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Ramos v. Commissioner of Social Security

United States District Court, D. New Jersey

December 30, 2019



          Hon. Kevin McNulty, United States District Judge

         Plaintiff Marisol Ramos brings this action pursuant to 42 U.S.C. §§ 405(g), 1383(c)(3), to review a final decision of the Commissioner of Social Security ("Commissioner") denying her claims to Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI") under Title II and XVI of the Social Security Act. Ramos seeks to reverse the finding of the Administrative Law Judge ("ALJ") that she has not met the Social Security Act's definition of disabled for a period of March 31, 2014, the alleged injury-onset date, through February 2016.

         The issue presented is whether the decision of the ALJ to deny Ramos's application for DIB and SSI is supported by substantial evidence. For the reasons stated below, this Court affirms the ALJ's decision.

         I. BACKGROUND[1]

         A. Facts

         Ms. Ramos was born in Puerto Rico (R. 40) and is 54 years old. (R. 62). She graduated from high school in Puerto Rico. (R. 41). Prior to 2014, Ms. Ramos had various jobs, including home health aide (R. 41) and work at a daycare center (R. 42) and a uniform factory. (R. 42-43).

         1. Treatment of Foot Pain

         Ms. Ramos was diagnosed with diabetes in 2002. (R. 410). On April 8, 2014, Ms. Ramos presented to The University Hospital in Newark, NJ, with pain in her right foot. (R. 363, 369). She was diagnosed with inflammation consistent with cellulitis. (R. 370).

         A few days later, on April 11, 2014, Ms. Ramos presented at a clinic for further evaluation of her right heel. (R. 400). Her doctor determined that Ms. Ramos would need surgery to drain an abscess from her foot. (R. 401). On April 14, 2014, Ms. Ramos was admitted to the hospital for treatment. (R. 452). She then underwent two surgical debridement procedures to treat the abscess and MRSA infection. (R. 452). She was discharged on April 22, 2014. (R. 443).

         During followup appointments in May and June, Ms. Ramos reported either no pain or minor pain to her right foot. (R. 672, 675, 678). During this time she began placing more weight on her right foot and ultimately returned to wearing regular shoes, using a diabetic heel cup as needed. (R. 672). By June 6, 2014, the incision on her right foot had healed. (R. 671).

         On June 24, 2014, the State requested an internal medical examination of Ms. Ramos. (R. 716). Rambhai C. Patel, M.D. conducted an examination of Ms. Ramos on July 8, 2014. (R. 717). Dr. Patel noted that Ms. Ramos experienced pain when walking or standing and that she walked with a nonprescription cane. (R. 717). Dr. Patel's diagnosis included "possibility of neuritis" and "Possibility of diabetic retinopathy and neuritis cannot be rule out." (R. 718 (sic in original)).

         From October 2014 through December 2014, Ms. Ramos had a handful of followup appointments with her doctors. Her September 2014 podiatric examination found decreased sensation in her feet, but no motor deficits. (R. 788). At some of these appointments Ms. Ramos reported pain in her foot. (R. 779, 788-89, 791). In each instance, Ms. Ramos was treated with ibuprofen, Tylenol, ice, and stretching, and was told to wear diabetic shoes. (R. 768, 779, 788-89, 791). In October 2014, Ms. Ramos was offered a steroid shot, but she declined. (R. 780). There are no records that Ms. Ramos sought treatment for this condition after December 2014.

         2. Treatment for Mental Health

         On June 18, 2014, Ms. Ramos was examined by David Bleich, M.D. (R. 665). During this appointment, Ms. Ramos complained of anxiety, stated that she was crying often, and reported hearing voices. (R. 665). Dr. Bleich reported that plaintiff was agitated, was crying, and could not sit still. (R. 666). Dr. Bleich referred Ms. Ramos to the ER, where she had a psychiatric consultation. (R. 650). During the consultation, Ms. Ramos stated that she had anxiety, shaking, suicidal thoughts, and tremors, and said she heard voices. (R. 641-42). She initially appeared anxious but became calmer after having lunch. (R. 643). Dr. Cheryl Kennedy, M.D., noted that Ms. Ramos was a poor historian and had decreased concentration and energy. (R. 641-42). She was prescribed Ativan, which yielded "good results." (R. 642).

         A week later, on June 24, 2014, she was evaluated at an outpatient clinic at Rutgers University Behavioral Health Care. (R. 724). Ms. Ramos was described as being a poor historian but did not present with abnormal thoughts or behavior. (R. 729). She further denied any ongoing symptoms of depression, crying, or voices, but stated that she had ongoing anxiety and nervousness. (R. 729). Ms. Ramos was prescribed Zoloft and Ativan and was enrolled in therapy. (R. 724-25). In July 2014, Ms. Ramos presented for a followup appointment. (R. 742). She reported that the medication was helping her sleep, but she had little appetite and reported feeling "tired of life." (R. 742).

         On August 27, 2014, Alexander Iofin, M.D., conducted an evaluation of Ms. Ramos at the request of the State. (R. 751). Dr. Iofin observed that she appeared anxious, but did not present as delusional or paranoid. (R. 753). Dr, Iofin further reported that Ms. Ramos did not appear agitated, unmanageable, or disruptive; however, she reported having anger control difficulties and mood swings. (R. 751-53). Dr. Iofin observed that Ms. Ramos's thought process was logical, but that she complained of memory loss. (R. 753). Tested, she repeated two out of three words immediately and zero out of three words five minutes later; was able to repeat four digits forward and two digits backwards; was unable to spell in English; had difficulties subtracting her serial 7s; knew the current President; provided simplistic proverb interpretations; and had reasonable impulse control. (R. 753-54).

         In followup appointments in 2014 and 2015, Ms. Ramos did not report continued anxiety or mood concerns. (R. 758, 763, 767, 772).

         B. Procedural History

         On April 29, 2014, Ms. Ramos applied for DIB and SSI. (R. 203-216). The application was denied initially and on rehearing. On February 23 and June 5, 2017, the ALJ held hearings. (R. 17).

         On August 30, 2017, the ALJ issued a decision (R. 17-29) denying disability benefits on the ground that Ms. Ramos was still able to perform work at step five of the sequential evaluation. (Id.).

         Ms. Ramos appealed. On August 15, 2018, the Appeals Council concluded that there were no grounds for review and affirmed the decision of the ALJ. (R. 1).

         On September 21, 2018, Ms. Ramos filed this action seeking to overturn the ALJ's decision to deny benefits. Initially assigned to Chief Judge Linares, it was reassigned to me upon Judge Linares's retirement. (DE 11).


         A. Standard of Review

         As to all legal issues, this Court conducts a plenary review. See Schaudeck v. Comm'r of Soc. Sec, 181 F.3d 429, 431 (3d Cir. 1999). As to factual findings, this Court adheres to the ALJ's findings, as long as they are supported by substantial evidence. Jones v. Barnhart,364 F.3d 501, 503 (3d Cir. 2004) (citing 42 U.S.C. § 405(g)). Where facts are disputed, this Court will "determine whether the administrative record contains substantial evidence supporting the findings." Sykes v. Apfel,228 F.3d 259, 262 (3d Cir. 2000). "Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Zirnsak v. Colvin,777 F.3d 607, 610 (3d Cir. 2014) (internal quotation marks and citation ...

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