Court Opinion

ID: 9482949
Source: CourtListenerOpinion
Date Created: 2023-08-05 09:06:08.354138+00
Date Added: 2024-06-11T17:49:18.979268
License: Public Domain

DAVID A. NELSON, Circuit Judge,
concurring in part and dissenting in part.
I agree that the judgment ought to be set aside, but I would instruct the district court to remand the case to the Secretary for further factfinding.
The principal reasons for disability among patients with symptoms like Dr. Cohen’s, according to Dr. Cheney, are “cognitive impairment” and “dysfunctional fatigue.” The ALJ found that Dr. Cohen’s cognitive impairment was not disabling, and there was substantial evidence in the record (Dr. Cohen’s ability to pass her law school examinations, e.g.) to support this finding. As to the extent of Dr. Cohen’s fatigue, however, there was testimony that she typically slept 18 hours a day and had to nap from two to four hours during the day. The vocational expert, Dr. Brooks, testified that the need to take such naps would “pretty much” preclude employment. Dr. Brooks also said that an individual “experiencing extreme fatigue which would be exacerbated by even minor levels of exertion” could not perform any of the jobs about which she had testified. Similarly, Dr. Brooks said, an individual who required two to three hours of sleep in order to recover from fatigue induced by short trips away from home would be unable to work. Finally, Dr. Brooks testified that an individual who had to rest approximately 18 hours a day would be unable to perform any jobs that exist in the national economy.
The Administrative Law Judge found that “[t]he claimant’s subjective complaints were not completely credible given her activities,” but he made no specific findings on the actual extent of Dr. Cohen’s fatigue. “[T]he best way to document the nature and severity of this fatigue syndrome,” according to Dr. Cheney, lies in “[o]bjective findings of immune system abnormalities and the elevation of lymphocyte secreted cytokines.” I cannot tell, from this record, to what extent Dr. Cohen’s immune system abnormalities have been objectively verified. Neither can I tell what her laboratory reports show about “the elevation of lymphocyte secreted cytokines” — and the decision issued by the AU suggests that he may have been no better informed on these matters than I am. Under the circumstances, it seems to me, the appropriate course would be to remand the case to the agency for specific findings on the significance of the laboratory reports and on whether Dr. Cohen simply lacked the stamina necessary to engage in substantial gainful employment. For us to make such findings ourselves, in my view, is to undertake a task that is outside our province.