under the surgical pair of this issue that at three years of age she was diagnosed with juvenile rheumatoid arthritis or r a's and was nearly immobile their symptoms over the years her the primary physical symptoms of  treated with a number of specific medications ferrari and then in march of two thousand and thirteen she suffered a stroke and then was placed on blood thinners and that from that point in time she has been taking those blood thinners as well h ask you mr scar she certainly has had her health problems over the years but that's not quite the question that the administrative law judge has to answer instead the administrative law judge has to decide whether despite those problems she retains some ability to work in this instance is a step five case in the in the national economy and one of your complaints about the outcome that the administrative law judge reaches i understand it is you say he didn't consider her severe fatigue but i want you to explain to me why the discussion that appears  age of twelve the algaes opinion isn't a full consideration of her city not not with the conclusion that you wanted but it begins there's a paragraph that begins as for the claimants complain fatigue the record suggests you could have been related to low iron hypothyroidism goes on other things and he comes to the conclusion did redress the ball and so even when people have problematic conditions if it can be addressed through medication or through other measures be able jayson title to say that's not something that prevents you from working so on what ground we measure fatigue medically but she has rheumatoid arthritis which is with severe fatigue by the mail mayo clinic enemy a clinic doctor is a very prominent symptom and she's been complaining of that i mean it  cost her she tried to work many jobs she had worked by trying to work by nine different jobs in the five years prior to putting a disability but her fatigue being the primary faction i'll get back to some of the other things you if you discussed it kept her from only completing part time employment for nine different temp set to work a temp she was even try to go to college which couldn't perform because she couldn't get back and forth and her fatigue was just too much for her t even attend college in the judge talks about a few of those things but i think each one of those is where it will distinguish in my brief from page twenty all the way through page twenty two so you mention a lot about the one opinion from d isn't was no does improved and so there's nothing that says the l g a has to go with the most pessimistic assessment there fabulous i mean the only objective test i think that you can really say she she was interested in this is finding out this fatigue so she went to other places cleaner or university wisconsin and then she had a  ok i guess you know your your burden is to somehow show was that given the standard of review substantial evidence standards of reviews you correctly noted why we what's the weak point or what's  going to follow the s s r which requires to function by functions assessment then you have to have acquiescence ruling which is called an a r that creates an express exception to how the ruling is is considered not wholly dismiss the allegations or complaints of mr lengthy nor did he find that her impairments did not limit her functional ability rather he properly analyze the evidence and found the degree to which was plain these impairment her fruitless efforts to obtain and maintain work should be regarded as pretty evidence that she can make it through a forty hour normal eight hour forty hour work week that to the other evidence in the record specifically the fact that one has a plane to complained of fatigue beginning in january two thousand and fifteen she last clean claim to fatigue several months later and by may of two thousand and fifteen had no more consistent complaints of city no and i think i understand that about the fatigue but what i'm interested in is it seems to me that if you're out there in the workforce trying to get a job you keep getting fired or laid off that strikes me as rather objective evidence that you don't have to wherewithal to maintain work that's actually pretty direct isn't it and i don't see i'm just sort of scrolling back up and not supported by the other evidence and the record had missed planes and showed consistent complaints of that she had doctors agreed that her fits was still disabling and that evidence was in the team for the record except  be expected to produce the bubble edge symptoms however the claim of statements concerning the intensity persistence cetera et cetera so he doesn't really say he doesn't believe her or that she lost the job josie he just i mean we just have this rather generic statement here i believe the rest of the algaes decision in great detail speaks of the evidence that does not support and explains the testimony about the extent of her limitations and in fact was plain she was only nineteen years old at the time she alleged she became disabled and only twenty three years old at the time the l g a issued its vision well as a matter young age she's trying to tell she's been disabled she was too right she had this juno rheumatoid arthritis which is what they call it when you're a juvenile correct your honor however the a l j is really only charged with looking at the period  issue here in this case explains he applied for disability in two thousand and fifteen stating that her disability began in june of two thousand and fourteen she did not apply as a child and she did not apply under the age of eighteen so when looking at the period of issue the relevant period here looked at the evidence inside it and did not dismiss the fact that she had had all of these problems prior to each two but big medical evidence does not actually start until two thousand and thirteen and at that time aside from you know one instance where her exhibit will have an inflammation flared up the  inflammation and arthritis is in fact in remission and controlled very well with the medication of and the a l j did not ignore the fact that it eventually became ineffective but then spoke of how additional and medication such as sia in fact controlled her arthritis again dale j also looked to the fact that her fatigue was not consistently an issue at least in statements from her doctors after the spring of two thousand and fifteen as well as the fact that her heart condition which she no doubt headed age to last very very severe you know requiring several surgeries by the time it's planes he alleged she was disabled and on the evil to work her heart condition was mostly stable her cardiologist continuously checked on her and did not find any functional limitations were warranted in fact her cardiologist dr wilson the only doctor to speak decided only appeal months ago and in that case as well as the case that issue here the ayles way did not dismiss the functions that planes the argues were not addressed in fact the l g s discussion implies that he considered all of those functions yet found that she was only able to perform a sedentary range of work with additional postural and environmental limitations there is no dispute that that what  clear that he also has considered the listings to which misplaying the alleged she was presumptively disabled while his statements in step three of his decision may have been brief he did a genocide of the applicable listings identify the criteria that this plane he had to meet in order to meet on that a cli equal those list events and his discussion and the rest of his decision clearly explained why those criteria were not met he was he relied on the opinion of dr foster a state agency reviewing physician who specifically said the scene fourteen point zero nine addressing inflammatory arthritis was not met and although he gave dr foster's opinion little weight he was discussing that more limitations were physicians who also hindmost claimed he could perform only sedentary work dale j gave greatly to these decisions the support the l g s assessed residual functional capacity and because they were not argued either in their decisions in fact after her stroke i was going to mention the fact that she's been on again on blood thinners for since that times and that was really not really addressed the session and finally the sars objective evidence guess she'd been she knew in two thousand and fifteen with the two cardio appointments to try to figure out the city and had that exercise test to show she had very very low exercise tolerance ok well thank you very