he recomménded a selective nerve-root injection at C6-7 for palliative and diagnostic value. He also wanted an MRI of her lumbar spine, more physical therapy, and a trial of cervical and lumbar traction. She had not received any of the recommended treatment and has been seen only in the emergency room for medical care since seeing Dr. Nunley. On cross-examination, Stoker said that when the December 5, 2014 accident occurred, she had an open workers’-compensation claim pending on her left knee, and that claim was settled in September 2015. She said that she has full use of both knees. She also said that she has a third-party lawsuit against the man who was driving the vehicle that hit her truck but denied that her third-party claim would benefit if she did “not get better.” She said that she wanted to get better and get back to work. She admitted that Dr. Nunley had been mistaken in his report that she had a hip injury and that she had not had any CTs or EMGs. In an opinion filed July 19, 2016, the ALJ held that Dr. Cathey’s IME report was admissible. The ALJ relied on Bryant v. Staffmark, Inc., 76 Ark. App. 64, 61 S.W.3d 856 (2001), which held that the Commission is given a great deal of latitude in evidentiary ^matters and is not bound by technical or formal rules of procedure. The ALJ reasoned that both HCE and Dr. Daniels had requested that Stoker be evaluated by a neurosurgeon and that Dr. Cathey is a neurosurgeon. The ALJ found no evidence, authority, or rationale as to why Dr. Cathey’s letter discussing his evaluation and conclusions should not be admissible. The ALJ then found Dr. Cathey’s opinion that Stoker had reached MMI and was no longer in need of additional medical treatment to be credible. The ALJ accorded more weight to Dr. Cathey’s opinion than to Dr. Nunley’s opinion because Dr. Cathey’s opinion was consistent with Dr. Daniels’s opinion that Stoker had reached MMI. The ALJ also relied on the surveillance video of Stoker returning from grocery shopping on January 20, 2016, and carrying four sacks of groceries in her left hand, which was inconsistent with her testimony that she had lost the grip in her left hand. On January 27, 2017, the Commission affirmed and adopted the decision of the ALJ, and this appeal timely followed. II. Standard of Review Under Arkansas law, the Commission is permitted to adopt the ALJ’s opinion. SSI, Inc. v. Cates, 2009 Ark. App. 763, 350 S.W.3d 421. In so doing, the Commission makes the ALJ’s findings and conclusions the findings and conclusions of the Commission. Id. Therefore, for purposes of our review, we consider both the ALJ’s opinion and the Commission’s majority opinion. Id. When reviewing a decision of the Commission, we view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the findings of the Commission and affirm that decision if it is supported by substantial evidence. Parker v. Atl. Research Corp., 87 Ark. App. 145, 151, 189 S.W.3d 449, 452 (2004). Substantial evidence is that relevant evidence that a reasonable mind might accept as adequate to support a conclusion. Id., 189 S.W.3d at 453. The issue is not whether this court might have reached a different result from the Commission; the Commission’s decision should not be reversed unless fair-minded pei-sons could not 17have reached the same conclusions if presented with the same facts. Id., 189 S.W.3d at 453. When a claim is denied because a claimant failed to show entitlement to compensation by a preponderance of the evidence, the substantial-evidence standard of review requires that we affirm if a substantial basis for the denial of relief is displayed by the Commission’s opinion. Id., 189 S.W.3d at 453. The Commission determines credibility, weighs the evidence, and resolves conflicts in medical testimony and evidence. Godwin v. Garland Cty. Landfill, 2016 Ark. App. 498, at 4, 504 S.W.3d 660, 662. The Commission is not required to believe the testimony of any witness but may accept and translate into findings of fact only those portions of the testimony it deems worthy of belief. Sandeford v. United Parcel Serv., Inc., 2014 Ark. App. 228, at 2, 2014 WL 1396660. It is not the role of the appellate court to weigh the evidence and judge the credibility of the witnesses. Id. Johnson v. PAM Transport, Inc., 2017 Ark. App. 514, at 5-6, 529 S.W.3d 678, 682. III. Evidentiary Ruling Stoker’s first argument is related to the Commission’s evidentiary ruling, which we consider under the following standards: The Workers’ Compensation Commission has broad discretion with reference to admission of evidence, and its decision will not be reversed absent a showing of abuse of discretion. Brown v. Alabama Elec. Co., 60 Ark. App. 138, 959 S.W.2d 753 (1998). The Commission is given a great deal of latitude in evidentiary matters; specifically, Arkansas Code Annotated section 11-9-705(a) (Repl. 1997) states that the Commission “shall not be bound by technical or statutory rules of evidence or by technical or formal rules of procedure.” Additionally, the Commission is directed to “conduct the hearing in a manner as will best ascertain the rights of the parties.” Ark. Code Ann. § 11-9-705(a); Clark v. Peabody Testing Service, 265 Ark. 489, 579 S.W.2d 360 (1979). In our view, it is clear that the Commission should be more liberal with the admission of evidence, rather than more stringent. Coleman v. Pro Transp., Inc., 97 Ark. App. 338, 344-45, 249 S.W.3d 149, 154 (2007) (citing Bryant, 76 Ark. App. at 69, 61 S.W.3d at 859); see also Clement v. Johnson’s Warehouse Showroom, Inc., 2012 Ark. App. 17, 388 S.W.3d 469. IsStoker contends that the IME should not have been admitted into evidence and that the Commission erred in relying on the IME in denying her claim. She claims that the key issue is whether it is proper for the insurance company to schedule an IME but not tell the claimant or the claimant’s lawyer that it is an IME and not an appointment for follow-up treatment as recommended by the then existing treating physician. Stoker cites the statutory provision stating that an injured employee may be required to submit to a physical examination and treatment by another qualified doctor, designated or approved by the Commission. Ark. Code Ann. § ll-9-511(a) (Repl. 2012). She also points to Commission Rule 099.30, which defines an IME as an examination and evaluation conducted by a practitioner different from the practitioner providing care. See Ark. Admin. Code 099-00.1 — 099.30(1) (H)(1) — (3) (WL current through Sept. 2017). The Rule further provides what should be included in an IME and how it should be billed. Id. Stoker argues, therefore, that an IME is not designed to treat but to generate proof to support either the claimant or the respondent. Stoker also references standards published by the American Medical Association for an IME and argues that Dr. Cathey did not comply with those standards. Stoker relies on her own testimony regarding her belief that she was going to see Dr. Cathey for epidural steroid injections, the description she gave of the examination performed by Dr. Cathey, and the explanation she gave about the cancel-ation of her last appointment .with Dr. Daniels. She sets forth the ALJ’s questions to her counsel regarding whether he would have agreed to allow Stoker to see Dr. Cathey had she been given notice of the IM-E. She contends, 18In other words, but for the ‘trickery’ of the insurance1 company it is likely Dr. Cathey would have never had the opportunity to declare Ms. Stoker at. MMI based, essentially, on exactly the same medical information that Dr. Daniels had available when he referred her for injections — injections she never • received. Stoker complains that the letter from the adjuster arranging the appointment with Dr. Cathey is absent from the record and has never been disclosed to her. She argues that the ALJ should have applied a negative inference to appellee’s failure to produce the introductory letter sent to Dr. Cathey and should have refused to allow his report.to be admitted as evidence unless the letter was submitted. Appellee contends that the admission of Dr. Cathey’s report was proper and within the Commission?s authority as a finder of fact. -We agree. It was not an abuse of discretion to admit the. report, and Stoker offers no authority or convincing argument to the contrary. Because the Commission is not bound by technical or statutory rules of evidence or by technical or formal rules of procedure; the Commission is empowered to allow whatever evidence it sees fit into the record. Ark. Code Ann. ■§ 1Í-9-705(a)(1). Stoker’s conclusion — had she known that Dr. Cathey was going to perform an IME, she would have refused to participate — -is not a basis upon which this court can reverse the Commission. Appel-lee points out that the Commission could have given Dr. Cathey’s report little or no weight had it seen fit, The Commission examined the available medical evidence and testimony and found. Dr. Cathey’s report to be convincing because it more closely resembled the reports by Dr. Daniels. Accordingly, we affirm the decision to admit the IME. IV. Additional Medical Treatment Stoker argues that with the addition of Dr. Cathey’s report, the ALJ. had four differing medical opinions. She argues that Dr, Daniels thought Stoker needed further treatment |inuntil Dr. ■Cathey became involved. Dr. Nunley suggested injections, further diagnostic testing, physical therapy, and cervical and lumbar traction. The company doctor who gave Stoker a physical to determine her fitness for work did not pass her. Therefore, the only doctor who gave up on further treatment was Dr. Cathey, described by Stoker as a “hired gun.” Stoker argues that the Commissipn should be’ concerned about regulation of the IME process in Arkansas. She argues that there is too much reliance on an IME and that “Respondents across the state have their (favorite’ • physicians, as do Claimants, of course.” She contends that the Commission should have used her case to establish a precedent that no claimant can be referred for an IME unless (1) the claimant is told that the examination will be an IME and‘the purpose of an IME is explained to the claimant, and (2) the claimant is given:a reasonable time to object to the physician chosen by the respondent. She urges this court to adopt these guidelines. She argues that the Commission arbitrarily disregarded the medical evidence of her failing the medical exam for returning to work and Dr. Nunley’s detailed findings and report. Further, she claims that Dr. Cathey’s opinion should be ruled to be inadmissible and that, at the very least, it should be given the least weight of all the opinions. She relies on Commissioner Hood’s dissent, wherein he opined that Dr. Cathey’s opinion should be given little weight because it was designed to save the employer money and Dr. Nunley had given Stoker a more thorough examination. We hold that the Commission did not arbitrarily disregard evidence. The ALJ’s opinion stated, Inin the present case, I find credible the opinion of Dr, Cathey indicating that by July 27, 2015, Ms. Stoker had reached maximum medical improvement and did not need any additional medical treatment including but not limited to physical therapy and injections. I accord more weight to Dr. Cathey’s opinion on these matters than the weight I accord Dr. Nunley’s opinion regarding the need for additional testing and treatment. I conclude that Dr. Cathey’s opinion is consistent with Dr. Daniels’ opinion shortly thereafter that Ms. Stoker had reached maximum medical improvement. In reaching this conclusion, I am also relying significantly on surveillance video of Ms. Stoker returning from grocery shopping on the evening of January 20, 2016. Although Ms. Stoker testified at the hearing that she has lost the grip of her left hand, this examiner counted four sacks of groceries that Ms. Stoker picked up out of the trunk one at a time with her right hand. She immediately transferred each of the four sacks into her left hand, so that when she walked from the car to the-door at-5:03 p.m., she carried four bags of groceries in her left hand and only one bag of groceries in her right hand. I did not find this activity consistent with her hearing testimony that she has lost the.grip in her left hand. Dr. Nunley’s opinion was not disregarded, it was just 'not given as much weight- as Dr. Cathey’s opinion. The Commission has the duty to resolve conflicting medical evidence, including medical testimony. Johnson, supra. Further, the Commission’s reliance on the video surveillance of Stoker carrying grocery sacks in her left hand shows that the choice of Dr. Cathey’s opinion over that of Dr,' Nunley was also based on the -record as a whole and on a determination of Stoker’s credibility. Having determined that the Commission committed no error in admitting Dr. Cath-ey’s IME report, the report, coupled with the Commission’s détermination on Stoker’s credibility, constitutes substantial evidence to support the Commission’s decision to deny additional medical treatment and testing. Affirmed. Abramson and Whiteaker, JJ., agree. . Stoker failed to include.a copy of the.sur: veillance video in the addendum, in violation of Ark. Sup. Ct. R. 4-2(a)(8)(A)(i) (2016); Because the DVD is not essential to Stoker’s argument regarding admission of the IME, ■we do not require rebriefing.

RAYMOND R. ABRAMSON, Judge 11 Larry L. Harrison worked for Street & Performance, Inc. (Street & Performance), for eleven and a half years as a hemi technician. He fíled a claim with the Arkansas Workers’ Compensation Commission (hereinafter “the Commission”) asserting that his neck, right-arm, and right-shoulder injuries resulted from his employment with Street & Performance. Following a hearing before an administrative law judge (ALJ), the ALJ issued an opinion denying his claim on June 21, 2016 in its entirety. Harrison appealed to the Commission, and on its de novo review, the Commission issued a unanimous opinion dated January 11, 2017, affirming in part and reversing in part the decision of the ALJ. Specifically, the Commission found that Harrison proved that he had sustained a compensable gradual-onset neck injury but failed to prove that he had sustained a compensable gradual-onset right-arm or shoulder injury. Harrison filed a pro se notice of appeal on February 1, 2017, and Street | ¾& Performance filed a notice of cross-appeal on February 7, 2017. The record was lodged with this court on March 14, 2017. We affirm on direct appeal and on cross-appeal. As a hemi technician at Street & Performance, Harrison provided technical assistance to customers over the phone and worked in the shop installing and repairing car motors. Harrison worked about ten hours a day at Street & Performance, typically spending about three to five hours on the phone and three to seven hours working in the shop. Harrison’s shop work included the removal and installation of wheels and tires, radiators, disc brakes, transmissions, motors, batteries, and other car parts. Harrison testified that he never counted how many cars he worked on in a year because it would fluctuate but that he always had at least two cars he would work on at the same time. Harrison denied that he had been injured in a specific incident. As to potential rapid or repetitive work, Harrison testified regarding two different work activities: (1) closing the garage-bay door and (2) using a floor jack. Harrison stated that lifting the garage door was the most repetitive thing he did at work and indicated that he had to open and close the door as many as fifteen times during a ten-hour shift. Harrison noted that he did not have to use the floor jack every day and used it for only 20 to 30 minutes at a time. Harrison began to experience issues with his right arm, including tingling in his fingers and muscle atrophy, in October 2013. On May 27, 2014, Harrison went to Sparks Preferred Clinic complaining of right-arm tingling and loss of muscle mass in his right arm. An x-ray of Harrison’s cervical spine revealed narrowed disc spaces. An MRI performed a month later revealed multiple disc protrusions, chronic compression conformity, and degenerated discs throughout the cervical Rspine. Harrison was referred to neurosurgeon Dr. Shawn Moore. Dr. Moore’s note from Harrison’s first’ visit on July 25, 2014, states that Harrison reported a three-year history of neck pain and frequent heavy lifting. Dr. Moore recommended surgery, which was performed September 12, 2014, Before this surgery, Harrison was off work beginning on August 25, 2014, while recovering from hernia surgery. Harrison never returned to work at Street & Performance after August 2014. On July 81, 2015, Harrison went to Mercy Hospital in Fort Smith with complaints of “chronic right shoulder pain.” He reported during intake that he had a history of heavy labor for many years and that he used to lift car radiators for a living. An x-ray of Harrison’s right shoulder was taken and was normal. An MRI or physical therapy were discussed as treatment options at the appointment. On September 28, 2015, Harrison saw Dr. Bao Dang at Sparks Family Medicine South for shoulder pain and chronic neck pain. Dr. Dang ordered an orthopedic referral. On October 27, 2015, Harrison saw Dr, Trent Johnson at Mercy Clinic Orthopedic in Fort Smith. Dr. Johnson’s examination revealed a right-shoulder rotator-cuff sprain and a possible full- or partial-thickness tear of the rotator cuff. A follow-up MRI revealed a full-thickness tear in the intersection of the supraspinatus tendon, tendinopathy, degenerative changes, bursitis, and a mild cyst. Dr. Johnson performed a right-shoulder arthroscopy with arthroscopic rotator-cuff repair, an acromioclavicular joint resection, and a biceps tenotomy on Harrison’s right shoulder on November 11,2015. Harrison filed a claim with the Commission claiming his neck, right-arm, and right-shoulder injuries resulted from his empfyyment with Street & Performance. Following a prehearing conference, Harrison’s claim was set for a hearing on March 29, 2016, with the Rissues being whether he sustained a compensable gradual-onset injury to his neck, right arm, and right shoulder as a result of his' employment with Street & Performance and, if he did, whether he was entitled to medical benefits, temporary-total-disability benefits, and attorney’s fees. ■ Before the hearing, Harrison submitted for the record a July 2015 letter from Dr. Moore that noted, “I think it is probable Mr. Harrison experienced cervical degenerative disc disease with radiculopathy related to his significant work-related obligations.” Dr, Moore also wrote, “Although degenerative disc disease is often considered a chronic degenerative process, the significant work-related obligations that Mr. Harrison performed most likely contributed to this underlying condition and the development of his neck pain and radi-culopathy.” Dr. Moore was called to testify at the March 29, 2016 hearing before the ALJ. Dr. Moore explained that Harrison’s condition, degenerative disc disease, is typically a chronic degenerative process, but it could be exacerbated by certain work conditions or trauma. As to his letter, Dr. Moore specifically testified that the “purpose of the letter was just to indicate [that Harrison] has a chronic degenerative condition but it can be exacerbated with significant activities.” Dr. Moore noted that while he could say that Harrison’s reported work activities. were “a contributing factor” in the condition, he could not put a percentage on how much or how little Harrison’s reported activities contributed to the chronic ^degenerative condition because “that’s subjective.” Dr, Moore testified that the letter he dictated was correct. Following the hearing, the ALJ issued an opinion denying Harrison’s claim in its entirety. Harrison then appealed to the Commission. As noted above, the Commission affirmed in part and reversed in part the ALJ’s decision. The Commission found that Harrison proved he had sustained a compensable gradual-onset neck injury but failed to prove that he had' sustained a compensable gradual-onset right-arm or shoulder injury. It is from those proceedings that both parties appeal. In reviewing a decision from the Commission, our court reviews the evidence and all reasonable inferences deducible therefrom in the light most favorable to the Commission’s findings and affirms if the decision is' supported by substantial evidence. Nichols v. Micro Plastics, Inc., 2015 Ark. App. 134. Substantial evidence-exists only if reasonable minds could have reached the same conclusion without resort to speculation or conjecture. Id. The issue is not whether the appellate court might have reached a different result from that of the Commission but whether reasonable minds could reach the result found by the Commission. Texarkana Sch. Dist. v. Conner, 373 Ark. 372, 284 S.W.3d 57 (2008). It is the Commission’s duty, not ours, to make credibility determinations, to weigh the evidence, and to resolve conflicts in the medical testimony. Martin Charcoal, Inc. v. Britt, 102 Ark. App. 252, 284 S.W.3d 91 (2008). We will not reverse the Commission’s decision unless we are convinced that fair-minded persons with the same facts before them could not have reached the conclusions of the Commission. Cedar Chem. Co. v. Knight, 99 Ark. App. 162, 258 S.W.3d 394 (2007). 6Questions concerning the credibility of witnesses and the weight to be given to their testimony are within the exclusive province of the Commission, and when there are contradictions in the evidence, it is within the Commission’s province to reconcile conflicting evidence and to determine the true facts. Neal v. Sparks Reg’l Med. Ctr., 104 Ark. App. 97, 289 S.W.3d 163 (2008). The Commission is not required to believe the testimony of the claimant or any other witnesses but may accept and translate into findings of fact only those portions of the testimony that it deems worthy of belief. Id. The Commission is the ultimate arbiter of weight and credibility. Towler v. Tyson Poultry, Inc., 2012 Ark. App. 546, at 2, 423 S.W.3d 664, 666. On appeal, Harrison’s challenge to the Commission’s finding that he did not suffer a compensable injury to his right arm or right shoulder is not preserved for our review. In his brief, he contends that this court should find that his right-arm and shoulder injury, a rotator-cuff tear, was a compensable consequence of his neck injury. However, he did not present this argument to the Commission. Before the Commission, his sole contention regarding his right-arm and shoulder injury was that it was a compensable gradual-onset injury arising out of the course of his employment with Street & Performance. We have routinely held that we will not consider arguments presented for the first time on appeal. Townley v. Ga. Pac. Corp., 2012 Ark. App. 48, 388 S.W.3d 475. Because Harrison is raising this matter for the first time on appeal and failed to get a ruling from the Commission, we are prevented from reviewing it. See Cooper v. Hiland Dairy, 69 Ark. App. 200, 11 S.W.3d 5 (2000); Jordan v. Tyson Foods, Inc., 51 Ark. App. 100, 911 S.W.2d 593 (1995). Accordingly, |7we affirm the Commission’s opinion that Harrison’s right-arm and shoulder injury are not compensable. On cross-appeal, Street & Performance argues that the Commission’s decision that Harrison suffered a gradual-onset injury to his neck is not supported by substantial evidence in the record and therefore should be reversed. We disagree. This court must view the evidence and all reasonable inferences in the light most favorable to the Commission’s decision and must affirm that decision when it is supported by substantial evidence. Nichols, supra. Here, the Commission’s decision is supported by substantial evidence. On de novo review, the Commission found that Harrison had sustained a compensable gradual-onset neck injury arising out of the course of his employment with Street & Performance. On cross-appeal to this court, Street & Performance argues that the Commission’s decision was based primarily on a letter Dr. Shawn Moore had written on July 27, 2015, and that the Commission erred as a matter of law by considering and crediting Dr. Moore’s letter opinion specifically but not his hearing testimony. A claimant seeking benefits for a gradual-onset injury to the neck must prove by a preponderance of the evidence that (1) the injury arose out of and in the course of his employment; (2) the injury caused internal or external harm to the body that required medical services or resulted in disability or death; and (3) the injury was the major cause of the disability or need for medical treatment. Smith v. Commercial Metals Co., 2011 Ark. App. 218, at 9, 382 S.W.3d 764, 769; Ark. Code Ann. § 11—9—102(4) (A)(ii) (b) & (E)(ii) (Repl. 2012). “Major cause” is defined as more than 50 percent of the cause. Ark. Code Ann. § 11-9-102(14)(A). | «Street & Performance contends that the Commission arbitrarily disregarded the full scope and substance of Dr. Moore’s opinion as clarified through his hearing testimony by considering only his letter. We are not persuaded by Street & Performance’s argument on cross-appeal. In its January 11, 2017 opinion, the unanimous Commission wrote, It is within the Commission’s province to weigh all of the medical evidence and to determine what is most credible. Minnesota Mining & Mfg. v. Baker, 337 Ark. 94, 989 S.W.2d 151 (1991). In the present matter, the Full Commission finds that Dr. Moore’s opinion as stated in his July 27, 2015 correspondence is supported by the record and is entitled to significant evidentiary weight. Dr. Moore credibly opined that claimant’s cervical condition was causally related to the claimant’s work for the respondents. Based on the evidence in the present matter, the Full Commission finds that the claimant proved he sustained a com-pensable injury to his neck in accordance with Ark. Code Ann. § 11 — 9— 102(4)(A)(ii)(b) (Repl. 2012). The claimant proved that he sustained an injury causing physical harm to his body which arose out of and in the course of employment and was not caused by a specific incident. The claimant established a compensable injury by medical evidence supported by objective findings, namely the compression fracture and bulging shown on the June 25, 2014 MRI of the claimant’s cervical spine. The claimant proved that these objective medical findings were causally related to the com-pensable injury. The claimant also proved by a preponderance of the evidence that the compensable injury was the major cause of his disability and need for treatment. We will defer to the Commission on credibility determinations and to resolve any conflicts in the medical testimony. Martin Charcoal, Inc., supra. Here, the Commission relied on Dr. Moore’s July 27, 2015 letter, which clearly states, “the significant work-related obligations that Mr. Harrison performed most likely contributed to this underlying condition and the development of his neck pain and radiculo-pathy.” We hold this satisfies that Harrison’s injury was a major cause of the disability or need for medical treatment. IflWith our standard of review in mind, we hold that fair-minded persons could have reached the Commission’s conclusion. Therefore, we affirm on cross-appeal. Affirmed on direct appeal and on cross-appeal. Murphy and Brown, JJ., agree. , Harrison was represented by counsel during at least part of the proceedings below. He appeared pro se on appeal to the Commission as well as on appeal to this court,

RAYMOND R. ABRAMSON, Judge On August 25, 2016, a Hot Spring County jury convicted appellant Darrell Sanders of two counts of rape. He was sentenced to a total of 42 years’ imprisonment in the Arkansas Department of Correction (ADC), On appeal, he challenges the sufficiency of the evidence and argues the circuit court erred in granting the State’s motion to admit evidence under Arkansas Rule of Evidence 404(b). For the following reasons, we affirm, Sanders’s victim was fourteen-year-old S.J., who lived with him on weekends in 2014. Sanders appeals his convictions and alleges that the evidence is insufficient to support his second conviction for rape because there was no evidence introduced at trial that he was the guardian of the victim. He also alleges that his now adult daughters’ testimony that he had sexually abused them when they were approximately SJ.’s age was improperly admitted under Rule 404(b) of the Arkansas Rules of Evidence. Although Sanders argues the sufficiency of the evidence in his -second point on appeal, double-jeopardy considerations require this court to consider a challenge to the sufficiency of the evidence before the other issues on appeal. See Jones v. State, 349 Ark. 331, 78 S.W.3d 104 (2002). To preserve the sufficiency of the evidence for appellate review a defendant must move for directed verdict at the close of the State’s evidence and at the close of all the evidence. Ark. R. Crim. P. 33.1(a) (2016). The failure of a defendant to challenge the sufficiency of the evidence at the times and in the manner required in subsection (a) will constitute a waiver of any question pertaining to the sufficiency of the evidence to support. the verdict or judgment. Ark. R. Crim. P. 33.1(c). Sanders did not move for a directed verdict at the close of the State’s case, nor did he move for a directed verdict at the close of all evidence. No motion for directed verdict was ever made, which is in contravention of Rule 33.1 of the Arkansas Rules of Criminal Procedure. Thus, Sanders’s sufficiency challenge is now barred on appeal. Sanders also argues that the circuit court erred in granting the State’s motion to admit evidence under Rule 404(b) of the Arkansas Rules of Evidence. Before trial, the State filed a motion to admit evidence of prior uncharged incidents of deviate sexual activity or sexual intercourse by Sanders with his two daughters who are now adults. A hearing was held and the State presented the testimony of Sanders’s daughters, who made the allegations. Rulings on the admissibility of evidence are matters within a circuit court’s discretion, and those rulings are not disturbed on appeal absent a showing of an abuse of that discretion and prejudice. Grant v. State, 357 Ark. 91, 93, 161 S.W.3d 785, 786 (2004). “Abuse of discretion is a high threshold that does not simply require error in the trial court’s ^decision, but requires that the trial court act improvidently, thoughtlessly, or without due consideration.” Id. Evidence of a person’s bad acts generally is not admissible to show action in conformity therewith. Ark. R. Evid. 404(b) (2016). Nevertheless, evidence of prior bad acts is admissible if they are independently relevant, that is, relevant to show a material fact other than that the accused is a criminal or bad person. Spencer v. State, 348 Ark. 230, 236, 72 S.W.3d 461, 464 (2002). “Evidence of other crimes, wrongs, or acts ... may ... be admissible for other purposes, such as proof of motive, opportunity, intent, preparation, plan, ... or absence of mistake or accident.” Ark. R. Evid. 404(b). Our supreme court has recognized for over a century a “pedophile exception” under which evidence of an accused’s prior sexual conduct with children is admissible “not for the purpose of proving a substantive crime, but to show the relation and familiarity of the parties, their disposition, and antecedent conduct towards each another, and as corroborative of the testimony of the [victim].” Williams v. State, 103 Ark. 70, 78, 146 S.W. 471, 474 (1912). Such testimony is admissible “when it is helpful in showing a proclivity for a specific act with a person or class of persons with whom the defendant has an intimate relationship.” Parish v. State, 357 Ark. 260, 268, 163 S.W.3d 843, 847 (2004). It is also admissible when it helps to show the depraved sexual instinct of the accused. Id. For the pedophile exception to apply, there must be a sufficient degree of similarity between the evidence to be introduced and the charged sexual conduct. Allen v. State, 374 Ark. 309, 316, 287 S.W.3d 579, 584 (2008) (citing Hamm v. State, 365 Ark. 647, 652, 232 S.W.3d 463, 468 (2006)). In Sanders’s case, the victim, S.J., and Sanders’s two daughters, all were | ¿approximately the same age when Sanders raped them. S.J. was fourteen. One daughter was thirteen, and the other daughter remembers being eleven or twelve when the sexual abuse started. Moreover, S.J. and the daughters were all raped by Sanders in similar locations: a car, a church, and in Sanders’s home. All were vaginally raped. The pedophile exception to Rule 404(b) is fully applicable here; we hold that the circuit court did not abuse its discretion in admitting the evidence. Accordingly, we affirm Sanders’s convictions and sentences. Affirmed. Gladwin and Whiteaker, JJ., agree.

N. MARK KLAPPENBACH, Judge | ¶ Appellant Wayne Travis Ray petitioned the Saline County Circuit Court to terminate his obligation to register as a sex offender pursuant to Arkansas Code Annotated section 12-12-919. He also filed a motion seeking to have that statute declared unconstitutional. The circuit court denied both requests. On appeal, Ray argues that section 12-12-919 is unconstitutional as applied to him under the equal protection clause and is an unconstitutional ex post facto law. Arkansas Code Annotated section 12-12 — 919(b)(l)(A)(i) (Repl. 2016) provides that fifteen years after having been released from incarceration, a sex offender may apply for an order to terminate the obligation to register. The court shall grant an order terminating the obligation to register upon proof by a preponderance of the evidence that the applicant has not been adjudicated guilty of a sex offense for fifteen years and is not likely to pose a threat to the safety of others. Ark. Code Ann. § 12-12-919(b)(2). However, this process does not Uapply to sex offenders who are required to make lifetime registration under Arkansas Code Annotated section 12-12-919(a), including a sex offender who “[h]as pleaded guilty or nolo contendere to or been found guilty of a second or subsequent sex offense under a separate case number, not multiple counts on the same charge.” The lifetime-registration requirement of section 12-12-919 was added to the statute by Act 1743 of 2001. Before that amendment, the statute provided a method by which all sex offenders could seek termination of the obligation to register. Ray’s obligation to register as a sex offender stemmed from his 1999 Saline County Circuit Court conviction for one count of sexual abuse in the first degree. Ray pleaded guilty in that case and was sentenced to five years’ imprisonment and five years’ suspended imposition of sentence. In April 2016, Ray filed a petition to terminate his obligation to register. He alleged that he had been released from the Department of Correction on November 1, 2000, had not been found guilty of a sex offense during the fifteen years since his release, and was not likely to pose a threat to the safety of others. However, Ray’s petition also noted that days after his 1999 conviction in Saline County Circuit Court, he was convicted in the Pulaski County Circuit Court of the same offense against the same |svictim. The sentences in those cases were ordered to run concurrently. The State responded that Ray’s petition should be denied because he was likely to pose a threat to others and that he should be reassessed with the Sex Offender Community Notification Assessment Program. Subsequently, Ray filed a motion to find section 12-12-919 unconstitutional. He alleged that he had been charged and convicted in two separate cases due to his move from one county to another but that the victim was the same in both cases, and the crimes had been committed over the course of several years. He claimed that the requirement in section 12-12-919 of lifetime registration for offenders found guilty of a subsequent sex offense under a separate case number was unconstitutional as applied to him under the equal protection clauses of the United States and Arkansas Constitutions. He also alleged that the statute was an unconstitutional ex post facto law under the United States and Arkansas Constitutions. The State responded that Ray was not eligible under the statute to apply for an order terminating his obligation to register. The Attorney General intervened and filed a response to Ray’s constitutional challenges. Following a hearing, the circuit court entered an order denying Ray’s petition to terminate his obligation to register because he had pleaded guilty to sex offenses in two separate cases. The court found that section 12-12-919 was not an unconstitutional ex post facto law because it was regulatory, not punitive, in nature and that the statute did not violate Ray’s equal protection rights because it was supported by at least one rational basis. |4The general rule in cases involving a question of the constitutionality of a statute is that the statute is presumed constitutional, and the burden of proving otherwise is on the challenger of the statute. Kellar v. Fayetteville Police Dep’t, 339 Ark. 274, 5 S.W.3d 402 (1999). Because statutes are presumed to be framed in accordance with the Constitution, they should not be held invalid for repugnance thereto unless such conflict is clear and unmistakable. Id. Ray first argues that application of the provision of section 12-12-919 requiring lifetime registration in his case violates his rights to equal protection under the federal and state constitutions. Equal protection under the law is guaranteed by the Fourteenth Amendment to the United States Constitution and by article 2, sections 2, 3, and 18 of the Arkansas Constitution. In .deciding whether an equal-protection challenge is warranted, there must first be a determination that there is a state action which' differentiates among individuals. Arnold v. State, 2011 Ark. 395, 384 S.W.3d 488. Ray has established that section 12-12-919 differentiates among defendants who are convicted of sex offenses in more-than one case and those who are convicted in only á single case. Ray does not dispute that the rational-basis -test is the applicable constitutional standard of -review. Under the rational-basis test, we presume the statute to be constitutional and rationally related to achieving its objectives. Arnold,, supra. The party challenging the constitutionality of the statute must prove that the statute is not rationally related to achieving any legitimate governmental • objective under any reasonably conceivable fact situation. Id. | fiEquaI protection does not require that persons be dealt with identically; it only requires that classification rest on real and not feigned differences, that the distinctions have some relevance to the purpose for which the classification is made; and that their treatment be not so disparate as to be arbitrary. Akers v. State, 2015 Ark. App. 352, 464 S.W.3d 483. When addressing an equal-protection challenge to a statute, it is not our role to discover'the áctuál basis for the legislátion. Id. We merely consider whether there is any rational basis that demonstrates the possibility of a deliberate nexus with state objectives so that legislation is not the product of arbitrary and capricious government purposes. Id. If we determine that any rational basis exists, the statute will withstand constitutional challenge. Id. Ray argues that the requirement of lifetime registration for defendants convicted in more than one case is intended to protect the public from individuals who pose a greater danger while allowing offenders who pose a lesser threat an opportunity to be removed from the registry. Ray contends that he was convicted in multiple case numbers merely “due to geography,” and the fact that he had only one victim demonstrates that he poses a lesser threat, líe argues that it is unfair that offenders with multiple victims and multiple offenses and who pose a higher threat than him can still seek termination of their obligation to register if they were convicted under only one case number, We agree with the State, however, that a rational basis exists for treating sex offenders convicted • under more thán one case number differently than those convicted under a single case number. The legislative intent behind the sex-offender registry is to protect the public |fifrom sex offenders, whom the legislature has found to pose a high risk of reoffending after having been released from custody. Ark. Code Ann. -§ 12-12-902. Individuals convicted of a subsequent sex offense under a second case number have committed more than one sex crime, and the General Assembly could have concluded that these individuals are more likely, to reoffend. The underinclusiveness of a particular provision does not make the provision unconstitutional. Landers v. Stone, 2016 Ark. 272, 496 S.W.3d 370. Thus, Ray’s argument concerning sex. offenders convicted of offenses against multiple victims under one case number does not render the legislature’s chosen classification unconstitution al. We hold that the lifetime-registration requirement for sex offenders convicted in a subsequent case meets the very deferential rational-basis standard, see Brown v. State, 2015 Ark. 16, 454 S.W.3d 226, and that Ray has failed to demonstrate that section 12-12-919 violates his right to equal protection. Ray next argues that because his convictions occulted before the amend-, ment of section 12-12-919 by Act 1743 of 2001, the requirement of lifetime registration violates the ex post facto prohibitions of the .United States and Arkansas Constitutions. A law is prohibited as ex post facto when it punishes as a crime an act previously committed, which was innocent when done; makes more burdensome the punishment for a crime after its commission; or deprives one charged with crime of any defense available according to law at the time when the act was committed. Kellar v. Fayetteville Police Dep’t, 339 Ark. 274, 5 S.W.3d 402 (1999) (citing Beazell v. Ohio, 269 U.S. 167, 46 S.Ct. 68, 70 L.Ed. 216 (1925)). If the law is regulatory or 7civil in nature, it cannot be an ex post facto law. Id. In Kellar, the appellant challenged the constitutionality of the original version of the Sex Offender Registration Act, Act 789 of 1997, codified as Arkansas Code Annotated sections 12-12-901 to -920. To determine whether the Act violated ex post facto clauses, the supreme court first determined that the intent of the legislature was nonpunitive and then examined the effects of the Act to see whether they transformed a civil remedy into a criminal penalty. To make its determination, the supreme court looked to the factors set forth in Kennedy v. Mendoza-Martinez, 372 U.S. 144, 83 S.Ct. 554, 9 L.Ed.2d 644 (1963), and concluded that [g]iven the overall balance of the Kennedy factors, we are left with the conclusion that, while there may be some punitive characteristics inherent in the registration and notification statute, the Act is essentially regulatory and therefore non-punitive in nature. Because it is not a form of punishment, it therefore cannot be considered a violation of the ex post facto clauses of the United • States and Arkansas Constitutions. In Parkman v. Sex Offender Screening & Risk Assessment Comm., 2009 Ark. 205, 307 S.W.3d 6, the appellant argued in part that certain amendments to the Sex Offender Registration Act after Kellar had been decided were criminal in nature. The supreme court compared- the cúrrent version of the statutes with those at issue in Kellar and held that the amendments did not transform what was already found to be civil in nature to be criminal or punitive. Ray acknowledges Kellar but argues that the effect of the Act is punitive, noting without citation several restrictions that apply to sex offenders. He notes that before the amendment regarding lifetime registration, he had an opportunity to be removed from the ^registry, although removal was never guaranteed. Ray does not explain, however, how this amendment, or any other changes in the law since Kellar or Parkman, should ■ change the Kellar analysis. He has failed to distinguish those cases or explain why what was previously found to be civil in nature should now be deemed criminal. Thus, we find no merit in Ray’s ex post facto claims. Affirmed. Virden and Brown, JJ., agree. . Three other categories of sex offenders are required to submit to lifetime registration under the current version of the statute: offenders found to have committed an aggravated sex offense; offenders determined by the court to be or assessed as a Level 4 sexually dangerous person; and offenders convicted of rape by forcible compulsion pursuant to section 5-14-103(a)(l) or other substantially similar offense in another jurisdiction. Ark. Code Ann. § 12 — 12—919(a).

"ROBERT J. GLADWIN, Judge\nliThe Ouachita County Circuit Court granted permanent custody of the mino(...TRUNCATED)

"KENNETH S. HIXSON, Judge\n| j Appellants Dorletha Brinkley Lambert and Timothy Brinkley appeal from(...TRUNCATED)

"ROBIN F. WYNNE, Associate Justice\n| , Appellant Thomas C. Ortega was convicted of rape and sentenc(...TRUNCATED)

"COURTNEY HUDSON GOODSON, Associate Justice\n| Appellant, Willie Hutcherson, appeals 'the dismissal (...TRUNCATED)

"MIKE MURPHY, Judge\n| ¶ This medical-malpractice case stems from the death of John D. Peters, Jr. (...TRUNCATED)

"KAREN R. BAKER, Associate Justice\n| íAppellant Myron Newjean Anderson, Jr., filed a pro se motion(...TRUNCATED)