Tax Classification and Financial Records
Questions 11 through 16

(a) What was Harold’s classification during 2010–2014 as reflected in these UC-filed IRS forms?

(b) If Harold was not disabled during this period, then UC filed false returns with the IRS for at least five consecutive tax years. Were these filings accurate? If not, what corrective filings have been made?

(a) What is Harold’s classification from 2016 forward as reflected in these UC-filed IRS forms?

(b) If Harold is a regular retiree, the Via Benefits transfer is prohibited under 42 U.S.C. § 1395ss(q)(1), which federally prohibits cancellation of Medigap coverage on the basis of geographic location. Please reconcile.

(a) Identify the specific document, WCAB order, QME finding, or written voluntary election authorizing the reclassification of Harold’s income from Distribution Code 3 (Disability) to Distribution Code 2 (Early Retirement) in 2015. If no such document exists, please state that for the record.

(b) Cite the specific UCRP provision, California Labor Code section, or other legal authority permitting reclassification from disability to retirement without a WCAB proceeding, without a new QME finding that the disability had resolved, and without Harold’s informed voluntary consent.

(c) Were all three 2015 forms filed with the IRS? If so, the IRS received reported income of $60,343.56 for $30,171.78 actually distributed.

(d) The Octagon Risk Services permanent disability determination of August 8, 2001 — issued on behalf of UC Los Angeles, based on the Qualified Medical Evaluator report of Dr. Steven Silbart dated December 27, 1999, establishing that Harold’s industrial injury of February 16, 1996 became permanent and stationary on July 21, 1997 with a permanent disability rating of 6¾% — has never been rescinded, altered, or amended by the WCAB. Under California Labor Code § 5803, only the Workers’ Compensation Appeals Board has jurisdiction to rescind, alter, or amend a permanent disability determination, and only upon notice and after an opportunity to be heard is given to the parties in interest, good cause appearing therefor. No such WCAB proceeding was ever initiated by UC, by Harold, or by any third-party adjusting company. If UC contends that a signed election form authorizes the 2015 reclassification, identify the specific WCAB proceeding in which Harold’s permanent disability determination was formally rescinded, altered, or amended as required by Labor Code § 5803 before or concurrent with that election. If no such WCAB proceeding occurred, explain the legal basis on which UC treated a signed election form — standing alone, without a WCAB order — as sufficient authority to override a permanent disability determination that only the WCAB has jurisdiction to change. A signed election form, without a corresponding WCAB order rescinding the permanent disability determination, is legally insufficient under § 5803 to authorize the reclassification from Distribution Code 3 (Disability) to Distribution Code 2 (Early Retirement).

(e) In approximately 2014–2015, a third-party adjusting company (Harold believed it may have been a company called Gates or Gallagher, but is certain it was a successor to Octagon Risk Services) contacted Harold, claimed no knowledge of the 2003 workers’ compensation settlement agreement, and stated Harold must convert from Duty Disability Income to Retirement Income or he would lose his income entirely. Attorney Edgar Saenz documented this in his November 9, 2021 letter to Alexander Bustamante, Senior Vice President and Chief Compliance & Audit Officer, University of California: Harold “filed the required paperwork for ‘Retirement Income’ feeling he had no choice. It was to convert to ‘Retirement Income’ or lose his benefits entirely.” That statement — that Harold must convert or lose his income — was false under UC’s own plan at the time it was made. UCRP § 8.18(a) guarantees that DDI continues until the member “elects” to retire. The Jacobs court confirmed DDI recipients “are never required” to convert. An election obtained by threatening to terminate benefits the plan itself guaranteed is not an affirmative election — it is compliance with a demand that the plan itself, the Court of Appeal, and UC’s own lead disability benefits analyst (under oath) all say cannot be made. The mechanism documented here — an institutional agent threatening total loss of benefits to coerce a classification change that financially benefits the institution — is structurally identical to the employer-forced Medicare Advantage transfers documented in Facts 1 through 6 of the Financial Context section of this letter, where employers and government entities tell retirees they must accept the coverage transfer or lose all employer-sponsored health benefits entirely. (See KFF, Fact 1; Fortune Well, Fact 2; USC Schaeffer Center, Fact 3; The Conversation, Fact 3; The Conversation, Fact 6.) The financial incentive is the same: UC’s annual cost savings per retiree transferred (Fact 5). The coercion mechanism is the same: accept or lose everything. The legal defect is the same: the retiree’s contractual and statutory rights prohibit the forced transfer. In Harold’s case, the additional legal defect is that the underlying permanent disability determination could not be changed by any mechanism other than a formal WCAB proceeding under Labor Code § 5803 — a proceeding that never occurred.

(a) For EACH account number change, please identify: (i) the date the change occurred; (ii) the UC employee, system, or process that initiated or caused the change; (iii) the reason for the change; and (iv) whether any other data in Harold’s account record was modified, reclassified, or lost during the same transaction.

(b) Was the first account number change in 2020 (from AS 0010747 to AS 0011041/AS 0011042) related to the processing of Ida Fong’s February–March 2021 investigation into my son’s erroneous disability coding and the subsequent removal of my son from the 1095-B?

(c) Was any account number change related to the 2015 reclassification of Harold’s income from IRS Distribution Code 3 (Disability) to Distribution Code 2 (Early Retirement)?

(d) Was any account number change caused by the failed Ascend Finance Transformation Project that UCLA CFO Stephen Agostini publicly identified in February 2026?

(e) Was any account number change caused by system upgrades that UC employee Ida Fong stated caused record loss in March 2021?

(f) Was any account number change part of data breach remediation following the December 24, 2020 UC Accellion breach (547,000+ individuals, disability accommodation data compromised)?

(g) Was any data, classification, benefit status, or disability coding associated with account number AS 0010747 migrated to, preserved in, or lost during transitions to AS 0011041 through AS 0012451?

(a) Who authorized the cessation of premium deductions from Harold’s pension? On what date was the cessation authorized? What legal authority was cited?

(b) UC stopped deducting premiums from Harold’s pension without notice. If UC subsequently treats the resulting gap in premium payments as a basis for any adverse coverage action, how was that condition not manufactured by UC itself?

(c) UC had already internally executed the coverage cancellation during January 2026 — BEFORE Williams-Cook was assigned on January 30, 2026. How was her “review” genuine when the outcome had already been implemented?

How does the institution that issued Distribution Code 3 on Harold’s 1099-R forms for at least five consecutive years simultaneously maintain it has no records of Harold’s disability status?