keys against corporate examining state agency doctors because after those doctors reviewed the file more than three hundred pages of additional medical records were submitted into the record and those medical records include some very significant findings concerning mr keyes medical conditions including a significant cervical spine surgery that the state agency doctors were unaware of yes and i know you're criticizing the reliance upon those doctors were there other medical opinions the l j should have relied upon there were there was no opinions concerning mr kids functional abilities by treating doctors that's why i find a such a difficult significant evidence that those doctors did not consider mr keys testified to significant limits and significant pains which caused trouble sleeping couldn't focus didn't mention the claimants rheumatoid arthritis are unaware of or didn't mention the diagnosis of carpal tunnel syndrome not mention the diagnosis of the nemean unaware the fact that mr keyes had to undergo a third surgery either cervical spine so the question for the l j was that all that evidence supported mr keyes testimony as to what his limitations wore their preponderance of the evidence in front of the able j support mr keyes testimony and relying i reports without the assistance of a medical mysteries was represented by counsel for the l j correct that's correct and the medical records that you're talking about came in that roughly a year between the something to be nothing right i mean or at least something to be something if you've got medical opinion saying this fellow is not disabled you are merrily i would think you need some medical opinions to the contr well that is contrary to what the court held in in stage your honor and in my opinion because again you've got medical evidence that was submitted three hundred pages of it that was primarily supportive responsibility to to do that and while their opinions may have been reasonable at the time that they issued their decisions but their opinions based on the evidence in the record at the time failed they could not reasonably find that those doctors opinions were supported given the significant amount of evidence including the fact that the state agency doctors didn't even mention the number of diagnoses that mr suffered i mean there's evidence in the file rheumatoid arthritis that he and i believe it was december of two thousand and ten you know all the sudden started having symptoms of rheumatoid arthritis said that the shoulder problem only occurred or occasionally i think only a few times pretty time of the year but mr keyes actually testified that it happened two or three times a month so that ability to use his hands chief finding by doctor on the musi was that the doctor actually tested the claim it took strength and it turned out that he had twenty five lb grip strength in his dominant right hand which is less than twenty five percent of normal grip strength for an adult mr keyes age the l j doesn't recognize that fine detail that mentions it but she seems to mentions it as if it's a normal finding and that was the problem in the herman case it's not a normal finding it's a very abnormal finding and it actually fully supports mr keyes testimony that on two thirds of the days on any given month he was unable to to grasp things there's also other significant evidence supporting that finding of the inability or difficulty grasping its women often had swollen wrists swollen fingers diminished sensation in his in his hand those that test so you it's not a question that the findings were present the doctor didn't test for that because mr t s went in to see the doctor complaining again of his severe neck pain and his severe back pain which is primarily what doctor he did treated him for so the absence of testing doesn't mean that the signs and onset of test results were no longer present just means that the doctor didn't test for them at that time there's evidence again later on in the file establishing that mr keys again to new day in problems with his hands and one finding by the surgeon that in fact he had decreased sensation in all of the derma tones in his hand meaning where all the nerves going into his may please the court my name is joshua day i represent social security administration as the appellant outline there are three primary issues here and before the court today and there are several facts fourteen commissioners argument really regarding all three issues and of particular import is the fact that all medical source means of records support the l g s finding and that the l g cited other evidence through treatment notes that showed improvement that showed a of complaints about several of these impairments and their symptoms now with respect to the medical source opinions of the state agency reviewing doctors doctors brylin sans  and in his assessment now that these doctors doctors brylin sans did not list or detail each and every diagnosis impairment that they considered does not show a lack of consideration they cited treatment  ports and they agreed with dr on lucy's bottom line opinion of sudden terri to light activity that that the public could perform sedentary to light activity no doctor no doctor believe that the appellant's rheumatoid arthritis or right shoulder condition are some no nothing requires not examining sources to base their opinions on a complete record before the ale j so security ruling ninety six six p contemplates that state is the agency doctors may not always have all the evidence before them but that does not preclude a nail j from giving these opinions considerable weight and the opponent does not actually prove that this letter evidence be likely to have changed doctor's opinion or that there was a need for updated opinions the l j didn't fact consider much of this later year she said rights rights and ed and the medical evidence doesn't bear out that it happened as frequently as the parents considers that that there were complaints and this is what happens when it does occur well no doctor gave an opinion that it was something that would limits the appellant's ability to perform full time work and and related when talking about  not the ale jay but the doctor knew what the doctors findings were and made a an actual pinion the clear opinion that the poem could perform sedentary to light activities the poet also argues that with respect to the hand condition that that that there were some findings in there that the algae did not do the algae did deal with those the gander not mentioned every detail but dealt with many of those and the o of hand conditions are very souther condition such as shoulder condition during sillies examinations is telling of course there is no need to test for something that a parent does not complain about it shows a lack of consistency in these complaints and in  these conditions bother the appellant and that's why the l j spying on that point is is supported by the record is not satisfied with the existing medical sources opinions all of which undermine his claims of disabling pain and symptoms and all of which support the algaes findings the opponent is also not satisfied that treatment records and other record evidence do not fully support his claims that they show improvement with treatment but they show a lack of complaints on many of these issues the record as a whole is complete and the medical source opinions are supported by the record