they please the court this case doesn't involve the constitution or large hole for asians or millions of dollars but it is very important to a woman by the name of jeannie lawrence in arkansas thi can no longer continue working due to the combined effects of pain in her neck her shoulder and particularly her right of her extremity now she has sought frequent treatment she's undergone occupational the both of those jobs require the ability to engage in frequent handling so she is unable to perform frequent handling of the chase finding us to that effect is not supported by substantial evidence then the commissioner is objective evidence clinical findings and even her limited activities and testimony all support that the objective evidence is off there was an m r i that was conducted in march of two thousand and thousand and sixteen found highly positive to nelson in both wrists he also noted markedly positive sperling test which is a test for cervical pain radiating into your arm and bilateral carpal tunnel syndrome so her pain could become a both from problems with her neck and also the carpal tunnel syndrome now dr when and who began treating this florence in january of in early two thousand and seventeen he saw her in march and april he's an orthopedist he was treating her specifically for her hand and arm pain and on both occasions in march in april two thousand and seventeen he noted that this warrants had pain with all range of motion and stress tests and so on and he noted that she was still having pain drive does all the driving she may accompany him to him to the grocery store but he does all of the putting of the the food in the baskets and things like this and she also testified that her children do most of the chores a the disability or the limitation yes that civically limitations are the postural limitations are formulated as to reaching and d engage in frequent hand of not frequent means up to two thirds of the work day five days a week so yes there is a distinction between reaching handling and fingering and in this particular case the o j signing was alluded to handling and that's that's what we're arguing that ass and so and so then the medical evidence that we're really focusing on is the elbow the carpal tunnel elbow wrist yes the bottom part of the are although her other conditions the condition with her neck the condition with her shoulder also can cause pain radiating down into that area the ridiculous what they call the ridiculous pain and with her ridiculous pain problem it would it would correct the pain that she was having you know with her shoulder and biceps that it would not correct any sort of ridiculous pain and so so her pain can come from  i think the medical evidence suggests their pain comes from two sources one of both of the are based on shoulder and neck problems and then number two  from her elbow in her wrist dealing with her carpal tunnel and also symptoms in that regard so our question here is is what is the evidence much less  miss lawrence has emphasized her complaints of pain but her examinations show that she had five out of five strength in the upper extremities i know motor or neurological adapters bit and war movement of all extremit they l j also consider that mrs lawrence is shoulder improved with surgery after surgery she reported that she was doing well for the guard to the right shoulder and experiencing reduced levels of pain i'm now mrs lawrence has argued that much of the evidence a l j consider pertaining to the right shoulder did not specifically address the right hand and arm and therefore her ability to handle however it's important to keep in mind that she originally alleged  lawrence's activities show that she could frequently handle with the right upper extremity in april th seen she told the agency that she could clean dry shop make meals whopper dark and care for her children now the assuming she receives help is inconsistent with her claim to the agency that she is completely unable to use for right our miss lawrence have also relied heavily on her march twenty seven scene testimony that she no longer performed or normal upper extremity examinations her own remarkable diagnostic findings as well as her improvement with the surgery and her daily activities support the able chase finding that she could perform up to frequent handling with the right upper the supreme court has recently articulated is not a hyperbole and again i point out that ultimately even if this court finds error with regard to a frequent handling limitation ultimately the a l j did find that had conservative treatment not really anything wrong with her hand well doctor who noted twice in april of two thousand a phone march two thousand and seventeen that she was having pain as a clinical five pain in all ranges of motion and stress test so this is this is something a little more serious than the commissioner let's on the normal nerve conduction study in april of two thousand and sixteen that this is not going to improve your ridiculous pain it will it will deal with the arthroscopically and ten adisa would not address the breaker and in february two thousand and seventeen dr specifically noted that her she was having she was doing well in her shoulder but she was still having pain in her right elbow so just because she had improvement in the shoulder doesn't mean the pain in her