right our fourth case for this morning is kathy thompson also gets nancy berryhill acting commissioner of social security s the morning may please the court my name is randall forbes i represent the f l lot cathy thompson who is a disability claim i think ultimately security cases boil down to what's in the r f c and then how does that relate to job numbers and in this case it is telling that with a ninth grade claimant the r c is written so that if she would be able to just be sure that i understand your claim looking back at this period as your claim that her cognitive and emotional limitations based on the acrophobia the panic disorder the depression would themselves have been enough to render render her incapable of work or is it your claim that those conditions on top of the physical impairments that she also suffered well i fishing i did not do this case at the ministry level but i can tell you that every j improperly gave it little weight that's correct and when the limitations that fairly derive from that report are put into the r the vocational expert valuating all of those limitations could find that there is no work available especially in relation to  work attendance issues on the agoraphobic part of it or meeting too many breaks because of psychological symptoms of make her in the work setting those kind of things disorders render her incapable of work because she was already found it was already found in snapping challenge here that the physical limitations that she experienced in that period did not do s this link report and i understand your position on that to say that she isn't just serving it's a mouthpiece for ms thompson there are some professional valuation going on here that's correct  he comments about the use of the word might in her conclusions and yet there are similar weasel words in the not counsel to eighty of examiners opinions the judge says nothing about them he the judge says that dr link didn't define moderate but he doesn't hold the nominee examiners to the same standard he doesn't require them to define mark felt partly because those are terms of art within social security and they're understood and one point is that all the non the non examiners and the examiner are all i've read public thousand of these psychological reports dr links report is of that dr like did a good job in my non psychologically professional opinion question about her conclusions she uses the word moderately and she talks about the overall picture yes one reason why i'm trying to get a handle on exactly you know what is it issue in this appeal is it does seem this would be reasonable for her to do so that action link looked at the full picture she talks about the physical impairments you know that the appellant suffered which clearly would have a bearing on her depression or mental health i mean things are rough right but when she makes that assessment she's not a medical doctor right she's just she's a psychologist so is it your position that assessment when she talks about her overall functioning is referring soley to the mental capacity because i think the a l j read it read it as referring to kind of full picture of the physical impairments as well as in your eyes and i make it i think reading context she's talking about the mental health issues mental health issues and and when she says moderate and attaches to work activities then she's essentially giving the opinion that all lubed work activities related to social functioning concentration persistence and pa of daily activities as they relate to mental issues all of those are in the moderate range and this i know i mentioned to your case at least once in the in the argument but this court has pretty much said that if you have moderate good day sion in concentration persistence and pace that's going to translate in some way or another to a he wasn't you know going beyond that that maybe you're on a ride and i don't know for sure i noticed that too i think the other side to arguing that the idea she could complete  good morning david love it on behalf of the commissioner may please the court documents opinions stood pretty much alone in the medical records as indicating significant mental limitations but it is a pretty comprehensive psychological evaluation  goes through quite a few pretty standard questions that she's got her starting around page three the mental status examination she's asking things like name date time who's the president you know where to sunrise west fifty two weeks and year in and on down through things tests or on math tests or on speech mood  extensive mental status exam and so it's not just dr blank saying you know she says i feel terrible and so now i dr linkable to write down the cheat feels terrible it's much more than that  or part of the problem here is there is that there are findings from mental status exam and then mixed into the out in the conclusion dr ling specifically links  her conclusions to ms thompson's reported symptoms and those symptoms were both physical and mental but that you're talking about the top of page six and it looks to me that really ready for she writes the sentence thank you for this referral she says based on the findings from this evaluation and the records supplied with the referral ms thompson is considered to be functioning at a moderate level to impaired in terms of work related activities in respect her overall level of functioning and she begins by saying i'm doing a mental status examination so you're really asking for a level of precision and drafting that doesn't seem realistic to me well your honor when ms when dr link says overall level of functioning if you look at that term and then go back to the last sentence of the relevant summary it seems as though the overall level of functioning is referring to mr thompson's reported symptoms that would include physical and mental i wasn't sure that that's the whole report is about mental and the reason for the referral undermines the significance of the report the annual jade's snarky about this report it's a very sell called opinion yes it's well it doesn't seem warranted at all this woman has done what strikes me as an extremely standard psychological ability examination well i think with the l j was getting at is that it's that dr link seems to look at both the physical and mental how can you get that when one sentence out of this whole thing might get you there but the context and and she's telling you what she does test results test results on the mental status examination and we go through pages of test results it's like three pages worth i just doesn't seem at all fair description well your hon was also getting at is that a lot of the test results were were fairly normal and that this as your honor mentioned this was a fairly extensive mental status exam and she can't multiply that's for sure she's not she can't do arithmetic she can't do serial sevens she completely screws that well your honor she got it the issue with the calculations of that she multiplied instead of out of well in one case that but then when she tries to do do that she did some it make some mistakes in that but what i was going is this was a very as it is your honor mentioned a fairly extensive mental status exam and it included remembering as objects after a twenty minute period and she was able to do that and dr link didn't need to redirect her and yet dr link study can attend to only pounced lara less than fifteen minutes that i think was a red flag for the l j in questioning where dr link is getting it's getting her was getting her conclusions these are very very basic tests you know this is the examination that's going on at the time that george w bush is president and she knows george w bush is president she doesn't know where the sun rises she says it rises in the west she has some fairly sensible answers to judgment she's not sure what these praveen proverbs mean which suggests an inability to think  abstractly people live in glass houses should not throw stones she said what you see is not always what it is i guess right but the other proverb she i think she pretty much got too many cooks spoil the broth too many poor people putting in makes it bad so she got that proverb and she does know a bunch of presidents and washington lincoln nixon and reagan and she did get a lot of the lobby edition right and and if you look at don't get the additional righteous she my plight i'm sorry a lot of the multiplication correct sorry are and she dresses up the subtraction but if you if you look at dr links opinion with the rest of the record which is what the l j dead is clearly you meant i just want you to admit that it's a mental status tests done by a professional the social security administration itself selected course it's one piece of evidence in the record i don't disagree with you about that at all yes this is what the only professional it's a non examining state person isn't going to have as much of a sense of what she can do since they've never met her this was a report from a psychologist but it's as i said before it seemed to take into account physical and mental limitations and that we've been through that but anyway ok ok i'm sorry is there i don't think it does i think the vast majority of the report the test that she does is a mental status test if of and there are two sentences in the report both of which appear on page six where you could by pushing think that she's can text to allies ing her psychological of pinion against the backdrop of the documents the social security administration itself has given her about what this woman does for a living she gives just a list it is alleged that ms thompson suffers from ankle problems arthritis panic attacks high blood pressure obesity diabetes and depression but she's not testing about anything but the panic attacks and the depression and counsel me ask a question following up on that if if she should if the chief judge would is correct here this is a mental status report can  disregard it or give it as little weight as he did or do you think if that's correct and it is a legitimate mentalist you know status examination that he still would have been cracked undermined the eldest house with weighing the mental opinion with all the medical opinions so the ets the elegies are all to give medical opinions as much weight as as is appropriate under the regulations and two of the two of the important factors on the regulations are consistency of bill to the l j looked at the rest of the record and he saw that this time since medicaid the thompsons mental health symptoms were controlled by medication she only had specialized mental health treatment for a six month period nine months issue here at the she stopped the treatment because she felt sure that she melts her goals and the counselor who was seeing her described her symptoms at that point as being mild practically on the slight level so indicates that they were based on the claimant subjective report of symptoms made at the single interview with dr link they were not based on dr links observations of the claims mental status or activities nor were they otherwise independently verified by dr link seems to me that's not an accurate description and history for dr link is administrative tests to work well the way i was just wrong i think well the way that i believe that that the l j is decision should be read is that he is that he was looking at dr links the lack of support being that some of the information came from physical symptoms and then seeing that that and then looking at  looking at the ms thompson's report of he was basically looking at miss thompson's report of physical symptoms and that the evidence from the mental sas exam didn't bear out the striking was faced with dr link who was alone in the record as as opining on significant limitations added to that was the indication that dr link based at least portions of her opinion upon physical symptoms not just mental symptoms and without the l j reasonably under the regulations afforded dr links opinions lusting great weight therefore we asked the court to affirm th anything further mr for