court's decision which alone makes reversal appropriate instead they argue for affirming someone of all to two alternative grounds but neither is correct st defendants argue that minos of bringing a claim for inadequate medical treatment not a failure to don't invoke any authority for this idea that if a doctor says you don't have a disability accommodation then you're not obligated to provide one now the knowledge of the doctor does become relevant to deliberate indifference which which we can discuss but the elements of an eighty eight dollars claim are having a disability having an actual disability and having that which is there are several ways to qualify as disobey a disabled but actual disability is one of them and then have that having that prisms despite springs or precedent in this court's precedent insisting that it applies and i would argue also that it's a particularly odd argument for defendants to meet here because they actually concede to the issue that there is a material question that he was to say doctor says that i made a medical determination that this person was not disabled courts are not allowed to peek behind the curtain at all and there's just no statutory basis for that in the text of the defendants don't even the friend that this report is that i know but i'm just asking what the doctor said yeah the doctor said i think it's fair to say that she said that he had no disability she testified that she looked at his medical records and his medical records were normal is what she testified in her deposition and if you look at his medical records his medical records are replete with a history of knee surgery him begging again and again and again for a low bond crow know him eventually obtaining one even though she did things like weighing out rules of construction that they must be read as broadly as possible and you did you know specifically state that the decisions in toyota motor manufacturing which sustained because he had a high correct and so the determination that you are upset with is the determination by the doctor that he didn't he didn't didn't qualify for doctor testified that she reviewed his medical records and they were normal and again we do these string sightseers one on each one of our reply brief time and time and time and time after again are the medical records are not normal they demonstrate he says over and over my knees locked up on a ladder and he begged for years to get a low bunk or no which of course benefits to him and absolutely no way other than safer  so she's testified that she reviewed those records so she so she knew she saw all these records that were fall of issues that required a low bunk rono and she also knew that previous doctor had given him a permanent lobe on cron o and she testified that disabilities are verified before ever giving a lobe of cron o so she knew that a previous doctor looked at the exact same evidence and said yes we gave him a l gronow and perhaps most critically she did not examine him she relied on incredibly unreliable information she said well i saw him twice and he seemed to find basically those two appointments had absolutely nothing to do with his knee pain she even testified i didn't examine his gait and she also testified that even if you were able to emulate correctly that has nothing to do necessarily with your ability to climb and you know i also note that another thing the medical records are full of is him begging for an m r i which is the only way that would reveal ligament damage and a doctor actually ordered him an m r i and then it was cancelled by c d c hours of ministration so so the idea that there are objective evidence you know she says i looked in the x rays were ok he didn't say that he had bone damage you said the a ligament damage so the question is did she know of a risk of a failure to accommodate and disregard it and the cited in the rd circuit reversed and said no there's there's a difference here we can't just chuck out disability cases by defendants invoking that of an employer would want a physician to verify whether an accommodation was needed and american doctor could look at the medical evidence and decide whether it was required or not but if we look at simmons i think that that provides controlling when president because in that case it was the medical staff at county jail that was him is on suicide watch which meant he didn't have access to outdoor recreation and other programs simmons that committed suicide and his parents sued under they a lleging that as suicide was a result of not having access to outdoor exercise and those programs to treat depression but this court held that deprivation of quote programs for activities to lessen his depression was not actionable under the  determination about what he needed the other has repeatedly interpreted simmons and all those decisions of mine the simmons rule they don't abrogate the a b m presence for example if a medical doctor makes the decision that on an accommodation is needed to treat a disability but then  make goes out and officers and the president discriminate by refusing to provide that accommodation will well that may be an eighty violation but that's not the case we have here where there was an underlying determination about whether he needed it opinions that he didn't need you know the lord and she also looked at the doctor about and says x rays and to clarify she was she actually testified was that it's possible that an x ray wouldn't show ligament damage but it moment there's an avenue and they also have medical negligence and you know some virus he still has medical negligence are his neck was and that was that's left intact that was the court denied ever been exorcised wrist action to a very specific need i'm so not saying i mean this ability is defined broadly that's what that's what we're supposed to do now is look at disability very broadly but she's not looking at he might very well be disabled he might have all sorts of disabilities might be unable to do other types of activities but she looked at it and decided he didn't have the type of impairment or severe impairment that would prohibit him from getting up to the upper bunk so that's what she decided and you know and that kind of goes into the deliberate indifference element which is you know even if you take new uses all of his facts the way he presents them in his brief as true will start all of them but that still doesn't amount to deliberate indifference provide examples of what was not sufficient so involved there was no facts specific of this investigation because of the pain of asked for real time court reporting so that he could read what was happening in his trial when he spread the county employees go fail the court not take you to the opposite conclusion with respect to the state defendants of the state defendants didn't look at the right document in the same style that showed he needed an interpreter and so they didn't order one for him but there is at least some and same thing while it's true that she wasn't specifically examining his knee during those visits she could think back about whether he was complaining about the knee whether he showed signs of pain or whether he was one sense of impairment and she determined that he wasn't so those are all part of her medical determination the fact that she looked over and so that's why you know it doesn't fall within the a p a but even if it does it shows that that was a fact that investigation which was you know much more then you know what i state basis that accessible bed is not a program so service or activity under the in fact that opinion said the you know the a b a probably doesn't apply in prisons at all i'm almost certain it would be absurd you know the supreme court held otherwise nine gay as well as several published opinions from the square and i would just say a final point about the deliberate indifference about how the other cases are about a failure to investigate this is precisely what we had here she testified that she needed to examine him that it was appropriate to examine him she did not do so instead she relied on examinations where he had absolutely no reason to bring up any of his knee issues because he had a permanent lobe on cron o he hadn't been warned that he would be taken away so he had absolutely no read my opposing counsel said why didn't you bring up his knee issues because he had a low bond at the time he had no idea that it would be taken away with no investigation and she specifically testified she learned nothing about his needs and those appointments they were totally unrelated things and she did not observe his gait and even if she had observing your age doesn't necessarily inform you about somebod