of cases talking about substantial evidence of the record as a whole is the there must be a medical basis for the residual functional capacity second issue i believe is the treatment of the treating physician doctoral monda he had no there has to be some medical or you have that the r f c determination is the social security the lawyers who argue well there wasn't there the r f c is a medical decisions of the made a mistake by doing it by and themselves her self those arguments don't prevail so i'm not sure where you're going government lies on the fact that they use the term the surgeries referring to the first three surgeries to bilateral carpal tunnel and neck surgery the surgeries were largely effective in the ads his neck is stiff and has pain in his hands are numb and he has a seventy percent of the range of motion in his neck that i would expect then following that we have a very objective evidence which is m g or connections to anybody in iran or just who describes it this is after two carpal tunnel surgeries as severe bilateral carpal tunnel surgery and mild issues with the nerves and the knack so the appellate is referred to a third or peak surgery surgeon who says this is why i don't do these with a scope i want to do a folk at and see what i'm getting as another carpal tunnel surgery which is not very successful but says he really needs it for needs one on the other hand too so fifteen minutes and can't sit for thirty minutes and he's gotta lie down thirty minutes every two hours but we know what the answer is going to be so a physician who's who's been asked to opine by a claimant or a claim comes up with that is it's not fully credible it's going to there's there's going to be some discounting of that on the question here where do you go from there if you go from there pages five zero forty five twenty two where he about explains what the surgeons did when they say there's a problem there's a problem this is what happens and this is what he sees and has seen for all these years that he has treated them now it is treatment drops off and there are two places in the records referring to that he doesn't have a job he doesn't have insurance this case has gone on for nine and a half years  issue entirely unrelated to the next surgery just like the range of motion is predictable following the next surgery the reality of it is the spondylosis would cause numbness in the hands in any event and the question isn't really do you have numbness in your hands the question is is it disabling and so the real issue is you know you have this list of things that dr lamont has says are the limitations on his abilities to engage in daily life activities right yes and the question is is that consistent with any other evidence when you have evidence that every half hour he lays down do we have evidence that he's not engaging in any other daily at life activities inconsistent with that because at the end of the day on the remaining with the doctor describes as a person who is completely and totally disabled from doing basically anything and i'm not sure i see that in the rest of the record what he says and there are battles and grow yeah there's i mean we're not saying that listen the question is can he have severe carpal tunnel syndrome and still be able to carry on other jobs that exist in six significant numbers the national economy right yes and the al jase as he can use his hands frequently that is doesn't make any sense that he has severe carpal tunnel syndrome kneel crawl crowds frequently reach only occasionally overhead frequently handor handled finger and feel those are just not things that are consistent with the medical moved down and up being frequent and not tell me what you just said concept well when he ended up at it page five sixty two with the fragment yes that being truthful and who he's not and what if he treated him for twenty years many of those years he was a heavy equipment operator yes so it's not it's not of the of this to have to lie down thirty minutes every two hours opinion is  please the core i'm john cox and i'm here on behalf of the acting commissioner of social security nancy burial as i understand it the only issue before the court today is really our a c and whether there is substantial evidence in the record to support the l g s r f c finding as everyone knows if there is substantial evidence to support the elders are a c finding the decision would be affirmed i don't quite i didn't make the argument on appeal as  being that i took it as being more specific than that there was not a proper evaluation treating physicians opinion and judge perhaps i was speaking at too high a level of generality and you are absolutely believe of whether there is substantial evidence in the record to support the l g s are received findings including the limitation to frequent fingering and feeling frequent handling fingering and feeling in terms of doctoral moniz opinion and can i interrupt you yes now for the first time am i right in the facts here that before the first day l j before the reaming and it said occasionally finger feel and all that right now george i don't have the first decision in front of me though i have reviewed it i cannot say specifically whether it was occasional handling i do know that it was a fall or range of light work in the sense that the new l g decision limits plain up to lifting and carrying up to ten pounds i believe counsel i thought it was clearly occasionally the first time can you can you determine what it is without in a second that's important to me i cannot determine that ok well we'll figure it out ok yes and i'm sorry about that ok well now let's suppose for a second and so you don't dodge it entirely let's suppose that the first time before the first day l j in said occasionally and a finger in feel ok and that's suppose on the second time it said frequently there something amiss if that's true no i don't think so judge i think that we're dealing with a situation where you have overlapping but not completely similar records the first decision was issued in october of two thousand and ten and that was shortly after plaintiff had recovered from his cervical procedure and then the criminal surgeries at that point dr lamont his first opinion was in the record but his telephonic opinion was not it was added to the appeals council so the record before the l j at that time went from between two thousand and seven to two thousand and ten the new mail j decision includes doctoral mondo's telephonic interview that also includes the relatively examination played a role in those specifically what's really relevant here is a doctor who was his counsel to the examination is relatively normal but the only limitations he finds is that plaintiff has what he characterizes as a slight reduction grip strength on the right side and he also says that plaintiff would have some difficulty in finger positioning on the right that could affect manipulation there are no limitations on the left side and so what you're talking about here in the second  decision is that plaintiff is required little treatment for his carpal tunnel syndrome over a period of four years and then to the extent he's received treatment he's reported that he got a good result and then you have a consultation examiner who looks at him after the relevant period and finds no limitations in his left wrist and only slightly imitation is in his right wrist and so i would not be surprised at all on this record if they l j would find fewer limitations and on the previous record what it begins with is the opinions of plaintiff's treating specialists and surgeons that those opinions were issued towards the beginning of the relevant period plaintiff injured his back while working as a heavy equipment operator in june of two thousand and seven is treating physician dr lamond refers him to specialists and surgeons to deal with his pain complaints doctor havey deals with carpal tunnel syndrome he performs to carpal tunnel release procedures and by january two thousand a dr parker has seen so much improvement that he is saying point if it can return to work consistent with light duty activities certainly not the job you've done in the past as a heavy equipment operator which confusingly as a medium level job because you're not carrying heavy items as much so dr havey and dr parker have essentially released play after return to a range of work at that point the third specialist dr meyer is a pain specialist and he treated plaintiff from before the relevant period even began and i believe it's july of two thousand and eight dr meyer examines plaintiff and plaintiff has several pain complaints but dr meyer characterizes his remaining limitations as relatively mild overall dr meyer makes the point that unfortunately plaintiff is not employed and appears to lack motivation to find appropriate work and dr meyer basically says the limitations that i see are not consistent with december of two thousand and nine there was a follow up procedure on the left non dominant wrist and that was dr turned performed that procedure and plaintiff after their procedure reported improvement was very little medical treatment after that  absolutely in july of two thousand and eight the next surgery and already resolved dr meyer performed the therapeutic injection and that would have been probably in july two thousand and ok this is i guess word we're calling about terms because it says under moderate sedation under relatively limited again until late two thousand and nine approximately december two thousand and nine when plaintiff reported some recurring problems with his left non dominant wrist at that point doctor turned bach performed a carpal tunnel release which would be the second on the left wrist third overall and then from that period through the end of the relevant period in two thousand and twelve there's virtually no medical treatment whatsoever that lack of medical treatment as l g explains supports the inference that the treating physicians also raised that the surgeries were relatively successful now relatively doesn't mean that they were perfectly successful and the  said the idea that he would be limited in terms of sitting or standing finds virtually no support in the record there's just nothing to support that but to the extent he said that plaintiff would have difficulty lifting and carrying more than ten pounds they relet almost full strength i think all those consul to examinations would have supported at least a full range of light work if not medium or heavy work and so the ale j explicitly assigns those consul to examinations weight in order to reach a more restrictive r f c finding now plaintiff has characterized the limitation of frequent work as virtually meaningless and that is certainly not the case under social security parlance frequently means up to two thirds of the work day by limiting plaintiff to no more than frequent handling fingering or feeling they l j was recognizing that this gentleman cannot perform repetitive or constant movements with his hands many jobs require repetitive and constant movement with your hands many assembly jobs involve using your hands to put things together i'm not positive of this but his driving job would likely require repetitive or constant handling because you're driving a truck and you're moving or securing while you're moving and your shifter lots of jobs require repetitive or constant handling a limitation of frequent is in fact significant on top of that remember that dr of allez oh no handling limitations with respect to plaintiff's left hand is left handed no limitations at all his right hand at slightly reduced strength and some difficulty with finger positioning that is what explains the handling limitation is  record this is a very well supported r f c that's very easy to understand based on the evidence before the l j and judges unless you have any further questions for me i would yield my remaining time when that surgery term was low confusing to me too at the physician the pain physician uses the term that he did surgeries that's where that comes from now remember anytime you go to a doctor meyer what did act was first thing the doctor meyer said i will not participate in the disabling process because he said as i am going to help you which i would have some sounds like you're saying a doctor who declined to attempt to give opinions as to work ability or disability is somehow somehow does not provide objective medical evidence that the l j can take into account no i think i'm a jack that strong the objective medical evidence that he provides actually is very helpful because he keeps on doing these pain treatment so you can't i mean you just want to dismiss a doctor because he didn't give an opinion i want you to dismiss his opinions which he starts out saying he's not going to give he says i'm not going to participate this then and then he does have some comments about that but he certainly supports the record by continuing to do these surgeries as he calls them for the for the pain the government at page sixteen of their one time but you cannot just dismiss a limitation of the use of one hand with a man who has tested as a letter and has completed the seventh grade twice this is not