may please the court the rule of law established and stuff will hold steady legally adequate examination contains three components first based upon the examination must be based upon the veterans prior medical history and examinations second the examination must describe the disability and sufficient detail so that the board's evaluation of the claim disability will be fully informed and third and what's at issue in this case is that the examination must clearly address the relevant facts court actually used the correct legal standard which includes this third acquirement that the examiner must clearly address the relevant facts medical science it's our contention that the veterans court misinterpreted the law by turning that requirement of a v examination into an r and b reasons or bases obligation on the board so our standard that this is our argument that this standard incorrectly shifts the analysis of the relevance and significance of medical facts from the medical expert to the board of veterans appeals which is in violation of the veterans court's own precedent and in coven as well as the requirement in thirty eight u s c seventy one a for a that the board's decision must be based on the evidence the relevant facts and medical science so so this argument was directly raised to the veterans court below we specifically cited to colvin and we decided to stuff well as well as any of us rodriguez for  the contention that these examinations were inadequate due to their failure to address these lay statements that mr ram submitted on his own behalf for his claim so we've got we have multiple statements in this case from mr rand's fellow service members which describe his reaction to the event the fact that he was unable to sleep the fact that he repeatedly stated that he could not get these events out of his head as well as the nature of the events themselves giving graphic detail as far as what mister actually witnessed in service and what the examiner stated in the examination is essentially if only well to directly quote the examiner on page sixty two of the joint appendix the difficulty in mr remsen case is that after the incident he didn't report any symptoms nor was he treated for anything other than depression and if he had s  in the joint appendix a page fifty there's a detailed statement from a richard nelson that describes that in fact mr ram was was there and he became horribly upset and extremely emotional and in the weeks afterwards he could not carry out any extended conversation he seemed emotionally changed and it's these types of complaints that it seems as if the examiner in this case was looking for in order to fight in order to find that either his depression is related to service or that he had a qualifying stressor for purposes of p t s d so that's where the standard stuff of comes in is that we believe that if the veterans court had properly applied the standard enunciated and stuff all it likely would have found that the examination was inadequate for ratings purposes and we also think that the harm here is that the significance of these symptoms in service is ultimately a medical determination that the board as well as and even mr rudd is not competent to make and by the board's own the same token the board is also not cobbett to say that these symptoms and service do not indicate a nexus with service and that's exactly why the veterans court and stuff will emphasize so much that  the standard here is whether or not the examiner has provided the medical opinion that's needed so that the board just not have to stray into relying on its own medical determinations in adjudicating the cla so it's our position that because the veterans court in this case applied the wrong legal standard the case should be reminded to adjudicate the case under the correct legal standard which requires the medical examiner to address the relevant facts of medical science we specifically raised to the veterans court below the veterans responses that the examiner doesn't need to address favorable evidence we believe this represents and it shows the federal courts mi you know we're not asking the court to look at the factual issues in this case we think that there is i mean there's certainly factual dispute as to whether or not these examinations are adequate and it's very argued in their brief that the examiners in fact consider these statements that's a factual dispute we're not asking the court to reach we don't think that the court has jurisdiction to reach those factual issues of course but but what was actually at issue here is whether or not the veterans court  court as well as the veterans court's decision itself i think you can look at the fact that we stated that we needed medical opinion on the potential medical significance of the slate statements that were submitted we argued that that was that the lack of such a medical opinion requires the board to route to rely on its own medical opinion in the end and this court can also look at the veterans court's decision which did not list in its listing of the legal standard that applied to  response to arguments that we need a medical opinion on these issues is simply that the examiner does not need to address favorable evidence that's a misinterpretation of the law because the examiner doesn't need to address the potential medical significance of the facts of the case there's no finding of fact in the veterans court's decisions decision that the examiner did consider this evidence and there's no finding the fact that this evidence was not medically significant it would not have changed the examiners opinion so i think given that entire context i think this court can simply look at the briefing and the veterans court's decision and determine that it has jurisdiction that a legal question is presented in that on the  evidence and address probative value we're arguing that this evidence potentially has medically medical significance to the question nexus which the board conceded in its case and its decision that the veteran is not competent to render such an so it's the medical examination examiner and not the board that needs to address this evidence because without such an opinion the board's addressing of that evidence is simply its own medical opinion but that evidence is not relevant and for those reasons we ask case because the veterans court applied the wrong standard and should apply the standard stuff there's several important things i like to know for the support of that first of all and most importantly the standard stuff a was the court was the standard applied by the veterans court and i believe it's on page four of the record where the with a better score to excuse me it's on page thirty five of the record the better the court's opinion specifically says states the standards and says a medical examination is adequate quote where it is based upon consideration of the veterans prior medical history and examinations and also describes his disability in sufficient detail so that the board's evaluation of the claimed disability will be a fully informed them and that is a direct quote from the staff of the case so the extent there are going t lockwood and the veteran seems to be taking this position that what staff will actually require was that the examined the medical examiner's report could only be adequate if it specifically discusses each and every piece of evidence  and then went on to say we merely providing a luster of list of items that may be helpful for the board to consider in making a fully informed determination of whether a medical fitted contains such sufficient information that it does not require the board to exercise independent medical judgment we do not hold that this list is exclusive or that any of these items would be necessary to render a valid opinion we hold only that a mere conclusion by a medical doctor is insufficient to allow the board to make an informed decision as to what weight to assign the doctor's opinion so there the veterans court is going into more detail about that standard and specifically refuting mr remsen characterization of that case that each and every piece of information must be specifically discussed by the examiner in order for that to be adequate instead of a more holistic standard where the board looks at  at all the at the totality of the circumstances surrounding the examiner support and determines whether or not it's adequate and then the other thing i would just like to emphasize to this court is the examiner did know about these statements in fact that pa sixty three of the record there are specific reference to these body statements and in the context of the fact that mr room was in contact with his fellow veterans and so there's no evidence that the examiner didn't know about these or took completely ignored these and in fact record records because it really shows the examiner was aware and so to the extent that mr ramsey position is that these were completely ignored by the examiner that's simply contradicted by the record and so our position is that although mr rem has characterized this as a legal challenge and it's purely to the standard the fact is that the standard even the standard that he's arguing for is the staff a standard and that was the standard that was applied by the veterans court and what he's actually arguing the grab them in of the veterans claim is that these this examiners report was inadequate because it did not consider certain information and that takes us directly back to the sports practice issue brigade and then various cases cited by freaky and previous progeny in which this court has held that it does not have jurisdiction over challenges to this it to the adequacy of the medical examiners opinion and so the secretary's position is certainly that this court does not have jurisdiction over over this challenge because it is not in fact  did not list that third requirement that the examiner must clearly address the relevant facts and medical science this was an important part of the court's decision and stuffing even though you know various court quoted stuff  l elsewhere in this decision is specifically stated that without the medical opinion they clearly address the relevant facts and medical science the board is left to rely on its own lay opinion which it is forbidden from doing that is a page thirty  four i'm sorry one twenty four of the court's decision and stuff will and then they stated again on the very next page the board must determine whether medical opinion contains sufficient information that it does not require the board to exercise independent medical judgment so our position here that these lay statements which were not the content of which was not addressed by the medical examiner in any way the board is not competent to address the potential medical significance whether or not the veterans reports to his friends and service indicate an onset of depression or potential cause of his current depression from those events in service as well as the board is not competent to state whether or not