The appellant’s application for Invalidity Pension was refused on the grounds that she was not considered to be permanently incapable of work. The appellant was a 56 year old woman who most recently worked as a fitness instructor. She had previously worked as a nurse and in customer services. She had been in receipt of Illness Benefit which had expired. She was not submitting medical certificates to the Department for the purposes of credited contributions. The appellant described on her application form and further notes how her various medical conditions had evolved and how they affected her: chronic fatigue, voice defect affecting communicating with others, memory lapses and sleep disturbances. She was diagnosed with MS in 1993 but generally remained in good health since then, with occasional MS type symptoms. Following a period travelling in 2015, she developed fatigue and then shingles and a persistent cough and breathlessness. She returned to work in January 2016 but had to cease work after 2 days. She was referred to a respiratory consultant and hospitalised for a period. She had been on a high dosage of antibiotics and steroids, and undergone multiple investigations. The cough and fatigue persisted. She aimed to return to work in September 2016 but it wasn’t possible due to low white blood cell count. She tried to exercise and lose some weight but damaged her knee and required steroid injections. She developed a persistent itch and irregular bruising. Her sleep was disturbed. The problem with her foot was identified as erythema nodosum [inflammatory condition characterised by inflammation of the fat cells under the skin]. She also had continued low white blood cell count but no reason had so far been identified.