Facts
The complainant, born in 1985, applied to the disability insurance in early November 2015, citing systemic lupus erythematosus (SLE) with secondary Sjögren syndrome. The IV office of the Canton of Zurich offered her a half disability pension from 1 July 2016 (preliminary notice of 25 October 2016). Following an objection by the competent pension fund, the administration obtained a rheumatological expert report dated 19 July 2017. On that basis it denied any pension entitlement, as the complainant was 70 to 75% capable of work in her previous office activity (decision of 26 October 2017).
The Social Insurance Court of the Canton of Zurich dismissed the appeal by judgment of 21 December 2018. It relied on the rheumatological expert report, according to which clinical and laboratory remission had existed since June 2016 and extra-occupational activities were only marginally restricted. It did not address a report from Hospital [B.] dated 19 December 2017.
Before the Federal Supreme Court, the complainant requested the award of a half disability pension from 1 July 2016, alternatively remittal for supplementary investigation. The IV office requested dismissal, and the Federal Social Insurance Office waived a response.
Subject of dispute: Whether the complainant's work capacity at the time of the pension was correctly determined, in particular whether the expert report has probative value and whether the hospital reports should have been taken into account.
Considerations
The appeal in public law matters may complain of a violation of federal law (Art. 95 lit. a FSCA). The establishment of facts can only be corrected in cases of manifest error or violation of law (Art. 97 para. 1 and Art. 105 para. 2 FSCA). In principle, the relevant period extends until the conclusion of the administrative procedure; however, later medical reports must be considered insofar as they permit conclusions about the earlier situation. The report from Hospital [B.] dated 19 December 2017 concerns the state of health before the decision of 26 October 2017 and is therefore relevant.
The lower court relied on the rheumatological expert report. However, the hospital physicians noted that the complainant, at a 50% office activity, showed marked fatigue and recurrent fever episodes, had to discontinue further training and was performing at her maximum at 50%. That she occasionally engages in leisure activities is not sufficient to assume work capacity exceeding 50%. The expert's statements on hardly restricted leisure activities must be qualified in light of the complainant's information about holidays.
The improved blood values alone do not prove work capacity. Fatigue as a consequence of the autoimmune disease may persist independently of disease activity in the blood count, which the expert also acknowledged. Furthermore, SLE follows an unpredictable and episodic course. The treating immunologists therefore recommended an evaluation of functional capacity (EFL), which does not appear dispensable from the outset for this clinical picture.
By relying solely on the expert report for work capacity and disregarding the divergent, reasoned view of the hospital physicians,…