incomplete r f c assessment and the this is found in page five of the season sixteen of the ministry of record the ale jase finding regarding the residual functioning capacity assessment was the undersigned finds the claimant has a residual functional written decision that was an oral statement that's page five of the decision is an incomplete residual functioning capacity assessment now opposing counsel says his claim that in the brief that they l j made it complete ind iscernible r f c finding which we respectfully disagree with and at another point in page eighteen of their brief said that it was a non substantive clerical error error that is easily remedied we of course reject that as well  so essentially the first argument opposing counsel is basically trying to rewrite the decision in a clear violation as far as i'm concerned now a lot of the brief deals with the most obvious admission in the mail jase finding that deals with my client misty vinson's impaired left hand which is seriously impaired i'm not to remember the latin expression that refers to the type of fracture she had but missed even some fell on the ice in indiana in two thousand and nine in february two thousand and nine she continued to work through two thousand and twelve but had no true no she had no treatment and if you look at the record it's a very sparse treatment she didn't have insurance she couldn't get treatment and she tried to work through it for three years but she couldn't do it after that period of time to obviously the worse it has been there's no question even even the records that are available in this case reflect that it's gotten worse from the time she filed until until the time of the hearing but she has a type of fracture with her left wrist here so that she has a deformity in anyone would see it ok anyone that saw her saw that she had it for me if she can hold her hand up like this as a result of the break that happened that will can never be repaired at this point her hand is cocked backward a little bit like this and then off to the side away from the flow now the objective evidence in this case was clear and it was not properly considered by the first of all the consult of examiner dr sh'ma kell that so security sent her to on two separate occasions both in june and september of two thousand and twelve he found that she had three out of five muscle strength now opposing counsel suggested in her brief to the district court that that so she is moderate strict first of all j never said that she had moderate strength in her left h in three out of five manual muscle testing is not moderate strength were they referring to the other hand no that can't be because she had five out of five strength in her right hand ok what point is that you're making  under under the force of gravity but any pressure under that would give way now five out of five muscle testing is a wide wide range of area anything that's not five out of five is an abnormality and three out of five is a very serious mind and that was not properly considered by the ale jay but in addition to that in addition to the manual muscle testing this the consultative examiner for the soul security administration did two was that with her leg she had diminished length from norm with her right hand as well but the left hand she only had four kilograms of force that she could exert and that was the best she was able to do in three trials was four kil grams which would be the equivalent to about eight point eight pounds ok so that as as we indicated before a ten year old girl who cannot exert eleven point eight pounds or eleven point is finding was a teacher's assistant events that she was capable of doing her past employment and that is relevant in this situation because she was over fifty five years old and if the she was found only past relevant work but they never even considered her grip strength that any point the judge they'll jay never mentioned that she had any deficiency with her grip strength and said that she could occasionally use her hand when her physician her treating physician the only physician in the record that saw her more than once said that she was disabled and couldn't work and that's the second argument that i really haven't gotten to yet but they'll jape totally did not consider the social security regulations in evaluating the medical opinion evidence in this case her dream tradition said that she couldn't possibly work with the condition in her left hand i don't diminish the left hand but was there any part of the rest of her body that was yes ye getting up from a seated position and then her own physician so that she had sitting and standing limitations pain and fatigue would interfere with her concentration and attention and that you would be excessively she'd have excessive absenteeism that she'd be missing work all the time because of her pain so there are there was also additional back questions but the primary focus is that there was objecting evidence regarding your left hand that was never considered and never mentioned in the decision whatsoever i mean the d c finding was incomplete it said the claim it is limited to my work except and for what's clearly an error or some type of oversight for whatever reason did not finish that sentence to include the nine exertional limitations however  page eighteen of the administrative record the explicitly indicates that his are her r f c includes no more than occasional handling in fingering with the left upper extremity that is a clear finding that the ale she makes within that decision and let's keep in mind that there was only one severe impairment and that was that left upper extremity impairment i want to note at that point also the opposing counsel talks about the back pain and lordosis he did not challenge the claim he did not challenge to o j step to finding that there was only one severe impairment but moving back to the r f c that conclusion and with the occasional handling and fingering is buttressed by the hearing transcript and on page fifty eight of the administrative record hypothetical number for the a o j limited for the hypothetical person to like work occasional handling in fingering with the left upper extremity with some postural limitations that's important because that hypothetical is the only hypothetical provided by the j that included the light limitation which opposing counsel acknowledges that the did limit her to the occasional handling and fingering which is explicitly noted within the body of up to a third of the work day and plan its own description of her past work as a computer coach on page one ninety eight of the administrative record she indicated that as a computer coach she spent no more than one point five hours out of an eight hour day handling small objects writing or typing so her own description of her past work is consistent with the l g s limitation to only occasional hands i think well this is where  hand or something but they managed to get by absolutely well now that's what i keep wondering heres is this make or totally disabled list because this one amputation of a hand is not found per se to saipan just by virtue of that amputation because especially of the non dominant limb so the fact that she has that single impairment to her left upper to me does not preclude work actively just on  own especially considering the medical evidence now with opposing counsel talks about the medical evidence regarding her hand but the medical evidence in this case actually supports if we greater limitation than she and the treating source assesses the training source himself consistently found through october two thousand and thirteen that she had a good frank emotion of her left hand and wrist and he did not identify any neurological deficits consistently throughout over two thousand and thirteen he not i know you're out of but if you look at the administrative record dr unequally findings are in exhibit seven f and nine f and in every single visit he noted a good range of motion and that's consistent with dr schmeichel in june two thousand and twelve the a complicated examiner he also noted a good range of motion of that left hand in risk with normal cordon ation and normal reflexes and based on his evaluation he found that the claimant could actually perform fine fingering manipulation just not on a repetitive basis which i reasons forward discounting that opinion and as we talked about before the first reason she found was the consistency with the clinical evidence as we just discussed he consistently found a good range of motion similar to dr schmeichel also found good friends of motion we just discussed he found a dentist that was not consistent and that is a valid consideration under four for a fifteen twenty seven c two for the o c i also found that dr michael did not provide sufficient support for his and his medical source table at dated november two thousand and thirteen that or any quit also indicated that the claimant had limitations on her ability to sit stand and walk however when asked to supply to supply the diagnosis supporting those supporting that limitation only mentioned that left upper extremity impairment the l j recently found that he did not provide sufficient support for his assessment and again that is a valid consideration under the regulations and it was a good reason for discounting that opinion means we prefer to rely on dr who examine the claimant was the one who determined the three out of five and based on his determination even with that reduced grip strength he still found she could still perform fine finger manipulations with that  assessed the three out of five he found that she could still perform fine fingering manipulative tested she could basically she could finger she just couldn't do it on a repetitive basis and that's consistent with the l g s limitation to occasional i am too but i think it's helpful to know if you look through dr nicolosi treating sources information he consistently says he calls her just says she has disfigurement he consistently calls it mild she said he does have some disfigurement but it's mild and that's because the last point i do think that i do need to point out to the court is opposing counsel says that at the second consultation examination in september two thousand and twelve the claimant demonstrated zero grip strength but if we look at those records which is the minister of record on page two sixty two to sixty four and to sixty five that consistently i think no less than five times refers that the claimant refused to participate in testing with her left hand so the fact that he indicated zero kilograms of force is in our minds is the fact that she wouldn't do the exam he consistently know that she refused to make a fist she refused to engage in testing she refused to move she had a splint on and you flat out refused to use it during testing so he couldn't test her grip strength during that second examination first of all dynamometer test testing is not a matter of refusal it's a matter of how much pressure you can squeeze on the instrument there were some testing that she refused to do because it was too painful for her to do and i would ask you to look at what dr she michael's actual findings were that she did not refuse that's what the ail jay said she did not refuse to submit to the test and that would that is trying to erase the fact that just three months before she took the test in only was able to generate four kilograms of force so from the time of june which you generally generated four kilograms of force discipline where she dropped from four kilograms does zero there's no question that she was she was deficient even in june and there was little to no statement made that she didn't try now there were certain times there was a progression in her hand so the when she went to the consultative exam the second time she did the research thing she did say i can't do because it's too painful ok and that's that's what the consultative exam that's social security's consultant examiner now they want to minimize everything about the treating physicians findings but one thing is that when you're  the movement of your first of all the three out of five doesn't refer to your ability use your hands that's your major muscle groups three out of five is the strength in your left arm not or his ability to grip those are not the testing of the same all right that's the testing of the strength in her left arm not in their hands ability to grip those are two separate test in addition to the fact that she's got a week left arm she can't grip with her left hand and that's not in consequential you because in so security really eighty five fifteen in ninety six six p both talk about the fact that i'm very involved pinching picking and otherwise working primarily with your fingers and that's more important  unskilled sedentary jobs and like jobs so it's not as the ability to use your hands to grip stuff is not as important if you're doing heavy work but if you're doing light work and you're doing sedentary work it's much more important than that or eliminates clearly on the vocational aspects of both of those so security rulings indicates that that eliminates a lot of jobs that you can do by the fact that you can't you don't have the use of both hands and that's bosso security rooms that's all security really eighty five fifteen