time but i would like to try to reserve two minutes for rebuttal there are two bases upon which this court an exercise its discretion to remain simply so wiped out from the effects not only of the severe medications he was taking but of the rheumatoid arthritis itself that he laid down about six hours out of a typical eight hour day and that of course coupled with the vocational expert's testimony that those limitations would be inconsistent with sustained work would require an administrative law judge to enter a finding of disability now against that the administrative law judge looked at the report of a one time examining physician and the examining physician was only two months after mr morrow applied for benefits obviously did not look at the vast number of records but most significantly in my opinion it did not look at the x ray that was performed as a result of the consultative examination and that's another important citation to the record that i would like to give at york two nine eight and that x ray report showed  the doctor upon whom the l g relied for a one time examination two months after the application never even mentions these severe findings and i can only express my amazement that his advanced arthritic changes with areas of the loss he loves this is fusion involving the radio karpal that's the wrist and the intercom pole joints those are the  is symmetrical on both sides so this affected both of his hands he happened to be the left hand yet the doctor who saw this man one time on your two nine three makes one statement restraints colon within normal limits period yet he did and did not even mention the x ray that was taken as part of this report by the time he'd written his report if you take a look at it i don't think the fact that it was taken later in the day is an excuse not to look at the at the report of the x ray if if it's ordered as part of the consultative exam which is not even mentioned i that's taken of the wrist show that the wrists are fused it's those two statements are simply impossible to reconcile i don't know what the doctor meant when he said within normal limits maybe he meant that they weren't swelling maybe he meant that they were red i don't know but he sure as heck couldn't a meant that there was full range of motion because those wrists are fused x rays don't lie so i would so basically i think we have a misrepresentation of the evidence what is important here to emphasize also is the differing legal standards that this court is very aware of between treating examining and non examining physicians so even if the opinion of a examining physician is substantial evidence that doesn't overcome the deference that is opinion that she gave in the end just before she moved on was inconsistent with her own notes and didn't reflect the conservative treatment conservative treatment there was no conservative government would you address kind of any stretch of the imagination and since you asked the question i came up with a case that i just found last night scrawled him as c r s c o g h a m a versus cold in its seventh circuit seven six five third six eight five seven circa two thousand and fourteen this is exactly that that a person who is willing to subject themselves to dangerous medical interventions is credible  tricksy for years when i'm on and i've been on humira and i know exactly what you're talking about i have to have blood work every month to show that it isn't killing my liver that doesn't mean it's not dangerous it is dangerous whether we're both on him or not you've got one minute left if i may may please the court my name is james byrd some period this morning on behalf of the acting commissioner of social security mr morrow claim the experienced ability to pay not just in his hands but throughout his body that's why the l j talked about these clinical surprised that mr amaro was as functional as he was he said he was surprisingly coordinated and surprisingly functional he was able to take his shoes on and off get on and off the examination table without assistance and had wrists and that i think is something that was raised by mr caldwell they do want to address because that does appear to be inconsistent with the x rays taken that same day but i think you have to look more closely in the record the medical record the  areas of fusion within those joints and what matters is what the functional limitations that are caused by those areas of fusion and dr young simply did not observe any he pined that mr morrow had no manipulative limitations that he could in fact do the full range of light work other object if i needed a comment on how long that he commented on how long i mean the job that was proposed was what housekeeper what that would involve using those wrists not just occasionally not just during an examination but hour after hour it was there any discussion as to by dr young as to how long the subject would be able to use his wrists and be active dr tysabri included no limitations at all  are physical problems with his wrists and i'm corey ok he didn't see that were ordered on what does he say that ok this is somebody who can hour after hour use his wrists i all skeptical about that and i may add the other part that i'm skeptical about as i look at the ale jay's decision i find it remarkably devoid of specifics when he says that a given opinions inconsistent when he says the claimant's testimony is inconsistent inconsistent with what he doesn't give us chapter and verse he just kind of leaves it to us to go hunting through the records to see if we can find any inconsistency that i'm not sure that's sufficient with l g to explicitly talk about the objective look at this decision piecemeal like i'm trying not to but he gives a conclusion referring to jack or charlie i give this opinion a letter weight because it heavily relies on the claimant subjective complaints and is inconsistent with the objective findings other opinion evidence in the record as a whole including dr charges own treatment records but he doesn't tell me what objective findings and he doesn't tell me what in dr china's own treatment records it's inconsistent with so how am i supposed to now well immediately prior to this they pages twenty and twenty one of the transcript goes through those objective findings at the bottom of page twenty of the record medical evidence indicates physical symptoms were mild good muscle gait sits on the exam table etc and then cites a specific exhibits a number of those exhibits i believe the most treatment notes within any one of those is about four or five and so this is not a situation where the court is combing through hundreds of pages of medical so i think the court can say that l j explicitly considered these things would have perhaps been easier to determine what he was talking about if you'd said one thousand f page x y or z possibly but the court  found in a number of cases it does not leave its ability to read into this decision at the door if it's if there is a reasonable inference to be found here the court may make it and i think there is one inference is the  testimony at the hearing was that he was only he he only needed a conservative treatment but when you look at the drugs that he had to take in order to maintain  or but they couldn't quite figure out if they ever if he ever was taken with him and reading through this i believe a reasonable reader that is talking about also the pain medications as we raise in our brief the mr morrow rarely if ever took prescription pain medications i think that's an important distinction here because the treatment to treat his rheumatoid arthritis he went off of certain of kinds of the treatment off the  for a while but he still was not there's no evidence that he was on high strength narcotic or o p o you'd pain relievers despite his complaints of increasing symptoms and i believe that is a fair reading of the l d s discussion of the conservative routine care and when you look at the first sentence of that paragraph i thought kolya prescribed him percocet there is but there's no evidence that he took it that's it when you look at the later records talking where he lists his medications that he's actually taking he never lists of prescription pain whatever reason dr young did not have access to those but again as i mentioned earlier what matters not necessarily is what's shown in those x rays in those m arise but what are the functional limitations as seen in person and dr young is the only person in this record the only physician in this record who actually tested mr morrow's functional ability to do things he did see doctor try it for a long time and i don't see how it seems reasonable that to think that china during the course of all her examinations would have also had an opportunity to observe him well certainly she had the opportunity to observe and she noted her observations of him but her at her examination her most recent examination prior to the date that she issued her opinion she saw him in september two thousand and nine for the last time wrote her opinion in january two thousand and ten after four months ada's the examination showed notes she reviewed the mild m r i findings mr morrow reported moderate swelling and pain and she herself reported moderate effects of the rheumatoid arthritis and yet four months later in her opinion she wrote severe deforming erosive rheumatoid arthritis there is just this disconnect between what she recorded her treatment notes and then what that opinion for months later said turned to the effectiveness of treatment another thing to note here is that dr czeisler herself apparently believed that the treatment was effective or would shortly be effective in her opinion she recommended that he not work for twelve months to give us time to get his  symptoms under control indicating her belief at least that he could return to work after that two of those twelve months unless the court has a for the questions i thank not court might be a little liberal and give me a couple extra seconds on rebuttal but we'll see the m r i that the commissioner thinks is so important is that two five one it was before the onset date of disability is irrelevant the problem the commissioner is focusing on of swelling that's not the problem the problem is contract normal range of motion simply not true both your doctor chuy's records and you will continually see an abbreviation d r o m stands for decreased range of motion you can't rewrite the evidence in a nailed a decision in order to support and i guess i'm going to stay within my one minute and let the court is for the questions for me