security disability benefits at step two of the sequential analysis this is nothing applied for disability insurance benefits alleging that she had become disabled in january of two thousand and twelve she was denied benefits when the judge found that her  psychologist but i thought that was one of the issues was that she never did seek out psychiatric care oh to the contrary your honor the claimant did see dr caplan for looks like it was over a year from two thousand and eleven to december was he a  and then the that's i believe that's going to be the records that existed and even cited to by the administrative law judge as a basis for finding that the claimants symptoms were not credible but that's a separate issue that i'll get into in a moment  the after the treatment of psychiatry is to claim it indeed went on to see there appear to care from a psychologist dr bashar ski and saw the doctor for multiple times on a weekly basis for therapy now establish that her anxiety was more than a slight abnormality and indeed had more than a minimal factor her ability to function in the workplace the screenful and it's intended to borrow or to get rid of concentration content was isolated and this is that administrative record to twenty those findings carried forward through the end of the treatment into december of two thousand and twelve well beyond the alleged onset date the claim and then went on to see a doctor but our skin april rd team the goal there was for dr barsky to help treat her panic attacks despite this treatment though over the course of three years the record demonstrates treating her for did her urge to go to the emergency room as a coping mechanism as they called it her safe place and this is true and for the record and mistreated record i believe it's  seven documents a judge's acknowledgment that these were indeed ings and in society related these there is a conflict between the judge's findings that he's in parents don't need that in this threshold and the finding that the claimant indeed had to go to the are as a result for ongoing side well but counsel i think part of the problem here and this is what i say try to spend some time fleshing out maybe you can help me is there does there is a conflict between even some of the medical it seemed in certain instances to could be contradictory to what dr r ski her own physician had to say about the severity of her parents so i think very lies one of the other issues that we brought up in improvements those wins are short lived the notes have an equal if not more number of reports which show that despite these increases in improvement there was periods where they were well to pull e r visits even in that very the inconsistency that the judge noted are just inaccurate the for example the judge does note that dr kaplan's report shows that she's stable you're under the record actually shows that stability was a goal not that she was stable indeed the original two thousand and eleven report showed that she had difficulties with concentration poor concentration the two thousand and twelve very last visit  can no thank you i think that's helpful i guess what i'm trying to figure out is what is our standard of review here because i think you're right that in the as you look through this in some areas they all j did make findings that are either not supported or in some instances contradict it but don't and szell evidence and if we review for substantial evidence if j has five or six reasons for dismissing or discounting miss malcolm testimony even if two or three of those don't seem to be supported don't we still have to credit that jones find me you know the two or three that maybe we meet we may even take a different view you're making a pretty compelling case for why miss malcolm is disabled but but we're not arguing this and so what do we do with that we have to discount do we have to go through every one of the  discredit it in order to rule for your client no your honor the dominik standard step sue simply requires that the claim show that her impairment is more has more than a minimal effect on her ability it's more than a slight at normality that's the standard the reason that the judge used to find that it was not are all invalid and we outlined every single one of this including the statement that he used for dr kaplan the statement that he used for  and the statements that he used about her daily activities these are all reasons that are inconsistent with the actual red record a full well one of them that he relied on the day o j relied on was that there was no evidence to substantiate any limitations in their ability to sit or walk or certainly not to the degree that she alleges and it seems like that would have been mentioned in the medical records so i mean there does something seem to be some suggestion that she was a validation how severe it was no you're right b b r visit seemed to be kind of record evidence on that but i guess that's what i'm getting at is there does seem to be some areas where she seemed to be embellishing even beyond what her own  specifically the twenty four thousand medical sources in indeed indicate that there were physical symptoms and hyper sensitivity to the physical symptoms that were oftentimes triggered by her in zion the fact that she pursed she believes that she's limited in these physical ways is not inconsistent with the various different emergency room visits she went in for whether it be for palpitations headaches or just plain anxiety these are consistent with the entirety of the record and we don't have to show objective evidence specifically outlines why she should be limited to say a limited physical limitations including not being able to stand sit or walk and that's not what the de minimis standard is we just simply have to show that it goes beyond more than a minimal impact and here the records from the psychologist the records in the psychiatry and the records from the emergency room visit emergency room all support the finding that the claimant has severe mental impairment really we're not arguing here that there are physical limitations we're not arguing that there are objective evidence to support that instead we're arguing that those physical manifestations with the claimant believes to be physical limits are the result for severe mental am can you hear me clearly we can and now in terms of you keeping track of your time can you see the clock or yes i do have a clock available ok great i will go ahead and if you like i can give you a one minute warning that would be appreciated thank you i'll do that and you may proceed take your honour's shape on behalf of the commissioner of social security to answer your honor's question about the standard to review the applies to this case it is a substantial evidence standards it's a standard that still applies to step two of the sequential evaluation and the review constitutes i agree with counsel that it is the record as a whole and it's our position that when you review this record as a that when the standard is that the algae needed a clear and convincing reason how do you combine that with this is the actual evidence standard you need substantial evidence of things that are clear and convincing well i mean i think that's part of the problem with the clear convincing reason standard is it's a little unclear what what is a clear and committed how that standard applies but the substantial evidence standard it's a it's more than a mere scintilla the evidence has to scintilla to support the conclusions of the l j so if we're applying that to the rationale that they'll just give for evaluating evidence say the subjective symptom testimony if there's substantial evidence in the record to support those reasons now a clear reason can be details a state the reason and we would say that yes they gave specific reasons whether it was the lack of objective support or the type of treatment and the effect of treatment or daily activities those are again the convincing has to be based on the substantial evidence standard and it's more than a mere scintilla i think that's part of the problem with that basically the clear and convincing reason standard is i  you look at the clear and convincing reason that was given by they all j and then i ask is there is there substantial evidence to support that clear and convincing reason and if there's not that clear and convincing reason we say there's substantial evidence to support that we might decide it differently but there is substantial evidence to support that do we then engage in a separate inquiry to say well even there the there is substantial evidence to support that we don't find it clear and same thing but it's looking to see if the rationale that the l j provided has support in the record and if it's articulated well enough in the l d s decision so that this court can discern whether you know the reason has to support and discredit the claim of testimony so there's clearly a separate step in our case law there has been that's how we have a standard that you're saying we should have isn't that right well it's saying that if the court is looking at  the reasons availed they gave it still looking to the substance of whether that is supporting the l g s conclusion and so if the court is not not convinced that the ayles a citation to say the daily activities related to you know the limitations that issue or was reasonable for the l j to have relied on the type of activity or the extent of the activity i still say that falls back on a substantial that specific part of the record here so one of the just use as i understand it's year is about whether miss muffet household activities show that she's actually more functional th she claims and my understanding is a all day said she could take care of her children and cook her testimony was that she could only take every children with the help of others that she could only cook small things and then would have to stop  that she couldn't drive at night and couldn't drive for more than five minutes and not on the freeway and i bet there are all these things that i guess you could characterize as partly functioning but you could also characterize them as really not  needs she has a driver's license she's able to take care of all of her family's needs at this time so the fact that she's saying she can take care of all the family needs that doesn't talk about any kind of assistance that she later on said that she could not take care of her children she could not reason and if we're looking into dr rich those report itself there is that's the support for it and to me that's convincing as she's saying that she can she's reporting to a doctor that she can perform all their activities and there's honor i would like to say that in this record if you're looking for the object of support for a severe impairment which you claim it had to prove here doctor but our cities records do not have the clinical support she does not record objective mental status examination and i disagree with the opposing counsel's cases cited in the reply brief particularly buchan ryan as support that a claim is subjective statements essentially alone can provide the necessary missing objective support that's not what th because i know a lot of the cases that i thought you were citing were about physical therapy i'm going to refer back to actually the cases that my opposing counsel cites in the reply brief so buck and ryan and although counsel has represented those who are saying that  the clinton subjective complaints are kind of the primary focus on ryan they talked about the clinicians actually did clinical interviews and performances as examination findings and particularly in ryan this court actually outlined the type of mental status examination findings and the list included and it was an exotic case as well behavior that was odd rapid speech easily agitated very angry distraught nervous shaky and edgy so those are the types of objective examination findings that is kind of like i guess i would describe as a physical manifestation of the mental impairment during mental status examination  but then when you get to the emergency room records for a very lengthy period of time which also overlapped dr caplan streetman i think about half of the time that he treated you don't see those types of examination findings and i would submit that given the nature of the impairment that claimant describes the l j and as dr of our city was exposed stated in the opinion that you would expect to see some sort of abnormalities during the clinical examination findings during the hospital records but consistently except for maybe one or two visits a claim and did kind of anxiety and one of those visits she actually had stopped taking her medication her select so that explains exacerbation of symptoms but consistently the emergency room records show that she was in no acute distress she was cooperative should know respiratory distress she's normal mood and normal aspect the fact that over several year period of time we have house records the consistently show these normal and i think that examination finding and we have no such mental that if examinations i need to contradict that from d if that that is substantial evidence to support the conclusion that the claimant although definitely having a medically determinable diagnosed mental impairment did not reach the level of severity as defined in the act in the commission's regulations with regard to the opposing counsel statement about the not being based on any objective findings or any records i think context again matters in this case this is a psychologist who's  counted specifically states that this is opinion in twenty four to speak is based credibility is important so it employed to help me where i'm up because i mean there was a lot more of that report than just what the psychologists was one hour sessions he was reporting on a whole bunch of scenarios that miss malcolm reported to him about things that were he stated or she stated rather that the claimant was in panic or had inside the attacks the are in distress they're not in what the defense counsel says should been in soap format however the record clearly documents the variety of different inside the episode that the claimant has supported by those visits which i made it leave they don't that she didn't go in there because she had she said she didn't tell the staff that she was having an anxiety attack rather that was and she was fearful of having a heart attack or she was fearful after she didn't go to the is documented in the treatment psychologists opinion to the issue of subjective statements about the severity of her impairment with the record the feel or to see a psychiatrist that the claimant somehow so bade her psychologist order but the records show she can't be away from home for more than a few hours at a time these are things that are dull to her impairment self and this court has previously cautioned against chastising a person with mental impairments for failing to seek proper rehabilitation  the record that the judge cited she was her husband her husband didn't report she could take care of herself her family and her it is indeed the she could not because of fear and and indeed the claimant could shower without her husband being there because to come she didn't regard yourself as a children's primary caretaker instead that job was for older children as her husband her in laws and her parents these are things that are inconsistent with the judges on fin