benefits because of syria very tense with her back among other limitations but that's been the main concern the male j in this case originally found that miss koch was disabled from included the a l c then have to compare at that point in time to a previous point in time and in order to determine whether there was an improvement have to be improvement from please the court jennifer selfie on behalf of the commissioner for social security as has already been indicated by the argument has gone forward and the questions that the court has asked the principal issue before this panel here today is whether or not the ale to a properly determined that appellant experienced medical improvement of her back condition as at the time of her two month post lumbar fusion surgery follow up appointment with dr promise medical improvement has to be shown based on a decrease in severity of impairments that were present at the time of the most recent favorable decision and it should be based on the signs and symptoms in the medical record it requires that the ale to compare the current appellants current condition with the condition complaining of tenderness with range of motion which he had done for a long period of time before her lumbar fusion surgery there was also no evidence in his examination appellant exhibited normal strength muscle tone and intact sensation she had normal which is especially important to notice as it is inconsistent with the findings of the consult with the those it is a significant amount of gap of panton but it just goes to show that she was taking less than she needed to before and objective medical evidence from the  that have been present in the prior imaging before she underwent corrective surgery most importantly plaintiff her self admitted that the surgery alleviated her she told the doctor night in october when she went to have her staples appears not only and her history of present illness for her reports but also in dr ramos assessment at the conclusion of the appointment which is t making an opinion that her symptoms had improved following that surgery and i would like to point out in an accuracy in opposing counsel statement that appellant nurse at the time of that two month my recollection of the decision was that he did not explain in great detail his basis for doing so but i do believe that he did say that he was reliant on the we talked about a number of how the beer the pain is significantly herself reported pain that significantly change after the surgery  we don't have a great deal of records that were officially part of the record and of course it's the commissioner's position that the post decision evidence is not relevant to  to the courts as you dictation here but i think it is important to note that he did continue to make some complaints of pain but elsewhere in the record she also indicated that she had an extremely high tolerance for pain and she continued throughout the relevant period even during her period of disability and during the period after that to maintain her additional evidence that she wanted to present this you would have to file a new request for disability benefits to start up after that date do i understand correctly that we're talking about a very finite period of time in this case that is what the appeals council's decision stated and all candor your honor at the decision if you look at the conclusion of it he said that his decision rang on from on the medical improvement granted there are significant findings in there such as the restricted range of motion but that's to be expected after a spinal fusion surgery but what he did not address the specific findings that himself had made that related to the fact that she was no longer complaining of tenderness with range of motion and the fact that absent from dr ramos findings was any evidence of muscle all normal if they report really back more questions that it answers if they actually perform a full physical examination we don't know but we do know that it is inconsistent with almost every other physical examination record and it's internally consistent with this coach the allegations are paying is eight out of t n so we're talking about improvement we're talking about ten out of ten where how bad is that and if the basis of his  sees based on her pain then it hasn't subsided and it definitely has not subsided point where she's going to be able to return to war there was a question asked about the timeframe and i'd like to see if i can help explain that the failed found to reach medical improvement to me two weeks prior to her date last shirt he rendered a decision almost a year later what that means is that she purse for benefits she's out all of the money that she's paid into social security system working on the courts are a life it's vapor she has to prove that she's disabled before that able to a decision and before that date last i'm sure because otherwise you'd have to reopen it and that's not possible and since it's precluded by the administrative procedure cobb and or the judge to render