but please the court i'm charles talbot representing mr churchill this is a social security denial and the main point to be emphasized in the case is the old days failure to abide by the agency's old rules and regulations specifically the pale french lee rejected all of the medical evidence in this case from treating sources relying solely on a one time examiner dr janssen agency rules under twenty c a far for sixteen point nine one three and s s r zero six point zero three p required consideration of medical information regarding regardless of the source an agency differentiates between what are termed acceptable medical sources these are doctors and psychiatrists and psychologists the doctor janssen was a psychologist and the  other treatment providers were all rejected on several grounds first of all the judge rejected all of the other medical evidence in this case one of the reasons given was because they were not acceptable medical sources in at least one instance she must characterize a physician as not being an acceptable medical source that's referencing dr hargrave secondly she says that the information is not to be considered because the information is provided in the s h s checkbox forms the reports that were filled out were d s h s forms they were not completely checkbox in the sense that in every single d s h s report there's annotated notes from the examiner as to their findings furthermore and this is the stronger point is all of the other medical providers in this case our treatment providers are not onetime examiners like dr janssen the report from the hale zimmerman hargrove  more are all from treating sources these are people who are on the active treatment team providing medical treatment for mr churchill's mental illness so they have more than just this for the the judge says well also that these people relied on mr churchill subjective reports that ignores the fact that with respect to these reports each of the examiners  is part of the treatment team and has the entirety of the medical record available to them as part of their assessment the only person who didn't have any substantial information is dr janssen she had one note one page that was post filing in this case the case was filed on april eighth two thousand and eight she had only one piece of paper from after this date was only shortly after the state and if anybody 's relying solely on the subject of it reports of mr churchill that's her but irrespective of that you can go through all the medical records they all right mr churchill i f score in the forty's ranging from forty five to forty nine indicating very serious mental illness and even dr janssen rated him in a forty nine that indicates severe mental illness work day that limitation is ignored by the judges not mentioned in the r of c and it's not mentioned in the questions asked of the vocational expert not hearing in cross examination when that limitation was presented to the vocational expert the comment was that that would preclude sustain gainful employment so we have errors in terms of evaluating the medical evidence and characterizing the nature of those sit down and you can reserve your remaining time thank you for  please the court martha bowden on behalf of the acting commissioner of social security good morning i'd like to address some of the topics that mr talbot addressed when he was presenting chris of all it's not an accurate statement that dr janssen was the only opinion that the l j relied on in making her non disability determination dr janssen was was one of the opinions she also  for disregarding the opinions of dr who even more not she yes he she gave one which was that it was inconsistent with the objective medical evidence that's what she said in the paragraph where she addressed dr moore's opinion she did not speak specify in that paragraph on page twenty five of the record what those specific pieces of objective evidence were but two pages and one page prior in the body of the decision she does chronicle the medical evidence that she found probative and it does in fact conflict with dr morse findings because dr moore said that mr churchill was markedly to severely limited in many functional domains that were required for even unskilled work and the medical evidence didn't support that and she chronicles the medical evidence in the body of her decision with her counsel do we have any precedent in the ninth circuit that gives us crimes as to how explicit or express a male j has to be and giving reasons referring to specifics if the jury thinks that particular doctor's testimony conflicts with the objective evidence well there is the case of embry on which mr churchill  which says just saying the objective evidence conflicts with this medical sources opinion is insufficient however embry is distinguishable from this case because in the embry matter the evidence that was in the body of  decision that the listed and discussed actually it was not inconsistent with the opinion so that was a mischaracterization and the court found that in that case so in this case if you look at the didn't even include jansons limitations from the hypotheticals to the v no those i those were included what what dr janssen actually said was that the that mr churchill may have limitations in his ability to handle complex tasks and what the r f c said was that he could do some complex tasks what what counsel said mr dr francis said was  that the claimant would have difficulty persisting through a work day that's not what she said she said if he were to have difficulty persisting through a work day it would be because of his depression symptoms and not because he had cognitive problems of concentration and attend e because she did some objective testing some trail making tests and a mental status examination and she found the results of those show that he did not have concentration and attention deficit and he had adequate recall so what she said was if you were to attack any problems persist in through work day it would be due to depression symptoms but it didn't seem like she actually adopted that as a limitation or i thought another thing i'd like to address is that one of the reasons that the day discounted the d s h as psychological evaluations was because they were in checkbox form without much narrative support that is a factor in the regulations that that the may properly rely on to discount a medical opinion and if you look at all of the d s h s evaluations in this case that the algae discounted they are in fact check box forms and other than that there is a little narrative written by each of the by mr mr zimmerman and miss hale and dr hargrave but what they say in their narrative section is soley  reported so for example in the record at page six thirty six what it says mr zimmerman wrote jeff that's mr churchill reports an inability to concentrate difficulty with memory recall and staying on task and pressure so she gave him a marked checkbox in that functional domain and that is representative of the rest of these opinions so all the handwriting was actually he reported he reported he reported and then that resulted in moderate mark limitations on their forms and that is doesn't it conflicts with their own treatment notes which don't show that he's markedly impaired and i'd also like to address council statement that these doctors and mental health counselors were not acceptable medical sources that is indeed one of the reasons that the gave for discounting for that reason her analysis should stand even if one of her reasons was erroneous and in there for the rest of the providers they are treating providers but not treating sources because under the regulations they weren't acceptable medical sources and that was fair to give them less deference because they aren't acceptable medical sources who are treated with the most deference of any provider do you have any other questions for the general informational question having to do with the merits of this case but we have a knowledgeable person from the agency in front of us if this individual mr churchill were awarded minutes on republic thank you judge in response to your question s s i is a need based program the payment of benefits is dependent upon the economic need of the recipient so when a person is found disabled under s s i he has a meeting with the agency and they explore his financial need the maximum benefit that can be paid this year is seven hundred thirty three dollars a month and it goes up every year due to the cost of living i c you what the benefits are it's about twelve thousand dollars a year roughly well know about eighty four hundred eighty four hundred ok and since this case was filed in two thousand and eight and only april benefits would be payable if he's judge rejected dr moore's statement in a simple sentence saying dr moore's opinion is not supported by the objective medical evidence and it's granted little weight there's little meat on that bone in the embry kitty says you've got to have more and we cited that in oregon that in our brief and and that's important because this is an acceptable medical source and this is a doctor moore's opinion is it is from an acceptable medical source as far as dr hargrave is concerned she is also an acceptable medical source but not found by the judge as an acceptable medical source and she put some pretty severe restrictions in her assessment including the ability to understand remember and follow complex instructions learn a new task in a quote interact appropriately with public contacts and maintain n there's more to it than what counsel said enough i can we laid out in our memorandum exactly what she said in the way of limitations and if you'll permit me she said that regarding her functional limitations she said that his major depressive disorder has psychotic features that he may have difficulty in persisting through a work day which would be attributable to vegetative symptoms of depression that he may have difficulty performing complex tasks due to a psychotic thought process and the fact that the isolates himself would lead to difficulty interacting with the public or with coworkers on a continuous basis she assessed a ga f score of forty nine and this court we didn't cite in our materials because it was a case decided by this court after that we briefs were filed with the court issued the and as i said in my opening remarks the gaffe scores in this case by all of the individuals including dr jansen all fall within a very narrow range of forty five to forty nine indicating that it's a pretty severely mentally impaired individual that's one of the reasons why we didn't argue credibility in this case that's mentioned peripherally critically in a response brief because with a person that's so seriously impaired we thought it would be contra indicated to argue against credibility because we just don't think this individual because of the level of severity of his mental illness is really able to keep it together long enough throughout these numbers of years to give any sort of consistent reference to his problems and and keep in mind that credibility in the social security context does not mean what it means parlance it doesn't mean a person is telling the truth or not or lying what it means is their statements about their condition are not consistent with the record it doesn't mean lying or telling the truth that means something else so