from dr donald dexter primary focus is on the opinion of dr florent wind akita that she could be active for no more than three hours per day left not more than fifteen pounds rarely meaning less than five percent of the  we we have the judge making two primary findings one being that she was working within the context of a worker's compensation  not in the car the doctor's opinion was in the work in the context of a worker's compensation case and not on her social security claim on the law or the facts of the case indicating that was inaccurate  the judge was actually saying that this was not a worker's compensation but that he started evaluating her based upon her representations that she needed help and evaluation and did apply for social security second part is the judge pointed to the demands placed upon her state that she was unable to work now the judge pointed this out in september of two thousand and ten when the statement was made yet the evaluation was done by dr florent in two thousand and twelve the fact that we waited for that length of time before he resumed willing to state his opinion would lead one to believe and i would point that we don't need a whole lot of the evidence according to the herman decision to stablish or substantiate what not or or what information the doctor relied upon the fact is he made the statement he's a treating source he felt that her condition was severe enough to make this finding and there is nothing but speculation on the part of the l j to assume or to try to assess that he did anything but this there's nothing that the judge points to that specifically identifie how or why this opinion would have been skewed in such a way to do benefit for the claimant now i have indicated in here that i was encouraging the court to adopt a more stringent position on the treating physician role and i would just take a moment point out that interestingly enough a couple of weeks ago the circuit rider published a decision from  judge johnston in the northern district of illinois addressing the same points i did which is the utter confusion that exists with the treating physician role and i think a lot of these cases especially this one come before the court because there is such confusion in the standard i think and it's my position that the the regulations adopted by the social security and by all basically have created a presumption that a treating source statement is given a presumption less significant evidence shows that that presumption is overcome the ninth circuit has indicated that presumption should be overcome only on clear satisfactory evidence and the court i would goggle kind of implied that already specifically indicating that a true that a consultant of the examination alone is insufficient evidence to overcome a treating source and i guess that's the question  and then the judge either approves it based on the treating physician rule or actually applies the regulatory factors and provides a two or three paragraph outline indicating the factors we would certainly additional economy if the court made clear that that was the expectation to begin with and any statement that any algy's you measured in terms of length of discussion kit we should do we need to be more specific than that and how how would that work the law that is the law and it is not the law there is some case law in the circuit which says that if the l j provides any indication that he considered the rules or she considered those regulations that's enough and there's some his law on that there's also case law it says that that has to be specifically address there's also some case law that says that the only applies if the presumption of controlling waiters overcome and then there's something that says that any evidence is sufficient to overcome the presumption so there's if a review of the case law over the last ten years seems to imply that there's some real inconsistency is and how it's at plot and what i'm asking is is option provide detailed assessment saying why provide clear and satisfactory evidence why the presumptions overcome then once that happens apply the regulatory factors by requiring this  initial phase we're saving not only federal district court time in reviewing these or also saving l j time because when there's a remained to do judges oftentimes judges who did not do the original case have to hear the remaining case and it's delaying and slowing down the whole process when the whole point of this was socially security established this pecking order that treating sources the most is the one  receive the most weight because they are familiar with the claimant they have observed they can assess credibility then the next is a consult of the examiner who's actually assess them and the least a weight is given to an examiner who is neither examined nor treated and they establish this which seems to imply that they want each of these to have different weight because they understand the impact of these on each in this particular  opportunity to see her exact situation so i guess that's the point i'm making on this and i'd ask the court to private to try and provide some clarity for all of  us in regards to this by requiring more meat on the front end so that these cases are reduced i know that judge johnson in his article indicated that in two thousand and fourteen there were four hundred eleven in the northern district of illinois but one hundred sixty in two thousand and five i know myself i filed one hundred twenty federal district court pieces last year or so and briefed every one of them myself so it's busy and we we continue to have this problem this is an issue that arises and almost probably seventy percent of the case i'll reserve my remaining time for  by the ninth circuit the question here as posed by counsel is whether or not there should be a presumption that the treating physician should be given controlling weight there is no basis in the law for a presumption right out of the gate at the tre physician should be given a controlling weight and appellant has not provided any statement that there is any law that cries and that is because there isn't the treating physician rule is actually somewhat straightforward as far as the agency is concerned if the opinion is well supported by medically acceptable clinical and laboratory diagnostic techniques and it's not inconsistent with other substantial evidence then the treating physicians opinion gets controlling weight when it comes up to this court and is reviewing a decision by  weight to give a treating physician we come to the substantial evidence standard if the l g s decision is supported by substantial evidence it stands this court knows it has the logical requirement which is a almost a commonsense requirement to l j has to provide the support for his or her opinion counsel opposing counsel would like the court to adopt a more stringent standard that would apply apparently a checklist of factors in every case or require the l j to address specific items every time that is why not called for by the regulations of statute and to it's unnecessary when this court gets a case before it if the l j is only touched on one factor and hasn't supported his or her decision as to why position is controlling way this court understandably sends it back it has a problem with it if an l j provides two or three reasons and those actually turn out to be enough when looking at the facts of the case then this court in certain instances might uphold that decision  it just goes back to a sort of common sense approach and the good reasons analysis the regulations just provide that the alteration applied good reasons for the weight given to the treating physician in this case those good reasons were provided counsel says that the primary focus is dr florence opinion i would note that the only focus is dr florence opinion that is the only opinion that counsel raises any argument on or challenges dale chase analysis of when it comes to that opinion the l j provided numerous reasons as to why he discounted the opinion it was quote contrary to the dr florens clinical findings it was contrary to the other objective findings in the record it appears designed to placate a demanding patient d l j's analysis is pretty clear here there's no question in my mind tonight doubt there's a question in the court's mind to reach the opinion as to why the l c a did not give control and great to the second opinion from d for what we had was an opinion in september of two thousand and ten where dr horn essentially limits claimant to you sedentary work not in those exact terms as defined by the agency but there's not a preclusion to work i sighed from that she can't walk on rough and on even surfaces has some problems with her legs but is a far cry from the january two thousand and twelve opinion where he essentially  d that she is disabled and then the question comes to in analysis analyzing that opinion is that well supported is it consistent in this case it is not in terms of what we know dr floor and looked a reaching his generate two thousand and twelve opinion we know only that he looked at the claimant there is no evidence that he had reviewed records at that point in time when dr florin goes through claimants various ailments  notes at the end that claimants husband backs up those findings are also skews patient is accompanied by her husband and agrees with the history as stated above which i believe decides not to give that opinion control w the court doesn't have any questions tells us she's not disabled not completely precluded from work at that point but that in two thousand and twelve takes the approach that additional respiratory and heart problems in pushed her over the edge to disabled veteran yes i did not show that it's entirely clear as to the basis for his more extreme opinion but given what's in his  there are additional information piece of information that are available in two thousand and twelve that were not available in two thousand and ten as well and i never can pronounce this right and arnold kyary malformation was found in the head she also suffered from bilateral older ra pathy that had to have surgery shell so started having the heart issues as well as she had had since two thousand and ten problems with the leg that had to be treated all of these are factors that the weigh in here now counsel did do doctor for him having me that he hadn't seen her for about a year or half or so right correct but there's nothing that indicates but the only thing is is as a general as her general practice basically her general practitioner access to the medical information would have been there i wish your doctors would say i reviewed the medical record in their records but they don't but i guess you would like to believe at least the doctors do review the records when they're before they treat a patient otherwise we would be talking about other issues legally but in this particular case of with respect to counsel clinical findings and other records the l j makes reference to them but there's nothing in any detail showing how there is this is alleged inconsistency where where is this in