and april of one nine hundred ninety eight with an adverse hearing decision dated january of two thousand and one and during the period that is covered by that by the onset date and the adverse hearing decision completely has consistently expressed his opinion that ms larson because of the combination of impairments is not able to function in any kind of a work environment i think the key question is whether or not  pages are attached to the index that the first type is a pain disorder associated just with psychological factors and in that situation there's really nothing physically wrong with the patient but they have a myriad of psychological symptoms which have  and cervical spine car status post carpal tunnel syndrome five or my outer and other physical impairments those physical impairments have a prominent role and the pain but also there are significant psychological conclude that the patient is honestly reporting what they subjectively feel because that in order to make that diagnosis the clinician has to rule out maleng arraign and rule out conscience conscious and to magnification larsen has a pain disorder when she gets examined she is not on physiologic findings on examination her complaints are in excess of what would be expected given the objective medical findings the question becomes are those signs and symptoms are they indicative of maleng arraign or intentional since the magnification or are they the product of psychological factors beyond her control and in order to diagnose a pain disorder the clinician has to conclude that those symptoms are a product of psychological factors beyond her control both the psychologists in the psychiatry has made that diagnosis the commissioner adopted that knows this but then relies upon those same findings to sable she is not credible and because she is not credible and because dr bronco relied upon he says are on a regular basis and he concluded that she couldn't function well you know counsel let me ask you this there was one of the concerns that you have when you have the treating physician who's as you say maybe hundreds of times and they choose to plea assume that she has pain now there was a board of examining physicians that apparently looked after her circumstances in some in her and her neck but they were looking at whether or not to reopen it later when industries claim or to open a way for labor in industries claim and they were only looking at something that was costly related to her industrial injury the psychologist dr cole and that panel meant it indicated that in his opinion she was psychologically nonfunctional but the psychological impairment was not found to be causally related to the industrial condition continue to deteriorate up to the date of the hearing the station by the time of the administrative hearing and really by november of one thousand nine hundred nine she was essentially an invalid she was receiving sure services to help her with her activities of daily living and she was she was getting help to get on and off the toilet and ever food prepared and to have her her own coin i don't think there's any dispute that your client that she could do actually judge that's not the case here the this case sits right on the equilibrium point between disability and nine disability because of her age and her vocation and background because  the administrative law judge in the commissioner of concluded she was limited to unskilled work if she was limited to sedentary where she was disabled under the medical occasional guidelines by rule the residual functional capacity a assessed in this case is the absolute minimum upon which your denial could be based if there's anything if if the r f d is wrong at all and any significant way it puts your end to it and corey disability but in order to do life work she's got to be able to be on her feet six hours of an eight hour day well earlier miss is the duncanson who is your witness yet in addition to testifying favorably to your client also gave some for testimony is a matter of record and it can be reviewed and there's no question as duncanson was frustrated with ms larsen she was living with her she was caring for her she was providing she was doing all this stuff for her and she wanted her to try to do more but if you look at first she what she said ms larson was able to do it still way below the sedentary level they talked about sometimes they would leave home for several hours and go into the community and go shopping but when they returned she'd have to go to bed and that level of activity is is not consistent even with sedentary activity let alone light activity little bit over  there an answer to that well part of the answer is that we've got two different sets of laws two different governments two different criteria we don't know what the criteria are for the state of washington to  and the l g looked at all of the facts the entire record listened to the testimony and made his decision that was somewhere in the middle of a very detailed residual functional capacity finding a very thorough examination of the medical evidence and she state agency reviewing physicians who had the advantage over all the other physicians of looking at all of the evidence that was in the record collectively and so security really ninety six sixty tells us they're experts in of course gets to the the whole basis of a pain disorder the key with the pain disorder here is that the diagnosis by itself does not immediately mean the plaintiff is entirely credible and dr cole part of the panel  examination said that she had a mild pain disorder we have to evaluate not just the diagnosis but the degree to which the diagnosis actually of the facts plain and in this case it's mild category two under the washing it's she has a pain disorder she's not a well woman absolutely is that other work she could do or apparently the ritz and that's you know counsel i'm sorry to interrupt you but i'll be candid with you i mean i think judge thomas just lai scrub floors this woman is not in this record by admission of everyone capable of doing any such thing and then of course you've got this idea that you get help on solicitor and then you acknowledge that us that the question of disability has a medical animal creational compartment and dr graham cole is qualified both in his professional capacity and as far as the regulations allow him to be qualified to give us an opinion about the medical then we would use those terms in the sort of context and i agree with you that the activities of the case when you initially read the statement of facts you think there's this woman can't work but that's not the standard the standard is what the people who understand i understand that the standard is very high don't get me in intensive care in order to visually disabled i agree but i don't think it was that she can't manipulate at all and i don't think there's any basis for that kind of