United States District Court, S.D. Texas, Brownsville Division
REPORT AND RECOMMENDATION OF THE MAGISTRATE
G. Morgan, United States Magistrate Judge
before the Magistrate Judge is the petition for review of the
denial of Disability Insurance Benefits filed by Priscilla
Alejandra Ruiz (“Ruiz”). Dkt. No. 1.
reviewed the record and the pleadings, the Court recommends
that the petition be denied. This recommendation follows from
the fact that there is substantial evidence to support the
findings of the Administrative Law Judge (“ALJ”).
September 24, 2013, Ruiz applied to receive Disability
Insurance Benefits and Supplemental Security Income. Dkt. No.
21-1, p. 15. Ruiz claimed that her disability effective
date was April 1, 2006. Id.
April 30, 2014, Ruiz's claim was denied. Id. On
May 22, 2015, after reconsideration, Ruiz's claim was
again denied. Id. On October 24, 2016, a hearing was
held before an ALJ. Id. On April 24, 2017, the ALJ
decided that Ruiz was not entitled to benefits. Id,
p. 34. On January 23, 2018, the Appeals Council denied
Ruiz's timely request for review. Id, p. 6. Ruiz
has sought timely review of the Commissioner's decision
in this Court.
was born in August 1983 and was 23 years old at the time of
her claimed disability onset date. Dkt. No. 21-1, p. 35.
had previously worked as a retail sales clerk, a
receptionist, and as a medical provider for a rehabilitation
facility. Dkt. No. 21-1, pp. 18-20. She graduated from
cosmetology school. Id. She is a single mother to
two children, including one child who has battled cancer.
Dkt. No. 27. At some unspecified date, she began receiving
Supplemental Security Income (“SSI”). On April
30, 2014, her SSI was discontinued after the Social Security
Administration determined that she was “now able to
work.” Dkt. No. 21-1, p. 47.
found that Ruiz suffered from “generalized anxiety
disorder and affective disorder.” Dkt. No. 21-1, p. 20.
These findings, generally, are undisputed. Instead, Ruiz
disputes the ALJ's finding that Ruiz has the residual
functional capacity (or “RFC”) to still perform
Ruiz's Medical History
her treatment and the disability process, Ruiz was examined
by multiple doctors. A summary of their observations and
April 20, 2004, Dr. Bert Levine conducted a “full
battery” psychological report on Ruiz. Dkt. No. 21-6,
p. 299. Dr. Levine concluded that Ruiz “presented a
history of depression that is documented by medical
records” and that “[r]ecords, observations and
test results” were consistent with that diagnosis.
Id., p. 302. Dr. Levine also noted that Ruiz
“has a documented diagnosis of a panic disorder without
agoraphobia, ” and that test records revealed
“anxiety with a phobic quality.” Id.
25, 2012, Ruiz went to the emergency room at Valley Baptist
Medical Center in Brownsville, complaining of headache,
facial cramping, insomnia, dizziness and anxiety. Dkt. No.
21-9, p. 499. The examination showed that she was
“oriented to person, place, time and situation”
with “normal memory” and that her “motor
functions [were] normal.” Id, p. 500. Ruiz was
discharged after her symptoms improved and she was given a
Xanax prescription to use as needed. Id., p. 501.
September 18, 2013, Ruiz was seen by Dr. Francisco Torres for
a psychiatric evaluation. Dkt. No. 21-11, p. 557. Dr. Torres
diagnosed Ruiz with “persistent depressive disorder,
” anxiety and “adjustment disorder with mixed
anxiety and depressed mood.” Id., p. 560. Dr.
Torres also noted that Ruiz had a Global Assessment of
Function (“GAF”) Score of 55. Id. This
score “is indicative of moderate difficulty in social,
occupational or school functioning.” Dkt. No. 21-1, p.
followup visit on November 14, 2013, Dr. Torres noted that
Ruiz “hasn't been consistent with her followup
appointments, but lately she wanted to continue the treatment
as she has been struggling with anxiety and
depression.” Dkt. No. 21-11, p. 563. Ruiz was
prescribed “Lexapro for anxiety and depression and
Trazodone for insomnia.” Id., p. 564.
December 11, 2013, Ruiz saw Dr. Torres for another followup
visit. Dkt. No. 21-11, p. 566. Ruiz reported that she had
been improving after taking her meds, “but she
wasn't able to tolerate the Lexapro because it was making
her feel weird and dizzy.” Id. (internal
quotations omitted). Ruiz discontinued the Lexapro
prescription and did not wish “to try any other
antidepressant at this time as she feels her moods are
better.” Id., p. 567.
March 5, 2014, Ruiz had another followup visit with Dr.
Torres. Dkt. No. 21-11, p. 570. At that time, Ruiz was unable
to take any “psychiatric medications as she is on her
first trimester of pregnancy.” Id., p. 571.
Ruiz “agreed to rely more on psychotherapy for the time
April 2, 2014, Ruiz had another follow up visit with Dr.
Torres, reporting that her mood was better and that she was
“not as depressed as before.” Dkt. No. 21-11, p.
14, 2014, at her next follow up visit with Dr. Torres, Ruiz
reported that she was no longer seeing a counselor and was
“in low spirits” and “feels desperate and
pressured.” Dkt. No. 21-11, p. 576. She was prescribed
Prozac for her depression. Id, p. 577-78.
29, 2014, Ruiz reported to Dr. Torres that Prozac was
helping, but she was anxious “after learning that her
baby might have Down's Syndrome.” Dkt. No. 21-11,
p. 579. Ruiz continued with her Prozac prescription.
Id., p. 581.
October 8, 2014, Ruiz reported to Dr. Torres that she
“hasn't taken her medications as prescribed as her
moods have been consistently better, ” and she
hadn't felt anxious or depressed. Dkt. No. 21-12, p. 621.
Ruiz agreed to go off her medications temporarily because she
was scheduled to give birth within the next two weeks and did
not want the medications to impact her child.
January 20, 2015, Ruiz had a follow up visit with Dr. Torres,
where she reported that she was in a good mood and did not
feel anxious or depressed, because she felt “the
medication is working.” Dkt. No. 21-12, p. 618. Again,
Ruiz was prescribed Lexapro for depression and Trazodone for
insomnia. Id, p. 620.
April 2, 2015, Ruiz was seen by Dr. Torres, informing him
that she was feeling depressed, anxious and had trouble
sleeping. Dkt. No. 21-12, p. 613. Ruiz felt that her
medications were not helping and she was “doing some
sort of counseling with a Scientologist.” Id.
Ruiz continued her prescriptions for Lexapro and Trazodone.
Id, p. 617. At this appointment, Ruiz's GAF
score was 63. Id.
10, 2015, Ruiz had another follow up visit with Dr. Torres,
where she reported that she continued to feel depressed and
suffered from “crying spells” and anxiety. Dkt.
No. 21-12, p. 608. Ruiz continued her prescriptions for
Lexapro and Trazodone. Id, p. 610-11. Her GAF score
was noted as 50. Id.
state agency consultants - Dr. Charles Lankford and Dr.
Robert Gilliland - reviewed Ruiz's medical records
regarding her mental abilities as part of the SSD process.
Furthermore, she was also personally interviewed by Dr. G.
Alan Trimble and Dr. Shelia Bailey as part of the process.