treated him and so yes there were this is a large file and there was some concerns that he appeared to show exaggerated symptoms but all of that is balanced out  completely undermined so to speak or overmind by the fact that he ultimately was found to have cervical spinal stenosis that required surgery so it's it's a little bit odd to say that somebody who actually was in such bad shape that he required spinal surgery it was exaggerating his his pain complaints apparently the surgeon didn't think so not only to the surgeon not being so behavior ok i would like to address that as well there's an interesting conundrum here when you if you have a condition that causes pain if you use the medication for the pain then you're drug seeking so bad that he was seeking mental pain medication throughout the record and he was provided he was prescribed pain and the thing is if you were abusing the pain medication the doctors will figure this out illness thesis in his in his spine cervical spine requiring surgery we have got several other opinions from treatment providers that agreed with that we've got a medical expert who testified who think relates to you what you're asking about the drug seeking mr she's the home he's been prescribed all these medications he's been diagnosed by several providers with a chronic pain respond to that immediately so i'll try to respond to that and rebuttal if he did obviously having cervical spine surgery is about the highest level of treatment you're ever going to find here  or what would how do you interpret so i would say that you can infer the langar rang from the three pieces of evidence that i discuss in the brief specifically the why delve signs with overreaction the inconsistency is on exam including grip strength and consistencies and the inconsistencies in the emergency room when he said when coleman said he can open it right hand and then the attending party noted that shortly thereafter he began using  than talking animatedly with opening and moving it around when he couldn't so i would say that you can rely on those three pieces of evidence the l j cited to infer maleng greying and then find that the algae did not need to provide any additional declined because of the edi alert showing a lot of schedule drugs and became very aggressive and then returned the very next day alleging neck pain but moving his neck freely when looking around the room when he fired dr foster with very strong language because he was denied extra pain medication so it's not and it's not as opposing counsel suggests and situation in which he claims it is  medication but when doing so he is making claims that are not consistent with the findings on examination and with his behavior so those two things occur together very strong inconsistency is with the medical record in discounting coleman's treating physicians but did the little j consider the other factors set forth in the twenty code the federal regulation for all four fifteen to seven those factors or some things like length of treatment relationship frequency and down lazy the consistency of the positions of specialization of the treating physician is there any evidence in the record that the j considered any of those other factors that forth and that regulation i haven't yet gone through the l g s decision to see if he discussed each of those factors individually with regard to each individual opinion but i would i would know that there is each of the individual factors with regard to egypt the individual opinion is there's no requirement that he did so and of course i noted previously i haven't gone through each of the individual opinion to see all of the factors working with each one of them but reason for each individual opinion that we could go through and i'm happy to address any questions on each individual patient but overall i would say that the a l j the expansive and so had a whole you look at the record and was able to substantiate the decision with substantial evidence and because the germination was rational  so once again turning to the l g s decision i don't see that the ale j specifically said that dr foster's opinion was contradict findings that theoretically could have supported a finding a mole inger ing one of them is not even clear that's the one with the p o s s waddles signs which looks like possible but it's been a might positive p l s s sounds more like possible but we can't really tell that's not real clear evidence and but let's just assume for the sake of argument that that wasn't the beginning of this case in appropriately drug seeking you know we can't tell you can't we can't measure i can't sit here you can sit there and and determine what kind of what level of pain he was in if you're in extreme pain there is one point he  d he went to the hospital given the lot in which is a very strong painkiller which is not prescribed i don't think you have to go to hospital to get it and it worked really well for me said that's great can i get a prescription for this and  course they couldn't when you're desperate in a lot of pain and especially at the beginning of this it wasn't all that clear exactly what was causing it it's only when the neuro surgeon saw that the m r i supported his being complaints and supported the need for surgery then i think that's the flipping way that really confirmed why everyone all the doctors here were correct what it boils down to here is a it's the  medical evidence and the medical opinions all of it yes good let me let's put it this way ok there's a saying that you know trial judges do what they do because they're there we do what we do because we're not and so obviously it's different and any of that i've been in the trial court so it's different when you actually look at people and you make credibility determination and you know any resolve that there's no doubt in the record that there are conflicts and there's a lot of evidence the psychologists who do the most thorough evaluation of that issue suspected that there may be some sort of asperger issues or something and so he comes across as a bit odd and because of that i think it's more important to rely on what the medical professionals including a life and psychologist have to say about his behaviors then to rely least a year and after that he didn't have an opinion he couldn't tell this is part of why i've only really question re man for a new hearing here rather than a word of benefits because there are obviously some challenges that should be fully evaluated and this chronic pain was never a valuated at all and that has to be part of the picture but i think the evidence you're actually supports finding that he's met the listing the entire time or at least the subset and carry the entire time