position on the basis of an independent neuro psychological examination that she suffers an organic cognitive disorder which by both case long and the liberties of historical claims handling practices should not be subject to that limitation and briefly before turning to the merits of that dispute the nature of the dispute should have a significant bearing on the way that the man is judged the twenty four month medlen nervous limitation flown here right now to maybe help focus and cut to the chase there's a lot of writing being devoted in this case to the cause of this mental illness no question she she has some sort of mental problem right yes that is there's no question that there's a two year limit for that that right there is a two year limit for conditions that a psychological or psychiatric  policy says you look at the most current d s l the most current says they no longer distinguish between causes of the illness so how do you w bad is an issue your one of the that quite frankly i don't think that i anticipated that that question i i don't think that you're familiar with the clause in the policy the long term disability policy right yes yes yes as mental it says mental illness means psychiatric or psychological condition classified as such in the most current edition of the d s m regardless of the underlying cause of the mental illness  so let's assume that you're right it's organic doesn't matter according to the language of the policy unless i'm just missing something that firstly i believe and again that this wasn't something that we extensively briefed below so  if i'm right or wrong about this the final decision in this case was january fourteenth two thousand and fourteen yes you're the parties of all assumed that the d s m four applied and all i'm telling you is the d s m five was published in two thousand and thirteen so everybody if i'm right about that seems to have been wrong right from the start but let's just ignore d s for which you all used hell but perhaps incorrectly notes that the term organic mental disorder is no longer used because it incorrectly implies that non organic mental disorders do not have a biological basis so if i'm reading that right and if i understand it correctly it doesn't matter what the causes you're on a human that all about cognitive disorders and it states the predominant disturbance is a clinically significant deficit in coordination representing a significant change from a previous level of functioning for each disorder in this section the ideology is either a general medical condition although the specific general condition may not be identifiable or a substance that is drug or alcohol abuse or a combination of the factors so the d s m four maintains a distinction between maintains a distinction between cognitive disorders thought to be the result of medical or substance abuse the us is psychiatric mood disorders i guess the question i have for you is i mean you seem to find or stan your argument correctly you're making your point sort of indirectly i mean you you have to establish persuade somebody that her depression is basically we're talking about right  know your know specifically what we're talking about is the cognitive deficits measured in in terms of decreased memory decreased attention i mean so that in trace you have to show that the cognitive deficits burden you're arguing that it has an organic cause you're pointing to the d s m for i guess the definition of cognitive disorder not otherwise specified right as you and you're pointing to some explanatory language there that says that particular condition as you just read has an organic or via logical whatever it was because it's so that's and so you're saying therefore her cause the cause of this condition her deficits must be organic it seems like the other side is taking a more direct approach to causation here namely they have a number of physicians who have looked at radiology type stuff of your client's brain and say there is no evidence of any organic dysfunction is that if a fair characterization do you think of what they're saying i i would think that that is a fixed characterization of their position in litigation  i think that my response to that well i mean you know i mean if you if the let me ask let me ask a question before you answer that question let me just teed up so i mean you know it's a it's a pretty deferential standard overview in these cases and my question is when they have a number of physicians who say there is no evidence of any organic problem and that sort of a direct  conclusion that they're making rather than a more inferential one why isn't that substantial evidence that supports the denial of benefits here in answer to that i i would f to weigh the opinion that it's a broken ankle versus an opinion that it's just a sprain equally when only one of the people who was make offering the opinion actually had access to the x ray only one doctor dr alter had access to the nearest i get as there is no organic process i can go on i think that he did say that quickly i would like to be very precise disease affecting her brain is not supported by the data i agree that he said that but he also didn't he didn't say why we know that dot dot dot to our bear looked at the data and said it does we know that dr all there the one that he's referring to yes yes you're on the air doesn't say directly that there is an organic cause here she never says that right no she gave a diagnosis from the d s and d s m four which is which by definition is a caused by a general medical condition by substance abuse and we reason but the second thing that daunts just said which i which i think is significant is that he didn't give us his opinion as to what he clearly thought the cause definitely was he said attributed causation to a wide range of factors including psychiatric factors apneic episodes that is poor breathing at night poorly managed blood sugars elevated li hypertension so dr all to lists both potential psychiatric cause and potential physical cause so we have one doctor saying i see implicitly a cognitive organic condition and we have another doctor who doesn't say i clearly think this is psychiatric not physical instead the doctor says it's multifaceted psychiatric and physical invariant calm but i mean i think we look at what he's saying as a whole yes he says variety of things but he elsewhere specifically says not this thing no evidence of you know organic problems here and he also didn't didn't didn't tell us why it's so that the the court and also the liberty who was reviewing the who was reviewing the opinions wasn't in a particularly good position to be judging the relative merits of specifically say that your client's m r i did not show any organic problem he said on a on a second m r i that he was unable to find anything on that m r i on which he could on which he could pin the problem well again he was saying that without the full context of all of the record he didn't happen you're a psychological testing hadn't been done at that point so we don't know what his opinion would have been had he had the opportunity to review the latest testing ok but on the other hand doctor over there never had didn't have dr i mean she didn't have this m r i data which another doctor says shows there's no organic cause i i would agree with that  but i would also agree that when when you go through the claims notes when you go through the manner in which liberty handled the case even though in previous similar cases libby has gone  to a to a great deal of effort to establish cognitive versus versus psychological specifically asking peer review as to give an opinion on on that topic liberty didn't delve into it that there is no claim snowed in when you dig into the file saying for all these reasons we've made a definitive conclusion that it's that it's psychological  contend that because liberty didn't didn't prove that it would was organic consistent with its burden of proof that the correct remedy should be reinstatement of benefits but perhaps you are right that the whole thing hasn't been reviewed properly by any of the doctors in the correct thing to do is simply to remain to the case to allow it to be to all o