hero taxes she paid throughout her working career i'll keep track of my own time but i do intend to try to reserve two minutes for rebuttal ok well we'll try to help thank you simplified and it can be simplified based on the opinions of the two treating doctors under the legal standard that states treating physician opinions are entitled vocational expert testimony that a person with those limitations would not be able to work we have a treating psychiatrist laura sherman and the occasional expert did not have to give  testimony beast upon her to imitate since because the l g interrupted and said if i were to accept that i would concede that that person could not work so once opinions of those treating doctors and he put he put them together and you said these are the same reasons for both the doctors really said dr sherman is in treatment records show things like she was cooperative she was oriented oriented just means you know where you are what day it is and who you are have logical process thing terms someone with scrambled thinking and those kinds of folks or people who have schizophrenia they have to lucian's they have loosened nations and i believe the ok we mentioned those as well but what did the l g say were this severe impairments in this case two major depressive disorder in generalized anxiety disorder so the question arises how do you take findings that deal with a thought disorder and use those findings to discredit the severity of the person who suffers from symptoms related to entirely different diagnoses major depressive disorder and anxiety disorder and the answer to that question is you don't because there's no connection between that lol list  that the o j provided we use the same list several times throughout his decision in major depressive disorder in generalized anxiety disorder now the commissioner does something thing about the commissioner's brief the commissioners brief says this court cannot substitute its judgment for that of began o j but the commissioner can't have it bo way either this court takes it upon itself to infers some sort of reasonable behind the a list of symptoms or this court cannot substitute its judgment for the l j but it can't  and so the commissioner is asking this court to perform the very task that the commissioner says this court is not allowed to perform mr column ask you suppose we agree with you in this court said no useful purpose would be served by remission for further proceedings and that's the case here because the only evidence the use juxtaposed with the treating doctor being the fact that the l g listed activities but just like my answer to judgment risk question the o j did not provide a connection between the evidence cited in the daily activities security and you saw i would like to start out by disagreeing with my opponent about the relevance of the normal mental status findings that the l t a relied upon the claimant at the hearing testified that part of why she couldn't work was because she has these anxiety attacks that cause that make she says i can't think real good then as the l g a outlines in the decision on starting on page twenty one claimant says that her impairment interfere with her ability to understand her ability to remember her ability to concentrate these are all cognitive sort of leaning factors that the l j properly relying on when you have a claim and who's that her anxiety attacks and depressive symptoms which we all agree that she has interfere with her ability to think she said that on multiple occasions so it's not inappropriate for the l g to relied on those normal findings that exist pretty ample throughout the record if you have the so so that goes to the the two treating sources who issued very extreme limitations they both found that the claim it was moderately limited in her ability to understand simple three tasks but then they found marked and extreme findings in every other category so when you have someone with a doctor saying that that's how limited the claim is and yet their own examination findings show all of these normal things that's the kind of concrete flipping evidence that the l t was was entitled to rely on and he did so appropriately in this case so  in the uk both doctors really made findings that were very very similar and if you look at both of their treatment records dr froehlich in particular almost never did any mental status examination findings and if you look at what's discussed during those training sessions it's about the claimant's problems with her her family life her her she's get going through a divorce she has sons that are in trouble with the law but they're not those are medical conditions that you know to be disabled under the social security act you have to be medically disabled so we agree that this claimant has these two sick severe mental conditions anxiety and depression but she stopped working because she did she stole something and that's all over the record she admits that to several doctors that that's why she stopped work so that's not a medical reason and yet she also says throughout the record over and over again that she's always been a nervous person a high strung person a panicky person so she was able to work for many many years with those same symptoms nothing changed except her family life  intense and you know we can sympathize with her very much but that's not a medical condition that's preventing her from working and you can see that when you look at all of the other actual examination findings she's she does well on the mental status examination findings she often she often is tearful when she's at these treatment sessions but even with that sort of anxiety she's hurt her mental status findings are very very largely normal throughout the record and that's with dr froehlich dr sherman when she started treating with southwest behavioral later on and then there are three different psychiatric consultation examinations and dr when's is the very last one in the record that's enough of a way two thousand and sixteen and dr when didn't assess any real mental limitations and then i would also ask you to look at some of her other treatment records she's not alleging anything but the mentals here but she does have a lot of primary care treatment at buckeye those which she's treating there for her gerd and her gastrointestinal symptoms and you don't see any of this elevated anxiety described in any of those treatment records and the mental status findings there because the doctors did more comprehensive evaluations are largely normal there as well but those doctors are essentially looking at physical things let me ask you this it appears to me that much of what you're relying on is in the records and sort of diagnostic records of her to treating doctors to contradict the treating doctor's conclusions that's a little tricky because the treating doctor concludes x but you're saying the treating doctor's own records contradict the conclusions that they reach and because this is a question of degree rather an on off switch i have trouble seeing how we can use the doctor's own reports to impeach the doctor's conclusions can you help me with that you're out of we you have several cases that say that i'm sure there's some in our brief but i cannot think of one off the top of my head right now but but there are several cases from this circuit that say an l j may use the inconsistency between a doctor's own records and they are but their records don't support that and one of the one of the mores in which a treating source as opinion would be entitled to greater weight is if it's supported the forms that the doctors filled out have no support on them whatsoever and in fact one of them actually says i think that that symptoms went far in the in the past when she was actually still working but but then you look at the other doctors who examined her the you have the three consultation examiners dr stafford dr mansfield blair and dr when and they all perform these examination findings and they don't they're also inconsistent with what's in the treatment records from doctors sherman and so i'm not sure that's answering your question though i just simple answer is that an elder is allowed to look at those treatment records independently in fact he has to look at the record as a whole and say what's in these records does not support these extreme findings and if you really look at it i mean they are saying she's extremely or markedly limited every category and yet that is just that that degree as you're saying of limitation doesn't come through in the treatment records that answer your question and so the l j properly relied on the inconsistency between the doctor's own findings and their extreme limitations and then he also properly relied on the two of the consultation examiners mansfield blair and and when and the the two state agency doctors doctor and dr fair and dr stafford was the st c e o and he did issue assess a limitation and he said that the client would be significantly limited in her ability to complete a work day but then dr saul who is the state agency doctor who looked at her case at the initial stage and on page sixty eight he goes into detail about why that's not supported by either her work history her activities of daily living or the fact that there aren't other market limitations elsewhere in that doctor's own assessment so the l j give the most weight to dr mansfield blair and heard limitations are consistent with the r c which is for simple tasks simple instructions and tasks no like consistent interaction with the public and then no dealing with any kind of customer complaint so if you if you look at what claimants allegations are those limitations satisfy them and claim it is able to do many family activities of daily living that would that are are inconsistent with her assertion that she's so extremely limited by panic and anxiety and depression that she can't leave her house on a regular basis means she's she's going to yard sales which is something that you're going to encounter strangers she is limiting her abilities but the r f c is limited to and the two jobs housekeeper and janitor are jobs that you can perform in relative isolation so that so that's also accounting for the particular symptoms that this woman has with some of her her back to her activities she is doing things outside of the house she goes to court with her son on multiple occasions she's done things that she says her stress level makes her thinking sort of go awry and yet she applied for her state retirement benefits she did her own taxes she is doing things she's learned how to do facebook that are inconsistent with these very extreme limitations that her doctors assess based on what she has has complained of so we believe that the l j provided the the adequate reasoning that a court can fin the path between his conclusions and the evidence and we ask you to uphold the eldest decision thank you very much mr caldwell you have s she may have some difficulty is dependent upon that are variable not your means field said nothing that supports the l j decision as written is simply a misrepresentation of what the agency doctor had to say i believe the case with his hers trying to remember is in the g h a and i am screening device that clinicians use to detect haagen that have impairments and so once again we have no connection between evidence relied upon and the conclusion thank you thank you