we raise several points of error for the sake of expediency let me briefly address two of the appellant's arguments that are you know uncontested are not directly contested and supply a basis for belief in the case before proceeding to the more robustly contested which the agency has not disputed arguing at the l j fatally erred by failing to apply the relevant mandatory factors in the agencies of political medical evidence regulations of twenty c f r section for and twenty seven c two factors detailed j must consider and determining what weight to accord to treating physicians who report even when the report is contradicted and is therefore not entitled to controlling way those factors include whether the treating a source is a specialist in the nature and extent of the treatment isn't and argument that was considered even if it was an articulated item by item the point is where in their brief they can see that that was futile or are they don't concede that they just don't address it and therefore it's uncontested that's my point not that it's conceded but that it's uncontested and they're sailing in factors because the treating physician here is a skilled psychiatrist a board certified psychiatry that's a factor that adds to the probative weight of the report it should have been analysis in the report that indicated we have considered that this is a skilled  specialist and that's a factor that gets evaluated and how much weight it gets even if it's contradicted you have a report that is contradicted by a non examining physicians psychologist and you have a treating specialist maybe the treating specialist gets more weight because of the specialization is that the real problem here i thought the real problem here was that the hypothetical so that's one of our major contested points the hypothetical acts like this woman has been gainfully employed and it just doesn't reflect the social functioning deficiencies that she has nor does it cite the fact that she's probably going to miss four days of work every month no i think that's absolutely correct and when then when the vocational expert a pines that if she was kind of missed two days of work a month it would be any job she could get so it just seems to me that that that the  the hypothetical is like apples and oranges with the picture that hammond has as painted did did the algae have the residual function capacity notes it looks like the two commonwealth  and there's really only one short paragraph a few sentences that explains attempts to explain rejection of the parts of the treating psychiatry's report that indicate that this bizarre you cannot sustain competitive work with respect to that portion which is a political deal jay speaks to both treating psychiatrist hammond and board certified advanced practice treating nurse error mead and says these reports refers to the reports by exhibit numbers but not even to these sources she says there is no medical evidence consistent with the proposition that the claimant would not be able to sustain work at the residual function of capacity identified above including low contact that is the only analysis in the opinion of direct evidence addressing specific concentration of persistence in pain is what i call production output in speed performance speed based limitations from sources we've actually seen the claimant and the ale jason now assists and explanation is fatally deficient on several bases st he says there's no evidence but there is evidence in fact these reports themselves are evidence this is an expensive five he lied on the portion of it that he support that he found supporting his opinion he relied on the checks but checkbox forms that were submitted by the non examining physician checkbox nature of the forms is not an issue in this case not relied on by the a physicians they had better hammond's treatment it's right they didn't have the final report that's right from dr have and where the nurse they didn't have the extensive work related functional capacity assessments that translate these treatment notes but we know that they've been seen every two weeks we don't have bi weekly treatment notes in this record but we know that they have observed and seen over every two week period as is mentioned in the in the record  and we have congregants between these reports both of these treating sources reach the same conclusion both of them find using slightly different language that mr moussaoui cannot perform cannot sustain competitive work they do find that she can understand and carry out simple instructions she has the cognitive capacity for that but she can't sustain it dr hammet says can't sustain it because she's unable to complete a normal contain those specific limitations in two of the hypotheticals yes you did occasionally expert so is your is your is your objection there really that that wasn't considered or included in the sufficiently capture the full extent of the public's condition as reflected in these expensive too expensive printing source reports but go ahead i'm sorry testimony and be and that the noncompetitive standards seem very consistent that this woman couldn't go to college because she couldn't be around people she she doesn't go out and do errands on her own she prefers to be in a j he doesn't say there's a lack of credibility but she spits and he credits the fact that she got to a college degree and she did it online because she couldn't be with other people and ended the r f c pretty much lays that out so when the hypo says she can have occasionally interaction with coworkers supervisor and general public she can handle changes to essential job functions on an occasional basis it doesn't reflect the fact that the r f c says she can't she can't do peace think she can't be in a social setting but i completely agree with that assessment and i point out that the agency defines occasional contact is up to a rd of a day that's two to half hours more than two and a half hours every single day having contact with someone who has indicated she never leaves the house unless it's absolutely necessary socially isolate isolate herself and isn't around any people not to mention the interference with the concentration and focus to to mention was a factor when she was in college that required to drop out got together with a panic attack saloons idea of being around people a few years ago she called those questions the dummy questions go through dummy questions because she says it makes the representatives dumb they hear the l j mention these other hypotheticals that sound like oh wow we're going to win this case we're going to clue twenty five percent off what the r f c is when the question was asked i have to say if that is the response that would be far less likely in this case because you had all the evidence and testimony to analyze to determine the functional capacity from the june to work two days a week that he had some basis for that certainly you have the full record for that basis now if on retrospect he thought well maybe it's not quite twenty five percent maybe it's twenty percent off task it's fifteen percent off to us but we should have included those limitations of the hypothetical at least we'd know we would have a translation of functional limitations in some manner that is concrete and is meaningful for vocational expert because of vocational knows nothing about the meaning of moderate how do we say no substantial evidence of stachel evidence is that very very very low threshold for for our ability to firmly age and there's no substantial evidence here yes i would say there is no substantial evidence here because i could go through each and every piece of evidence but not examining physicians have an incomplete file the consultant about your waiter who was viewed as providing conflicting evidence actually know was distracted and preoccupied by her condition doing simple arithmetic exercises in the in the course of this short evaluation one shot evaluation donna cooper represent the commissioner social security good morning if i may i'd like to start where the conversation was heading which is the substantial evidence that would support the l g one thousand in that despite some evidence in the record the claimants testimony some evidence in support now i don't the form from dr hammond is evidence and it's important evidence but there what is it that contradicts that information that the l g was keyed to when he nurse there their reports are in lockstep that this woman can't meet these competitive these pretty important competitive factors and and be a l j pretty much discounts it doesn't even really good music under laois that should be the key evidence that should carry the day should it not it can and sometimes it does and in reality there were problems with the g s evaluation of observations that the hearing and that obviously gave this court pause and concern and was dissatisfied here however there was information in the record from dr hammond herself that the emphasized and that that information shows one hundred percent one hundred percent normal mental extatic examination repeated later that means normal mood normal judgment normal insight every single mental status check box is normal and the mental capacity yes in terms about zarf social function so then the other thing that's shown by those notes your honor is that they say nothing about certain problems if your honor looks at the notes they say nothing about being unable to be near others nothing and then we also at the agency in this is another component of the substantial evidence analysis i sent this lady for a consultation examination with dr e l koski and one of the facts that is in that report is that she was pleasant and friendly with intact social skills and no serious psychopathology so although the l j accepted that this was a claimant who did prefer to have a lower level of social contact he did not end up crediting for reasons that were grounded firmly in the record as contrasted with morality where the court was concerned that the algae was doing his own speculation are those to the very errors that we someone was unable to work for sustained periods recognising that there's a difference between house and we use and performs in a home or a treatment setting versus in work setting the stresses of a work environment that c certainly be the case your honor and in some cases there is a history that is really marked by high levels of mental illness and your honor that simply wasn't the case here or at least the l g had the fact finding latitude under substantial evidence testified otherwise this was a claimant who sought very limited mental health treatment who was able to raise her family independently who was able to shop she did not say in her testimony that she could not shop alone i mean i'm sorry her and her function report but she could not shop alone she said that she sometimes shopped alone that's not exactly the same as her testimony she was not it she was not noted in any of the treatment records to have an inability to socialize or to go outside of her home she's not diagnosed with agoraphobia so those things do happen in some cases you will see a history that's marked like that but here she sought treatment only in two thousand and twelve even when she presented the doctors described her impairment as moderate not big stream and once she started the treatment within a few months the find of her symptoms her own doctors are only mild and in there's a lot of forms of doctor ok so there's this there's the the medical source statement and the treatment notes so the medical store statement is what the plaintiffs are relying on as well as for testimony because of the check boxes but that same form that same form which is that the record at one thousand and sixty five tells the reader a number of important things before it gets to the check boxes and these are things that the l t did not overlook and commented on specifically who saw this woman repeatedly in response to a question as to whether she'd be absent from work they had the choice of picking never one day a month two days a month three days a month four days a month or more than four days a month both of them picked more than four days a month that's not in the hypothetical it isn't that in and of itself that these people are saying there is no way this woman is going to be in the workplace day after day after so your honor certainly identifying a fact or finding that could be made from this record the question is whether that the factual finding that must be made for should have been then the why should there be some reference in the hypothetical and so your honor that there were alternative hypotheticals and to judge house's question earlier my view on that subject is that the l t a will frequently include those questions so that it streamline it streamlines the hearing or hear the sending of iraq the tories and when the l k propounded alternative hypothetical questions they were on this issue about sustaining work activity and the l j address that in the occurrence if we were out here and we had a ve had a hearing and we had a claim that attorney and hearing often in my experience the algaes will ask questions that the claimants attorney on cross would ask to get them out of the wet and then to get them what to get them taken care of so that they don't it's more efficient so that way that will frequently happen and then if the l j upon further study of the record find that those limitations are appropriate to include for  decision at the record page fifty five the x be able to explain that he's looked at this issue of her billeted assisting work that's what those two alternative hypos and the check boxes in dr hammond's form address and the a r j says i've looked at this issue about being able to sustain work and i find that there's no medical evidence consistent with the proposition that she'd not be able to sustain work at the r c identified above including low contact and the low contact histrionic is important because she did explain that she did testify that she would prefer a lower context a choice and that's why she switched from community college to non like college and the a l j credited that to a certain degree but now you're point to her testimony and the statement is not that she is basing this on her testimony he's saying that there is no medical evidence none whatsoever that would be consistent or support the conclusions of the treating physician and nurse it does does that accurately reflect we for the record in your view it does your honor because i think the evidence is really the the medical evidence for this proposition comes from dr hammond's checkbox and this checkbox forms and what he's saying is i'm comparing that checkbox to the rest of the medical record and i'm not finding it longer but he did say that he that he discounts her credibility in part in other words he's not accepting that she's unable to perform work in a low contact job and mind you during the period that we're talking about she was also operating as a babysitter she stopped that she couldn't stand it she had lost children wrapped and so then the l j i understood that fact and explained specifically that job is not suitable for her but not other way the hypothetical was because she's she has work experience as a babysitter and an airplane cleaner she hasn't worked in ages so that's the way the process works your honor those that those pieces of information are given to me and we all know what a baby sitter does so once the l g a tell the vocational expert that this should be a low contact a vision we all know because we know what a baby sitter does that vocational experts going to say that the past work is not appropriate of course that's what happened here but even the information from her her own personal experience and the idea that she is independently raising her children when her testimony is that she gets a phone call to which to be woken up and how she raises them is waking them sometimes cooking and other than that when it comes to even basic functions like shopping that she needs assistance in the company men who don't we have that concern here is we didn't merola stat and when we're talking about mental health treatment we should be particularly concerned about an a ok substituting their own medical judgment for that of the treating physician two responses your honor of course we have to look carefully at the record and we have to we have to make sure th doing what your honor just stated here we have testimony to the effect that your honor stating but it wasn't on contradicted her own her own own form before her testimony did not say that she couldn't shop but said that she shopped in stores that at the record at two hundred and forty nine that when she didn't have somebody to come to her she could still go she went out alone she said that she can use public transportation she said that she arrived at her consultation examination using train public transportation and she had intact social skills so there is always some conflicting evidence the other point that your honour's making in terms of medical review is that the l t did have the  views from two experts the state agency expert psychologist dr benson and an expert psychiatry as dr campion who also looked at available records and made essentially the precise finding that the ale chain me which is that despite the moderate this claim is the sets with moderate limitations not extreme one mark but despite the moderate limitations that this particular claimant has in the areas of social percent normal mental status and saying nothing about an inability to socialize and in fact you'll see one of those treatment notes that says you know every thing is normal everything including would include there is not in desire to know did other th and there's an eps for of sixty five dollars which is a very high score it reflects somebody with my old symptoms mind she goes from moderate to mild and so with the state agency doctors did not have was the later treatment notes which i'm explaining right now show fully normal mental status only mild symptoms and the a l j nonetheless still goes with the views of the state agency experts and gives her a respectfully around her many people to college in five years and she was raising children so so what he does to account for that again he's being he's trying to draw a reasonable conclusion that is respectful and grounded in the evidence it does not reflect a one hundred percent acceptance of the claims testimony it does not reflect one hundred percent acceptance of dr hammond's form but it does reflect a logical reasonable conclusion from the full evidentiary picture i grounded in that evidence your picture not based on your data on speculation as medical experts work and respectfully under the b step standard which is not high just whether in reasonable mind could direct a verdict medically skeptical clinical and laboratory diagnostic techniques and is not inconsistent with other substantial evidence in the case record the adjudicator must give it controlling weight does just that in some ways seem to to alter  the us the burden if it's sort of an inverse in terms of what role the substantial evidence plays that is as i read this regulation it seems to be saying if you have the treating other substantial evidence so that's correct your honor and i i don't i don't see it as putting a burden but what it does mean is that in order for an l g decision to be appropriate it has to give appropriate reasons for just county treating source opinion that you can't give i mean you really you're not you're not permitted under the regulations to properly give a treating source an opinion controlling weight if it doesn't enjoy if it's if it's contradicted by others and central evidence in the record and here when we have the physicians assessment not just like straight words in the reports but the physicians treatment notes generated in the time leading to her checkbox for saying my assessment is that this person is doing well not doing better from some very low baseline but actually doing well that the medications have regulated her mood that she has a gap score of sixty five which is very high only in the in the realm of normal a mild symptoms her concentration and memory are both listed repeatedly as intact that's the kind of evidence that if properly viewed by analogy would not permit her anxiety is better but but not wholly i mean correct on it on the form itself it does say those things but then the job because we don't simply have treating physician writing notes and then awarding benefits obviously what we do is we have the a l j test that against the record and when the testing occurs against the treating physicians own notes instead of saying mediocre saying she's responding well she's doing well she only has mild symptoms that's the kind of a situation that the a l j is supposed to be scrubbing for because otherwise we just had training doctors writing in no course you could say that in her very controlled environment it was good but he his own form and even the checkbox form itself says that she's responded well and per if a claimant is unable to leave the house for example if the claimant is unable to shop for her children it's hard to medication and treatment now so that's what that's what the doctor is reporting she responded well to and that is not exactly what we were addressing in in the broader world where we were looking at language like stable and under control honor in this case however for example and and the treatment notes themselves which are important for you to consider as well as the checkbox form the assessment is doing well not just stable there's a box check for stable improved doing well and mild symptoms in the g s score so if a person has mild symptoms with the l t a ended up doing which again may not be the same conclusion that every single person sitting in the algaes chair would reach but the question is whether this is a was permitted to reach the conclusion that if i count for low contact and i take this recent college graduate even out of complexity do i think that there are jobs that she could appropriately perform and the answer that he came up with supported by multiple sources of evidence was yes thank you  treating physician evidence and why it can be controlling i would point out as well that the rest of the regulation does as well that even when the treating physician report is controverted by substantial evidence my point one would be that i started my argument out which i said was i'm contested by the agency that nd part says you still have to consider what weight to give the treating physician report even if it's contra verted by substantial evidence and you have to apply factors such as considering whe treating is a specialist and considering the frequency of treatment which here is every two weeks that's a very significant treatment and neither of those factors were considered in that case and that is a fatal error of law as recognized by the nd circuit just as some are in the substantial evidence supporting the decision yet the standard of review is deferential in review of facts but it's not deferential with respect to application of the law and application is a law application of the regulations the in her condition but we see by two thousand and fourteen when nurse added need we gave her report this area was having two to three severe sudden panic attacks every week and she now again had this ng s as a side effect from her psychiatry list that was mediocre this is looking at the future even acknowledging improvement the prog overall prognosis is mediocre between it's not going to get that much better i also agree with the suggestion that when you lou out or reject the treating physician because of an isolated period of time you are in essence substituting your lay view of the evidence for that of the treating it's a treating as a longitudinal base of information in which to rely on which to determine whether we've got ups and downs going on or whether we have something that is inclined that's going to continue on an incline or it's going to stay d at some functional level in here the skilled treating physician in concurrence with the skilled  hammond knows her own treatment knows mindful of the ups and downs that are afflicted news treatment notes or a longitudinal assessment for work related functional capacity shows otherwise her prognosis shows otherwise mindful of that so that doesn't contradict it based on her own assessment same linger era me who's in pretty carmel gill behavioral clinic i've already outlined why i believe the the nih examining reports extensive reports about are directed specifically to work with weighted functioning which most significant disability assessment how it affects ability to work then they're acting on a substantially incomplete and deficient slate information the output therefore already diminished by the fact that they're not examining so they've never seen which is why in decisions in cases like brown a well and dorcas court has assured reliance on not examining reports even with a f