The ALJ did not proceed to step five, instead concluding at
step four that Claimant failed to meet her burden of proving
that she could not perform her past work as a payroll clerk.
Claimant's accounts of the debilitating effects of her disease
were determined not to be credible, in large part due to the
ALJ's conclusion that the record reflected an ability to do
housework, to undertake occasional weekend trips, and to
engage in certain forms of exercise. The ALJ discounted the
credibility of Claimant's treating physician and an examining
physician, stating that their assessments were based on the
subjective complaints of Claimant, who was found not credi-
ble. Both physicians had determined that Claimant was dis-
abled. The ALJ instead relied on the assessments of the two
Social Security consultative examiners, who he deemed to be
more objective.

1. Claimant's Credibility

Claimant contends that the ALJ's credibility findings were
unsupported by substantial evidence in the record. Claimant
argues that the ALJ erroneously discounted her physical com-
plaints, where the record indicates no inconsistencies or
embellishments. Claimant also argues that the ALJ mischarac-
terized the record in an effort to discount the severity of her
symptoms. In addition, the ALJ erred by failing to account for
the effects of persistent fatigue on Claimant's residual func-
tional capacity to perform substantial gainful work.

[1] We recognize that the ALJ is responsible for determin-
ing credibility, resolving conflicts in medical testimony, and
for resolving ambiguities. Andrews v. Shalala , 53 F.3d 1035,
1039 (9th Cir. 1995). The ALJ's findings, however, must be
supported by specific, cogent reasons. Rashad v. Sullivan, 903
F.2d 1229, 1231 (9th Cir. 1990). Once the claimant produces
medical evidence of an underlying impairment, the Commis-
sioner may not discredit the claimant's testimony as to the
severity of symptoms merely because they are unsupported by
objective medical evidence. Bunnell v. Sullivan 947 F.2d 341,
343 (9th Cir. 1991) (en banc). Unless there is affirmative evi-
dence showing that the claimant is malingering, the Commis-
sioner's reasons for rejecting the claimant's testimony must
be "clear and convincing." Lester v. Chater, 81 F.3d 821, 834
(9th Cir. 1996) (internal quotation marks omitted); Swenson,
876 F.2d at 687. "General findings are insufficient; rather, the
ALJ must identify what testimony is not credible and what
evidence undermines the claimant's complaints." Lester, 81
F.3d at 834; Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir.
1993).

[2] We conclude that the ALJ's finding that Claimant's
activities indicate an ability to work is unsupported by the
record. The activities Claimant described to her doctors, on
disability forms, and at her hearing, were fully consistent with
CFS. Her activities were sporadic and punctuated with rest.
Even more prolonged undertakings might be consistent with
the disease, as CFS is "characterized by periods of exacerba-
tion and remission." Cohen v. Secretary of Health & Human
Servs., 964 F.2d 524, 530 (6th Cir. 1992) (describing the epi-
sodic nature of CFS). Several courts, including this one, have
recognized that disability claimants should not be penalized
for attempting to lead normal lives in the face of their limita-
tions. See, e.g., Cohen, 964 F.2d at 530-31 (ruling that a
claimant should not be penalized for attempting to maintain
some sense of normalcy in her life); Cooper v. Bowen, 815
F.2d 557, 561 (9th Cir. 1987)(noting that a disability claimant
need not "vegetate in a dark room" in order to be deemed eli-
gible for benefits). See also Fair v. Bowen, 885 F.2d 597, 603
(9th Cir. 1989) ("Many home activities are not easily transfer-
able to . . . the more grueling environment of the workplace,
where it might be impossible to periodically rest or take
medication."). Only if the level of activity were inconsistent
with Claimant's claimed limitations would these activities
have any bearing on Claimant's credibility.

Our examination of the record shows that the ALJ has erred
in characterizing statements and documents contained therein
to reach the conclusion that Claimant exaggerated her symp-
toms. Examples include the ALJ's description of Claimant's
aerobic activity and Tupperware sales,1 and his characteriza-
tion of an activities report completed by Claimant's sister-in-
law.2 In essence, the ALJ developed his evidentiary basis by
not fully accounting for the context of materials or all parts
of the testimony and reports. His paraphrasing of record mate-
rial is not entirely accurate regarding the content or tone of
the record. We conclude that his approach and conclusions do
not fully account for the nature of CFS and its symptoms.3
See, e.g., Sarchet v. Chater, 78 F.3d 305, 307-09 (7th Cir.
1996) (reversal required where ALJ's characterization of the
record reflected misunderstanding of CFS); Sisco v. Health &
Human Servs., 10 F.3d 739, 743-46 (10th Cir. 1993) (reversal
required where ALJ's credibility findings and interpretation
of the record were not supported by substantial evidence).4
[3] There is considerable evidence in the record that
detracts from the ALJ's conclusions. Nowhere has the ALJ
pointed to affirmative evidence of malingering. Instead, he
quotes a general comment by a consulting examiner, Dr. Ng,
about the facility with which CFS symptoms can be exagger-
ated. This fact is true, and makes CFS cases difficult to adju-
dicate, but a general observation such as this in an insufficient
reason to discount Claimant's credibility. In fact, Dr. Ng con-
cluded that Claimant met the CDC's criteria for the diagnosis
of CFS and was disabled.5 Nor did the ALJ emphasize that
four other doctors agreed with the CFS diagnosis, a fifth doc-
tor diagnosed possible CFS, and a sixth diagnosed a fatigue
syndrome. None of the examining doctors provided medical
evidence countering the CFS diagnosis. Claimant tested posi-
tive for the Epstein-Barr antibody, which frequently correlates
with CFS. She exhibited the constellation of symptoms often
associated with CFS, including a persistent low-grade fever.6
She also underwent years of testing and examination to rule
out other possible illnesses. In addition, the record shows that
Claimant periodically advised her doctors when she was feel-
ing somewhat better. This is unlikely behavior for a person
intent on overstating the severity of her ailments. We con-
clude that the ALJ provided unsatisfactory reasons for dis-
counting Claimant's credibility, and that his findings were
unsupported by substantial evidence based on the record as a
whole.

2. Residual Functional Capacity

[4] The ALJ also failed to take into account the debilitating
effects of CFS when making his determination, at step four,
that Claimant had the residual functional capacity to perform
her past work. Although the ALJ found that "the medical evi-
dence establishes that Claimant has chronic fatigue
syndrome," the ALJ's evaluation of functional capacity
ignored the key symptom of CFS, which is persistent fatigue.

[5] Social Security regulations define residual functional
capacity as the "maximum degree to which the individual
retains the capacity for sustained performance of the physical-
mental requirements of jobs." 20 C.F.R. 404, Subpt. P, App.
2 S 200.00(c) (emphasis added). In evaluating whether a
claimant satisfies the disability criteria, the Commissioner
must evaluate the claimant's "ability to work on a sustained
basis." 20 C.F.R. S 404.1512(a); Lester , 81 F.3d at 833 (inter-
nal quotation marks omitted). The regulations further specify:
"When we assess your physical abilities, we first assess the
nature and extent of your physical limitations and then deter-
mine your residual functional capacity for work activity on a
regular and continuing basis." Id. atS 404.1545(b). This court
has noted that "[o]ccasional symptom-free periods - and even
the sporadic ability to work-are not inconsistent with
disability." Lester, 81 F.3d at 833.

The ALJ's finding that Claimant could return to her past
work as a payroll clerk was premised, almost exclusively, on
reports by two consulting examiners hired in 1993 in connec-
tion with Claimant's disability claim. Dr. Wood examined
Claimant on a one-time basis and found "no muscle atrophy,
normal reflexes, normal grip strength, and a full range of
motion of all extremities." He found "no limitations in sitting,
standing, walking, hand movements, or fine finger
movements," and estimated that she would be able to "lift,
push, or pull up to 15 to 20 pounds without difficulty." Claim-
ant's ability to perform light work was evaluated on the basis
of these orthopedic factors only. Although Dr. Wood's report
also included a diagnosis of "possible CFS" and a notation
that Claimant manifested "extreme lethargy," the potential
effects of fatigue on her functional capacity were not consid-
ered.

Dr. Moseley, a psychologist, administered a series of stan-
dard psychological tests and, finding that Claimant had no
major social deficits, concluded that she could return to an
"eight-hour workday routine and forty-hour work week." Dr.
Moseley did not have Claimant's medical file, except for the
brief report written by Dr. Wood two months prior. Neither
doctor assessed Claimant's ability to perform sustained work.

[6] Because the ALJ's evaluation of residual functional
capacity failed to address claimant's ability to undertake sus-
tained work activity, his analysis did not comport with the
Social Security Administration's regulatory requirements. See
Cohen, 964 F.2d at 529 ("Although her mental capacity per-
haps would have been more than adequate, Cohen simply
would have lacked the stamina for such employment."); Rose,
34 F.3d at 19 ("The question here is the extent to which
claimant's fatigue in fact restricts his residual functional
capacity."); Williams v. Shalala, 1995 WL 328487, at *6
(holding that, where the ALJ failed to consider claimant's
non-exertional limitations, the "ALJ's decision, on the whole,
reflect[ed] an analysis inconsistent with the appropriate
framework for assessing disability claims premised on
CFS."). The ALJ's finding on residual functional capacity
was not supported by substantial evidence as it failed to
account for the effects of fatigue on Claimant's ability to
function in the workplace.

3. Physicians' Opinions

[7] In finding that Claimant's CFS had not rendered her
disabled, the ALJ rejected the opinions of Claimant's treating
physician, Dr. Jacobson, and an insurance carrier's consulting
examiner, Dr. Charney, and instead relied on the opinions of
the two Social Security consulting examiners, Dr. Wood and
Dr. Moseley. The ALJ failed to provide clear, convincing,
specific or legitimate reasons for rejecting the opinion of Dr.
Jacobson. The ALJ also provided no legitimate basis for
rejecting the opinion of Dr. Charney, who was hired by
Claimant's private insurance carrier to examine Claimant and
who would have no incentive to overstate her limitations.

[8] The opinions of treating doctors should be given more
weight than the opinions of doctors who do not treat the
claimant. Lester, 81 F.3d at 830. Where the treating doctor's
opinion is not contradicted by another doctor, it may be
rejected only for "clear and convincing" reasons supported by
substantial evidence in the record. Id. (internal quotation
marks omitted). Even if the treating doctor's opinion is con-
tradicted by another doctor, the ALJ may not reject this opin-
ion without providing "specific and legitimate reasons"
supported by substantial evidence in the record. Id. at 830,
quoting Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983).
This can be done by setting out a detailed and thorough sum-
mary of the facts and conflicting clinical evidence, stating his
interpretation thereof, and making findings. Magallanes, 881
F.2d at 751. The ALJ must do more than offer his conclu-
sions. He must set forth his own interpretations and explain
why they, rather than the doctors', are correct. Embrey v.
Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988).

In disability benefits cases such as this, physicians may ren-
der medical, clinical opinions, or they may render opinions on
the ultimate issue of disability -- the claimant's ability to per-
form work. As we stated in Matthews v. Shalala , 10 F.3d 678
(9th Cir. 1993), " `[t]he administrative law judge is not bound
by the uncontroverted opinions of the claimant's physicians
on the ultimate issue of disability, but he cannot reject them
without presenting clear and convincing reasons for doing
so.' " Id. at 680 (quoting Montijo v. Secretary of Health &
Human Servs., 729 F.2d 599, 601 (9th Cir. 1984)). See also
Lester, 81 F.3d at 830; Embrey, 849 F.2d at 422.7 A treating
physician's opinion on disability, even if controverted, can be
rejected only with specific and legitimate reasons supported
by substantial evidence in the record. Lester , 81 F.3d at 830.
In sum, reasons for rejecting a treating doctor's credible opin-
ion on disability are comparable to those required for reject-
ing a treating doctor's medical opinion.

In the present case, the ALJ, writing in the third person,
provided the following rationale for rejecting the opinions of
Dr. Jacobson and Dr. Charney:
The consultative examinations of Drs. Wood and
Moseley, which the Administrative Law Judge found
to be objective, found the claimant capable of work.
The Administrative Law Judge does not credit the
assessments of Dr. Jacobson or Dr. Charney. These
conflict with the more objective assessments in the
consultative examinations of Drs. Moseley and
Wood and are based on the subjective complaints of
the claimant who was found not very credible.

[9] We conclude that the ALJ's rejection of the opinions of
Dr. Jacobson and Dr. Charney on the premise that they were
based on the subjective complaints of the claimant is ill-suited
to this CFS case. The ALJ's reasoning runs counter to the
CDC's published framework for evaluating and diagnosing
CFS. Chronic fatigue is defined as "self-reported persistent or
relapsing fatigue lasting six or more consecutive months."
Centers for Disease Control, The Chronic Fatigue Syn-
drome: A Comprehensive Approach to its Definition and
Study, 121 Annals of Internal Medicine 954 (1994) (emphasis
added). Although CFS is accompanied by symptoms such as
body aches, low-grade fevers, memory problems, headaches,
and extended flu-like symptoms, which Claimant manifested,
the presence of persistent fatigue is necessarily self-reported.
The final diagnosis is made "by exclusion," or ruling out
other possible illnesses. Dr. Jacobson followed Claimant's
progress for three and a half years, referred her to several spe-
cialists and conducted extensive lab testing to rule out other
possible illnesses.

The ALJ decision cited a general comment made by Dr. Ng
that because "it was the job of the treating physician to be
compassionate and supportive of the patient," the treating
physician would have no motivation to discount a patient's
complaints of CFS symptoms. This skepticism of a treating
physician's credibility flies in the face of clear circuit prece-
dent. See Lester, 81 F.3d at 833 ("The treating physician's
continuing relationship with the claimant makes him espe-
cially qualified to evaluate reports from examining doctors, to
integrate the medical information they provide, and to form an
overall conclusion as to functional capacities and limitations,
as well as to prescribe or approve the overall course of
treatment.").

[10] The ALJ decision noted that Dr. Jacobson had written
letters describing Claimant's condition in response to requests
from Claimant's long-term disability carrier and her attorney.
The Commissioner contends that Dr. Jacobson's credibility
can be questioned because he had responded to such requests.
Recent circuit opinions have discussed the relative evidentiary
value of solicited opinion letters. Our opinions reveal that the
mere fact that a medical report is provided at the request of
counsel or, more broadly, the purpose for which an opinion is
provided, is not a legitimate basis for evaluating the reliability
of the report. Evidence of the circumstances under which the
report was obtained and its consistency with other records,
reports, or findings could, however, form a legitimate basis
for evaluating the reliability of the report.

In Burkhart v. Bowen, 856 F.2d 1335 (9th Cir. 1988), we
rejected a doctor's opinion in a letter requested by counsel
where the opinion was unsupported by medical findings, per-
sonal observations, or test reports. Id. at 1339-40. We noted
in Burkhart that "given the evidence before the ALJ, [the fact
that the letter had been solicited by counsel] was not the only
reason the ALJ gave for rejecting (the doctor's) statements."
Id. at 1339. However, In Lester, where there was no sound
basis for rejecting a doctor's opinion that had been solicited
by counsel, we stated that "the purpose for which medical
reports are obtained does not provide a legitimate basis for
rejecting them." 81 F.3d at 832. In Saelee v. Chater, 94 F.3d
520 (9th Cir. 1996), citing Lester, we rejected a doctor's opin-
ion letter where "actual improprieties" had been found. Id. at
523. In Saelee, the doctor's opinion letter varied from his
treatment notes and "was worded ambiguously in an apparent
attempt to assist [the claimant] in obtaining social security
benefits." Id. at 522. In that case, the ALJ found that there
was "no objective medical basis for the opinion. " Id. at 523.

[11] We clarify here that, in the absence of other evidence
to undermine the credibility of a medical report, the purpose
for which the report was obtained does not provide a legiti-
mate basis for rejecting it. In the present case, the fact that Dr.
Jacobson drafted response letters should have no adverse
affect on his credibility or the weight of his determination. Dr.
Jacobson's letters were consistent with his findings spanning
several years. His opinion was drawn from three and a half
years of treatment and is supported by medical reports in the
record. His clinical findings were not contradicted by any of
the examining physicians.

[12] We also conclude that the record provides no basis for
the ALJ's finding that Social Security consulting examiners
Wood and Moseley were more objective than Drs. Charney or
Jacobson. Dr. Charney, who agreed with the CFS diagnosis
and found Claimant to be disabled, was hired by Claimant's
disability carrier to evaluate her eligibility for long-term bene-
fits. If any bias were to exist, it would have been expected to
be against Claimant. In addition, there is nothing in the record
to show a lack of objectivity in Dr. Jacobson, who treated
Claimant for over three years. In contrast, Drs. Wood and
Moseley examined Claimant on a one-time basis. In the
absence of Claimant's key medical records, Dr. Moseley per-
formed standard psychological tests, and from that limited
information pronounced that "she may be expected to resume
. . . an eight-hour workday routine and 40-hour work week."

IV.

Evaluation as an Excess Pain Case

Claimant contends that the ALJ also erred by characterizing
her case as an "excess pain" case, and applying Social Secur-
ity Ruling (SSR) 88-13, which provides guidance for evaluat-
ing complaints of disabling pain. SSR 88-13, Soc. Sec. Rep.
Ser. 652, 1988 WL 236011. Claimant did not allege excess
pain as the basis for her claim,8 yet the ALJ decision stated:

The claimant has alleged pain which is neither
evinced nor supported by the objective medical evi-
dence in this record. Such excessive pain complaints
will be considered in light of other indicia of credi-
ble pain beyond the objective medical evidence of
record.

Citing to SSR 88-13, the ALJ noted:

In evaluating the claimant's allegation of `disabling
pain' in this instance, the ALJ has given consider-
ation not only to the medical evidence of record, but
also to the type, dosage, effectiveness, and side
effects of any prescribed pain medication and to
other treatment for pain symptoms. The claimant's
daily activities and functional restrictions during the
relevant period have been considered as well in eval-
uating the credibility of the claimant's alleged dis-
abling pain complaints.

[13] Although SSR 88-13 applies to the evaluation of pain
"and other symptoms,"9 the ALJ considered only pain and its
effect on Claimant's activities and the potential relief by med-
ication, rather than fatigue which is the basis of Claimant's
disability claim. The ALJ's focus on pain medication and
treatment is misplaced, as the CDC has made it clear that no
definitive treatment for CFS exists.10 But even more salient is
the fact that the ALJ failed to consider the Program Opera-
tions Manual System ("POMS") guidelines on CFS issued by
the Social Security Administration in 1993. The POMS policy
states in pertinent part:

Chronic Fatigue Syndrome (CFS), previously known
as Chronic Epstein-Barr Virus Syndrome, and also
currently called Chronic Fatigue and Immune Dys-
function Syndrome, is a systemic disorder consisting
of a complex of variable signs and symptoms which
may vary in duration and severity. The etiology and
pathology of the disorder have not been established.
Although there are no generally accepted criteria for
the diagnosis of cases of CFS, an operational con-
cept is used by the medical community. There is no
specific treatment, and manifestations of the syn-
drome are treated symptomatically.

CFS is characterized by the presence of persistent
unexplained fatigue and by the chronicity of other
symptoms. The most prevalent symptoms include
episodes of low-grade fever, myalgias, headache,
painful lymph nodes, and problems with memory
and concentration. These symptoms fluctuate in fre-
quency and severity and may be seen to continue
over a period of many months. Physical examination
may be within normal limits. Individual cases must
be adjudicated on the basis of the totality of the evi-
dence, including the clinical course from the onset of
the illness, symptoms, signs, and laboratory findings.
Consideration should be given to onset duration,
severity and residual functional capacity following
the sequential evaluation process.

POMS S DI 24575.005 (1993). The ALJ's failure to acknowl-
edge the POMS guidelines may be emblematic of the reluc-
tance to acknowledge CFS that appears to underlie his
decision.

V.

Conclusion

For the reasons described herein, we hold that the ALJ's
decision that Claimant is capable of performing full-time light
work and returning to her past work as a payroll clerk is not
supported by substantial evidence. After three and a half years
of treatment and referral to a series of specialists, Claimant's
treating physician found her to be disabled. An examining
physician hired by Claimant's insurance carrier also deter-
mined that she was disabled. The ALJ's finding that Claimant
was not disabled was premised almost exclusively on reports
by two Social Security consultative examiners hired in con-
nection with Claimant's Social Security disability claim. Dr.
Wood's conclusion that Claimant was not disabled was based
exclusively on an evaluation of orthopedic factors such as
reflexes, grip strength, and ability to sit, stand and walk.
Although Dr. Wood's report noted that Claimant manifested
"extreme lethargy," the potential effects of fatigue on her
functional capacity were not considered. Dr. Moseley's exam-
ination was limited to psychological testing and her mental
capacity to work, and did not consider Claimant's fatigue
resulting from CFS. Neither doctor assessed Claimant's abil-
ity to perform work on a sustained basis in light of the fatigue
caused by CFS. We conclude, therefore, that the evidence in
the record does not support the discounting of the treating
physician's conclusion that Claimant is disabled from future
employment.

The final question for us to resolve is whether to remand
for further proceedings or for an award of benefits. The deci-
sion whether to remand a case for additional evidence or sim-
ply to award benefits is within the discretion of the court.
Swenson v. Sullivan, 876 F.2d 683, 689 (9th Cir. 1989) (citing
Varney v. Secretary of HHS, 859 F.2d 1396, 1399 (9th Cir,
1988) (Varney II)). In Varney II, we held that in cases where
the record is fully developed, a remand for further proceed-
ings is unnecessary:

In cases where there are no outstanding issues that
must be resolved before a proper disability determi-
nation can be made, and where it is clear from the
administrative record that the ALJ would be required
to award benefits if the claimant's excess pain testi-
mony were credited, we will not remand solely to
allow the ALJ to make specific findings regarding
that testimony. Rather, we will . . . take that testi-
mony to be established as true.

Varney II, 849 F.2d at 1401. See also Swenson, 876 F.2d at
689 (directing an award of benefits where no useful purpose
would be served by further proceedings); Rodriguez v. Bowen,
876 F.2d 759, 763 (9th Cir. 1989) (same); Winans v. Bowen,
853 F.2d 643, 647 (9th Cir. 1988) (accepting uncontradicted
testimony as true and awarding benefits where the ALJ failed
to provide clear and convincing reasons for discounting the
opinion of claimant's treating physician).

Here, the ALJ determined, at step four, that Claimant had
the residual functional capacity to perform her past work as
a payroll clerk. Had he reached step five, he would have been
required to determine whether she was able to perform other
work that exists in significant numbers in the national econ-
omy. 20 C.F.R. S 404.1561.

In general, if a claimant suffers only from exertional limita-
tions, e.g., strength limitations, the ALJ at step five may apply
the Commissioner's Medical-Vocational Guidelines[the
"grids"] to match the claimant with appropriate work. 20
C.F.R. Pt. 404, Subpt. P, App. 2, S 200.00(b). The grids are
based on strength factors only. Id.11 The ALJ may apply the
grids in lieu of taking testimony of a vocational expert only
when the grids accurately and completely describe the claim-
ant's abilities and limitations. Jones v. Heckler, 760 F.2d 993,
998 (9th Cir. 1985) (citation omitted). If the grids fail accu-
rately to describe a claimant's limitations, the ALJ may not
rely on the grids alone to show the availability of jobs for the
claimant. Id. (citations omitted). See also Bapp v. Bowen, 802
F.2d 601, 605-06 (2d Cir. 1986) (stating that application of
the grids is inappropriate where a claimant's work capacity is
significantly diminished beyond that caused by an exertional
impairment). In these cases, the ALJ must also hear the testi-
mony of a vocational expert. Desrosiers v. Secretary of
Health & Human Servs. 846 F.2d 573, 578 (9th Cir. 1988
(Pregerson, J., concurring) (citing Perminter v. Heckler, 765
F.2d 870, 872 (9th Cir. 1985)).12

We do not remand this case for further proceedings because
it is clear from the administrative record that Claimant is enti-
tled to benefits. Because limitations caused by CFS include
non-exertional limitations, the Commissioner cannot, at step
five, rely exclusively on the grids. Testimony of a vocational
expert is required.

At Claimant's hearing before the ALJ, a vocational expert
did testify about the nature of Claimant's limitations. The
expert testified that if Claimant's testimony were credited
concerning her fatigue, she would be unable to perform her
past work, due to her need to take frequent naps and an inabil-
ity to carry out repetitive tasks. See Kornock v. Harris, 648
F.2d 525, 527 (9th Cir. 1980) (citations omitted) ("The ability
to work only a few hours at day or to work only on an inter-
mittent basis is not the ability to engage in `substantial gainful
activity.' "). The vocational expert also testified that if Claim-
ant were to require just one day per week of rest, she would
be unable to perform her past work or any other work.13
Clamant's past work as a payroll clerk is classified as sed-
entary work, which is the lowest classification under the regu-
lations. 20 C.F.R. S 404.1565. In Sisco , which involved
similar facts, the Tenth Circuit determined that"[b]ecause
sedentary work is the lowest classification under the statute,
there is no need for further proceedings in this matter other
than a remand for an award of benefits." 10 F.3d at 745-46.

We conclude that a remand for further proceedings would
serve no useful purpose. We reverse the judgment of the dis-
trict court and remand with instructions to remand to the ALJ
for an award of benefits.

REVERSED AND REMANDED. the end


FOOTNOTES

1 The ALJ noted the following:

"On the Disability Report which she completed for her initial
interview she stated that her chronic fatigue syndrome caused her
to be fatigued when she performed hard physical labor or aero-
bics. Hard physical labor or aerobics would fatigue an unim-
paired individual and is not indicative of disability." After noting
that Claimant could pay bills and keep the family books, the ALJ
stated that "[s]he appears to have been doing Tupperware sales."

Sections from Claimant's Disability Report, upon which the above com-
ments are based, actually read as follows:

"Very weak, tired extremely, very forgetful, body aches, extreme
headaches, sore throat, so tired many times can't get out of bed
for long hours/days. Become fatigued if I do hard physical work
or aerobics." The same report notes that Claimant's activities
include "rest, try to exercise at least 20 minutes a day." The
report also notes that her treating physician, who diagnosed CFS,
had recommended 20 minutes of exercise daily. Claimant's
household chores included: "cook, three times a week (try), clean
10 minutes daily if I feel up to it. Shop. Have most food deliv-
ered. Odd jobs 20 minutes one time a week." With regard to Tup-
perware sales, Claimant noted that she "Tr(ies) to sell
Tupperware." She indicated that she gives the Tupperware books
to her sisters who bring the books to work and take orders. Her
daughter writes up the orders, and her husband helps.
2 The ALJ provides the following description of the sister-in-law's activity report:

"Ms. Eyre stated that the claimant paid the bills and did the
household accounts. For recreation she enjoys going to Monterey,
or out to the movies, or out to dinner with friends. She reads a
lot and goes to Bible study. She gets along with everybody."

The ALJ focused primarily on one question in the activities
questionnaire which asked: "What type of recreational activities
or hobbies does the applicant enjoy and spend time on?" Ms.
Eyre responded that Claimant goes "to movies and down to Mon-
terey for a break, or out with friends for dinner. " However, a
broader sample from Ms. Eyre's activities report provides the fol-
lowing description of Claimant's daily life:

"Some days she stays home in bed all day . . . . Some she can
go run errands but she tires out easily. . . some days she sleeps
a lot . . . . She has gained a lot of weight and isn't as critical about
the clothes she wears. Sometimes she doesn't care about how she
looks. She was never this way before her illness . .. . [Sometimes
she cooks meals], her daughter, stepson and husband all take
turns . . . . Sue shops occasionally. She never goes alone . . . . She
misses (Bible study) a lot because she has no energy even to just
sit and listen . . . . She gets tired a lot. Real lethargic. She always
comes to our house and ends up falling asleep . . . . [S]he finishes
things but sometimes it takes a few days because she gets tired
so easily."
3 Chronic fatigue syndrome is a disease that did not become widely
known in the medical community until 1988 when the first diagnostic arti-
cle was published. It was also in 1988 that the CDC accepted chronic
fatigue syndrome as a disease. Reed v. Secretary of Health & Human
Services, 804 F. Supp. 914, 916 (E.D. Mich. 1992).
4 See also Sabo v. Chater, 955 F. Supp. 1456, 1463 (M.D. Fla. 1996)
(ruling that a reversal was required where the ALJ failed to apply stan-dards
appropriate to CFS); Fragale v. Chater, 916 F. Supp. 249, 254
(W.D.N.Y. 1996)("CFS . . . may produce symptoms which `significantly
impair [a] claimant's ability to perform even sedentary work. . . .' ")
(quoting Rose v. Shalala, 34 F.3d 13, 17 (1st Cir. 1994)); Williams v.
Shalala, 1995 WL 328487, at *6 (W.D.N.Y. May 19, 1995) (holding that
a remand was required where the ALJ's decision "reflects an analysis
inconsistent with the appropriate framework for assessing disability claims
premised on CFS."); Irwin v. Shalala, 840 F. Supp. 751, 770 (D. Or. 1993)
(holding that a reversal was required where the ALJ discredited testimony
of CFS claimant and doctors); Powell v. Chater , 959 F. Supp. 1238, 1245
(C.D. Cal. 1997) (ruling that a remand was required where the ALJ's per-
ceived inconsistencies in the record were "minimal at best.").
5 Dr. Ng commented, "[a]fter reviewing the medical records of Mrs.
Reddick and performing the history and physical on February 4, 1992, I
have to agree with Dr. Charney that she does meet the CDC criteria for
the diagnosis of chronic fatigue syndrome." He also stated, "[i]ncidentally
I think she should also be seen by a psychiatrist to see whether there is any
underlying psychological disorder. However, this would not change the
fact that she still is disabled, even if her symptomology is secondary to a
psychiatric disorder."
6 Dorland's Medical Dictionary outlines some of the symptoms com-
monly associated with CFS. The dictionary defines chronic fatigue syndrome
as a "persistent debilitating fatigue of recent onset, with reduction
of physical activity to less than half of usual, accompanied by some com-
bination of muscle weakness, sore throat, mild fever, tender lymph nodes,
headaches, and depression, with the symptoms not attributable to any
other known causes." Dorland's Illustrated Medical Dictionary 1627
(28th ed. 1994).
7 In Embrey we rejected the ALJ's conclusory statements rejecting the
treating doctor's opinion on disability: "Here, the ALJ does not give suffi-
ciently specific reasons for rejecting the conclusion of [Embrey's treating
orthopedist] that Embrey is `permanently disabled . . . .' Nor does the ALJ
explain why he disagrees with Dr. Baker's conclusion that Embrey is per-
manently unemployable . . . . Instead, he merely states that the objective
factors point toward an adverse conclusion and makes no effort to relate
any of these objective factors to any of the specific medical opinions and
findings he rejects. This approach is inadequate. " Embrey, 849 F.2d at
422.
8 In her April 5, 1993 application for disability benefits, Claimant
referred to her "disabling condition." In the accompanying disability
report filed on April 5, 1993 she lists her disability as "Chronic Immune
Dysfunction" or "Chronic Fatigue Syndrome. " The SSA's denial notice of
her initial application dated September 27, 1993 notes that "you said that
you were unable to work because of chronic fatigue syndrome." In Claim-
ant's request for a hearing by an Administrative Law Judge dated March
3, 1994, she stated, "Due to chronic fatigue syndrome, I am totally
disabled." Commissioner writes in its opening brief that "Claimant filed
her application for disability insurance benefits under Title II of the Act
on April 5, 1993, alleging that she had been unable to work since October
4, 1989 due to chronic fatigue syndrome."
9 SSR 88-13, 1988 WL 236011; 20 C.F.R. SS 404.1598, 404.1528-29,
416.908, 416.928-29.
10 Centers for Disease Control, "The Chronic Fatigue Syndrome: A
Comprehensive Approach to its Definition and Study, " 121 Annals of
Internal Medicine 953 (1994). See also,"The Chronic Fatigue Syndrome,"
90 American Journal of Medicine 730, 736 (June 1991).
11 The Medical-Vocational Guidelines indicate that they are based on
strength factors and may not be appropriate in cases involving non-
exertional limitations:

Since the rules are predicated on an individual's having an
impairment which manifests itself by limitations in meeting the
strength requirements of jobs, they may not be fully applicable
where the nature of an individual's impairment does not result in
such limitations . . . .

20 C.F.R. Pt. 404, Subpt. P, App 2 S 200.00(e). See also 20 C.F.R. S 404.-
1569(a) (defining non-exertional limitations as limitations that do not
directly affect a claimant's [muscular] strength).
12 In Periminter, we held that pain is a non-exertional limitation. We
also determined that, absent other reliable evidence that the claimant could
perform specific jobs, a vocational expert was necessary. 765 F.2d at 872.
13 The relevant section of the transcript reads as follows:

ALJ:If I were to credit the claimant's testi-
mony concerning her fatigue and pain,
would the claimant be able to perform
her past relevant work?

Vocational Expert:No, she would not.
ALJ:Why is that?
Vocational Expert:Because of the need to take frequent naps
during the day. Some days unable to get
out of bed to get to work. Performing
repetitive tasks, such as using a com-
puter, would probably increase the
fatigue that is being described.

ALJ:Okay [Claimant's attorney], any ques-
tions of the Vocational Expert?

Claimant's Attorney:Just one. If she was limited to her bed
even one day a week, only one day a
week, would your answer still be the
same about her inability to perform her
past relevant work or any other work?
Vocational Expert:Yes.

Claimant's Attorney:Okay, I have nothing further.