N O T FO R PUB L ICAT IO N UNITED STATES C OUR T OF APPEALS FOR THE NINTH C IR C UIT HAR OUTYUN KAR

AB AJAKYAN, Pla i ntiff-Appe lla

nt, v. NANC Y A. B ERR

YHILL, Ac ting C om m issione r of the Soc ia l Se c urity Adm inistra

tion, De fe nda n t-Appe l le e . No. 15-55242 D.C . No. 2:14-c v-01024-SJO-AN M EM O R ANDUM *

Appe a l from

the Unite d

Sta t e s Distric t C ourt for the C e ntra l Distric t of C a lifornia S. Jam e s Ote ro, Distric t Judge , Pre siding Subm itte d Oc tobe r 18, 2017 ** B e fore : C LIFTON, N.R . SM ITH, a nd C HR ISTEN, C irc uit Judge s. Harouty un Ka ra ba jaky an a ppe a ls pro se the distric t c ourt’ s de c ision a ffirm ing the C om

m issione r of Soc ia l Se c urity ’ s de n ia l of Ka ra b a jaky an’ s 

# FIL ED

OCT 18 2017 M OLLY C. DW Y ER, CLERK U . S. CO URT O F APPEALS

* This disposition is not a ppropria te for public a t ion a

nd is not pre c e de nt e xc e pt a s provide d

by Ninth C irc uit R

ule 36-3.

* * The pa

ne l una nim ously c onc lude s this c a se is suita ble for de c ision without ora l a

rgum e nt. Se e Fe d. R . App. P. 34(a )(2).a

pplic a tion for disa

bility insura nc e be ne fits a

nd supple m e nta l se c urity

inc om e unde r Title s II and XVI of the Soc ia l Se c urity Ac t. W e re vie w de novo, G hanim v . C olv in , 763 F.3d 1154, 1159 (9th C ir. 2014), a nd a ffirm . Kara ba jaky an c onte nds tha

t the a dm i nistra

tive la w judge (“ ALJ” ) e rre d in re je c ting his te stim ony a

bout his sy

m ptom s a nd lim ita tions. W e disa gre e . The ALJ provide d two, spe c i fic , c le ar a nd c onvinc ing re a sons for finding Kara ba jaky an’ s sy

m ptom te stim ony

le ss tha n fully c re dible : (1) the c onside ra ble ga ps in his c ardia c tre a tm e nt; a n d (2) his fa ilure to follow m e dic a l a dvic e , inc l uding his re fusa l to unde rgo re c o m m e nde d te sting a

nd tre a tm e nt. Se e Fair v . Bow e n , 885 F.2d 597, 603–04 (9th C ir. 1989) (e xpla ining tha t “ une xpla ine d, or ina d e quate ly

e x p la ine d” fa ilure to se e k tre a tm e nt a nd fa ilure to follow a

pre sc ribe d c ourse of tre a tm e n t c an c onstitute c le ar a nd c o nvinc ing re a sons for disc ounting a c la im ant’ s c re dibility

re ga rding his or he r sym

ptom s). The re c ord re fle c ts a ne arly se ve n-y e ar ga

p be twe e n Ka

ra ba jaky an’ s 2004 visit to one c ardiologist a

nd his ne xt visit to a nothe r c ardiologist in 2011. Eve n if Ka ra ba jaky an ha d lim ite d funds a nd no m e dic a l insura

n c e , the ALJ pe rm issibly

c onc lude d tha

t Ka ra ba jak y an’ s a bility to se e k a nd obta in low-c ost m e dic a l c are during the re le va nt pe riod supports a re a s ona ble infe re nc e tha

t he c ould ha

ve obta i ne d som e c ardia c c are ha d his sym ptom s from his he art c ondition be e n a s disa b ling a s he re porte d. Se e Orn v . 2Astrue , 495 F.3d 625, 638 (9th C ir. 2007); se e also Fair , 885 F.2d a t 603 (“ W hile the re are any

num be r of good re a sons for not [se e king tre at m e nt] , a c la i m ant’ s fa ilure to a sse rt one , or a

finding by

the ALJ tha

t the proffe re d re a son is not be lie va ble , c an c a st doubt on the sinc e rity of the c la im a

nt’ s pa in te stim ony .” ) (inte rna l c ita

tions om itte d); se e also Flate n v . Se c ’yof He a lth and Human Se rv s. , 44 F.3d 1453, 1464 (9th C ir. 1995) (noting tha t the ALJ prope rly

disc ounte d c la im ant’ s a s se rtion “ that la c k of m one y

pre ve nte d he r from

se e king he lp for ongoing proble m s, be c a

use she sought a

p propria t e m e dic a l c are from

a [doc tor] for othe r m e d ic a l sy

m ptom s . . . during the

inte rve ning y e ars” ). Ka

ra b a jak y an’ s argum e nt tha

t, be c a use he c om

p le te d m e d ic a l tra i ning in Arm e nia , he doe s not ne e d to “ run to a

doc tor with e ve ry

pa in or disc om fort,” doe s not e x pla in the long ga p in tre a tm e nt for wha

t he a lle ge s is a

disa bling c ardia c c ondition. Fina lly , the re c ord c onta ins no m e dic a l re c ords to substa ntia te Kara ba jaky an’ s c la im

tha t he wa s se e n by

c ardiologists while

in Arm e nia

in 2008, nor would one m onth of tre atm e nt in Arm e nia unde rm i ne the ALJ’ s re a soning a bout the c onside ra

ble ga ps in se e king c ardia c tre a tm e n t. As a re sult, a ny e rror in the A LJ’ s third re a son—

Kara ba jaky an’ s c o ntinue d sm oking a ga inst m e dic a l a dvic e — wa s ha rm le ss be c a

u s e the ALJ’ s spe c ific findings re g arding Kara ba jaky an’ s re fusa l to se e k re gula r c ardia c c are and to submi t to the te sting a nd 3tre a tm e n t re c om m e nde d by

his tre a ting phy sic ia

ns we re c le ar a

nd c onvinc ing re a s ons. Se e Bray

v . Astrue , 554 F.3d 1219, 1227 (9th C ir. 2009) (a ffirm ing a n a dve rse c re dibility

de te rm inat ion tha

t re ste d in pa

rt on the fa c t tha

t the c l a im ant fa ile d to quit sm

oking be c a

use the ALJ provide d othe r inde pe n de nt ba se s for disc ounting the

c l a im ant’ s te stim ony ). Kara ba jaky an c onte nds tha

t the ALJ im

prope rly gave little we ight to the opinion of his tre a ting phy sic ia n, M anve l M . M a z m a

n y an, M . D., whic h wa s re c o rde d on a

phy sic a l R e sidua l Func tiona l C a pa c i ty (“ R FC ” ) Asse ssm e nt form c om ple t e d in Ja

nua ry 2012. W e disa gre e . The ALJ provide d a spe c ific and le gitim ate re a son for giving little we ight to Dr. M a z m any a n ’ s opinion: his sta te m e nt wa s not supporte d by the spa rse m e dic a l re c ord, a

nd it la c ks obje c tive m e dic a l e vide nc e for the lim ita tions he im

pose d. Ne ithe r the R

FC Asse ssm e nt form nor Dr. M a z m an y an’ s e a rlie r tre a tm e nt note s provide any inform at ion a

bout how Ka ra ba jaky an’ s dia gnose s tra

nsla te into the spe c ific an d

se ve re lim ita

t ions de ta ile d in the R

FC Asse ssm e nt, e .g., le g e l e va tion a nd fre q ue nc y of re quire d bre a ks. Se e C onne tt v . Barnhart , 340 F.3d 871, 874–75 (9th C ir. 2003) (holding that the ALJ did not e rr in re

je c ting the c ontrove rte d opinion of a tre a ting phy sic ia

n whose re stric tive func tiona l a s se ssm e nt wa s not supporte d by tre a tm e nt note s); Thomas v . Barnhart , 278 F.3d 947, 957 (9th C ir. 2002) (“ The ALJ ne e d not a c c e pt 4the o pinion of a ny phy sic ia n, inc luding a tre a ting phy sic i an, if tha t opinion is brie f, c onc lusory , a

nd ina de quate ly

supporte d by c linic a l findings.” ). W e a lso disa gre e with Ka ra ba jaky an’ s c onte ntion tha

t the ALJ should ha

ve gran te d his re que st for a pre -he aring on the re c o rd (“ OTR ” ) de c ision on the ba sis of re c ord e v ide nc e de m onstra ting tha t he m e t Listing 4.02A1 a n d B 1 for c a

rdia c im pa irm e nts (“ the c a

rdia c listing” ). The long ga ps in Ka ra ba jak y an’ s c ardia c tre a tm e n t, c ouple d with his re fusa l to c om ply with his doc tors’ a dvic e and re c o m m e ndations, support the

ALJ’ s de te rm ination tha

t Ka ra ba jaky an fa ile d to sa tisfy Listing 4.02’ s introduc tory re q uire m e nt tha

t a c la im ant pre se nt e vide nc e of c hronic he art fa ilure “ while on a re g im e n of pre sc ribe d tre a tm e n t.” 20 C . F.R . Pt. 404, Subpt. P, App. 1, Listing 4.02. As a re sult of fa iling to show tha t the listing’ s introduc tory

re quire m e nt wa s m e t, Ka ra ba jaky an fa ile d to e sta

blish tha t he wa s e ntitle d to a

fa v ora ble finding a

t Ste p 3. Tac k

e tt v . Apfe l , 180 F.3d 1094, 1099 (9th C ir. 1999) (“ To m e e t a liste d im pa irm e nt, a

c la im ant m

u st e sta blish tha t he or she m e e ts e a c h c ha

ra c te ristic of a liste d im

pa irm e nt re le va

nt to his or he r c l a im .” ). B e c a use Ka ra ba jaky an fa ile d to e sta

blish tha t he m e t e sse ntia l re quire m e nts for Listing 4.02 a

t the tim e of his he aring, the ALJ did not e rr by fa iling to issue

an OTR de c ision prior to the

he aring da

te . Se e C urry v . Sulliv an , 925 F.2d 1127,

51131 (9th C ir. 1991) (a pply i ng ha

rm le ss e rror rule to re vie w of a dm inistra tive de c isions re ga

rding disa bility ). Kara ba jaky an a lso c onte nds tha

t the ALJ fa ile d to inc lude a ll of his lim ita tions in the

R FC a sse ssm e nt a

nd the hy pothe tic a l que stions pose d to the voc a tiona l e xpe rt (“ VE” ), an d tha t, a s a re s ult, the ALJ’ s Ste p 5 de t e rm ination is inc o rre c t . W e disa gre e . The ALJ ga ve c le ar a nd c onvinc i ng re a sons for disc ounting Ka

ra ba j a ky an’ s sy

m ptom te stim ony

an d spe c ific and le gitim a te re a s ons for giving lim

ite d we ight to Dr. M a z m any an’ s opinion tha t Ka ra ba jaky an’ s lim ita tions e xc e e de d those se t out in the R FC . For this re a son, the ALJ did not ne e d to inc orpora te those lim ita tions in the

R FC finding or in the

hy pothe t ic a l que stions pose d

to the VE. Se e 20 C .F.R . §§ 404.1545(a ), 416.945(a ); Bay l iss v . Barnhart , 427 F.3d 1211, 1217 (9th C ir. 2005); Ose nbroc k v . Apfe l , 240 F.3d 1157, 1163 (9th C ir. 2001). M ore ove r, be c a use the func tiona l lim ita

tions ide ntifie d by the A LJ in the RFC for light work we re supporte d by the m e d ic a l e vide nc e the ALJ c re d ite d, a

nd be c a use the re c ord c onta ins no m e d ic a l e v ide nc e supporting Kara ba jaky an’ s a sse rtion tha

t the ALJ e rre d by

not inc orpora ting limita

tions re la te d to his suffe ring from he m orrhoids, the ALJ’ s Ste p 5 de te rm ination is supporte d by substa

ntia l e vide nc e . Se e Magallane s v . Bow e n , 881 F.2d 747, 756–57 (9th C ir. 1989). 6Fina lly , Ka ra ba jaky an’ s c onte ntions tha

t the ALJ wa s bia s e d a ga inst him , and tha t the Appe a ls C o unc i l e rre d in de ny ing his re que st for re vie w , la c k m e rit. The re c ord doe s not support his a lle ga t ions tha

t the ALJ’ s be h a vior re fle c te d a c le ar ina bility to re nde r fa ir judgm e nt. The pre sum ption of im

pa rtia lity wa s not re butte d. R ollins v . Massanari , 261 F.3d 853, 857–58 (9th C ir. 2001). Additiona lly , this c ourt la c k s jurisdic tion to re vie w the Appe a ls C ounc il’ s de nia l of a re que st for re vie w, whic h is a non-fina l a ge n c y

a c tion. Bre w e

s v . C omm’r of Soc . Se c . Admin. , 682 F.3d 1157, 1161 (9th C ir. 2012). AFFIRM E D.

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