Beighley v. Commissioner of Social Security Administration
Court Docket Sheet

District of Arizona

3:2017-cv-08203 (azd)

COMPLAINT filed by Arthur James Beighley, Jr. (submitted by Edward Wicklund).

Case 3:17-cv-08203-SPL Document 1 Filed 10/02/17 Page 1 of 3 1 Edward A Wicklund, Esq. 2 Olinsky Law Group 300 South State Street, Suite 420 3 Syracuse, NY 13202 4 N.Y. Bar No. 5027818 Telephone: (315) 701-5780 5 Facsimile: (315) 701-5781 6 twicklund@windisability.com 7 Attorney for Plaintiff Arthur James Beighley, Jr. 8 UNITED STATES DISTRICT COURT 9 FOR THE DISTRICT OF ARIZONA 10 PRESCOTT DIVISION 11 ARTHUR JAMES BEIGHLEY, JR.,) NO. 12 Soc.Sec. #XXX-XX-3638,) Plaintiff,) 13) 14 v.) COMPLAINT 15) NANCY A. BERRYHILL, acting) 16 Commissioner of Social Security,) 17 Defendant.) 18 __________________________________) 19 Plaintiff, Arthur James Beighley, Jr., by his attorney, Edward A. Wicklund, alleges 20 as follows: 21 22 1. The jurisdiction of this Court is invoked pursuant to 42 U.S.C. §§ 405(g) 23 and 1383(c)(3) to review a decision of the Commissioner of Social Security denying 24 Plaintiff’s application for Supplemental Security Income benefits for lack of disability. 25 26 2. This action is an appeal from a final administrative decision denying 27 Plaintiff’s claim. 28 Case 3:17-cv-08203-SPL Document 1 Filed 10/02/17 Page 2 of 3 1 3. This action is commenced within the appropriate time period set forth in the 2 attached Appeals Council Notice dated August 1, 2017. (Exhibit A). 3 4 4. Plaintiff, whose social security number is XXX-XX-3638, resides in Dolan 5 Springs, Mohave County, Arizona, which is within this judicial district and division. 6 5. The Defendant, Nancy A. Berryhill, is the acting Commissioner of Social 7 8 Security of the United States of America. 9 6. Plaintiff is disabled. 10 7. The agency committed error of law by denying Appeals Council review of 11 the decision by the Administrative Law Judge, or otherwise to deny relief that was within 12 13 the authority of the Appeals Council. 14 8. The conclusions and findings of fact of the Defendant are not supported by 15 substantial evidence and are contrary to law and regulation. 16 17 WHEREFORE, Plaintiff prays that this Court: 18 1. Find that the Plaintiff is entitled to Supplemental Security Income benefits 19 under the provisions of the Social Security Act; or 20 21 2. Remand the case for a further hearing; 22 3. Award attorney’s fees under the Equal Access to Justice Act, 28 U.S.C. § 23 2412, on the grounds that the Commissioner’s action in this case was not substantially 24 25 justified; and 26 4. Order such other and further relief as the Court deems just and proper. 27 Dated this 2nd day of October, 2017. 28/////////Case 3:17-cv-08203-SPL Document 1 Filed 10/02/17 Page 3 of 3 1 BY: s/Edward A. Wicklund 2 Edward A. Wicklund, Esq. Attorney for Plaintiff 3 (Pending Admission Pro Hac Vice) 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Exhibit A

EXHIBIT A Case 3:17-cv-08203-SPL Document 1-1 Filed 10/02/17 Page 2 of 5 til \_I.Q SOCIAL SECURITY ADMINISTRATION Refer to: TLC ~ST90¢> ~3638 Office of Disability Adjudication and Review 5107 Leesburg Pike 0-~:;,-I ==!!!i Falls Church. VA 22041-3255 Telephone: (877) 670-2722 Date: August 1. 2017:!!!!:-I!!!! j..... iii:-I-,-,-. I,=-iii NOTICE OF APPEALS COUNCIL ACTION RECEIVED,-iii0_;!! '-Mr. Arthur James Beighley Jr AUG 0121111 0_ Iii:-iii == This is about your request for review of the Administrative Law Judge's decision dated--iii June 29, 2016. You submitted reasons that you disagree with the decision We considered the == reasons and cKhibited them on the enclosed Order ofthe Appeals Council. We found that the--= iii iii reasons do not provide a basis for changing the Administrative Law Judge's decision. = I!!!!I We Have Denied Your Request for Review II w~ found no reason under our rules to review tire Administrative Law Judge's decision. Therefore, we have denied your request for review. This means that the Administrative Law Judge's decision is the final decision of the Commissioner of Social Security in your case. Rules We Applied I We applied the laws~ regulations and rulings in effect as ofthe date we took this action. Under our rules, we will review your case for any ofthe fonowing reasons: • The Administrative Law Judge appears to have abused his or her discretion. • There is an error of law. • The decision is not supported by substantial evidence. • There is a broad policy or procedural issue that may affect the public interest...--• w~ receiv~ additional evidence that you show is new, material, and relates to lh~ period on or before the date of the hearing decision. You must also show there is a reasonable-==== Susped Soeial Security Fraud?-IIiiiiiiii =--Please visit http://oIg.ssa..gov/r or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101). See Next Page Case 3:17-cv-08203-SPL Document 1-1 Filed 10/02/17 Page 3 of 5 Arthur Janres B~ighley Jr _-3638) Page 2 01'3 probability that the additional evidence would change the outcome of the dedsion. You must show good cause for why you missed informing us about or submitting it earli~. If You DIsagree-With Our Action If you disagree with our action, you may ask fOr court review of the Administrative Law Judge's decision by filing a civil action. If you do not ask for court revi~w, the Administrative Law Judge's decision will be a final decision that can be changed only under special rules. How to FHe a Civil Action You may me a civil action (ask for court review) by filing a complaint in the United States District Court tOr the judicial district in which you live. The complaint should name the Commissioner of Social Security as the defendant and should include the Social Seauity number(s) shown at the top ofthis letter. You or your representative mu&1 deliver copies of your complaint and of the summons issued by the court to the U.S. Attorney for the judicial district where you file your complaint, as provided in rule 4(i) ofthe Federal Rules ofC!vil Procedure. YOLl or your representative must also send copies of the complaint and summons, by certified or registered mail, to the Social Security Administration's Office ofthe General Counsel that is responsible for the processing and bandling of litigation in the particular judicial district in which the complaint is filed. 'Ibe names, addresses, and jurisdictional responsibilities of these offices are published in the Federal Register (70 FR 73320, December 9,2005), and are available on-Line at the Social Security Administration's Internet site. http://policy.ssa.gov/poms.ns17Jinksl0203)06020. You or your representative must also send copies ofthe complaint and summons, by certified or registered mail, to the Attorney General of the United States, Washington, DC 2()530. Time To File a Civil Action • Y00 ha ve 60 days to file a civil action (ask for court review). • The 60 days start the day after you receive this letter. We assume you received this letter 5 days after the date on it unless you show us that you did nol receive it within the 5-day period. • If you cannot file for court review within 60 days, you may ask the Appeals Council to extend your time to file. You must have a good r~n for waiting more than 60 days to ask for court review. You must make the request in writing and give your reason(s) in the request. See Next Page Case 3:17-cv-08203-SPL Document 1-1 Filed 10/02/17 Page 4 of 5 Arthur James Bejghley If _ _3638) Page 3 of3 iiiiii!!!! You must mail your request for more time to the Appea]s Council at the address shown at the top ofthis notice. Please put the Social Security number(s) also shown at the top of this notice on your request. We wiH send you a letter telling you whether your request for more time has been granted. =;;;;-!!!! =!!!! II About The Law The right to court review for claims under Title II (SociaJ Security) is provided for in Section 205(g) of the Social Security Act. This section is also Section 405(g) of Title 42 of the United = States Code. The right to court review for claims under Title XVI (Supplemental Security Income) is provided for in Section 163 1(cX3) of the Social Security Act This sectioll is also Section 1383(c) of Title 42 ofthe United States Code. The rules on filing civil actions are Rules 4(c} and (i) in the Federal Rules of Civil Procedure.-iiiiiii = If You Have Any Questions = If you have any questions, you may call, write, or visit any Social Security office. If you do iiiiiii!!!!. caU or visit an oftice, please have this notice with you. The telephone number oftlle local offiCI: that serves your area is (877)457-1733. Its address is: Social Security 205 North Marina Prescott, AZ 86301-3105 Jonathan M. Grossman Appeals Officer Enclosure: Order of Appeals Council cc: Bradford D. Myler P.O. Box 127 Lehi, UT 84043-0127 Case 3:17-cv-08203-SPL Document 1-1 Filed 10/02/17 Page 5 of 5 Social Security Administration OFFICE OF DISABIUTY ADJUDICATION AND REVIEW = iii...!!!!! = ORDER OF APPEALS COUNCIL...!!!!!-iii = IN THE CASE OF CLAIM FOR iii!!!!! iii Arthur James Beighley Jr Supplemental Security Income (Claimant) = l1li3_6_38_______________ (Wage Earner) (Social Security Number)... iii The Appeals Council has received additional evidence wh.ich it is making part ofthe r~cord.... iii That evidence consists ofthe fol1owing exhibits: Exhibit 168 Request for Review of Hearing Decision/Order (HA-520) dated July 13, 2016 Exhibit 18E Representative Brief{letter) from Howard D. Olinsky dated September 2, 2016 Date: Augub11, 2017.. o 5

Civil Cover Sheet

http://www.azd.uscourts.gov/cgi-bin/generate_civil_js44.pl Case 3:17-cv-08203-SPL Document 1-2 Filed 10/02/17 Page 1 of 1 UNITED STATES DISTRICT COURT DISTRICT OF ARIZONA This automated JS-44 conforms generally to the manual JS-44 approved by the Judicial Conference of the United States in September 1974. The data is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. The information contained herein neither replaces nor supplements the filing and service of pleadings or other papers as required by law. This form is authorized for use only in the District of Arizona. The completed cover sheet must be printed directly to PDF and filed as an attachment to the Complaint or Notice of Removal. Plaintiff(s): Arthur James Beighley, Jr. Defendant(s): County of Residence: Mohave County of Residence: Mohave County Where Claim For Relief Arose: Mohave Plaintiff's Atty(s): Defendant's Atty(s): Edward A. Wicklund, Esq. Olinsky Law Group 300 S. State St., Ste. 420 Syracuse, New York 13202 315-701-5780 II. Basis of Jurisdiction: 1. U.S. Government Plaintiff III. Citizenship of Principal Parties (Diversity Cases Only) Plaintiff:-N/A Defendant:-N/A IV. Origin: 1. Original Proceeding V. Nature of Suit: 864 SSID Title XVI VI.Cause of Action: 42 USC 405(g) and 42 USC 1383(c)(3): Denial of Social Security Disability Insurance benefits and Supplemental Security Income benefits. VII. Requested in Complaint Class Action: No Dollar Demand: Jury Demand: No VIII. This case is not related to another case. Signature: s/Edward A. Wicklund Date: 10/2/2017 If any of this information is incorrect, please go back to the Civil Cover Sheet Input form using the Back button in your browser and change it. Once correct, save this form as a PDF and include it as an attachment to your case opening documents. Revised: 01/2014 1 of 1 9/29/2017, 2:36 PM

Letter)(SLQ

Case 3:17-cv-08203-SPL Document 1-3 Filed 10/02/17 Page 1 of 1 October 2, 2017 Via CM/ECF Clerk U.S. District Court 401 West Washington Street, SPC 1 Phoenix, AZ 85003-2118 Re: Beighley v. Berryhill Complaint Filing Social Security Proceeding Dear Sir/Madam: Enclosed please find the complaint, civil cover sheet, proposed summonses, and application to proceed in forma pauperis to be filed in the above-referenced matter. If anything further is needed, kindly advise. Respectfully,/s/Edward A. Wicklund Attorney for Plaintiff, pending admission pro hac vice EAW/mps

SUMMONS Submitted by Arthur James Beighley, Jr. (submitted by Edward Wicklund).

Case 3:17-cv-08203-SPL Document 3 Filed 10/02/17 Page 1 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action UNITED STATES DISTRICT COURT for the District __________ of Arizona District of __________))) ARTHUR JAMES BEIGHLEY, JR.) Plaintiff(s))) v. Civil Action No.))) NANCY A. BERRYHILL, ACTING) COMMISSIONER OF SOCIAL SECURITY) Defendant(s)) SUMMONS IN A CIVIL ACTION To: (Defendant’s name and address) Office of the Regional Chief Counsel, Region X Social Security Administration 701 Fifth Avenue, Suite 2900 M/S 221A Seattle, WA 98104-7075 A lawsuit has been filed against you. Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney, whose name and address are: Edward A. Wicklund, Esq. Olinsky Law Group 300 S. State St., Ste. 420 Syracuse, NY 13202 If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court. CLERK OF COURT Date: Signature of Clerk or Deputy Clerk Case 3:17-cv-08203-SPL Document 3 Filed 10/02/17 Page 2 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date). u I personally served the summons on the individual at (place) on (date); or u I left the summons at the individual’s residence or usual place of abode with (name), a person of suitable age and discretion who resides there, on (date), and mailed a copy to the individual’s last known address; or u I served the summons on (name of individual), who is designated by law to accept service of process on behalf of (name of organization) on (date); or u I returned the summons unexecuted because; or u Other (specify):. My fees are $ for travel and $ for services, for a total of $ 0.00. I declare under penalty of perjury that this information is true. Date: Server’s signature Printed name and title Server’s address Additional information regarding attempted service, etc:

Summons

Case 3:17-cv-08203-SPL Document 3-1 Filed 10/02/17 Page 1 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action UNITED STATES DISTRICT COURT for the District __________ of Arizona District of __________))) ARTHUR JAMES BEIGHLEY, JR.) Plaintiff(s))) v. Civil Action No.))) NANCY A. BERRYHILL, ACTING) COMMISSIONER OF SOCIAL SECURITY) Defendant(s)) SUMMONS IN A CIVIL ACTION To: (Defendant’s name and address) United States Attorney General Constitution Avenue & 10th St., NW Washington, DC 20530 A lawsuit has been filed against you. Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney, whose name and address are: Edward A. Wicklund, Esq. Olinsky Law Group 300 S. State St., Ste. 420 Syracuse, NY 13202 If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court. CLERK OF COURT Date: Signature of Clerk or Deputy Clerk Case 3:17-cv-08203-SPL Document 3-1 Filed 10/02/17 Page 2 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date). u I personally served the summons on the individual at (place) on (date); or u I left the summons at the individual’s residence or usual place of abode with (name), a person of suitable age and discretion who resides there, on (date), and mailed a copy to the individual’s last known address; or u I served the summons on (name of individual), who is designated by law to accept service of process on behalf of (name of organization) on (date); or u I returned the summons unexecuted because; or u Other (specify):. My fees are $ for travel and $ for services, for a total of $ 0.00. I declare under penalty of perjury that this information is true. Date: Server’s signature Printed name and title Server’s address Additional information regarding attempted service, etc:

Summons)(SLQ

Case 3:17-cv-08203-SPL Document 3-2 Filed 10/02/17 Page 1 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action UNITED STATES DISTRICT COURT for the District __________ of Arizona District of __________))) ARTHUR JAMES BEIGHLEY, JR.) Plaintiff(s))) v. Civil Action No.))) NANCY A. BERRYHILL, ACTING) COMMISSIONER OF SOCIAL SECURITY) Defendant(s)) SUMMONS IN A CIVIL ACTION To: (Defendant’s name and address) United States Attorney's Office District of Arizona Two Renaissance Square 40 N. Central Avenue, Suite 1200 Phoenix, AZ 85004-4408 A lawsuit has been filed against you. Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney, whose name and address are: Edward A. Wicklund, Esq. Olinsky Law Group 300 S. State St., Ste. 420 Syracuse, NY 13202 If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court. CLERK OF COURT Date: Signature of Clerk or Deputy Clerk Case 3:17-cv-08203-SPL Document 3-2 Filed 10/02/17 Page 2 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date). u I personally served the summons on the individual at (place) on (date); or u I left the summons at the individual’s residence or usual place of abode with (name), a person of suitable age and discretion who resides there, on (date), and mailed a copy to the individual’s last known address; or u I served the summons on (name of individual), who is designated by law to accept service of process on behalf of (name of organization) on (date); or u I returned the summons unexecuted because; or u Other (specify):. My fees are $ for travel and $ for services, for a total of $ 0.00. I declare under penalty of perjury that this information is true. Date: Server’s signature Printed name and title Server’s address Additional information regarding attempted service, etc:

This case has been assigned to the Honorable Steven P Logan. All future pleadings or documents should bear the correct case number: CV-17-08203-PCT-SPL. Notice of Availability of Magistrate Judge to Exercise Jurisdiction form attached.

Case 3:17-cv-08203-SPL Document 4 Filed 10/02/17 Page 1 of 1 AO 85 (Rev. 8/97) Notice, Consent, and Order of Reference-Exercise of Jurisdiction by a United States Magistrate Judge (For Use In Civil Cases With District Judge as Presider) UNITED STATES DISTRICT COURT _______________________________ District of __________________________________________________ NOTICE, CONSENT, AND ORDER OF REFERENCE-Plaintiff EXERCISE OF JURISDICTION BY A UNITED STATES MAGISTRATE JUDGE v. Case Number: Defendant NOTICE OF AVAILABILITY OF A UNITED STATES MAGISTRATE JUDGE TO EXERCISE JURISDICTION In accordance with the provisions of 28 U.S.C. 636(c) and Fed.R.Civ.P.73, you are hereby notified that a United States magistrate judge of this district court is available to conduct any or all proceedings in this case including a jury or nonjury trial, and to order the entry of a final judgment. Exercise of this jurisdiction by a magistrate judge is, however, permitted only if all parties voluntarily consent. You may, without adverse substantive consequences, withhold your consent, but this will prevent the court’s jurisdiction from being exercised by a magistrate judge. If any party withholds consent, the identity of the parties consenting or withholding consent will not be communicated to any magistrate judge or to the district judge to whom the case has been assigned. An appeal from a judgment entered by a magistrate judge shall be taken directly to the United States court of appeals for this judicial circuit in the same manner as an appeal from any other judgment of a district court. CONSENT TO THE EXERCISE OF JURISDICTION BY A UNITED STATES MAGISTRATE JUDGE In accordance with the provisions of 28 U.S.C. 636(c) and Fed.R.Civ.P. 73, the parties in this case hereby voluntarily consent to have a United States magistrate judge conduct any and all further proceedings in the case, including the trial, order the entry of a final judgment, and conduct all post-judgment proceedings. Signatures Party Represented Date _____________________________________ __________________________________ ____________________ _____________________________________ __________________________________ ____________________ _____________________________________ __________________________________ ____________________ _____________________________________ __________________________________ ____________________ ORDER OF ASSIGNMENT IT IS HEREBY ORDERED that this case be assigned to ______________________________________________________ United States Magistrate Judge, for all further proceedings and the entry of judgment in accordance with 28 U.S.C. 636(c), Fed.R.Civ.P. 73 and the foregoing consent of the parties. All further documents filed with the court are to carry the following case number ________________________________________. ________________ _____________________________________________________________________________________ Date United States District Judge NOTE: RETURN THIS FORM TO THE CLERK OF THE COURT ONLY IF ALL PARTIES HAVE CONSENTED ON THIS FORM TO THE EXERCISE OF JURISDICTION BY A UNITED STATES MAGISTRATE JUDGE.

ORDER that the Application {{2}} is granted. Plaintiff may proceed in forma pauperis without prepayment of costs or fees or the necessity of giving security. IT IS FURTHER ORDERED that Plaintiff shall be responsible for service by waiver or of the summons and complaint. Signed by Judge Steven P. Logan on 10/3/17.

Case 3:17-cv-08203-SPL Document 5 Filed 10/03/17 Page 1 of 1 1 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA 8) No. CV-17-08203-PCT-SPL Arthur James Beighley, Jr., 9)) Plaintiff,) ORDER 10) vs. 11)) Commissioner of Social Security) 12 Administration,) 13)) Defendant.) 14 15 Before the Court is Plaintiff’s Application to Proceed in District Court Without 16 Prepaying Fees or Costs (Doc. 2). Having considered the financial information contained 17 in the application and finding Plaintiff is unable to pay the costs of these proceedings, 18 IT IS ORDERED that the Application (Doc. 2) is granted. Plaintiff may proceed 19 in forma pauperis without prepayment of costs or fees or the necessity of giving security. 20 IT IS FURTHER ORDERED that Plaintiff shall be responsible for service by 21 waiver or of the summons and complaint. 22 Dated this 3rd day of October, 2017. 23 24 Honorable Steven P. Logan United States District Judge 25 26 27 28

SCHEDULING ORDER (See Order for details). Signed by Judge Steven P Logan on 10/3/17.

Case 3:17-cv-08203-SPL Document 6 Filed 10/03/17 Page 1 of 3 1 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA 8) Arthur James Beighley, Jr., No. CV-17-08203-PCT-SPL 9)) Plaintiff,) SCHEDULING ORDER 10) vs. 11)) Commissioner of Social Security) 12) Administration, 13)) Defendant.) 14) 15 16 Plaintiff seeks judicial review and reversal of the final decision of the 17 Commissioner of the Social Security Administration. Pursuant to Rule 16.2 of the Local 18 Rules of Civil Procedure ("LRCiv"), Rules of Practice of the U.S. District Court for the 19 District of Arizona,1 the Court enters this Scheduling Order. Accordingly, 20 IT IS ORDERED: 21 1. That the parties must fully comply with LRCiv 16.1 in its entirety as 22 follows: 23 (a) Opening Brief. Within sixty (60) days after the answer is filed, Plaintiff must file an opening brief addressing why 24 the Commissioner’s decision is not supported by substantial evidence or why the decision should otherwise be reversed or 25 the case remanded. Plaintiff’s opening brief must set forth all errors which Plaintiff contends entitle him or her to relief. 26 27 1 The Clerk of Court assigned this case to the expedited track pursuant to LRCiv 16.2(b)(1)(A)(i), and the deadlines in this action are therefore set without holding a 28 scheduling conference. The local rules may be found at: http://www.azd.uscourts.gov/local-rules. Case 3:17-cv-08203-SPL Document 6 Filed 10/03/17 Page 2 of 3 1 The brief must also contain, under appropriate headings and in the order indicated below, the following: 2 (1) A statement of the issues presented for review, set forth 3 in separate numbered paragraphs. 4 (2) A statement of the case. This statement should indicate briefly the course of the proceedings and its disposition at the 5 administrative level. 6 (3) A statement of facts. This statement of the facts must include Plaintiff’s age, education, and work experience; a 7 summary of the physical and mental impairments alleged; a brief outline of the medical evidence; and a brief summary of 8 other relevant evidence of record. Each statement of fact must be supported by reference to the page in the record 9 where the evidence may be found. 10 (4) An argument. The argument, which may be preceded by a summary, must be divided into sections separately treating 11 each issue. Each contention must be supported by specific reference to the portion of the record [by reference to 12 specific page numbers] relied upon and by citations to statutes, regulations, and cases supporting Plaintiff’s 13 position. If any requested remand is for the purpose of taking additional evidence, such evidence must be described in the 14 opening brief, and Plaintiff’s argument must show that the additional evidence is material and that there is good cause 15 for the failure to incorporate such evidence into the record in a prior proceeding. If such additional evidence is in the form 16 of a consultation examination sought at Government expense, Plaintiff’s opening brief must make a proffer of the nature of 17 the evidence to be obtained. 18 (5) A short conclusion stating the relief sought. 19 (b) Answering Brief. Defendant must file an answering brief within thirty (30) days after service of Plaintiff’s opening 20 brief. Defendant’s brief must (1) respond specifically to each issue raised by Plaintiff and (2) conform to the 21 requirements set forth above for Plaintiff’s brief, except that a statement of the issues, a statement of the case and a 22 statement of the facts need not be made unless Defendant is dissatisfied with Plaintiff’s statement thereof. 23 (c) Reply Brief. Plaintiff may file a reply brief within fifteen 24 (15) days after service of Defendant’s answering brief. 25 (d) Length of Briefs. Unless otherwise ordered by the Court, the opening and answering briefs may not exceed twenty-five 26 (25) pages, including any statement of facts, with the reply brief limited to eleven (11) pages. The case will be deemed 27 submitted as of the date on which Plaintiff’s reply brief is filed or due. 28 2 Case 3:17-cv-08203-SPL Document 6 Filed 10/03/17 Page 3 of 3 1 (e) Oral Argument. If either party desires oral argument, it must be requested in the manner prescribed by Rule 7.2(f) of 2 the Local Rules of Civil Procedure upon the filing of the opening brief. Whether to allow oral argument is at the 3 discretion of the Court. 4 5 LRCiv 16.1(a)-(e) (emphasis added). 6 2. That, in presenting any issue for review, a general allegation that the 7 Commissioner committed legal error, or that the Commissioner’s determination is not 8 supported by substantial evidence, is insufficient to raise that issue;2 9 3. That, if either party fails to timely file a brief in full compliance with this 10 Order, the Court may strike the non-complying brief, dismiss the case, or remand to the 11 agency, as appropriate;3 and 12 4. That Plaintiff shall serve Defendant with a copy of this Order within fifteen 13 (15) days of any appearance. 14 Dated this 3rd day of October, 2017. 15 16 Honorable Steven P. Logan United States District Judge 17 18 19 20 21 22 23 2 24 See Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989) (explaining that the Commissioner’s decision to deny benefits would be overturned "only if it is not 25 supported by substantial evidence or is based on legal error"); Greenwood v. FAA, 28 F.3d 971, 977 (9th Cir. 1994) (explaining that the court "review[s] only issues which are 26 argued specifically and distinctly in a party’s opening brief[,]… will not manufacture arguments for [a party], and a bare assertion does not preserve a claim") (internal citation 27 omitted); LRCiv 16.1. 3 28 See generally Fed. R. Civ. P. 41(b). 3

Summons Issued as to Commissioner of Social Security Administration, U.S. Attorney and U.S. Attorney General.

Case 3:17-cv-08203-SPL Document 7 Filed 10/04/17 Page 1 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action UNITED STATES DISTRICT COURT for the District __________ of Arizona District of __________))) ARTHUR JAMES BEIGHLEY, JR.) Plaintiff(s))) v. Civil Action No.))) NANCY A. BERRYHILL, ACTING) COMMISSIONER OF SOCIAL SECURITY) Defendant(s)) SUMMONS IN A CIVIL ACTION To: (Defendant’s name and address) Office of the Regional Chief Counsel, Region X Social Security Administration 701 Fifth Avenue, Suite 2900 M/S 221A Seattle, WA 98104-7075 A lawsuit has been filed against you. Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney, whose name and address are: Edward A. Wicklund, Esq. Olinsky Law Group 300 S. State St., Ste. 420 Syracuse, NY 13202 If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court. CLERK OF COURT Date: Signature of Clerk or Deputy Clerk ISSUED ON 8:14 am, Oct 04, 2017 s/Brian D. Karth, Clerk Case 3:17-cv-08203-SPL Document 7 Filed 10/04/17 Page 2 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date). u I personally served the summons on the individual at (place) on (date); or u I left the summons at the individual’s residence or usual place of abode with (name), a person of suitable age and discretion who resides there, on (date), and mailed a copy to the individual’s last known address; or u I served the summons on (name of individual), who is designated by law to accept service of process on behalf of (name of organization) on (date); or u I returned the summons unexecuted because; or u Other (specify):. My fees are $ for travel and $ for services, for a total of $ 0.00. I declare under penalty of perjury that this information is true. Date: Server’s signature Printed name and title Server’s address Additional information regarding attempted service, etc:

Summons

Case 3:17-cv-08203-SPL Document 7-1 Filed 10/04/17 Page 1 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action UNITED STATES DISTRICT COURT for the District __________ of Arizona District of __________))) ARTHUR JAMES BEIGHLEY, JR.) Plaintiff(s))) v. Civil Action No.))) NANCY A. BERRYHILL, ACTING) COMMISSIONER OF SOCIAL SECURITY) Defendant(s)) SUMMONS IN A CIVIL ACTION To: (Defendant’s name and address) United States Attorney's Office District of Arizona Two Renaissance Square 40 N. Central Avenue, Suite 1200 Phoenix, AZ 85004-4408 A lawsuit has been filed against you. Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney, whose name and address are: Edward A. Wicklund, Esq. Olinsky Law Group 300 S. State St., Ste. 420 Syracuse, NY 13202 If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court. CLERK OF COURT Date: Signature of Clerk or Deputy Clerk ISSUED ON 8:14 am, Oct 04, 2017 s/Brian D. Karth, Clerk Case 3:17-cv-08203-SPL Document 7-1 Filed 10/04/17 Page 2 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date). u I personally served the summons on the individual at (place) on (date); or u I left the summons at the individual’s residence or usual place of abode with (name), a person of suitable age and discretion who resides there, on (date), and mailed a copy to the individual’s last known address; or u I served the summons on (name of individual), who is designated by law to accept service of process on behalf of (name of organization) on (date); or u I returned the summons unexecuted because; or u Other (specify):. My fees are $ for travel and $ for services, for a total of $ 0.00. I declare under penalty of perjury that this information is true. Date: Server’s signature Printed name and title Server’s address Additional information regarding attempted service, etc:

Summons)(BAS

Case 3:17-cv-08203-SPL Document 7-2 Filed 10/04/17 Page 1 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action UNITED STATES DISTRICT COURT for the District __________ of Arizona District of __________))) ARTHUR JAMES BEIGHLEY, JR.) Plaintiff(s))) v. Civil Action No.))) NANCY A. BERRYHILL, ACTING) COMMISSIONER OF SOCIAL SECURITY) Defendant(s)) SUMMONS IN A CIVIL ACTION To: (Defendant’s name and address) United States Attorney General Constitution Avenue & 10th St., NW Washington, DC 20530 A lawsuit has been filed against you. Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney, whose name and address are: Edward A. Wicklund, Esq. Olinsky Law Group 300 S. State St., Ste. 420 Syracuse, NY 13202 If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court. CLERK OF COURT Date: Signature of Clerk or Deputy Clerk ISSUED ON 8:14 am, Oct 04, 2017 s/Brian D. Karth, Clerk Case 3:17-cv-08203-SPL Document 7-2 Filed 10/04/17 Page 2 of 2 AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date). u I personally served the summons on the individual at (place) on (date); or u I left the summons at the individual’s residence or usual place of abode with (name), a person of suitable age and discretion who resides there, on (date), and mailed a copy to the individual’s last known address; or u I served the summons on (name of individual), who is designated by law to accept service of process on behalf of (name of organization) on (date); or u I returned the summons unexecuted because; or u Other (specify):. My fees are $ for travel and $ for services, for a total of $ 0.00. I declare under penalty of perjury that this information is true. Date: Server’s signature Printed name and title Server’s address Additional information regarding attempted service, etc:

SERVICE EXECUTED filed by Arthur James Beighley, Jr: Return of Service re: Summons, Complaint and Scheduling Order upon US Attorney's Office, Office of General Counsel, Attorney General on 11/1/2017.

Case 3:17-cv-08203-SPL Document 8 Filed 11/06/17 Page 2 of 6 Date: November 6, 2017 Michelle Callahan: The following is in response to your November 6, 2017 request for delivery information on your Certified Mail™/RRE item number 9314869904300040121981. The delivery record shows that this item was delivered on October 30, 2017 at 1:28 pm in PHOENIX, AZ 85004. The scanned image of the recipient information is provided below. Signature of Recipient: Address of Recipient: Thank you for selecting the Postal Service for your mailing needs. If you require additional assistance, please contact your local Post Office or postal representative. Sincerely, United States Postal Service Case 3:17-cv-08203-SPL Document 8 Filed 11/06/17 Page 4 of 6 Date: November 6, 2017 Michelle Callahan: The following is in response to your November 6, 2017 request for delivery information on your Certified Mail™/RRE item number 9314869904300040122063. The delivery record shows that this item was delivered on October 30, 2017 at 1:06 pm in SEATTLE, WA 98104. The scanned image of the recipient information is provided below. Signature of Recipient: Address of Recipient: Thank you for selecting the Postal Service for your mailing needs. If you require additional assistance, please contact your local Post Office or postal representative. Sincerely, United States Postal Service Case 3:17-cv-08203-SPL Document 8 Filed 11/06/17 Page 6 of 6 Date: November 6, 2017 Michelle Callahan: The following is in response to your November 6, 2017 request for delivery information on your Certified Mail™/RRE item number 9314869904300040122094. The delivery record shows that this item was delivered on November 1, 2017 at 5:20 am in WASHINGTON, DC 20530. The scanned image of the recipient information is provided below. Signature of Recipient: Address of Recipient: Thank you for selecting the Postal Service for your mailing needs. If you require additional assistance, please contact your local Post Office or postal representative. Sincerely, United States Postal Service

NOTICE OF ATTORNEY APPEARANCE: Benjamin J. Groebner appearing for Commissioner of Social Security Administration.

1 Elizabeth A. Strange First Assistant United States Attorney 2 District of Arizona 3 Benjamin J. Groebner 4 Special Assistant United States Attorney 5 Office of the General Counsel Social Security Administration 6 701 Fifth Avenue, Suite 2900 M/S 221A 7 Seattle, WA 98104-7075 State Bar No. WA36808 8 Fax: (206) 615-2531 benjamin.groebner@ssa.gov 9 Telephone: (206) 615-2494 10 Of Attorneys for the Defendant 11 IN THE UNITED STATES DISTRICT COURT 12 DISTRICT OF ARIZONA 13 Arthur James Beighley, Jr., No. CV-17-08203-PCT-SPL 14 15 Plaintiff, 16 DEFENDANT'S NOTICE OF vs. APPEARANCE 17 Nancy A. Berryhill, 18 Acting Commissioner of Social Security, 19 Defendant. 20 21 PLEASE TAKE NOTICE that Defendant Commissioner of Social Security 22 23 hereby notifies Plaintiff and this Court that the following Special Assistant U.S. 24 Attorney will appear as counsel of record in the above-captioned case: 25 26 27 28 1 Benjamin J. Groebner Special Assistant United States Attorney 2 Office of the General Counsel 3 Social Security Administration 701 Fifth Avenue, Suite 2900 M/S 221A 4 Seattle, WA 98104-7075 5 State Bar No. WA36808 Fax: (206) 615-2531 6 benjamin.groebner@ssa.gov Telephone: (206) 615-2494 7 8 DATED this 29th day of December 2017. 9 Respectfully submitted, 10 11 ELIZABETH A. STRANGE First Assistant United States Attorney 12 District of Arizona 13 s/ Benjamin J. Groebner 14 BENJAMIN J. GROEBNER 15 Special Assistant United States Attorney 16 Of Counsel for the Defendant: 17 MATHEW W. PILE 18 Acting Regional Chief Counsel, Social Security Administration Office of the General Counsel, Region X 19 701 Fifth Avenue, Suite 2900 M/S 221A 20 Seattle, WA 98104-7075 21 22 23 24 25 26 27 28 2 1 CERTIFICATE OF SERVICE 2 I hereby certify that the foregoing Notice of Appearance was filed with the Clerk of 3 the Court on December 29, 2017, using the CM/ECF system which will send notification 4 5 of such filing to the following: Edward Allen Wicklund. 6 s/ Barbara Eadie 7 BARBARA EADIE 8 Paralegal Specialist Office of the General Counsel 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3

ANSWER to [1] Complaint by Commissioner of Social Security Administration.

1 Elizabeth A. Strange First Assistant United States Attorney 2 District of Arizona 3 Benjamin J. Groebner 4 Special Assistant United States Attorney 5 Office of the General Counsel Social Security Administration 6 701 Fifth Avenue, Suite 2900 M/S 221A 7 Seattle, WA 98104-7075 State Bar No. WA36808 8 Fax: (206) 615-2531 benjamin.groebner@ssa.gov 9 Telephone: (206) 615-2494 10 Of Attorneys for the Defendant 11 IN THE UNITED STATES DISTRICT COURT 12 DISTRICT OF ARIZONA 13 Arthur James Beighley, Jr., No. CV-17-08203-PCT-SPL 14 15 Plaintiff, 16 ANSWER vs. 17 Nancy A. Berryhill, 18 Acting Commissioner of Social Security, 19 Defendant. 20 21 Defendant, in answer to Plaintiff's complaint, admits, denies and alleges as 22 follows: 23 1. Defendant admits this court has jurisdiction pursuant to 42 U.S.C. § 405(g). 24 25 2. Defendant admits the allegations contained Paragraphs 2 and 3. 26 3. Defendant lacks sufficient knowledge sufficient to form a belief about the 27 28 1 allegations in Paragraph 4, except that Plaintiff's social security number is a 2 matter of record with the Defendant. 3 4. Defendant admits the allegations contained in Paragraph 5. 4 5 5. Defendant denies the allegations contained in Paragraphs 6, 7, and 8. 6 6. The remainder of the Complaint is a prayer for relief, including a request for 7 attorney's fees. Defendant denies that Plaintiff is entitled to judgment or any 8 requested relief. 9 10 7. Defendant denies all allegations of the complaint not specifically admitted or 11 clarified. 12 8. In accordance with 42 U.S.C. § 405(g), Defendant files as part of the answer a 13 14 certified copy of the transcript of the record including the evidence upon which 15 Defendant based the challenged decision. 16 WHEREFORE, Defendant prays for judgment dismissing the complaint, with 17 18 costs, and for judgment in accordance with 42 U.S.C. § 405(g), affirming Defendant's 19 decision. 20 /// 21 22 23 /// 24 25 /// 26 27 28 2 1 DATED this 2nd day of January 2018. 2 Respectfully submitted, 3 ELIZABETH A. STRANGE 4 First Assistant United States Attorney 5 District of Arizona 6 s/ Benjamin J. Groebner BENJAMIN J. GROEBNER 7 Special Assistant United States Attorney 8 9 Of Counsel for the Defendant: 10 MATHEW W. PILE 11 Acting Regional Chief Counsel, Social Security Administration 12 Office of the General Counsel, Region X 701 Fifth Avenue, Suite 2900 M/S 221A 13 Seattle, WA 98104-7075 14 15 16 17 18 19 20 CERTIFICATE OF SERVICE 21 I hereby certify that the foregoing Answer was filed with the Clerk of the 22 Court on January 2, 2018, using the CM/ECF system, which will send notification 23 24 of such filing to the following: Edward Allen Wicklund. 25 26 s/ Megan Moore 27 MEGAN MOORE Paralegal Specialist 28 Office of the General Counsel 3

NOTICE of Filing Certified Copy of Administrative Transcript re: [10] Answer to Complaint filed by Commissioner of Social Security Administration.

1 Elizabeth A. Strange First Assistant United States Attorney 2 District of Arizona 3 Benjamin J. Groebner 4 Special Assistant United States Attorney 5 Office of the General Counsel Social Security Administration 6 701 Fifth Avenue, Suite 2900 M/S 221A 7 Seattle, WA 98104-7075 State Bar No. WA36808 8 Fax: (206) 615-2531 benjamin.groebner@ssa.gov 9 Telephone: (206) 615-2494 10 Of Attorneys for the Defendant 11 IN THE UNITED STATES DISTRICT COURT 12 DISTRICT OF ARIZONA 13 Arthur James Beighley, Jr., No. CV-17-08203-PCT-SPL 14 15 Plaintiff, 16 NOTICE OF FILING CERTIFIED vs. ADMINISTRATIVE/TRANSCRIPT 17 OF RECORD Nancy A. Berryhill, 18 Acting Commissioner of Social Security, 19 Defendant. 20 21 PLEASE TAKE NOTICE the Acting Commissioner of the Social Security 22 Administration, by and through Benjamin J. Groebner, Special Assistant United States 23 Attorney for the District of Arizona, files herein in accordance with section 205(g) of the 24 25 Social Security Act, 42 U.S.C. § 405(g), as part of the answer a certified electronic copy 26 of the transcript of the record including the evidence upon which the findings and 27 decision complained of are based. In addition, a paper copy was delivered to the court. 28 1 DATED this 2nd day of January 2018. 2 3 Respectfully submitted, 4 ELIZABETH A. STRANGE 5 First Assistant United States Attorney District of Arizona 6 s/ Benjamin J. Groebner 7 BENJAMIN J. GROEBNER 8 Special Assistant United States Attorney 9 Of Counsel for the Defendant: 10 MATHEW W. PILE 11 Acting Regional Chief Counsel, Social Security Administration 12 Office of the General Counsel, Region X 701 Fifth Avenue, Suite 2900 M/S 221A 13 Seattle, WA 98104-7075 14 15 16 17 18 CERTIFICATE OF SERVICE 19 20 I hereby certify that the foregoing Notice of Filing Certified 21 Administrative/Transcript of Record was filed with the Clerk of the Court on 22 January 2, 2018, using the CM/ECF system, which will send notification of such 23 filing to the following: Edward Allen Wicklund. 24 25 26 s/ Megan Moore MEGAN MOORE 27 Paralegal Specialist 28 Office of the General Counsel 2

Certification Page

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIZONA (PRESCOTT DIVISION) ARTHUR JAMES BEIGHLEY JR. Plaintiff VS. CIVIL ACTION NO. 3: 17 - CV - 08203 NANCY A. BERRYHILL ACTING COMMISSIONER OF SOCIAL SECURITY Defendant CERTIFICATION The undersigned, as Chief, Court Case Preparation and Review Branch 1, Office of Appellate Operations, Office of Disability Adjudication and Review, Social Security Administration, hereby certifies that the documents annexed hereto constitute a full and accurate transcript of the entire record of proceedings relating to this case. * F ' i ' P + THIN Styrie NANCY CHUNG Date: November 29, 2017 * * * Certified Administrative Records (CAR) are not compatible with Optical Character Recognition (OCR), therefore the Agency cannot provide a OCR searchable CAR.

Court Transcript Index

Court Transcript Index Civil Action Number: 3:17-CV-08203 Claimant: Arthur James Beighley, Jr Account Number: 552-92-3638 No. of Court Transcript Index Page No. Pages Withdrawal/Revocation of Representation (WDREP), dated 1 1 09/27/2017 AC Denial (ACDENY), dated 08/01/2017 2-7 6 Outgoing ODAR Correspondence (OUTODARC), dated 05/04/2017 8-10 3 Appointment of Representative (1696), dated 09/09/2016 11-12 2 Representative Correspondence (REPLTR), dated 09/02/2016, from 13-15 3 Howard D. Olinsky AC Correspondence (ACCORR), dated 08/07/2016 16-22 7 Representative Fee Agreement (FEEAGRMT), dated 07/13/2016 23 1 Appointment of Representative (1696), dated 07/13/2016 24-25 2 ALJ Hearing Decision (ALJDEC), dated 06/29/2016 26-41 16 Report of Contact (5002), dated 04/27/2016 42 1 Transcript of Oral Hearing (TRANHR), dated 04/12/2016 43-60 18 Exhibits Exhibit No. of No. Description Page No. Pages 1A Initial Disability Determination by State Agency, Title XVI, 61 1 dated 03/26/2014 2A Disability Determination Explanation-T16 No RFC, No PRT, 62-68 7 DDS Dr., dated 03/26/2014 3A Reconsideration Disability Determination by State Agency, 69 1 Title XVI, dated 09/03/2014 4A Disability Determination Explanation-T16 No RFC, No PRT, 70-79 10 DDS Dr., dated 09/03/2014 1B Representative Fee Agreement, dated 09/29/2013 80-81 2 2B Appointment of Representative, dated 10/15/2013 82 1 3B T16 Notice of Disapproved Claim, dated 03/26/2014 83-86 4 4B Request for Reconsideration, dated 04/22/2014 87-89 3 5B Personal Decision Notice, dated 09/04/2014 90-93 4 6B Request for Hearing by ALJ, dated 10/09/2014 94-96 3 7B Request for Hearing Acknowledgement Letter, dated 97-108 12 10/23/2014 8B Objection to Video Hearing 109 1 9B Hearing Notice 110-129 20 10B Acknowledge Notice of Hearing, dated 03/04/2016 130-131 2 11B Representative Fee Agreement, dated 11/09/2014 132 1 12B Appointment of Representative, dated 03/04/2016 133 1 13B Notice Of Hearing Reminder 134-139 6 14B Appointment of Representative 140-141 2 DATE: November 29, 2017 The documents and exhibits contained in this administrative record are the best copies obtainable. Court Transcript Index Civil Action Number: 3:17-CV-08203 Claimant: Arthur James Beighley, Jr Account Number: 552-92-3638 Exhibits Exhibit No. of No. Description Page No. Pages 15B Representative Fee Agreement 142 1 16B Request for Review of Hearing Decision/Order, dated 143 1 07/13/2016 1D Application for Supplemental Security Income Benefits, dated 144-152 9 10/28/2013 2D Certified Earnings Records, dated 11/05/2015 153-154 2 3D Detailed Earnings Query, dated 11/05/2015 155-161 7 4D Summary Earnings Query, dated 11/05/2015 162 1 5D New Hire, Quarter Wage, Unemployment Query (NDNH), 163 1 dated 04/07/2016 6D Certified Earnings Records, dated 04/07/2016 164-165 2 7D Detailed Earnings Query, dated 04/07/2016 166-167 2 1E Disability Report - Field Office, dated 10/29/2013, from Field 168-170 3 Office 2E Disability Report - Adult, dated 10/29/2013 171-179 9 3E Authorization for Source to Release Information to SSA, 180 1 dated 04/15/2014 4E Disability Report - Appeals, dated 04/18/2014 181-186 6 5E Disability Report - Field Office, dated 04/24/2014, from Field 187-188 2 Office 6E Exertional Activities Questionnaire, dated 08/23/2014 189-191 3 7E Copy of Case Development Claimant Correspondence, dated 192-193 2 08/23/2014 8E Disability Report - Appeals, dated 10/08/2014 194-198 5 9E Disability Report - Field Office, dated 10/09/2014, from Field 199-200 2 Office 10E Work History Report, dated 08/23/2015, from BRADFORD 201-204 4 DOUGLAS MYLER 11E Exhibit List to Rep PH2E, dated 11/05/2015 205-215 11 12E Work Background, dated 11/23/2015 216-217 2 13E Recent Medical Treatment, dated 11/23/2015 218-219 2 14E Medications, dated 11/23/2015 220-222 3 15E Resume of Vocational Expert 223-224 2 16E Representative Correspondence, dated 04/05/2016 225-226 2 17E Representative Correspondence, dated 05/03/2016, from 227 1 Atty 18E Representative Brief, dated 09/02/2016 to 09/02/2016, from 228-229 2 Howard D. Olinsky 1F Laboratory Test Report, dated 06/05/2013, from WESTERN 230-241 12 MOUNTAIN MEDICAL CENTER PC DATE: November 29, 2017 The documents and exhibits contained in this administrative record are the best copies obtainable. Court Transcript Index Civil Action Number: 3:17-CV-08203 Claimant: Arthur James Beighley, Jr Account Number: 552-92-3638 Exhibits Exhibit No. of No. Description Page No. Pages 2F Office Treatment Records, dated 11/05/2012 to 06/09/2013, 242-379 138 from WESTERN ARIZONA REG MED CTR 3F Office Treatment Records, dated 08/01/2013, from NORTH 380-383 4 COUNTRY HEALTHCARE 4F Office Treatment Records, dated 07/03/2013 to 11/05/2013, 384-394 11 from WESTERN ARIZONA PULMONARY ASSOCIATES 5F Laboratory Test Report, dated 03/02/2014, from EFREN 395 1 CANO, D.O. (KINGMAN) 6F CE Physical Medicine, dated 03/02/2014, from 396-403 8 CANO,EFREN, D.O. 7F Office Treatment Records, dated 03/25/2014 to 05/01/2014, 404-407 4 from RICHARD CARDONE 8F Office Treatment Records, dated 12/16/2013 to 08/20/2014, 408-429 22 from WESTERN MOUNTAIN MEDICAL CENTER PC 9F Medical Source - No MER Available, dated 08/30/2014, from 430-431 2 WESTERN MOUNTAIN MEDICAL CENTER PC 10F Misc Medical Records, dated 02/23/2015 432-435 4 11F Progress Notes, dated 01/11/2014 to 04/18/2014, from 436-440 5 Richard Cardone 12F Office Treatment Records, dated 09/04/2012 to 08/01/2013, 441-484 44 from North County Healthcare - Flagstaff 13F Office Treatment Records, dated 06/06/2013 to 01/11/2016, 485-518 34 from Cahser and Lung Specialists 14F Office Treatment Records, dated 12/15/2014 to 03/09/2016, 519-558 40 from Western Mountain Medical Center 15F Progress Notes, dated 03/24/2016, from Western Mountain 559-561 3 Medical Center 16F Office Treatment Records, dated 12/15/2014 to 10/21/2015, 562-589 28 from Western Mountain Medical Center DATE: November 29, 2017 The documents and exhibits contained in this administrative record are the best copies obtainable.

Payment Documents and Decisions

0 Payment Documents and Decisions Civil Action Number: 3: 17 - CV - 08203 Claimant: Arthur James Beighley, Jr Account Number: 552 - 92 - 3638 Exhibits Exhibit No. Page No. No. of Pages 1A 61 2A 62 - 68 Description Initial Disability Determination by State Agency, Title XVI, dated 03 / 26 / 2014 Disability Determination Explanation - T16 No RFC, No PRT, DDS Dr ., dated 03 / 26 / 2014 Reconsideration Disability Determination by State Agency, Title XVI, dated 09 / 03 / 2014 Disability Determination Explanation - T16 No RFC, No PRT, DDS Dr ., dated 09 / 03 / 2014 P N ЗА 69 4A 70 - 79 10 DATE: November 29, 2017 The documents and exhibits contained in this administrative record are the best copies obtainable. SOCIAL SECURITY ADMINISTRATION 6. WE'S NAME C B O UNE CLA ESE 0 EXHIBIT NO. 1A PAGE: 10F 1 DISABILITY DETERMINATION AND TRANSMITTAL 1. DESTINATION | 2. DDS CODE 3. FILING DATE | 4. SSN BIC (if CDB or DWB CLAIM) DDS ODO DRS DQB INTPsc | S03 10 / 28 / 2013 | D D D D 552 - 92 - 3638 00 5. NAME AND ADDRESS OF CLAIMANT (include ZIP code) ARTHUR JAMES BEIGHLEY JR PO BOX 551 7. TYPE CLAIM (Titre II) DOLAN SPRINGS AZ 86441 DIB FZ DWB CDB - R CDB - D RD - R RD - D RD P - R P - D MQFE O D D D D D D D D D O 8. TYPE CLAIM (Title XVI) DI Ds D Dc D BIO BSO BCD 9. DATE OF BIRTH 11. REMARKS 03 / 13 / 1954 Cimt Phone: 928 - 767 - 3124 DDS Received 10 / 29 / 2013 12. DISTRICT - BRANCH OFFICE ADDRESS (include ZIP Code) PRESCOTT 205 N. MARINA STREET PRESCOTT, AZ 86303 DI 10. PRIOR ACTION PO I PTO PD DO - BO CODE 909 13. DO - BO REPRESENTATIVE 11A. A 2 14. DATE Presumptive Disability Impairment DETERMINATION PURSUANT TO THE SOCIAL SECURITY ACT, AS AMENDED 18A. PRIMARY DIAGNOSIS BODY SYS. CODE NO. 16B. SECONDARY DIAGNOSIS | CODE NO. 03 4960 7240 15. CLAIMANT DISABLED A. O Disability Disability Began CHRONIC PULMONARY INSUFFICIENCY (COPD) DISORDERS OF BACK (DISCOGENIC / DEGENERATIVE) Disability Ceased 17. DIARY TYPE MO / YR. REASON 18. CASE OF BLINDNESS AS DEFINED IN SEC. 1614 (a) } { 2 } y [ 216) (0) 19. CLAIMANT NOT DISABLED Not Disab. for Cash Bene. A UPurp. Through Disab for Cash Benefit Through Date of Purp. Beg. Current Determination B. 0CC YRS. EDYRS. 12 12th gra | 24. MOB CODE 25. REVISED | Initial Recon DHU Before Age 22 7CD8 OHM) SCOUT Prev Ref 20. VOCATIONAL BACKGROUND 21. VRACTION SC A D. . A. B. L C 23. MED LIST NO. ALJ Hearing Appeals Council 22. REG - BASIS CODE N30U.S. District Court DET U AS .: " Merima D 26. LIST NO. A. E. 27. RATIONALE See Attached SSA - 4268 - 44 / C4 Check if Vocational Rule Met. Cite Rule 28. A. E. O term _ Period of Disability Disability Period | 30. DISABILITY EXAMINER - DDS 13 BIL192 Judy Bilbrey 29. LTRIPAR NO. Estab Beg 31. DATE 03 / 26 / 2014 Continues | 32. PHYSICIAN OR MEDICAL SPEC. SIGNATURE See eCAT DDE dated 2014 - 03 - 26 Term 33. DATE 03 / 26 / 2014 32B. SPEC. CODE | 32A. PHYSIÇLANOR. MERICAL SPEG. NAME (Stamp, Print or Type) Bonald Robins M. D. (19) 19 34. REMARKS BRADFORD DOUGLAS MYLER PO BOX 127 LEHI UT 84043 MULTIPLE IMPAIRMENTS CONSIDERED 34A. CONBINE D ULTIPLE HOHSE VE RE - SE VE RE 348. COMBINED MULTIPLE HONSE VE RE - NON SEVERE 35. BASIS CODE 38. DATE | 35. REV. DE T. 37. SSA REPRESENTATIVE CODES SSA CODE Oper BIL192 Form SSA - 831 - C3 (5 / 89) BASE 11 / 15 / 05 Date 03 / 26 / 2014 1 I 5 5 61 O DECISION O CASE CONTROL Case + Dec DE Case DisabIIPPSDeterminattofitxPlatfations of 20 EXHIBIT NO. 2A PAGE: 1 OF 7 This Disability Determination Explanation is for the DI claim at the Initial level. CLAIMANT INFORMATION CLAIMANT INFORMATION Name: Arthur James Beighley JR SSN: 552 - 92 - 3638 Phone Number: 928 - 767 - 3124 Secondary Phone Number: 415 - 404 - 5413 Address: Mailing Residence PO BOX 551 DOLAN SPRINGS, AZ 86441 PO BOX 551 DOLAN SPRINGS, AZ 86441 claimant Gender: M Self Reported Height: 68 inches Self Reported weight: 148. 0 lbs Special Indications: This case has been flagged as a Quick Disability Determination (ODD) . RELEVANT DATES Below table represents the Relevant Dates Date of Birth Current Age AOD Age at DFI DI AOD Age at DFI DLI Age at DLI 60 years 58 years (Closely 10 03 / 13 / 1954 approaching 02 / 01 / 2013 Imonths retirement (Advanced age) Does the individual have an attorney / appointed representative ? Yes age) Representative's name, address and phone number: Bradford Douglas Myler PO BOX 127 LEHI, UT 84043 801 - 766 - 5442 ALLEGATIONS OF IMPAIRMENTS The individual filed for Initial claim for disability on 10 / 28 / 2013 due to the following illnesses, injuries, or conditions: Lung cancer, stage unknoWII COPD BACK PROBLEMS HYPERTENSION 62 The individual alleges inability to function and / or work as of 0 EXHIBIT NO. 2A 02 / 01 / 2013 PAGE: 2 OF 7 TECHNICAL ISSUES Is the individual working ? No Is Presumptive Disability / Presumptive Blindness appropriate for this claim ? No Prior Electronic Filings Electronic Level Filing Prior Initial Claim Determination Protective AC Claim Status Application Filing or Remand Type Filing Date Date Decision Date Date Initial DIB Closed 05 / 09 / 2005 08 / 23 / 2005 Disclaimer: The Determination or Decision Date in the table above is propagated from the Decision Date field in eView, and may be later than the date on the Determination or DecisioII notice. A Determination or Decision (initial or revised) is final as of the date of the notice. Refer to DI 27501. 001A for exceptions. Alleged Onset Date: 02 / 01 / 2013 Has the individual performed work after the Alleged Onset Date (AOD) ? No Has any period (s) of work been determined to be an unsuccessful Work Attempt, Subsidized / Sheltered Work or involved Impairment - Related Work Expenses, or other technical issue ? No EVIDENCE OF RECORD The following initial evidence has been received IN Source of EFREN CANO, D. O. (KINGMAN) Evidence EF Received 03 / 25 / 2014 Opinion Yes Evidence Type CE Rprt Level Opinion 1 of 1 Opinion EFREN CANO, D. O. (KINGMAN) Source Name Opinion Date 03 / 02 / 2014 Is the Opinion | Yes from an Acceptable Medical Source Type of Source Norm - Treating Source Relationship Type of Opinion | Medical Opinion Record Source Statement 0 EXHIBIT NO. 2A PFT test - Inormal Dx: Pulmonary nodule, COPD, back pairn, HTN PAGE: 3 OF 7 Normal gait, AD. Lungs - Inild rhornchi in the right lower lobe. Heart normal. Muscle strength 5 / 5, sensation intact, ROM WNL, DTRS normal. EFREN CANO, D0. (KINGMAN) Source of Evidence EF Received Opinion Evidence Type Level 03 / 25 / 2014 No CE Rprt | IN WESTERN MOUNTAIN MEDICAL CENTER PC Source of Evidence EF Received Opinion Evidence Type Level 12 / 09 / 2013 No MER IN WESTERN ARIZONA REG MED CTR Source of Evidence EF Received Opinion Evidence Type Level 11 / 15 / 2013 No MER IN UnknowII Name Source of Evidence EF Received Opinion Evidence Type Level | 10 / 29 / 2013 No Evidence 5002 ROC | IN The following evidence has been requested: Source of Evidence WESTERN ARIZONA PULMONARY ASSOCIATES WESTERN ARIZONA PULMONARY ASSOCIATES WESTERN ARIZONA PULMONARY ASSOCIATES WESTERN MOUNTAIN MEDICAL CENTER PC NORTH COUNTRY HEALTHCARE | EF Request Date 01 / 15 / 2014 01 / 08 / 2014 10 / 29 / 2013 | 10 / 29 / 2013 | 10 / 29 / 2013 Level IN IN | IN ZIZIĆ | IN CLAIM COMMUNICATIONS 64 Medical / Psych Consultant 0 EXHIBIT NO. 2A Subject: Somatic = QDD PAGE: 4 OF 7 Details: QDD Threshold: Sed SOM: Lung cancer, COPD, back problems, HTN Patho in June shows the following: 6 / 5 / 13 Right lower lung lobe Bx Few fragments of benign pulmonary parenchyrna with marked acute inflammation But clmnt has no PCP and doesn ' t appear to have any fu tx. Please advise on next step if PFT is needed ? or something else ? thanks, arms for bil. 2 / 10 / 2014 416 PFS. PLEASE REVIEW. NEED CURRENT FU EXAM WITH TS OR OBTAIN CE - MSS IM DER * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 3 / 25 / 14 Thank you for your review of this case. CE and PFT on file and bookmarked. Both were WNL. Thanks, Judy 3 / 26 / 2014 416 NON SEVERE. DER Signature: Judy Bilbrey 03 / 26 / 2014 CONSULTATIVE EXAMINATION (S) (CE) This section has not been completed for this claim. FINDINGS OF FACT AND ANALYSIS OF EVIDENCE Analysis Chavez: NO Prior: Yes Threshold: Sed ADL: SOM: Lung cancer, COPD, back problems, HTN 6 / 5 / 13 Right lower lung lobe Bx Few fragments of benign pulmonary parenchyma with marked acute inflammation 6 / 4 / 13 - 6 / 10 / 13 DCSummary Dx: Lung nodule, COPD, status post biopsy, status post purulent bronchitis, Cough, Smoker. Pt doesn ' t have a РСР . DIAGNOSTIC DATA: 1. Chest x - ray: Resolution of previously noted post - biopsy pulmonary hemorrhage, frontal and lateral views of the chest The previously described pulmonary Contusion of the right lung base has been improving. Single front view of the chest, no pneumothorax. 2. CT chest with IV contrast: Focal mass identified in the posterior basal segment of the right lower lobe with adjacent area of ground - glass opacities and consolidation, perhaps represent postobstructive consolidation. The mass measures 2x2 cm in greatest dimensiori, highly concerning of broTichogenic carcinoma. 3. EKG, normal sinus rhythm. 3 / 2 / 14 CE / PFT PFT test - Inormal Dx: Pulmonary nodule, COPD, back pairn, HTN Normal gait, no AD. Lungs - Inild rhonchi in the right lower lobe. Heart normal. Muscle strength 5 / 5, sensation 65 intact, ROM WHiaseRTofiYil8203 - SPL Document 11 - 4 Filed 01 / 02 / 18 Page 7 of 20 EXHIBIT NO. 2A 416 – CASE ANALYSES PAGE: 5 OF 7 416 - Case Analysis1 Indicate whether this 416 - Case Analysis is for: Current Evaluation Subject: SOB, COPD Details: PLEASE REQUEST PFS BEFORE AND AFTER WITH 3 OR MORE TRIALS WITH COMMENTS ON EFFORT, VARIANCE AND THE STABILITY OTF THE CLAIMANT DURING THE TEST. TRACINGS MUST INCLUDE THE VOLUME / TIME FORMAT. HE SHOULD NOT USE HIS INHALERS FOR 4 HRS PRIOR TO THE TEST. These findings complete the medical portion of the disability determination. MC / PC or SDM Signature Donald Robins M. D. (19) 02 / 10 / 2014 416 - Case Analysis2 Indicate whether this 416 - Case Analysis is for: Current Evaluation Subject: COPD, HTN, BACK PAIN, LUNG NODULE (BENIGN) Details: CLAIMANT IS A 60 YEAR OLD MALE WHO WENT TO THE ER FOR SOB IN 2013 ANDA RT LOWER ԼՒԱՐ NODULE WAS DISCOVERED AND BX ' D. NO MALIGNANT CELLS WERE NOTED. ACUTE INFLAMMATORY CELLS WERE SEEN. ON 3 / 2 / 2014 HE WAS EXAMINED BY THE CE - MSS DR CANO. THE EXAMINATION WAS NORMAL. PFS PERFORMED ON THE SAME DAY WERE NORMAL. CASE IS NON SEVERE. These findings Complete the medical portion of the disability determination. MC / PC or SDM Signature Donald Robins M. D. (19) 03 / 26 / 2014 MEDICALLY DETERMINABLE IMPAIRMENTS AND SEVERITY (MDI) 66 0 EXHIBIT NO. 2A ADULT MEDICALLY DETERMINABLE IMPAIRMENTS (MDI) PAGE: 6 OF 7 Does the individual have one or more medically determinable impairments ? Yes IMPAIRMENT DIAGNOSIS 4960 - COPD 7240 - Spine Disorders PRIORITY Primary Secondary SEVERITY Non Severe NOIn Severe Does the individual have a combination of impairments that is severe ? No ADULT MEDICAL DISPOSITION Not Severe - Impairment or combination of impairments does not significantly limit physical or mental ability to do basic work activities ASSESSMENT OF POLICY ISSUES SYMPTOMS AND CREDIBILITY Can one or more of the individual's medically determinable impairment (S) (MDI (S)) reasonably be expected to produce the individual's pain or other symptoms ? Yes Are the individual's statements about the intensity, persistence, and functionally limiting effects of the symptoms substantiated by the objective medical evidence alone ? No When considering the following factors, which were the most informative in assessing the credibility of the individual's statements ? Other factors Severity of claimant's SxS Inot fully supported by MER OIn file What is your assessment of the credibility of the individual's statements regarding symptoms considering the total medical and non - medical evidence in file ? Partially Credible Credibility assessment: Severity of claimant's SxS Inot fully supported by MER On file WEIGHING OF OPINION EVIDENCE The following displays medical opinions from non - treating or non - examining sources; it also contains ' other ' opinions from treating, non - treating, non - examining or other sources: Level Weight Source of Evidence EFREN CANO, D. O. (KINGMAN) Opinion Source Name EFREN CANO, D. O. (KINGMAN) Opinion Date 03 / 02 / 2014 | Initial RESIDUAL FUNCTIONAL CAPACITY No RFC / MRFC assessments are associated with this clairm. ASSESSMENT OF POLICY ISSUES - CONTINUED RECONCILING OF SOURCE OPINION 0 EXHIBIT NO. 2A PAGE: 7 OF 7 Are there medical source and / or other source opinions about the individual's limitations or restrictions which are more restrictive than your findings ? No DETERMINATION Based on the documented findings, select the determination: Not Disabled Is there medical evidence of DAA ? There is no evidence of any substance abuse disorder / DAA issue DI Claim / 225364900 Indicate which of the following Acquiescence Rulings are applicable None of the ARS considered apply to this claim REGULATION BASIS CODE (RBC) Regulation Basis Code: N30 - 20CFR416. 920 (C) - CLAIMANT AGE 18 OR OLDER PERSONALIZED DISABILITY EXPLANATION (PDE) PDE Text: You have stated that you were disabled due to the above listed conditions. Medical and other evidence in your file shows that your condition has not resulted in complications which would completely disable you from all basic work activities at this time. Therefore, based on the evidence, we have concluded that your conditions are not severe enough to keep you from working. Consequently, this claim is denied. SIGNATURES ADULT MC / PC or SDM Signature Donald Robins M. D. (19) 03 / 26 / 2014 Disability Adjudicator / Examiner Signature: Judy Bilbrey 03 / 26 / 2014 eCAT version: 8. 2. 1 68 SOCIAL SECURITY ADMINISTRATION 6. WE'S NAME C B O LAID UTWS CLA 0 EXHIBIT NO. 3A PAGE: 1 OF 1 DISABILITY DETERMINATION AND TRANSMITTAL 1. DESTINATION | 2. DDS CODE 3. FILING DATE | 4. SSN BIC (if CDB or DWB CLAIM) DDS ODO DRS DQB INTPsc | S03 10 / 28 / 2013 | D D D D 552 - 92 - 3638 00 5. NAME AND ADDRESS OF CLAIMANT (include ZIP code) ARTHUR JAMES BEIGHLEY JR PO BOX 551 7. TYPE CLAIM (Titre II) DOLAN SPRINGS AZ 86441 DIB FZ DWB CDB - R CDB - D RD - R RD - D RD P - R P - D MQFE O D D D D D D D D D O 8. TYPE CLAIM (Title XVI) DS DC 9. DATE OF BIRTH 11. REMARKS 03 / 13 / 1954 Cimt Phone: 928 - 767 - 3124 Recon filed 04 / 18 / 2014 12. DISTRICT - BRANCH OFFICE ADDRESS (include ZIP Code) PRESCOTT Recon received 04 / 29 / 2014 205 N. MARINA STREET 909 PRESCOTT, AZ 86303 | DIBIDS I DE O BID BSD BCD DI XI CD 10. PRIOR ACTION PO V PTO 2 DO - BO CODE 13. DO - BO REPRESENTATIVE 11A. A 2 14. DATE Presumptive Disability Impairment DETERMINATION PURSUANT TO THE SOCIAL SECURITY ACT, AS AMENDED 18A. PRIMARY DIAGNOSIS BODY SYS. CODE NO. 16B. SECONDARY DIAGNOSIS | CODE NO. 03 4960 4020 15. CLAIMANT DISABLED A. O Begen Disability Began CHRONIC PULMONARY INSUFFICIENCY (COPD) HYPERTENSIVE CARDIOVASCULAR Disability Ceased 17. DIARY TYPE MO / YR. REASON 18. CASE OF BLINDNESS AS DEFIN N N SEC. 1614 (a) (2 } Y { 216)) 19. CLAIMANT NOT DISABLED Not Disab. for Cash Bene. A UPurp. Through Disab for Cash Benefit Through Date of Purp. Beg. Current Determination B. 0CC YRS. EDYRS. 12 12th gra | 24. MOB CODE 25. REVISED | Initial Recon DHU Before Age 22 7CD8 OHM) SCOUT Prev Ref 20. VOCATIONAL BACKGROUND 21. VRACTION SC A D. . A. B. L C 23. MED LIST NO. ALJ Hearing Appeals Council 22. REG - BASIS CODE N30U.S. District Court DET AU. D. HAN ER D 26. LIST NO. A. E. 27. RATIONALE See Attached SSA - 4268 - 44 / C4 Check if Vocational Rule Met. Cite Rule 28. A. Period of Disability Disability Period E. 29. LTRIPAR NO. Estab Beg 31. DATE 09 / 03 / 2014 E. O Ferm _ Term 33. DATE 30. DISABILITY EXAMINER - DDS 15 ARR879 Marcella Arrington Continues 32. PHYSICIAN OR MEDICAL SPEC. SIGNATURE See eCAT DDE dated 2014 - 09 - 03 PHYSICIAN. OR MEDICAL Allen Radkowsky M P YKO g A M E } . Print o 09 / 03 / 2014 32B. SPEC. CODE 19 34. REMARKS BRADFORD DOUGLAS MYLER PO BOX 127 LEHI UT 84043 Recon Affirmation. MULTIPLE IMPAIRMENTS CONSIDERED 34A. CONBINE D ULTIPLE HOHSE VE RE - SE VE RE 348. COMBINED MULTIPLE HONSE VE RE - NON SEVERE 35. BASIS CODE 38. DATE | 35. REV. DE T. 37. SSA REPRESENTATIVE CODES SSA CODE Form SSA - 831 - C3 (5 / 89) BASE 11 / 15 / 05 Oper ARR879 69 O DECISION O CASE CONTROL Date 09 / 03 / 2014 Case # 1479649 Dec DE Case 3Disali Ft GPDeterminatioiffSplinatiom1 of 20 EXHIBIT NO. 4A PAGE: 1 OF 10 This Disability Determination Explanation is for the DI claim at the Reconsideration level. CLAIMANT INFORMATION CLAIMANT INFORMATION Name: Arthur James Beighley JR SSN: 552 - 92 - 3638 Phone Number: 928 - 767 - 3124 Secondary Phone Number: 415 - 404 - 5413 Address: Mailing Residence PO BOX 551 DOLAN SPRINGS, AZ 86441 UNKNOWN DOLAN SPRINGS, AZ 86441 Claimant Gender: M Self Reported Height: 68 inches Self Reported Weight: 148. 0 lbs Special Indications: None. RELEVANT DATES Below table represents the Relevant Dates ACE " DF bu DLI Age at DLI Date of Birth Current Age AOD Age at DFI AOD 60 years 5 months 58 years 03 / 13 / 1954 Closely 02 / 01 / 2013 10 months approaching (Advanced retirement age) age) Does the individual have an attorney / appointed representative ? Yes Representative's name, address and phone number: Bradford Douglas Myler PO BOX 127 LEHI, UT 84043 801 - 766 - 5442 ALLEGATIONS OF IMPAIRMENTS The individual filed for Initial claim for disability on 10 / 28 / 2013 due to the following illnesses, injuries, or conditions: Lung cancer, stage unknowII; COPD; BACK PROBLEMS; HYPERTENSION; 70 The individual alleges inability to function and / or work as of 0 EXHIBIT NO. 4A 02 / 01 / 2013 PAGE: 2 OF 10 RECONSIDERATION ISSUES Has there been any change (for better or worse) in the illness, injuries, or conditions since last completing a disability report ? Yes Approximate date the changes occurred: 1 / 20 / 2014 Claimant - supplied Information: Everything is getting worse. Have there been any new physical or mental limitations as a result of the illness, injuries, or conditions since last completing a disability report ? Yes Approximate date the changes occurred: 1 / 14 / 2014 Claimant - supplied Information: I have a hard time breathing. If I do anything strenuous, I am out of breath. Have there been any new illnesses, injuries or conditions since last completing a disability report ? Yes Approximate date the changes occurred: 3 / 10 / 2014 Claimant - supplied Information: I am having problems with my knee. Does the prior determination substantively and technically resolve all pertinant adjudicative issues ? No Has the individual worked since last completing a disability report ? No Prior Electronic Filings AC Electronic Level Prior Initial Determination Protective Claim Claim Status Application Filing or Remand Type Filing Filing Date Date Decision Date Date Initial DIB Closed 05 / 09 / 2005 08 / 23 / 2005 Disclaimer: The Determination or Decision Date in the table above is propagated from the Decision Date field in eView, and may be later than the date on the Determination or Decision notice. A Determination or Decision (initial or revised) is final as of the date of the notice. Refer to DI 27501. 001A for exceptions. Alleged Onset Date: 02 / 01 / 2013 Has the individual performed work after the Alleged Onset Date (AOD) ? No Has any period (s) of work been determined to be an unsuccessful work attempt, or involved subsidies / special conditions, impairment - related work expenses, or other technical issue (s) ? No Case 3: 17 - cv - 08203 - SPL DEEųRETTE PÉiled 01 / 02 / 18 Page 13 of 20 EXHIBIT NO. 4A RECORD PAGE: 3 OF 10 The following reconsideration evidence has been received WESTERN MOUNTAIN MEDICAL CENTER PC Source of Evidence EF Received Opinion Evidence Type Level 09 / 02 / 2014 No MER Reconsideration WESTERN MOUNTAIN MEDICAL CENTER PC Source of Evidence EF Received Opinion Evidence Type Level 08 / 30 / 2014 No Evidence MER Reconsideration BRADFORD DOUGLAS MYLER | Source of Evidence EF Received Opinion Evidence Type Level 08 / 27 / 2014 No 3rd Prty Correspond Reconsideration BRADFORD DOUGLAS MYLER Source of Evidence EF Received Opinion Evidence Type Level 08 / 27 / 2014 No 3rd Prty Correspond Reconsideration BRADFORD DOUGLAS MYLER Source of Evidence EF Received Opinion Evidence Type Level 08 / 26 / 2014 No 3rd Prty Correspond Reconsideration WESTERN ARIZONA PULMONARY ASSOCIATES Source of Evidence EF Received Opinion Evidence Type 08 / 13 / 2014 No MER Level 0 EXHIBIT Nb 4A PAGE: 4 QF 10 Source of NORTH COUNTRY HEALTHCARE Evidence EF Received 08 / 12 / 2014 Opinion No Evidence Type MER Level Reconsideration RICHARD CARDONE Source of Evidence EF Received Opinion Evidence Type Level 08 / 11 / 2014 No MER Reconsideration The following initial evidence has been received Source of EFREN CANO, D. O. (KINGMAN) Evidence EF Received 03 / 25 / 2014 Opinion Yes Evidence Type CE Rprt Level Initial Opinion 1 of 1 Opinion EFREN CANO, D. O. (KINGMAN) Source Name Opinion Date 03 / 02 / 2014 Is the Opinion Yes from an Acceptable Medical Source Type of Source Non - Treating Source Relationship Type of Opinion Medical Opinion Record Source Statement PFT test - Normal Dx: Pulmonary nodule, COPD, back pain, HTN. NOTImal gait; 10 AD. Lungs - Mild rhonchi in the right lower lobe. Heart normal. Muscle strength 5 / 5. Sensation intact. ROM WNL. DTR'S Iormal. EFREN CANO, D. O. (KINGMAN) Source of Evidence EF Received Opinion Evidence Type Level 03 / 25 / 2014 No CE Rprt Initial 0 EXHIBIT Nb 4A PAGE: 5 QF 10 Source of WESTERN MOUNTAIN MEDICAL CENTER PC Evidence EF Received 12 / 09 / 2013 Opinion No Evidence Type MER Level Initial WESTERN ARIZONA REG MED CTR Source of Evidence EF Received Opinion Evidence Type Level | 11 / 15 / 2013 No MER Initial UnknowT ] Name Source of Evidence EF Received Opinion Evidence Type Level 10 / 29 / 2013 No Evidence 5002 ROC Initial The following evidence has been requested: Source of Evidence | BEIGHLEY JR, ARTHUR JAMES BRADFORD DOUGLAS MYLER BRADFORD DOUGLAS MYLER BEIGHLEY JR, ARTHUR JAMES BEIGHLEY JR, ARTHUR JAMES BRADFORD DOUGLAS MYLER WESTERN ARIZONA PULMONARY ASSOCIATES WESTERN ARIZONA PULMONARY ASSOCIATES WESTERN ARIZONA PULMONARY ASSOCIATES WESTERN MOUNTAIN MEDICAL CENTER PC NORTH COUNTRY HEALTHCARE EF Request Date 08 / 08 / 2014 08 / 08 / 2014 08 / 08 / 2014 08 / 08 / 2014 08 / 08 / 2014 08 / 08 / 2014 01 / 15 / 2014 01 / 08 / 2014 10 / 29 / 2013 | 10 / 29 / 2013 10 / 29 / 2013 Level | Reconsideration Reconsideration | Reconsideration Reconsideration | Reconsideration Reconsideration | Initial Initial Initial | Initial Initial CLAIM COMMUNICATIONS Medical / Psych Consultant Subject: SOMATIC 74 Details: 74 DESETABOBANECKED820 - SELFDDuientWIELAAIFII ed OLARA & DEPageGS DÉT20 EXHIBIT NO LA WORK PAGE: 6 OF 10 Medical Consultant Response (Somatic): Initial - level determination of NS affirmed. Please see recon - level 416 for further discussion. Thanks. RAD3779 / 3 / 2014 Signature: Marcella Arringtorn 09 / 03 / 2014 CONSULTATIVE EXAMINATION (S) (CE) Is a CE (s) required ? No FINDINGS OF FACT AND ANALYSIS OF EVIDENCE Reconsideration Analysis CLMT AND REP ALLEGS WORSENING - JAN 2014 AOD: 10 / 28 / 13 ED: 12 CHAVEZ: NO THRESHOLD: LT - PRW = LABOR / DRIVER SX: LBP, LEG PAIN BIL, SOB, DIZZINESS. . . . . ADL: CLEAN HOUSE, DO YARD WORK, WATCH GRAND CHILDREN, WATCH TV, AFTER CLEANING OR DOING YARD WORK BACK HURTS A LOT, WALK. 5 MILES, IT TAKES ME ABOUT 1. 5 HRS DE SUMMARY (SOM) HX OF LBP, R LUNG NODULE (NOCARCINOMA) SOM CE 3 / 2014: DR CANO PFT = WNL, NO 02 OR ASSIST DEVICE General Claimant is cooperative, in no acute distress, is able to sit in the chair without discomfort for the duration of the exam. The claimant is able to stand, walk to the examination table, is able get orito and sits on the examination table without assistance and without difficulty. The claimant has a normal gait, is able to stoop without difficulty, is able lift each foot off the ground and stand without assistance and demonstrated appropriate balance including walking on heels and toes. The claimant was observed standing from a sitting position and sitting from a standing position without difficulty or assistance. Neurological Clairmant is alert and oriented to person, place, time, and event, affect and speech are congruent, and thought process is cogent. The clairmant's cranial nerves ll – XII are grossly intact with no focal neurological deficits. Respiratory Lungs assessed, upper and lower lobes, and has mild rhonchi in the right lower lobe. Cardiovascular Normal Heart assessed, regular rate and rhythm noted, Si S2 normal, without murmurs, clicks, rubs, or gallops noted. Low Back Detailed Exam The thoracic and lumbar spine were assessed including flexion, extension, rotation, and lateral bending of the lumbar and thoracic spine and full active and full passive range of Imotion for the claimant's age and habitus with no gross deformity noted in the thoracic or lumbar spine including the erector spin m muscles of the back. The clairmant dernies pain with palpatior or moveImerit of the back. Skin is intact without wounds, lesions ulcerations, erytherna, edema, or ecchymosis was noted in the thoracic tissue. The claimants thoracic muscle bulk is normal without atrophy, or spasms noted in the erector spin m muscles and strength is normal in the lower extremities with no focal deficits evaluated with gait assessment, rarige of motion and strength testing. Finally, the claimant's spine was evaluated and no scoliosis noted. The clairmant denied pain with straight leg lift greater than 60 degrees without shooting pain dowTI either leg. The clairmant denied shooting pain down the surface of the leg with hip flexion and knee extension in the sitting position with dorsiflexion of the foot. The claimant dernies abnormal sensation to light touch, vibration, or pain including paresthesia, dysesthesia, hypoesthesia, hyperesthesia, hypoalgesia in the lower extremities with no focal deficits. What is the diagnosis ? 1) Pulmonary nodule. 2) Chronic obstructive pulmonary disease. 3) Back pain. 4) Hypertension. 75 0 EXHIBIT NO. 4A PAGE: 7 OF 10 WARMC: 11 / 12 - 6 / 2013 LBP, R LUNG NODULE (NO CARCINOMA) . . . . . WESTERN AZ: 7713 - 11 / 2013 SUBJECTIVE: Mr. Arthur came after 3 months follow up doing pretty good on Symbicon inhaler along with nebulizer with Albuterol but unfortunately according to patient Syınbicort is not covered by the AHCCCS. Patient denies any chest pain or palpitation, patient still smokes atleast 8 to 10 cigarettes a day. CHEST EXAMINATION: Clear on auscultation with decrease breath sounds, no rates or wheezing on auscultation. CARDIOVASCULAR: SI and S2 normal, No 53 and S4. GI: Abdomen soft, bowel sounds positive, norrno - active, no hepatosplenomegaly, no tenderness, EXTREMITIES: No cyanosis, clubbing and ederna bilaterally. No calf tenderness, no Cords palpable. NEUROLOGICAL: Patient is fully alert, awake, oriented x 3. no gross deficit IMPRESSION: 1. Mild emphyserna. 2. Chronic tobacco abuse, still smokes 8 to 10 cigarettes a day. 3. Hypertension, 4. GERD. 5. Peptic ulcer disease. WESTERN MTN: 6 / 2013 CT (PATH – LUNG. . ., specimen is received with two stairn slides. RT LOWER LOBE MASS, ADEQUATE CELLULARITY. WESTERN MTN: 12 / 2013 - 8 / 2014 CV - RRR, LUNGS - CTA, EXT'S - EDEMA B / L. . . . Marital Status: single. Exercise: yes, walks 2 miles most days Tides bicycle. Caffeine: yes, frequency: 112 pot of cofee a day, no tea, 1 - 2 sodas a day. CARDIOLOGY: no Chest Pain, no Shortness of Breath, none. no Palpitations. no Dizziness. Ino Leg Ederma, no Fatigue, no Orthopnea, no PND (paroxSyrmal nocturnal dyspnea) . GASTROENTEROLOGY: no Abdominal Pain. Ilo Nausea. Ino VOIniting. RESPIRATORY. Ilo Shortness of Breath. no DOE (dyspnea OIn exertiori), no Persistent Cough. no Chest History of Present Illness Follow - u Patient is here for a followup postop patient has significant history of hypertension his blood pressure is very well controlled, he's not having any acute chest pain, palpations, or shortness of breath. Patient has history of lung nodule which was biopsied per patient it was negative for malignancy, he continues to followup with hermatology oncology. Patient has very diminished breath sounds, he has COPD, he continues to Smoke, Smoking cessation discussed with patient. Overall patient feels well. He does not have any other acute complaint. Vital Signs HR 56, BP n3 / 67, Ht Wt 145, BMI 21. 72. Physical ExaminatioII GENERAL. General Appearence: well appearmg, no acute distress. Mental Status: alert and oriented. HEART: Rate: regular. Rhythm: regular. Heart sounds: normal S1S2, no S3 or S4. LONGS. Auscultation: CTA bilaterally, no wheezing / rhoncht, rates / crepitation. Airflow: decreased air movement ABDOMEN: General: soft. Bowel sounds: nornoactive. Tenderness: none. DistentioII nome. EXTREMITIES: Ederna: Bilateral, nome. Assessments 1. HypertensioII, Benign - 4011 (Primary) 2. COPD (unspecified) - 491. 20 3. GERD (Gastroesophageal reflux disease ] - 530. 81 4. LUNG NODULE - 786. 6 416 - CASE ANALYSES 416 - Case Analysis3 Indicate whether this 416 - Case Analysis is for: Other Period (s): 10 / 28 / 2013 - Present Subject: NS. Details: T16 - Only. 0 EXHIBIT NO. 4A FD: 10 / 28 / 13. PAGE: 8 OF 10 AOD: 2 / 1 / 13. Allegations: Lung cancer - stage unkrıOWII, COPD, hypertension, back problems. Claimant is a 60 - year - old male. This is a recon, clairmarit having been denied in 3 / 14 as nonsevere. Initial - level allegations are as above. Per his 3441, claimant alleges that: 1. " Everything is getting worse. " Approximate date the changes occurred: 1 / 20 / 2014. 2. " I have a hard time breathing. If I do anything strenuous, I am out of breath. " Approximate date the changes occurred: 1 / 14 / 2014. 3. " I am having problems with my knee. " Approximate date the changes occurred: 3 / 10 / 2014. File review: 1. Clairmant does not have lung cancer. Rather, during a mid - 2013 hospitalization for a COPD exacerbation, he was found to have a R lower lobe pulmonary nodule. Biopsy of the nodule was benigin, as was a PET scal. 2. Claimant has COPD, but it is well - controlled or ProAir * (albuterol) & ipratropium. [ COMMENT: He listed an inhaled steroid in his 3368 but not in his 3441. ] In 8 / 13, pre - & post - bronchodilator FEV1 ' s were 79 & 89 % - respectively – of predicted. In 3 / 14 — in conjunction with a somatic CE these values were 93 & 97 % - respectively – of predicted. 3. BP's are somewhat labile but overall controlled OIl a beta - blocker, a calcium charinel blocker, an ACE inhibitor, and a diuretic. 4. At his 3 / 14 somatic CE, claimant stated that back pain is a problem only once or twice per year and responds to steroid injections. He is not on pain medication on an ongoing basis. 5. The exam component of claimant's CE revealed a normal BMI, room air pulse oximetry, and vital signs. Mild rhonchi were auscultated in the R lower lobe with the lungs otherwise clear. There were no other significant positive findings with regard to either knee, claimant's gait, or otherwise. AssessImerit: The initial - level determinatioII of nonsevere is affirmed. These findings complete the medical portion of the disability determination. MC / PC Signature Allen Radkowsky M. D. (19) 09 / 03 / 2014 MEDICALLY DETERMINABLE IMPAIRMENTS AND SEVERITY (MDI) ADULT MEDICALLY DETERMINABLE IMPAIRMENTS (MDI) Does the individual have one or more medically determinable impairments ? Yes IMPAIRMENT 4960 - COPD 4020 - Hypertensive Vascular Disease PRIORITY Primary Secondary SEVERITY NOIn Severe Non Severe Does the individual have a combination of impairments that is severe ? No ADULT MEDICAL DISPOSITION Not Severe - Impairment or combination of impairments does not significantly limit physical or mental ability to do basic work activities 0 EXHIBIT NO. 4A PAGE: 9 OF 10 ASSESSMENT OF POLICY ISSUES SYMPTOMS AND CREDIBILITY Can one or more of the individual's medically determinable impairment (s) (MDI (S)) reasonably be expected to produce the individual's pain or other symptoms ? Yes Are the individual's statements about the intensity, persistence, and functionally limiting effects of the symptoms substantiated by the objective medical evidence alone ? No When considering the following factors, which were the most informative in assessing the credibility of the individual's statements ? Other factors Severity of clairmant's SXS not fully supported by MER on file What is your assessment of the credibility of the individual's statements regarding symptoms considering the total medical and non - medical evidence in file ? Partially Credible Credibility assessment: Severity of claimant's SXS not fully supported by MER On file WEIGHING OF OPINION EVIDENCE The following displays medical opinions from non - treating or non - examining sources; it also contains ' other ' opinions from treating, non - treating, non - examining or other sources: Source of Evidence | Opinion Source Name Level opinion Date Weight EFREN CANO, D. O. (KINGMAN) EFREN CANO, D. O. (KINGMAN) Initial 03 / 02 / 2014 Great Weight Explain how you weighed the opinion (s) above: Objective findings support the vendor's nonsevere MSS. RESIDUAL FUNCTIONAL CAPACITY No RFC / MRFC assessinerits are associated with this claim. ASSESSMENT OF POLICY ISSUES - CONTINUED RECONCILING OF SOURCE OPINION Are there medical source and / or other source opinions about the individual's limitations or restrictions which are more restrictive than your findings ? No DETERMINATION Based on the documented findings, select the determination: Not Disabled Is there medical evidence of DAA ? There is no evidence of any substance abuse disorder (DAA issue DI Claim / 22883615 78 0EXHIBIT NO. 4A PAGE: 10 OF 10 3 Indicate which of the following Acquiescence Rulings are applicable None of the ARs considered apply to this claim REGULATION BASIS CODE (RBC) Regulation Basis Code: N30 - 20CFR416. 920 (C) - CLAIMANT AGE 18 OR OLDER PERSONALIZED DISABILITY EXPLANATION (PDE) PDE Text: Your condition does not result in significant limitations in your ability to perform basic Work. activities. We have determined that your Condition is not severe enough to be considered disabling. In deciding this, we considered the medical records, your statements, and how your condition affects your ability to work. SIGNATURES Adult MC / PC Signature Allen Radkowsky M. D. (19) 09 / 03 / 2014 This reconsideration file has been thoroughly reviewed to ensure that the total evidence of record is sufficient and consistent to support the proposed determination. Disability Adjudicator / Examiner Signature: Marcella Arrington 09 / 03 / 2014 eCAT version: 9. 0. 98

Non Disability Related Development

5 Non Disability Related Development Civil Action Number: 3: 17 - CV - 08203 Claimant: Arthur James Beighley, Jr Account Number: 552 - 92 - 3638 Exhibits Exhibit No. of Pages No. 1D 2D 3D 4D 5D Description Page No. Application for Supplemental Security Income Benefits, dated 144 - 152 10 / 28 / 2013 Certified Earnings Records, dated 11 / 05 / 2015 153 - 154 Detailed Earnings Query, dated 11 / 05 / 2015 155 - 161 Summary Earnings Query, dated 11 / 05 / 2015 162 New Hire, Quarter Wage, Unemployment Query (NDNH), 163 dated 04 / 07 / 2016 Certified Earnings Records, dated 04 / 07 / 2016 164 - 165 Detailed Earnings Query, dated 04 / 07 / 2016 166 - 167 6D 7D DATE: November 29, 2017 The documents and exhibits contained in this administrative record are the best copies obtainable. FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 8: 58 / ST. 8: 55 / No. 7502918494 P 1 5EXHIBIT NO. 1D FAGA: afQF9 INSERT THIS END FIRST Client Name: Arthur James Beighley JR Document Description: Application for Supplemental Security Income Benefits (Abbreviated) Form Name: 8001 Printed by: S. Gray ULYSWLLLLTKLIPU IKI IKSAANEIKIAN RQID: BD373278975 SITE: 909 DR: F SSN: 552923638 DOCTYPE: 1020 RF: cs: 39d5 Request ID: Site ID: SSN: Document Type: BD373278975 909 552 - 92 - 3638 1020 WWWrLTITWL TLTILINWAYIYLI TO THTTMmmmmmmm NTNULT WTHIWN TWITTERLYLTILT Form Specific Information: TITUTITTLIN Note: paper Document Date: 10 / 28 / 2013 144 http: / / edcs. ba. ssa. gov / edcs / ServletPrintBarcode ? barcodeIndex = 5 & fp = 1383062630144 10 / 29 / 2013 FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 8: 58 / ST. 8: 55 / No. 7502918494 P 2 5EXHIBIT NO. 1D PAGE: 2 OF 9 SOCIAL SECURITY ADMINISTRATION OTEL APPLICATION FOR SUPPLEMENTAL SECURITY INCOME Form Approved OMB No. 0960 - 0444 Do not write in this space D DEFERRED О АВАР I am / We are applying for Supplemental Security Income and | O FS - SSAVAPP O FS - REFERRED any federally administered state supplementation under Title | Filing Date XVI of the Social Security Act, for benefits under the other | (Month, Day, Year) programs administered by the Social Security Administration, ! and where applicable, for medical assistance under Title XIX of the Social Security Act. O Receipt O Protective Preferred Language: TYPE OF CLAIM O Individual O O Individual U Ineligible Spouse Individual with O Couple D Child O Child with Parents PARTI - - BASIC ELIGIBILITY - Answer the questions below beginning with the first moment of the filing date month. First Name, Middle Initial, Last Name 2. Sex 3. Birthdate 4. Social Security Number Male (month, day, year) ARTHUR JAMES BEIGHLEY JR. O Female 03 / 13 / 1954 552 - 92 - 3638 Spouse's / Parent (s) Name (s) 6. Sex 7, Birthdate 8. Social Security Number (s) O Male (month, day, year) CAROL HANES 01 / 01 / 1963 UNKNOWN O Female 5. Date of Marriage: (month, day, year) 12 / 09 / 1985 9. Other Name (s) and Social Security Number (s) you, your spouse / parents used: (a) Your Other Name (s) (including Maiden Name) Your Other Social Security Number (s) | (b) Spouse's / Mother's Other Name (s) (including Maiden Name) CAROL POSLEY Spouse's / Mother's Other Social Security Number (s) (c) Father's Other Name (s) Father's Other Social Security Number (s) FORM SSA - 8001 - BK (11 / 2009) Destroy Prior Editions Page 1 145 FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 8: 58 / ST. 8: 55 / No. 7502918494 P 3 5EXHIBIT NO. 1D PAGE: 3 OF 9 10. Your Place of Birth (City and State or Foreign Country) SAN FRANCISCO, CA 11. | spouse's Place of Birth (City and State or Foreign Country) | UNKNOWN, MO 12. If you are filling for yourself, go to (a); if you are filing for a child, go to (e) . (a) Are you unable to work because of illnesses, You Your Spouse, if filing | injuries, or conditions ? YES O NO O YES O NO Go to (b) . Go to # 13 Go to (b) Go to # 13 | (b) Enter the date you became unable to work. (month, day, year) (month, day, year) 2013 - 02 - 01 Go to (c) Go to (c) (c) What are your illnesses, injuries or conditions ? | (Brief Description) (Brief Description) LUNG CANCER, COPD, BACK PROBLEMS, | HYPERTENSION Go to (d) Go to (d) | (d) If you were unable to work because of illnesses, O YES O NO injuries, or conditions before age 22, do you have a Provide name (s) and parent who is age 62 or older, unable to work Social Security Number (s) because of illnesses, injuries, or conditions or in Remarks. deceased ? Go to # 13 Go to # 13 | (e) When did the child become disabled ? (month, day, year) Go to () (f) what are the child's disabling illnesses, injuries or conditions ? o to (g) (g) Does the child have a parent or stepparent who O YES O NO is 62 or older, unable to work because of illnesses, Provide name (s) and injuries, or conditions, or deceased ? Social Security Number (s) in Remarks. Go to # 13 Go to # 13 If you (and your spouse filing for benefits) were a United States citizen at birth, go to # 17; otherwise go to (a) . (a) Are you a naturalized United States citizen ? Your Spouse, if filing O YES O NO O YES O NO Go to # 17 Go to (b) Go to # 17 Go to (b) (b) Are you an American Indian born outside the Your Spouse, if filing | United States ? O YES O NO D YES O NO Go to (c) Go to (d) Go to (C) Go to (d) | (C) Check the block that shows your American Indian status. Your Spouse, if filing O American Indian born in Canada Go to # 17 o American Indian born in Canada Go to # 17 13. You You You www. O Member of a Federally recognized Indian Tribe D Member of a Federally recognized Indian Tribe Name of Tribe: Go to # 17 Name of Tribe: Go to # 17 O Other American Indian O Other American Indian Explain in Remarks, then go to (d) Explain in Remarks, then go to (d) FORM SSA - 8001 - BK (/ 2009) Page 2 146 FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 8: 58 / ST. 8: 55 / No. 7502918494 P 4 5EXHIBIT NO. 1D PAGE: 4 OF 9 لا O wwwwww. (d) Check the block below that shows your current immigration statuş . You Your Spouse, if filing Amerasian immigrant O Amerasian immigrant Go to # 14 Go to # 14 O Lawful Permanent Resident O Lawful Permanent Resident Go to # 14 Go to # 14 Refugee O Refugee Date of entry (month, day, year); Date of entry (month, day, year); Go to # 16 Go to # 16 Asyleo O Asylee Date status granted (month, day, year) Date status granted (month, day, year) Go to # 16 Go to # 16 Conditional Entrant O Conditional Entrant Date status granted (month, day, year): Date status granted (month, day, year): Go to # 16 Go to # 16 O Parolee for One Year O Parolee for One Year Go to # 16 Go to # 16 O Cuban / Haitian Entrant O Cuban / Haitian Entrant Go to # 16 Go to # 16 a Deportation / Removal Withheld a Deportation / Removal Withheld Date (month, day, year): Date (month, day, year): Go to # 16 Go to # 16 o Other Other Explain in Remarks, then Go to (e) Explain in Remarks, then Go to (e) | (e) If you have status, or have applied for status, as the spouse, child, or parent of a child of a United States citizen, or a lawfully admitted permanent resident, Go to # 15; otherwise Go to # 17. 14. l (a) Date of Admission: You Your Spouse, if filing (month, day, year) (month, day, year) O YES O NO Go to (c) Go to (d) (b) was your entry into the United States sponsored Q YES O NO by any person or promoted by an institution or Go to (c) Go to (d) group ? | (e) Give the following information about the person, institution or group: Name Address Telephone Number | (d) What was your immigration status, if any, before adjustment to lawful permanent resident ? You (month, day, yoar) From; Your Spouse, if filing (month, day, year) From: To; Q YES O NO Go to (f) Go to # 16 To: (e) If filing as an adult, did your parents ever work in O YES D NO | the United States before you were 18 ? Go to () Go to # 16 | (1) Name and Social Security Number of parent (s) who worked. Name: Social Security Number: | Name: Social Security Number: FORM SSA - 8001 - BK (11 / 2009) Page 3 147 FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 8: 59 / ST. 8: 55 / No. 7502918494 P 5 5EXHIBIT NO. 1D PAGE: 5 OF 9 15 O YES Go to (b) You O NO Go to # 17 Your Spouse, if filing O YES O NO Go to (b) Go to # 17 (a) Have you, your child, or your parent, been subjected to battery or extreme cruelty while in the United States ? | (b) Have you, your child, or your parent filed a petition with the Department of Homeland Security for a change in immigration status because of being subjected to battery or extreme cruelty ? Are you, your spouse, or parent an active duty member or a veteran of the armed forces of the United States ? O YES | Go to # 16 O NO Go to # 17 O YES Go to # 16 O NO Go to # 17 16. O YES Explain in Remarks, then Go to # 17 O NO Go to # 17 (month, day, year) 17. (a) When did you first make your home in the United States ? | (b) Have you lived outside of the United States since then ? (c) Give the date (s) of residence outside the United States. O YES Explain in Remarks, then Go to # 17 V NO Go to # 17 (month, day, year) 1954 - 03 - 13 O YES " NO Go to (c) Go to # 18 (month, day, year) Date Left; | O YES O NO Go to (c) Go to # 18 (month, day, year) Date Left: Date Returned: O YESU NO Go to (b) Go to # 19 18. Date Returned: | (a) Have you been outside the United States (the 50 YES R NO States, District of Columbia and Northern Mariana Go to (b) Go to # 19 Islands) 30 days prior to the filing date ? (b) Give the date (month, day, year) you left the (month, day, year) United States and the date you returned to the Date United States. Left: Date Returned: (a) Do you have any unsatisfied felony warrants D YES NO for your arrest ? Go to (b) Go to # 20 (b) In which State or country was the warrant Name of State / Country issued ? Go to (c) (c) was the warrant satisfied ? O YES O NO Go to (d) Go to # 20 | (d) Date warrant satisfied: (month, day, year) (month, day, year) Date Left: Date Returned: o YES O NO Go to (b) Go to # 20 | Name of State / Country Go to (c) O YES O NO Go to (d) Go to # 20 (month, day, year) 20. O YES NO Go to (b) Go to # 21 (a) Do you have any unsatisfied Federal or State warrants for violating the conditions of probation or parole ? (b) In which State or country was the warrant issued ? O YES ONO Go to (b) Go to # 21 e de a Name of State / Country | Name of State / Country (c) Was the warrant satisfied ? Go to (c) O YES O NO Go to (d) Go to # 21 (month, day, year) Go to (c) O YES O NO Go to (d) Go to # 21 (month, day, year) (d) Date warrant satisfied: FORM SSA - 8001 - 0K (11 / 2009) Page 4 148 FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 8: 59 / ST. 8: 55 / No. 7502918494 P 6 5EXHIBIT NO. 1D PAGE: 6 OF 9 TTTTTTTTTTTTTTTTTT PART II LIVING ARRANGEMENT (Use " Remarks " to explain any change between the first moment of the filing date month and today .) 21. (a) Mark the box that describes where you live. | House, apartment, mobile home, houseboat O Noninstitution (rest home, retirement home, or group home) O Room in commercial establishment O Institution (hospital, rehabilitation center, prison, or school) O Room in private home O Transient (b) Date you began living there: 2006 - 0 22. Mark the box that describes with whom you live. If you live in a foster home, group home, or an institution, or if you are a transient, do not answer but explain in remarks. O Alone | Spouse / Parents and / or Children Q Other People TITUTT 23. PART III - RESOURCES (Show resources as of the first moment of the flling date month. Vse " Remarks " to explain any changes .) if you own, or your name or your spouse's / parent's name (s) appear on any of the following items (either | alone or with other people's name (s)), enter the total cash value of iterm (s) on each linę . Co - owned Dollar Value Description of Items With Others Dollar Value Spouse or YES NO Marked YES Yes | No You Own Parents Own a. Vehicles (cars, trucks, | 1982 FORD boats, motorcycles) . MUSTANG How many ? 1 | b. Insurance policies $ 800. 00 $ $ 0. 00 $ | c. Cash at home, with | you, or anywhere else $ 0. 00 d. Savings, checking accounts, stocks, bonds s 0. 00 $ e. Trust (s) Is 0. 00 $ | f. Property other than the home you live in Is 0. 00 $ | g. Life estates or | property you inherited $ 0. 00 $ | h. Other items that can be turned into çash 0. 00 FORM SSA - 8001 - BK (11 / 2009) Page 5 149 FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 8: 59 / ST. 8: 55 / No. 7502918494 P 7 5EXHIBIT NO. 1D PAGE: 7 OF 9 24. 25. You Are there any assets set aside to meet burial expenses Your Answer O YES NO for you or your spouse / parent (s) ? (If " Yes " describe the Spouse's Answer Q YES O NO item in " Remarks " .) Mother's Answer O YES O NO Father's Answer O YES O NO (a) Have you or your spouse sold, transferred title, Your Spouse disposed of or given away, any money or other property, including money or property in foreign O YES I NO O YES O NO countries, since the first moment of the filing date month or within the 36 months prior to the filing date Month ? f (b) If you co - owned any money or property with another You Your Spouse person (s), did you or any co - owner sell, transfer, or give away any co - owned money or property within the 36 O YES NO O YES O NO months prior to the fiting date month ? | IF YOU ANSWERED " YES " TO (a) OR (6), GO TO (c) . IF " NO " TO BOTH, GO TO # 26, OWNER'S / CO - OWNER'S NAME DESCRIPTION OF PROPERTY DATE OF DISPOSAL | Item # 1 Item # 2 Item # 3 RELATIONSHIP TO OWNER NAME AND ADDRESS OF PURCHASER OR RECIPIENT | VALUE OF PROPERTY AND / OR AMOUNT OF CASH GIFT $ Item # 1 Item # 2 item # 3 SALE PRICE OR OTHER CONSIDERATION ARE OTHER CONSIDERATIONS OR PROCEED EXPECTED ? EXPLAIN DO YOU STILL OWN PART OF THE PROPERTY ? O YES Y NO muun Item # 1 O YES E NO Item # 2 O YES. NO Item # 3 SOLD ON OPEN MARKET ? GIVEN AWAY ? Item # 1 O YES NO Item # 2 O YES & NO | item # 3 O YES NO FORM SSA - 8001 - BK (11 / 2009) O YES È NO O YES E NO O YES NO TRADED FOR GOODS / SERVICES ? O YES NO O YES & NO O YES & NO Page 6 150 FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 8: 59 / ST. 8: 55 / No. 7502918494 P 8 5EXHIBIT NO. 1D PAGE: 8 OF 9 mm mm 26. Do you give us permission to obtain any financial You Your Spouse records from any financial institution ? | YES O NO O YES O NO PART IV - INCOME (List all Income received since the first moment of the filing date month or expected in the next 3 months .) 27. | List cash, checks, and direct payment to bank accounts you (your spouse / parents) received or expect to receive. Include income from wages, sick pay, self - employment, interest, social security, assistance based on need, VA, gifts, pensions, and any other type of income. Give date last paid if income will stop in the next 3 months. Also note here if anyone pays any bills for you directly or gives you money to pay them. Person Receiving Type of Income Amount Frequency Date Last Source of Income Received Paid Income Child Pays Bills LINDA $ $ 28. | (a) Does your spouse / parent pay court ordered child support ? O YES Go to (b) E NO Go to # 29 (b) Give the amount and frequency of payment: AA PART V - FOOD STAMPS 29. (a) Are you currently receiving food stamps ? You (b) Have you received a recertification notice within the past 30 days ? (C) Have you filed for food stamps in the last 60 days ? | (d) Have you received a favorable decision ? Your Spouse, if filing YES ONO O YES O NO Go to (b) Go to (c) Go to (b) Go to (c) O YES E NO O YES O NO Go to (e) Go to # 30 Go to (e) Go to # 30 O YES O NO D YES O NO Go to (d) Go to (e) Go to (d) Go to (e) O YES O NO D YES O NO Go to # 30 Go to (e) Go to # 30 Go to (e) O YES 因 NO O YES O NO Go to # 30 Explain in (1) | Go to # 30 Explain in (f) (e) May I take your food stamp application today ? (1) Explanation: TITUT PART VI – MISCELLANEOUS ANSWER # 30 ONLY IF YOU ARE REQUESTING BENEFITS ON BEHALF OF SOMEONE ELSE; OTHERWISE GO TO # 31. 30. Name of Person Requesting Benefits Relationship to Claimant Your Social Security Number FORM SSA - 8001 - BK (11 / 2009) Page 7 151 FROM SOCIAL SECURITY ADMIN. PRESCOTT AZ (TVE) OCT 29 2013 9: 00 / ST. 8: 55 / No. 7502918494 P 9 EXHIBIT NO. 1D PAGE: 9 OF 9 I TI TI TUTTI I T T - - Huws. . . . 32. PART VIII - - IMPORTANT INFORMATION - - PLEASE READ CAREFULLY 31. The Social Security Administration will check your statements and compare its records with records from other state and Federal agencies, including the internal Revenue Service, to make sure you are paid the correct amount. We have asked you for permission to obtain from any financial institution, any financial record about you that is held o the institution. We will ask financial institutions for this information whenever we think it is needed to decide if you are ellgible or if you continue to be eligible for SSI benefits. Once authorized, our permission to contact financial institutions remains in offoct until one of the following occurs: (1) you or your spouse notify us in writing that you are cancelling your permission, (2) your application for SSI is denied in a final decision, (3) your eligibiwty for ssi terminates, or (4) we no longer consider your spouse's income and resources to be available to you. If you or your spouse do not give or cancel your pommission you may not be eligible for SSI and we may deny your claim or stop your payments. PART IX - SIGNATURES I declare under penalty of perjury that I havo vxamined all the information on the form, and on any accompanying statements or forms, and it is true ind conect to the best of my knowledge. I understand that anyone who knowingly glvos talae Information, or cause someone else to do so, commits a crime and may be sent to prison, or may face other penaltles, or both. | Your Signature (First name, middle initiat, last name) (write in ink) Date (month, day, year) 9 - 29 - 23 Telephone number (a) at which you may ba SIGN contacted during the day | HERE · Craza. HERE 928 - 767 - 3124 34. | spouse's Signature (First Narfé, middle initial, last name) (Wrds in ink) (Sign only if applying for payments) SIGN HERE > 35. Applicants Mailing Address (Number and street, apt. no ., P. O. box or rural route) PO BOX 551 T 33. Your Signal City and State DÓLAN SPRINGS, AZ Zip Code 86441 Enter name of county (if any) in which you tive 38. claimants Residence Address (lf different from applicant's mailng address City and State Zip Code Enter name of county (if any) in which you tive 37. TI 38 | If you are blind or visually impaired, check the type of mail you want to receive from us: o Certified O Regular O Regular with a follow - up phone call WITNESSES Your application does not ordinarily have to be witnessed. If however, you have signed by witnesses to the signing who know you must sign below giving their full addresses. | 1. Signature of witness | 2. Signature of Witness }, two Address (Number and Street, City, State, and Zip Code) Address (Number and Street, City, State, and ZIP Code) FORM SSA - 8001 - BK (11 - 2009) Page 9 152 5EXHIBIT NO. 2D Arthur James Beighley Jr SSN: 552 - 92 - 3638 PAGE: 1 OF 2 Refer to: Y INDT 6 3 8 ICERS 11 / 05 / 15 FULL RECORD DISPLAY ICFR NH NAME ARTHUR BEIGHLEY SN: 552 - 92 - 3638 PG 001 + EVENT ICERS EARNINGS RECORD TID CERTIFIED EARNINGS RECORD ALERTS POSSIBLE INCOMPLETES 1982 1985 2001 2005 2012 FROZEN MILITARY INDICATOR 1976 (SSN - 552923638) FR0Z EN MILITA PRIOR CLAIM DATA DOES NOT EXIST ON DRAMS POSSIBLE GAPS 2003 2010 2011 POSSIBLE DUPLICATES PRIOR TO 1978 POSSIBLE DUPLICATES 1984 2002 2008 POSSIBLE INCOMPLETES PRIOR TO 1978 FILING DATE USED BY SYSTEM EQUALS ONSET DATE INFORMTNL DISABILITY EXCLUSION 20 / 40 INSURED TEST NOT MET DISABILITY NON - EXCLUSION 20 / 40 INSURED TEST NOT MET DISABILITY EXCLUSION FULLY INSURED STATUS MET DISABLED NH IS FULLY INSURED RIB DISABILITY NON - EXCLUSION FULLY INSURED STATUS MET PRIOR CLAIM STATUS - A ID INFO DATES DIB INPUT N O H REQ NAME: BEIGHL REQ SEX: M REQ DATE OF BIRTH: 03 / 13 / 1954 DATE OF ONSET: 02 / 01 / 2013 MBR / INPUT DATA ONSET: 12 / 16 / 2002 DENIAL / DISALLOWANCE: J1 ONSET: 11 / 01 / 2012 DENIAL / DISALLOWANCE: 90 ONSET: 02 / 01 / 2013 DENIAL / DISALLOWANCE: 90 ONSET: 02 / 01 / 2014 DENIAL / DISALLOWANCE: 90 DISABILITY: EXCL REQ QC: 37 EXCL HAS: 040 DISAI S: 04 0 NON — EXCI DIS DLI: 1 SSA QC 1937 THRU 1950 QC: 0 WAGE QC AFTER 1946: 144 WAGE QC AFTER 1950: 144 SE QC: NONE AG QC: NONE SSA INS STAT المالية F 7 O | 0 тот соy TOT EARN TOT AFTER 1936: TOT AFTER 1950: 560557. 36 560557. 36 RAILROAD RQSM DMW SE AG O CON 0 N A N) N O LLO COMPUTATIONAL YEARLY EARNINGS MAX AMT YR QC REGULAR U NH INDEXED 7800 69 NNC # 553. 25 70 CCCC 1212. 30 71 CN # C 1262. 40 9000 72 CCCC 4252. 43 10800 73 CCNC 2051. 82 13200 74 cccc 5884. 40 14100 75 CCCC 6669. 26 15300 76 # NCC 842. 62 16500 77 CCCC 12473. 76 17700 250 78 CCCC 15655. 39 22900 260 79 CCCC 13627. 56 25900 290 80 CCCC 9604. 79 29700 310 81 CCCC 7678. 28 32400 340 82 CCCC 2262. 69 35700 370 83 CCCC 4580. 72 37800 390 84 CCCC 25912. 35 39600 410 85 cccc 2223. 19 42000 440 86 CCCC 5768. 45 43800 460 87 cccc 11572. 10 45000 470 88 CCCC 11730. 72 48000 500 89 CCCC 24974. 17 51300 520 90 CCCC 26200. 98 53400 540 91 cccc 20675. 72 55500 570 92 CCCC 20847. 09 ن ن ن ن ن ن H H P 0 0 0 0 0 0 0 153 5EXHIBIT NO. 2D Arthur James Beighley Jr SSN: 552 - 92 - 3638 PAGE: 2 OF 2 Refer to: 0 0 0 0 O O O O 0 0 0 0 0 21557. 23 26934. 63 | 30172. 84 32125. 04 31941. 02 28787. 69 41877. 39 36841. 38 6537. 48 34856. 48 N N O 57600 590 93 CCCC 60600 620 94 CCCC 61200 630 95 cccc 62700 64 0 96 cccc 65400 670 97 CCCC 68400 700 98 CCCC 72600 740 99 cccc 76200 780 00 cccc 80400 830 01 CCCC 84900 870 02 CCCC 87000 890 03 NNNN 87900 900 04 CNNN 90000 920 05 NNNN 94200 970 06 cccc 97500 1000 07 CCCC 102000 1050 08 CCCC 106800 1090 09 CCCN 1120 10 NNNN 1120 11 NNNN 110100 1130 12 NNNN 113700 1160 13 NNNN 117000 1200 14 NNNN 118500 1220 15 NNNN 1047. 02 170. 00 6874. 69 6958. 72 11413. 67 3924. 93 NO O N) 20. 71 154 QRY DATE: 11 / 05 / 15 AN: 552 - 92 - 3638 DOC: T2P UNIT: EDEQY PG: 001 DEQR INPUT: YRS REQ: 1Case 3: 17 - CVV082034SPLLS DOCUMENT 1916ENFiled 01 / 02 / 18 Page 13 of 25 EXHIBIT NO 3D NON - COVERED DETAILS; SPECIAL WAGE PAYMENT; EMPLOYER ADDRESS MEF: NA: A J BEIGHL DB: 03 / 1954 SX: MAK: PAGE: 1 OF 7 DETAIL COVERED FICA EARNINGS AND EMPLOYER NAME AND ADDRESS FOR YEARS REQUESTED EIN: 952146513 PAPERCRAFT LLC 3310 E MIRALONIA AVE ANAHEIM CA 92806 - 0000 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S 0078 AA A J BEIGHL 15655. 39 15655. 39 8143 - 49 - 18769 00379 WAGE TOTAL 15655. 39 OASDI EMPLOYER TOTAL 15655. 39 78 OASDI YEARLY TOTAL 15655. 39 ن ن ل 0 0 0 2 2 2 4 2 4 EIN: 135596707 RH MACY & CO INC 151 W 34TH ST NEW YORK NY 10001 - 2101 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PRS 0079 AA 0010 A BEIGHL 2349. 85 2349. 85 9292 - 85 - 11502 00280 WAGE TOTAL 2349. 85 OASDI EMPLOYER TOTAL 2349. 85 EIN: 940457907 BROADWAY STORES INC % BANKERS TR 7 W 7TH ST CINCINNATI 0079 AA A BEIGHL 73. 68 73. 68 9134 - 46 - 18638 00380 WAGE TOTAL 73. 68 OASDI EMPLOYER TOTAL 73. 68 EIN: 941461208 LANDSTROM CO INC 817 GRENADA LANE FOSTER CITY CA 94 404 - 3803 0079 AA 0000 A BEIGHL 1435. 63 1435. 63 9093 - 90 - 38019 00380 WAGE TOTAL 1435. 63 OASDI EMPLOYER TOTAL 1435. 63 EIN: 95214 6513 PAPERCRAFT LLC 0079 AA A J BEIGHL 9768. 40 9768. 40 9098 - 53 - 14059 00380 WAGE TOTAL 97 68. 40 OASDI EMPLOYER TOTAL 9768. 40 79 OASDI YEARLY TOTAL 13627. 56 9 9 9 5 5 9 8 EIN: 135596707 R H MACY & CO INC RPYR REO LOAC NAME EARNINGS 0080 AA 0010 A J BEIGHL 9604. 79 WAGE TOTAL 9604. 79 OASDI EMPLOYER TOTAL 9604. 79 80 OASDI YEARLY TOTAL 9604. 79 TOTAL COMP CONTROL NUMBER PR S 9674. 54 0306 - 85 - 00218 00281 [ 0 0 0 anos a ono una semana en EIN: 135596707 R H MACY & CO INC RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PRS 0081 AA 0010 A BEIGHL 2012. 37 2056. 27 1167 - 85 - 23533 00182 WAGE TOTAL 2012. 37 OASDI EMPLOYER TOTAL 2012. 37 EIN: 941392969 INDUSTRIAL CORPORATION FKA INDUSTRIAL CHEMICAL CO OF SAN FRANCISCO INC 69 JENNIFER LN ALAMO CA 94507 - 1207 0081 AA A BEIGHL 5347. 79 1033 - 46 - 14234 00182 WAGE TOTAL 5347. 79 5 O N 155 7 5 3 4 7 3 7 3 4 [ NN 00 00 N. N N. OASDI EMPLOYER TOTAL 5347. 79 EIN: 941489258 Case 3: 17 - EVT68203 - SPEETDotGament 11 - 6 Filed 01 / 02 / 18 Page 14 of 25 EXHIBIT NO. 3D % FRED CARROLL 650 CALIFORNIA ST STE 2530 PAGE: 2 OF 7 SAN FRANCISCO CA 94108 - 2702 0081 AA A J BEIGHL 78. 72 1042 - 49 - 15580 00182 WAGE TOTAL OASDI EMPLOYER TOTAL 78. 72 EIN: 941508650 W & J SLOANE INC 414 FIFTH AVE NEW YORK NY 10018 - 2702 0081 AA AA A BEIGHL 81. 96 81. 96 1047 - 45 - 18226 00282 WAGE TOTAL 81. 96 OASDI EMPLOYER TOTAL 81. 96 EIN: 942237713 0 L M INTERNATIONAL CORP 868 COWAN RD BURLINGAME CA 94010 - 0000 0081 AA A J BEIGHL 157. 44 157. 44 1235 - 49 - 01574 00382 WAGE TOTAL 157. 44 OASDI EMPLOYER TOTAL 157. 44 81 OASDI YEARLY TOTAL 7 6 7 2 EIN: 9 4 2 5 5 EIN: 135596707 R H MACY & CO INC RPYR REO LOAC NAME EARNINGS TOTAL COME CONTROL NUMBER PR s 0082 AA 0010 A BEIGHL 2202. 69 2202. 69 2241 - 85 - 13251 00283 WAGE TOTAL 2202. 69 OASDI EMPLOYER TOTAL 2202. 69 AMERICAN IMPROVEMENT CO PO BOX 4858 WALNUT CREEK 0082 AA A J BEIGHL 60, 00 60. 00 2046 - 52 - 06417 00183 WAGE TOTAL 60. 00 OASDI EMPLOYER TOTAL 60. 00 82 OASDI YEARLY TOTAL 2262. 69 9 4 5 9 8 5 8 EIN: 140569840 CLUETT PEABODY & CO INC 3200 HIGHLANDS PKWY SE STE 300 SMYRNA GA 30082 - 5192 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S 0083 AA 0000 A J BEIGHL 4580, 72 4580. 72 3149 - 85 - 25578 00184 WAGE TOTAL 4580. 72 OASDI EMPLOYER TOTAL 4580. 72 83 OASDI YEARLY TOTAL 4580. 72 0 0 0 0 S EIN: 360879160 A M CASTLE & Co 1420 KENSINGTON RD STE 220 OAK BROOK IL 60523 - 2165 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR 0084 AA A BEIGHL 25912. 35 25912. 35 4085 - 05 - 00686 00285 WAGE TOTAL 25912. 35 OASDI EMPLOYER TOTAL 25912. 35 84 OASDI YEARLY TOTAL 25912. 35 N N N N U U U U TOTAL COMP CONTROL NUMBER PR S 94. 32 5246 - 85 - 05806 00686 V EIN: 140569840 CLUETT PEABODY & CO INC RPYR REO LOAC NAME EARNINGS 0085 AA 0000 A BEIGHL 94. 32 WAGE TOTAL 94. 32 OASDI EMPLOYER TOTAL 94. 32 EIN: 360879160 A M CASTLE & CO 0085 AA A BEIGHL WAGE TOTAL 1487. 86 OASDI EMPLOYER TOTAL 1487. 86 في فر في 0 0 0 156 1 4 7 1487. 86 5083 - 18 - 17839 00986 V 9 4 2 7 7 5 7 TRANSFER CONNECTION INC 5 EXHIBIT NO. 3D S SAN FRANCISCO CA 94080 - 6811 0085 AA A J BEIGHL 555. 00 555. 00 5064 - 46 - 16208 01186 V PAGE: 3 OF 7 WAGE TOTAL 555. 00 OASDI EMPLOYER TOTAL 555. 00 EIN: 942778173 GATEWAY WAREHOUSE SERVICES CORP PO BOX 7509 OAKLAND CA 94601 - 0509 0085 AA A BEIGHL 86. 01 86. 01 5072 - 49 - 16835 01086 V WAGE TOTAL 86. 01 OASDI EMPLOYER TOTAL 86. 01 85 OASDI YEARLY TOTAL 2223. 19 3 5 5 9 N N N 6 7 2 6 2 7 5 9 1 7 2 4 9 2 6 00 00 00 ili ii ii ii ilii i 3 il EIN: 135596707 R H MACY & CO INC RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PRS 0086 AA A BEIGHL 2285. 02 2285. 02 6056 - 90 - 03975 00787 V WAGE TOTAL 2285. 02 OASDI EMPLOYER TOTAL 2285. 02 EIN: 360879160 A M CASTLE & Co 0086 AA A BEIGHL 672. 84 672. 84 6275 - 90 - 06689 01187 V WAGE TOTAL 672. 84 OASDI EMPLOYER TOTAL 672. 84 EIN: 940457907 BROADWAY STORES INC 0086 AA 0104 A J BEIGHL 2177. 28 2177. 28 6056 - 90 - 14926 00787 V WAGE TOTAL 2177. 28 OASDI EMPLOYER TOTAL 2177. 28 EIN: 942775780 TRANSFER CONNECTION INC 0086 AA A J BEIGHL 424. 00 424. 00 6111 - 59 - 31609 01287 V WAGE TOTAL 424. 00 OASDI EMPLOYER TOTAL 424. 00 EIN: 942778173 GATEWAY WAREHOUSE SERVICES CORP 0086 AA A BEIGHL 114. 03 114. 03 6126 - 60 - 44350 01487 V WAGE TOTAL 114. 03 OASDI EMPLOYER TOTAL 114. 03 EIN: 951279160 EASTERDAY JANITORIAL SUPPLY CO 75 BROADWAY STE 111 SAN FRANCISCO CA 94111 - 1423 0086 AA A J BEIGHL 95. 28 WAGE TOTAL 95. 28 OASDI EMPLOYER TOTAL 95. 28 86 OASDI YEARLY TOTAL 5768. 45 2 | 0 I LO 3 4 6 3 6 – 8 7 5 8 6 T U U U 0 0 0 Un 00 00 00 2 2 2 EIN: 133354540 MACYS WEST INC * FEDERATED CORP SERV INC TAX DEPT 7 W SEVENTH ST CINCINNATI OH 45202 - 2424 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S 0087 IA A BEIGHL 2417. 96 2417. 96 9128 - 88 - 01932 00890 V WAGE TOTAL 2417. 96 OASDI EMPLOYER TOTAL 2417. 96 EIN: 940457907 BROADWAY STORES INC 0087 AA 0104 A J BEIGHL 9154. 14 9154. 14 7052 - 92 - 19573 01188 V WAGE TOTAL 9154. 14 OASDI EMPLOYER TOTAL 9154. 14 87 OASDI YEARLY TOTAL 11572. 10 ES " in 157 EIN: 940457907 BROADWAY STORES INC RPYR REO LOAC NAME EARNINGS 0088 AA 0104 A J BEIGHL 11730. 72 WAGE TOTAL 11730. 72 OASDI EMPLOYER TOTAL 11730. 72 88 OASDI YEARLY TOTAL 11730. 72 TOTAL COMP CONTROL NUMBER PR S 11730. 72 8391 - 92 - 00646 02189 V 157 0 0 0 0 5 EXHIBIT NO. 3D EIN: 940457907 BROADWAY STORES INC RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S PAGE: 4 OF 7 0069 AA 0104 A J BEIGHL 2497 4. 17 24974. 17 9199 - 91 - 03596 02390 V WAGE TOTAL 24974. 17 OASDI EMPLOYER TOTAL 24974. 17 89 OASDI YEARLY TOTAL 2497 4. 17 TOTAL COMP CONTROL NUMBER PR S 26200. 98 0014 - 99 - 27776 00991 V EIN: 940457907 BROADWAY STORES INC RPYR REO LOAC NAME EARNINGS 0090 AA 0104 A J BEIGHL 26200. 98 WAGE TOTAL 26200, 98 OASDI EMPLOYER TOTAL 26200. 98 90 OASDI YEARLY TOTAL 26200. 98 N N N N TOTAL COMP CONTROL NUMBER PR S 20675. 72 1192 – 91 - 00631 01892 V EIN: 940457907 BROADWAY STORES INC RPYR REO LOAC NAME EARNINGS 0091 AA A J BEIGHL 20675. 72 WAGE TOTAL 20675. 72 OASDI EMPLOYER TOTAL 20675. 72 91 OASDI YEARLY TOTAL 20675. 72 U U U UN. N N N N TOTAL COMP CONTROL NUMBER PR S 20847. 09 2017 - 99 - 05495 01093 V EIN: 940457907 BROADWAY STORES INC RPYR REO LOAC NAME EARNINGS 0092 AA A J BEIGHL 20847. 09 WAGE TOTAL 20847. 09 OASDI EMPLOYER TOTAL 20847. 09 92 OASDI YEARLY TOTAL 20847. 09 TOTAL COMP CONTROL NUMBER PRS 21557. 23 3108 - 85 - 19156 00894 V EIN: 940457907 BROADWAY STORES INC RPYR REO LOAC NAME EARNINGS 0093 AA A J BEIGHL 21557. 23 WAGE TOTAL 21557. 23 OASDI EMPLOYER TOTAL 21557. 23 93 OASDI YEARLY TOTAL 21557. 23 N N NJ N mana menteri TOTAL COMP CONTROL NUMBER PR s 26934, 63 4123 - 86 - 92 449 00895 V EIN: 940457907 BROADWAY STORES INC RPYR REO LOAC NAME EARNINGS 0094 AA A J BEIGHL 26934. 63 WAGE TOTAL 26934. 63 OASDI EMPLOYER TOTAL 26934. 63 94 OASDI YEARLY TOTAL 26934. 63 NN NI TOTAL COMP CONTROL NUMBER PR s 30172. 84 5123 - 87 - 51494 00996 V EIN: 940457907 BROADWAY STORES INC RPYR REO LOAC NAME EARNINGS 0095 AA A J BEIGHL 30172. 84 WAGE TOTAL 30172. 84 OASDI EMPLOYER TOTAL 30172. 84 95 OASDI YEARLY TOTAL 30172. 84 EIN: 911319190 VWR INTERNATIONAL INC PO BOX 6660 RADNOR PA 19087 - 8660 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S 0096 AA A J BEIGHL 21551. 15 21551. 15 6106 - 87 - 93988 00997 V WAGE TOTAL OASDI EMPLOYER TOTAL 21551. 15 EIN: 940457907 BROADWAY STORES INC 158 N 1 U U U 0096 AA A J BEIGHL 10573. 89 10573. 89 6105 - 85 - 68767 00997 V Cate B7 - cv - 08203SPL89 Document 11 - 6 Filed 01 / 02 / 18 Page 17 of 25 EXHIBIT NO. 3D OASDI EMPLOYER TOTAL 10573. 89 96 OASDI YEARLY TOTAL 32125. 04 PAGE: 5 OF 7 TOTAL COMP CONTROL NUMBER PR S 31941. 02 7058 - 86 - 90294 00398 V EIN: 911319190 VWR INTERNATIONAL INC RPYR REO LOAC NAME EARNINGS 0097 AA A J BEIGHL 31941. 02 WAGE TOTAL 31941. 02 OASDI EMPLOYER TOTAL 31941. 02 97 OASDI YEARLY TOTAL 31941. 02 TOTAL COMP CONTROL NUMBER PR S 28787. 69 8145 - 87 - 29072 01599 V EIN: 911319190 VWR INTERNATIONAL INC RPYR REO LOAC NAME EARNINGS 0098 AA A J BEIGHL 28787. 69 WAGE TOTAL 28787. 69 OASDI EMPLOYER TOTAL 28787. 69 98 QASDI YEARLY TOTAL 28787. 69 ON O O TOTAL COMP CONTROL NUMBER PR 41877. 39 9062 - 87 - 72732 00400 V EIN: 911319190 VWR INTERNATIONAL INC RPYR REO LOAC NAME EARNINGS 0099 AA A J BEIGHL 41877. 39 WAGE TOTAL 41877. 39 OASDI EMPLOYER TOTAL 41877. 39 99 OASDI YEARLY TOTAL 41877. 39 0 0 0 0 EIN: 911319190 VWR INTERNATIONAL INC RPYR REO LOAC NAME EARNINGS 0000 AA A J BEIGHL 36841. 38 WAGE TOTAL 36841. 38 OASDI EMPLOYER TOTAL 36841. 38 00 OASDI YEARLY TOTAL 36841. 38 UN TOTAL COMP CONTROL NUMBER PRS 36841. 38 0078 - 91 - 38739 00801 V TOTAL COMP CONTROL NUMBER PRS 6537. 48 1065 - 92 - 16211 00702 v EIN: 911319190 VWR INTERNATIONAL INC RPYR REO LOAC NAME EARNINGS 0001 AA A J BEIGHL 6537. 48 WAGE TOTAL 6537, 48 OASDI EMPLOYER TOTAL 6537. 48 01 OASDI YEARLY TOTAL 6537. 48 TOTAL COMP CONTROL NUMBER PRS 34856. 48 2052 - 91 - 25968 00603 V EIN: 911319190 VWR INTERNATIONAL INC RPYR REO LOAC NAME EARNINGS 0002 AA A J BEIGHL 34856. 48 WAGE TOTAL 34856. 48 OASDI EMPLOYER TOTAL 34856. 48 02 OASDI YEARLY TOTAL 34856. 48 م ن ن ل 03 NONE EIN: 200307941 MACYS CORPORATE SERVICES INC 7 W 7TH ST FL 17 CINCINNATI OH 45202 - 2468 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PRS 0004 AA A BEIGHL 1047. 02 1047. 02 4063 - 88 - 29164 00805 V WAGE TOTAL 1047. 02 OASDI EMPLOYER TOTAL 1047. 02 04 OASDI YEARLY TOTAL 1047. 02 NNN 159 EIN: 941718865 Case 3: 1PEVTÒ82031 - SPEVI Boement 11 - 6 Filed 01 / 02 / 18 Page 18 of 25 EXHIBIT NO. 3D % GREGG NI EMUTH 397 W CHANNEL RD PAGE: 6 OF 7 BENICIA CA 94510 - 1117 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S 0005 AA A BEIGHL 170. 00 170. 00 5052 - 90 - 61427 00606 V WAGE TOTAL 170. 00 OASDI EMPLOYER TOTAL 170. 00 05 OASDI YEARLY TOTAL 170. 00 cu catena mesta EIN: 651092199 RANDSTAD HORIZONS L P RANDSTAD 60 HARVARD MILL SQ WAKEFIELD MA 01880 - 3208 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR s 0006 AA A J BEIGHL 1529. 69 1529. 69 6092 - 90 - 51937 01207 V WAGE TOTAL 1529. 69 OASDI EMPLOYER TOTAL 1529. 69 EIN: 941718865 DELTA TECH SERVICE INC 0006 AA A BEIGHL 5345. 00 5345. 00 6143 - 65 - 56348 02207 V WAGE TOTAL 5345. 00 OASDI EMPLOYER TOTAL 5345. 00 06 OASDI YEARLY TOTAL 6874. 69 TOTAL COMP CONTROL NUMBER PR s 6958. 72 8099 - AH - 91007 01208 V EIN: 651092199 RANDSTAD HORIZONS I P RPYR REO LOAC NAME EARNINGS 0007 AA A J BEIGHL 6958. 72 WAGE TOTAL 6958. 72 OASDI EMPLOYER TOTAL 6958. 72 07 OASDI YEARLY TOTAL 6958. 72 0 00 00 00 TOTAL COMP CONTROL NUMBER PR s 11413. 67 9071 - BN - 08803 00709 V EIN: 651092199 RANDSTAD HORIZONS L P RPYR REO LOAC NAME EARNINGS 0008 AA A J BEIGHL 11413. 67 WAGE TOTAL 11413. 67 OASDI EMPLOYER TOTAL 11413. 67 08 OASDI YEARLY TOTAL 11413. 67 TOTAL COMP CONTROL NUMBER PRS 3924. 93 0049 - AJ - 60798 00510 V EIN: 651092199 RANDSTAD HORIZONS I P RPYR REO LOAC NAME EARNINGS 0009 AA A J BEIGHL 3924. 93 WAGE TOTAL 3924. 93 OASDI EMPLOYER TOTAL 3924. 93 09 OASDI YEARLY TOTAL 3924. 93 10 NONE 11 NONE E 3 7 3 EIN: 900783793 MANINANG V RANDSTAD EMPLOYMENT SOLUTIONS LP ET AL % SIMPLURIS 3176 PULLMAN ST STE 123 COSTA MESA CA 92626 - 3317 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S 0012 AA A BEIGHL 20. 71 20. 71 3087 - BM – 17443 01113 V WAGE TOTAL 20. 71 OASDI EMPLOYER TOTAL 20. 71 160 12 OASDI YEARLY TOTAL 20. 71 5 EXHIBIT NO. 3D 13 NONE PAGE: 7 OF 7 14 NONE 15 NONE DETAIL COVERED MQGE EARNINGS AND EMPLOYER NAME AND ADDRESS FOR YEARS REQUESTED (1983 - 1990) NO COVERED MQGE EARNINGS POSTED FOR YEARS REQUESTED DETAIL NON - COVERED EARNINGS AND W - 2 PENSION DATA AND EMPLOYER NAME AND ADDRESS FOR YEARS REQUESTED NO NON - COVERED EARNINGS AND W - 2 PENSION DATA POSTED FOR YEARS REQUESTED REMARKS CLAIMS ACTIVITY - - SEE MER CLAIMS ACTIVITY - - SEE SSR 161 SEQY DTE: 11 / 05 / 15 AN: 552 - 92 - 3638 Case 3: 17 - cy - 08203 - SP MEF QN: 552 - 92 - 3638° ' NA: AUBEIGHL DOC: T2P UNIT: ESEQY Document 11 - 6. Filed 01 / 02 / 18 DB: 03 / 1954 SX: MAK: age 20 250PX ET DE 10 EXHIBIT NO. 4D PAGE: 1 OF 1 SUMMARY FICA EARNINGS FOR YEARS REQUESTED YEAR EARNINGS YEAR EARNINGS YEAR EARNINGS YEAR 1969 553. 25 1980 9604. 79 1991 20675. 72 2002 1970 1212. 30 1981 7678. 28 1992 20847. 09 2003 1971 1262. 40 1982 2262. 69 1993 21557. 23 2004 1972 4252. 43 1983 4580. 72 1994 26934. 63 2005 1973 2051. 82 1984 25912. 35 1995 30172. 84 2006 1974 5884. 40 1985 2223. 19 1996 32125. 04 2007 1975 6669. 26 1986 5768. 45 1997 31941. 02 2008 1976 842. 62 1987 11572. 10 1998 28787. 69 2009 1977 12473. 76 1988 11730. 72 1999 41877. 39 2010 1978 15655. 39 1989 24974. 17 2000 36841. 38 2011 1979 13627. 56 1990 26200. 98 2001 6537. 48 2012 EARNINGS 34856. 48. 00 1047. 02 170. 00 6874. 69 6958. 72 11413. 67 3924. 93. 00. 00 20. 71 SUMMARY MQGE EARNINGS FOR YEARS REQUESTED NO MQGE EARNINGS FOR YEARS REQUESTED REMARKS CLAIMS ACTIVITY - - SEE MBR 162 5EXHIBIT NO. 5D PAGE: 1 OF 1 - - - - - NDNH - T16 QUERY for 552 - 92 - 3638 No New Hire / Wage / UC Reports - - - - - NDNH - T2 QUERY for 552 - 92 - 3638 - No DCF or client Record Found - - - - - - 163 5EXHIBIT NO. 6D PAGE: 1 OF 2 NH NAME INPUT RUN DATE CONTROL ARTHUR J BEIGHLEY 04 / 07 / 16 04 / 07 / 16 V: 07 / 15 / 14 552 - 92 - 3638 JR SN: 552 - 92 - 3638 PG 001 + DO: X65 UNIT: AK DERO MOD: 04 H H H H H I W HII EVENT ICERS EARNINGS RECORD TID CERTIFIED EARNINGS RECORD ALERTS POSSIBLE INCOMPLETES 1982 1985 2001 2005 2012 FROZEN MILITARY INDICATOR 1976 (SSN - 552923638) PRIOR CLAIM DATA DOES NOT EXIST ON DRAMS POSSIBLE GAPS 2003 2010 2011 POSSIBLE DUPLICATES PRIOR TO 1978 POSSIBLE DUPLICATES 1984 2002 2008 POSSIBLE INCOMPLETES PRIOR TO 1978 FILING DATE USED BY SYSTEM EQUALS ONSET DATE INFORMTNL DISABILITY EXCLUSION 20 / 40 INSURED TEST NOT MET DISABILITY NON - EXCLUSION 20 / 40 INSURED TEST NOT MET DISABILITY EXCLUSION FULLY INSURED STATUS MET DISABLED NH IS FULLY INSURED RIB DISABILITY NON - EXCLUSION FULLY INSURED STATUS MET PRIOR CLAIM STATUS - A ID INFO REQ NAME: BEIGHL REQ SEX: M REQ DATE OF BIRTH: 03 / 13 / 1954 DATES DATE OF ONSET: 02 / 01 / 2013 DIB INPUT MBR / INPUT DATA ONSET: 12 / 16 / 2002 DENTAL / DISALLOWANCE: J1 ONSET: 11 / 01 / 2012 DENIAL / DISALLOWANCE: 90 ONSET: 02 / 01 / 2013 DENIAL / DISALLOWANCE: 90 ONSET: 02 / 01 / 2014 DENIAL / DISALLOWANCE: 90 INS STAT DISABILITY: EXCL REQ Qc: 37 EXCL HAS: 040 NON - EXCL REQ QC: 37 NON - EXCL HAS: 040 DIS DLI: 12 / 11 TOT COV SSA QC 1937 THRU 1950 QC: 0 WAGE QC AFTER 1946: 144 WAGE QC AFTER 1950: 144 SE QC: NONE AG QC: NONE TOT EARN SSA TOT AFTER 1936: 560557. 36 TOT AFTER 1950: 560557. 36 COMPUTATIONAL YEARLY EARNINGS MAX AMT YR QC REGULAR NH INDEXED RAILROAD RQSM DMW SE AG 7800 69 NNC # 553. 25 70 CCCC 1212. 30 71 CN # C 1262. 40 9000 72 cccc 4252. 43 10800 73 CCNC 2051. 82 13200 74 cccc 5884. 40 14100 75 cccc 6669. 26 15300 76 # NCC 842. 62 16500 77 CCCC 12473. 76 O O O ON O U U O 164 5 EXHIBIT NO. 6D PAGE: 2 OF 2 J BEIGHLEY NH NAME INPUT ARTHUR 04 / 07 / 16 JR SN: 552 - 92 - 3638 PG 002 DO: X65 UNIT: AK DERO MOD: 04 U NH INDEXED RAILROAD RQSM DMW SE AG COMPUTATIONAL YEARLY EARNINGS MAX AMT YR QC REGULAR 17700 250 78 cccc 15655. 39 22900 260 79 CCCC 13627. 56 25900 290 80 CCCC 9604. 79 29700 310 81 CCCC 7678. 28 32400 340 82 CCCC 2262. 69 35700 370 83 сесс 4580. 72 37800 390 84 Ссса 25912. 35 39600 410 85 CCCC 2223. 19 42000 440 86 cccc 5768. 45 43800 460 87 CCCC 11572. 10 45000 470 88 CCCC 11730. 72 48000 500 89 CCCC 24974. 17 513 00 520 90 cccc 26200. 98 53400 540 91 cccc 20675. 72 55500 570 92 ССҫҫ 20847. 09 57600 590 93 cccc 21557. 23 60600 620 94 cccc 26934 ' . 63 61200 630 95 cccc 30172. 84 62700 640 96 CCCC 32125. 04 65400 670 97 CCCC 31941. 02 68400 700 98 cccc 28787. 69 72600 740 99 cccc 41877. 39 76200 780 00 CCCC 36841. 38 80400 830 01 cccc 6537. 48 84900 870 02 cccc 34856. 48 87000 890 03 NNNN 87900 900 04 CNNN 1047. 02 90000 920 05 NNNN 170. 00 94200 970 06 CCCC 6874. 69 97500 1000 07 CCCC 6958. 72 102000 1050 08 CCCC 11413. 67 106806 1090 09 CCCN 3924. 93 1120 10 NNNN 1120 11 NNNN 110100 1130 12 NNNN 20. 71 113700 1160 13 NNNN 117000 1200 14 NNNN 118500 1220 15 NNNN 1260 16 NNNN 165 QRY DATE: 04 / 07 / 16 AN: 552 - 92 - 3638 DOC: X65 UNIT: EDEQY PG: 001 DEQR INPUT: YRS REQ: 2Case 3: 17 - CVV08203 SPELS DOCUMENT 1916ENFiled 01 / 02 / 18 Page 24 of 25 EXHIBIT NO ZD NON - COVERED DETAILS; EMPLOYER ADDRESS MEF: NA: A J BEIGHL DB: 03 / 1954 SX: MAK: PAGE: 1 OF 2 DETAIL COVERED FICA EARNINGS AND EMPLOYER NAME AND ADDRESS FOR YEARS REQUESTED EIN: 911319190 VWR INTERNATIONAL INC 100 MATSONFORD RD BLDG 1 RADNOR PA 19087 - 4569 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR 0001 AA A J BEIGHL 6537. 48 6537. 48 1065 - 92 - 16211 00702 V WAGE TOTAL 6537. 48 OASDI EMPLOYER TOTAL 01 OASDI YEARLY TOTAL 6537. 48 S 3 7 00 000 TOTAL COMP CONTROL NUMBER PR S 34856. 48 2052 - 91 - 2596800603 V EIN: 911319190 VIWR INTERNATIONAL INC RPYR REO LOAC NAME EARNINGS 0002 AA A J BEIGHL 34856. 48 WAGE TOTAL 34856. 48 OASDI EMPLOYER TOTAL 34856. 48 02 OASDI YEARLY TOTAL 34856. 48 03 NONE EIN: 200307941 MACYS CORPORATE SERVICES INC 7 W 7TH ST FL 17 CINCINNATI OH 45202 - 2468 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S 0004 AA A BEIGHL 1047. 02 1047. 02 4063 - 88 - 29164 00805 V WAGE TOTAL 1047. 02 OASDI EMPLOYER TOTAL 1047. 02 04 OASDI YEARLY TOTAL 1047. 02 EIN: 941718865 DELTA TECH SERVICE INC % GREGG NI EMUTH 397 W CHANNEL RD BENICIA CA 94510 - 1117 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PRS 0005 AA A BEIGHL 170. 00 170. 00 5052 - 90 - 61427 00606 V WAGE TOTAL 170. 00 OASDI EMPLOYER TOTAL 170. 00 05 OASDI YEARLY TOTAL 170. 00 EIN: 651092199 RANDSTAD HORIZONS L P RANDSTAD 60 HARVARD MILL SQ WAKEFIELD MA 01880 - 3208 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PR S 0006 AA A J BEIGHL 1529. 69 1529. 69 6092 - 90 - 51937 01207 V WAGE TOTAL 1529. 69 OASDI EMPLOYER TOTAL 1529. 69 EIN: 941718865 DELTA TECH SERVICE INC 0006 AA A BEIGHL 5345. 00 5345. 00 6143 - 65 - 56348 02207 V WAGE TOTAL 5345. 00 OASDI EMPLOYER TOTAL 5345. 00 06 OASDI YEARLY TOTAL 6874. 69 0 0 0 5 4 5 5 5 6 4 8 O U U U H 166 EIN: 651092199 RANDSTAD HORIZONS L P RPYR REO LOAC Nedse 3: 17 - cv - 68203LSPL Ddeuient11 - 6 OFed OI 62718 PPage 25 of 25 EXHIBIT NO. ZD 0007 AA A J BEIGHL 6959. 72 6958. 72 8099 - AH - 91007 01208 V WAGE TOTAL 6958. 72 PAGE: 2 OF 2 OASDI EMPLOYER TOTAL 6958. 72 07 OASDI YEARLY TOTAL 6958. 72 0 0 0 00 00 00 TOTAL COMP CONTROL NUMBER PR S 11413. 67 9071 - BN - 08803 00709 V EIN: 651092199 RANDSTAD HORIZONS L P RPYR REO LOAC NAME EARNINGS 0008 AA A J BEIGHL 11413. 67 WAGE TOTAL 11413. 67 OASDI EMPLOYER TOTAL 11413. 67 08 OASDI YEARLY TOTAL 11413, 67 TOTAL COMP CONTROL NUMBER PR S 3924. 93 0049 - AJ - 60798 00510 V EIN: 651092199 RANDSTAD HORIZONS L P RPYR REO LOAC NAME EARNINGS 0009 AA A J BEIGHL 3924. 93 WAGE TOTAL 3924. 93 OASDI EMPLOYER TOTAL 3924. 93 09 OASDI YEARLY TOTAL 3924. 93 0 0 0 0 N. N. N. 10 NONE 11 NONE EIN: 900783793 MANINANG V RANDSTAD EMPLOYMENT SOLUTIONS LP ET AL % SIMPLURIS 3176 PULLMAN ST STE 123 COSTA MESA CA 92626 - 3317 RPYR REO LOAC NAME EARNINGS TOTAL COMP CONTROL NUMBER PRS 0012 AA A BEIGHL 20. 71 20. 71 3087 - BM - 17443 01113 V WAGE TOTAL 20. 71 OASDI EMPLOYER TOTAL 20. 71 12 OASDI YEARLY TOTAL 20. 71 0 0 0 0 13 NONE 14 NONE 15 NONE 16 NONE DETAIL NON - COVERED EARNINGS AND W - 2 PENSION DATA AND EMPLOYER NAME AND ADDRESS FOR YEARS REQUESTED NO NON - COVERED EARNINGS AND W – 2 PENSION DATA POSTED FOR YEARS REQUESTED REMARKS CLAIMS ACTIVITY - - SEE MBR CLAIMS ACTIVITY - - SEE SSR 167

OPENING BRIEF by Arthur James Beighley, Jr.

3 1 Edward A. Wicklund 2 Admitted Pro Hac Vice Olinsky Law Group 3 300 South State Street, Suite 420 4 Syracuse, NY 13202 NY State Bar No. 2044865 5 Telephone: (315) 701-5780 6 Facsimile: (315) 701-5781 twicklund@windisability.com 7 8 IN THE UNITED STATES DISTRICT COURT DISTRICT OF ARIZONA 9 10 Arthur James Beighley, Jr., 11 Plaintiff, Civil No. CV-17-08203-PCT-SPL 12 vs. 13 14 Nancy A. Berryhill, PLAINTIFF'S OPENING BRIEF Acting Commissioner of Social 15 Security, 16 Defendant. 17 PLAINTIFF'S OPENING BRIEF 18 IN SUPPORT OF A SOCIAL SECURITY APPEAL 19 I. STATEMENT OF THE ISSUES PRESENTED FOR REVIEW 20 21 1. The RFC is not supported by substantial evidence because the ALJ failed to properly evaluate the opinion evidence. 22 23 II. STATEMENT OF THE CASE 24 (A) Administrative Proceedings 25 On October 28, 2013, Arthur James Beighley, Jr. ("Plaintiff") protectively filed an 26 27 application for Title XVI Supplemental Security Income benefits, alleging disability 28 beginning February 1, 2013. Plaintiff's application was initially denied on March 26, Page 1 3 1 2015, and denied upon reconsideration on September 4, 2014. T 83, 90. Plaintiff 2 requested a hearing. T 94. On June 29, 2016, Administrative Law Judge ("ALJ") 3 4 Randolph E. Schum issued an unfavorable decision, finding not disabled at Step 4 of the 5 sequential evaluation process. T 26-36. The Appeals Council denied Plaintiff's request 6 for review, leaving the ALJ's decision as the final agency decision. T 2-5. Plaintiff filed 7 8 this action seeking judicial review. Dkt. No. 1. This Court has jurisdiction. 42 U.S.C. 9 §§ 405(g), 1383(c)(3). 10 The Social Security Administration ("SSA") has promulgated a five-step 11 sequential evaluation process for use in making disability determinations. See 20 C.F.R. 12 13 §§ 404.1520(a), 416.920(a). The ALJ's decision describes the five-step process. T 30– 14 31. At Step 1, the ALJ found that Plaintiff has not engaged in substantial gainful activity 15 since October 28, 2013, the application date. T 31. At Step 2, the ALJ found chronic 16 17 obstructive pulmonary disease ("COPD") to be a severe impairment. T 31. At Step 3, 18 the ALJ that found these impairments did not meet or equal a listing. T 32. The ALJ 19 found that Plaintiff has the residual functional capacity ("RFC") to perform "light" work 20 21 except: 22 ...the claimant is limited to lifting and/or carrying a maximum of 20 pounds 23 occasionally and ten pounds frequently. The claimant is limited to standing and/or walking six hours out of eight. The claimant is limited to sitting six 24 hours. The claimant is limited to occasionally climbing stairs and/or ramps, 25 but never ladders, ropes, or scaffolds. The claimant is limited to occasionally stooping, kneeling, crouching, and crawling. The claimant should avoid 26 concentrated exposure to fumes, odors, dusts, gases, and unprotected heights. 27 28 Page 2 3 1 T 32. At Step 4, the ALJ found, based upon vocational expert ("VE") testimony, that 2 Plaintiff could perform past relevant work as a driver (DOT#919.683-014). T 35-36. 3 4 III. STATEMENT OF FACTS 5 (A) Plaintiff's Age, Education, & Work History 6 Plaintiff, born in 1954, has at least a high school education. T 145, 46. Past 7 relevant work includes employment as a driver. T 36. The VE classified Plaintiff's past 8 9 relevant work as a driver as light and unskilled. T 58. 10 (B) Concise Summary of Medical Records and Opinions Relevant to this 11 Appeal 12 On March 2, 2014, Dr. Efren Cano, DO conducted a consultative examination and 13 provided a medical source statement. T 402. Dr. Cano's diagnoses included pulmonary 14 15 nodule, COPD, back pain, and hypertension. T 402. Dr. Cano opined that Plaintiff's 16 conditions have not or will not impose any limitations for twelve continuous months. T 17 402. The ALJ gave little weight to Dr. Cano's opinion. T 34. 18 19 On March 26, 2014, state agency medical consultant Dr. Donald Robins, MD 20 found Plaintiff's impairments to be non-severe. T 67. Dr. Robins determined that 21 Plaintiff is not disabled. T 68. The ALJ gave partial weight to Dr. Robins' opinion. T 22 23 35. 24 On September 3, 2014, state agency medical consultant Dr. Allen Radkowsky, 25 MD found Plaintiff's impairments to be non-severe. T 77. Dr. Radkowsky determined 26 27 that Plaintiff is not disabled. T 78. The ALJ gave partial weight to Dr. Radkowsky's 28 opinion. T 35. Page 3 3 1 On February 23, 2015, treating physician Dr. Nabila Aslam, MD provided an 2 opinion regarding Plaintiff's RFC. T 433-435. Dr. Aslam's opinion is based on a 3 4 diagnosis of COPD. T 433. COPD causes Plaintiff to experience fatigue and shortness 5 of breath upon exertion. T 433. Dr. Aslam opined that Plaintiff can sit for sixty minutes 6 at one time and stand/walk for sixty minutes at one time. T 433. Dr. Aslam opined that 7 8 Plaintiff can sit for eight-hours in an eight-hour workday. T 433. Dr. Aslam opined that 9 Plaintiff can stand/walk for one hour in an eight-hour workday. T 433. Dr. Aslam 10 opined that Plaintiff needs a job which permits shifting of positions at will from sitting, 11 standing or walking. T 433. Dr. Aslam opined that Plaintiff needs to take unscheduled 12 13 breaks during an eight-hour workday, lasting fifteen to thirty minutes, depending on 14 exertion. T 433. Dr. Aslam opined that Plaintiff is capable of performing reaching, 15 handling, and fingering activities fifty-percent of an eight-hour workday. T 434. Dr. 16 17 Aslam opined that Plaintiff would be absent as a result of his impairments once or twice a 18 month. T 434. Dr. Aslam opined that Plaintiff is not a malingerer. T 434. Dr. Aslam 19 opined that Plaintiff is physically capable of working an eight-hour day, five days a week 20 21 on a sustained basis. T 434. Dr. Aslam opined that Plaintiff has had the limitations and 22 restrictions outlined in the RFC since July 20, 2013. T 435. 23 (C) Hearing Testimony 24 25 Plaintiff's Testimony 26 Plaintiff testified that on the date of the hearing he was sixty-two years old. T 46. 27 Plaintiff left his last position as a driver/detailer because his back and other impairments 28 Page 4 3 1 were hurting too much, from going in and out of the cars. T 48. Plaintiff testified that he 2 doesn't believe he can work due to COPD, arthritis in his legs, back pain, and becoming 3 4 dizzy for no reason at all. T 49. Every couple of days, Plaintiff will experience a dizzy 5 spell, often resulting in him falling over. T 49. Plaintiff testified that he uses his inhalers 6 more than prescribed because he cannot breathe a lot of the time. T 52. Plaintiff will 7 8 wake up in the middle of the night unable to breath. T 52. Plaintiff has cut back to three 9 cigarettes a day but has not noticed an improvement in his breathing or dizziness. T 52. 10 Plaintiff makes sure to not miss his medications. T 52. Plaintiff's medications are paid 11 for by Arizona Health Care Cost Containment System (AHCCCS). T 53. He does not 12 13 receive any cash assistance. T 53. He receives sixty dollars a month in food stamps. T 14 53. 15 Plaintiff testified that he spends most of his time watching TV, spending time with 16 17 his grandkids, or doing yardwork. T 54. Plaintiff is lucky to get an hour of house and 18 yard work done in a day. T 54. Plaintiff will babysit his grandkids, nine and five. T 55. 19 He would not be able to lift or carry them. T 55. 20 21 Plaintiff testified that if there were a job available where he could just do the 22 driving portion of the past driver/detailer job, he would not be able to due to his back, 23 legs, and breathing. T 56-57. Plaintiff testified that, after a while, he just cannot breathe. 24 25 T 57. Plaintiff uses his rescue inhaler seven times a day. T 57. He is supposed to use it 26 three times a day. T 57. Plaintiff has been using the nebulizer twice day. T 57. He is 27 28 Page 5 3 1 supposed to use it once a day. T 57. Plaintiff has been using his nebulizer twice a day 2 for three years. T 57. 3 4 Vocational Expert Testimony 5 The VE testified that an individual with the RFC relied upon in the decision would 6 be able to perform the driver job without the auto detailing (DOT#919.683-014). T 58. 7 8 The VE then testified that an individual with an RFC limiting that individual to 9 lifting/carrying ten pounds occasionally/less than ten pounds frequently, and 10 standing/walking up to two hours out of eight, sitting for at least six, with everything else 11 the same as the first hypothetical, would not be able to perform Plaintiff's past relevant 12 13 work. T 59. 14 IV. ARGUMENT 15 Pursuant to 42 U.S.C. §§ 405(g), 1383(c)(3), this Court may review the record to 16 17 determine whether the Commissioner applied the proper legal standards and whether 18 substantial evidence supports the final agency decision to deny the Plaintiff benefits. 19 Substantial evidence means more than a mere scintilla. "It means such relevant evidence 20 21 as a reasonable mind might accept as adequate to support a conclusion." Richardson v. 22 Perales, 402 U.S. 389, 400 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 23 229 (1938)). 24 25 1. The RFC is not supported by substantial evidence because the ALJ failed to properly evaluate the opinion evidence. 26 27 In determining how much deference to give a physician's medical opinion, the 28 Ninth Circuit distinguishes between the opinions of treating physicians, examining Page 6 3 1 physicians, and non-examining physicians. See Lester v. Chater, 81 F.3d 821, 830 2 (9thCir. 1995). Generally, an ALJ should give the greatest weight to a treating physician's 3 4 opinion and more weight to the opinion of an examining physician than a non-examining 5 physician. See Andrews v. Shalala, 53 F.3d 1040-41 (9thCir. 1995); see also 20 C.F.R. § 6 404.1527(c)(2)-(6) (listing factors to be considered when evaluating opinion evidence, 7 8 including length of examining or treating relationship, frequency of examination, 9 consistency with the record, and support from objective evidence). 10 If a treating or examining physician's medical opinion is not contradicted by 11 another doctor, the opinion can be rejected only for clear and convincing reasons. See 12 13 Lester, 81 F.3d at 830 (citation omitted). Under this standard, the ALJ may reject a 14 treating or examining physician's opinion if it is "conclusory, brief, and unsupported by 15 the record as a whole[ ] or by objective medical findings," Batson v. Commissioner, 359 16 17 F.3d 1190, 1195 (9thCir. 2004), or if there are significant discrepancies between the 18 physician's opinion and her clinical records, see Bayliss v. Barnhart, 427 F.3d 1211, 1216 19 (9thCir. 2005). 20 21 When a treating or examining physician's opinion is contradicted by another 22 doctor, it can be rejected "for specific and legitimate reasons that are supported by 23 substantial evidence in the record." Lester, 81 F.3d at 830-31 (citation omitted). To 24 25 satisfy this requirement, the ALJ must set out "a detailed and thorough summary of the 26 facts and conflicting clinical evidence, stating his interpretation thereof, and making 27 findings." Cotton v. Bowen, 799 F.2d 1403, 1408 (9th Cir. 1986). Under either standard, 28 Page 7 3 1 "[t]he ALJ must do more than offer his conclusions. He must set forth his own 2 interpretations and explain why they, 'rather than the doctors', are correct." Embrey v. 3 4 Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988). 5 Since the opinion by Plaintiff's treating physician is contradicted by other non- 6 treating and non-examining physicians, the specific and legitimate standard applies. 7 8 The ALJ's erroneous analysis begins with a misunderstanding of which of 9 Plaintiff's doctors provided the February 23, 2015 residual functional capacity 10 assessment. T 34, 433. The ALJ credits Dr. Richard Cardone, MD as the source of this 11 opinion. T 34. However, a review of the medical record shows that this opinion was 12 13 provided by Dr. Nabila Aslam through Dadiki Sherpa, PA. T 577-79, 580-81. On 14 February 9, 2015, Ms. Sherpa explained to Plaintiff that the paperwork would be 15 completed in two weeks, at his next appointment. T 581. On February 23, 2015, the date 16 17 of the RFC, treatment notes state 18 [Plaintiff] is requesting a disability paperwork filled for his COPD. I 19 explained to patient that he most likely would not qualify for the disability because [his] COPD symptom is only on exertion, he could work which 20 requires sitting as he does not have any problem sitting for 7-8 hours, in 21 fact he tells me that he [can sit down] for 7-8 hours without any issues. I have filled the paperwork with Dr. Aslam, but [re-explained] to patient that 22 most likely he would not qualify for disability. Patient was examined and 23 evaluated with Dr. Aslam, dictation done by []Dadiki. 24 T 577. It is clear that the opinion was not provided by Dr. Cardone, a physician with 25 little contact with Plaintiff other than an April 18, 2014 colonoscopy, and an examination 26 27 prior to that colonoscopy. T 438-440. 28 Because of this error, the ALJ's analysis of the opinion evidence is flawed. Two Page 8 3 1 reasons provided by the ALJ for assigning no weight to Dr. Aslam's (Cardone) opinion 2 are directly related to Dr. Cardone's treating relationship with Plaintiff. T 35. The ALJ 3 4 discounts Dr. Aslam's (Cardone) opinion because inter alia "Dr. Cardone provided this 5 assessment on February 23, 2015. Dr. Cardone last physically examined Plaintiff on 6 April 18, 2014. Additionally, the last physical examination Dr. Cardone administered in 7 8 2014 showed normal findings. In addition, claimant alleged no complaints during this 9 examination." T 35. The consideration of the opinion would be different if the ALJ had 10 evaluated the opinion as if it belonged to the doctor who provided it. Since the ALJ 11 analyzed the opinion as if it belonged to Dr. Cardone, the analysis of the opinion 12 13 evidence is flawed and this case must be remanded for proper consideration of the 14 opinion evidence. Plaintiff's treating relationship with Dr. Aslam is significant. 15 Regarding the other reasons why the ALJ discounts the opinion of Plaintiff's 16 17 treating physician, the opinion is supported by Dr. Aslam's treatment notes, the medical 18 record as a whole, and indicates which parts were "per patient." Dr. Aslam has been 19 treating Plaintiff since at least June 4, 2013. T 252. At that time, Plaintiff was 20 21 hospitalized due to an exacerbation of COPD. T 253. Plaintiff had been experiencing 22 shortness of breath, weakness, coughing, and chest pain. T 252, 304. A right lower lung 23 mass was found. T 256. Biopsy revealed the mass to be benign. T 233. Since that time, 24 25 Plaintiff sought treatment at Western Mountain Medical Center, where he was seen by 26 Dr. Aslam, Ms. Padiki, or a colleague of Dr. Aslam, Dr. Ernesto Sequeira Abarca, MD. 27 Further, Dr. Aslam received copies of treatment notes produced by Dr. Anees Arshad, 28 Page 9 3 1 MD, FCCP of Western Arizona Pulmonary Associates. T 387, 389, 499, 501, 504. 2 Treatment records regularly showed that Plaintiff complained of shortness of breath with 3 4 and without exertion. T 388, 393, 397, 411, 445, 461, 500, 516, 524, 527, 530, 533, 536, 5 539, 560, 563, 567, 570, 575, 577. In addition, Plaintiff has been counseled to take his 6 time getting up from a sitting position, due to dizziness when he stands up. T 417. On 7 8 August 8, 2013, spirometry testing revealed mild emphysema with air trapping and 9 hyperinflation that showed response to bronchodilator and a severe reduction in diffusion 10 capacity. T 518. Plaintiff treats his COPD with Albuterol-Ipratropium Bromide and 11 Symbicort inhalants. T 562. Plaintiff testified that he uses his rescue inhaler up to seven 12 13 times a day and his nebulizer twice a day. T 57. 14 Dr. Aslam opined that Plaintiff's shortness of breath occurs upon exertion due to 15 COPD. T 433. Dr. Aslam opined that Plaintiff can sit for eight hours a day and 16 17 stand/walk for one hour a day, depending on exertion. T 433. Depending on exertion, 18 Plaintiff would need to take unscheduled breaks. T 433. Dr. Aslam opined that Plaintiff 19 can perform handling, fingering, and reaching activities fifty-percent of an eight-hour 20 21 work day. T 434. Dr. Aslam opined that Plaintiff would be absent from work once or 22 twice a month. T 434. Dr. Aslam opined that Plaintiff is not a malingerer. T 434. 23 Finally, Dr. Aslam opined that Plaintiff is physically capable of working an eight hours a 24 25 day, five days a week on a sustained basis. T 434. 26 Dr. Aslam's opinion is supported and contradicted by the opinions of the state 27 agency medical consultants and the consultative examiners. The state agency medical 28 Page 10 3 1 consultants, finding Plaintiff's impairments non-severe, did not provide an RFC. T 66- 2 68, 77-79. The consultative examiner, Dr. Efren Cano, DO, did not provide a RFC, 3 4 opining that Plaintiff's conditions would not impose any limitations for twelve 5 continuous months. T 402. Thus, Dr. Aslam's opinion is supported in that all opinion 6 physicians believe that Plaintiff is not disabled, and contradicted in that Dr. Aslam 7 8 provided limitations where the others did not. Had those limitations been adopted, 9 Plaintiff would have been found disabled, since, due to Plaintiff's age, education, and 10 work experience, the question of disability becomes whether or not Plaintiff retains the 11 RFC to perform past relevant work, a question likely not considered by Dr. Cano or Dr. 12 13 Aslam. See 20 C.F.R. Pt. 404, Subpt. P, App. 2, §§ 201.05, 201.12. The proper analysis 14 of Dr. Aslam's opinion is pivotal to Plaintiff's disability claim. 15 The opinions of the state agency medical consultants, given partial weight, 16 17 provided the basis for the ALJ's RFC. T 35. The ALJ wrote "[s]pecifically, the above 18 residual functional capacity is based on the findings of the state medical consultants." T 19 35. However, as noted above, the state agency medical consultants did not provide an 20 21 opinion as to Plaintiff's RFC; their opinion was limited to finding Plaintiff's impairments 22 non-severe. T 66-68, 77-79. Given the error in the ALJ's analysis of Dr. Aslam's 23 opinion, and no mention of Dr. Cano's opinion providing basis, the opinion of a non- 24 25 examining physician cannot by itself constitute substantial evidence that justifies the 26 rejection of the opinion of a treating physician. See Lester 81 F.3d 821, 831. This is 27 especially true when those basis opinions are not opinions at all regarding RFC, but 28 Page 11 3 1 opinions regarding severity of impairments that the ALJ disagreed with. T 31. 2 In conclusion, the ALJ's RFC is not supported by substantial evidence because the 3 4 ALJ committed harmful error in evaluating the opinion evidence. The ALJ failed to 5 properly evaluate the opinion of Dr. Aslam, and specifically based the RFC finding off of 6 the opinions of state agency medical consultants who did not provide an opinion 7 8 regarding RFC. Had Dr. Aslam's opinions, with disregard for the "per patient" 9 limitations, been adopted, Plaintiff would have been found unable to perform past 10 relevant work; a favorable decision would have been issued. This case must be remanded 11 for proper evaluation of the opinion evidence. 12 13 V. CONCLUSION 14 For the foregoing reasons, it is respectfully requested that the final agency 15 decision be vacated and this matter be remanded for further administrative proceedings 16 17 including a de novo ALJ hearing and a new decision. 18 Date: March 5, 2018 Respectfully submitted, 19 /s/ Edward A. Wicklund 20 Edward A. Wicklund Admitted Pro Hac Vice 21 Olinsky Law Group 22 One Park Place 300 South State Street 23 Suite 420 24 Syracuse, NY 13202 NY State Bar No. 2044865 25 Telephone: (315) 701-5780 26 twicklund@windisability.com 27 28 Page 12 3 1 IN THE UNITED STATES DISTRICT COURT DISTRICT OF ARIZONA 2 3 Arthur James Beighley, Jr., 4 Plaintiff, 5 vs. 6 Civil No. CV-17-08203-PCT-SPL 7 Nancy A. Berryhill, Acting Commissioner 8 of Social Security, 9 Defendant. 10 11 12 13 Certificate of Service 14 This is to certify that I have this day served counsel for the Defendant with 15 Plaintiff's Brief by electronically filing the foregoing with the Clerk of the Court by 16 using the CM/ECF system which will send electronic notification of such filing to: 17 Benjamin J. Groebner 18 Special Assistant United States Attorney 19 20 21 This 5th day of March 2018. 22 /s/ Edward A. Wicklund 23 Edward A. Wicklund 24 25 26 27 28 Page 13

RESPONSE BRIEF by Commissioner of Social Security Administration re [12] Brief - Opening.

1 Elizabeth A. Strange First Assistant United States Attorney 2 District of Arizona 3 Benjamin J. Groebner 4 Special Assistant United States Attorney 5 Office of the General Counsel Social Security Administration 6 701 Fifth Avenue, Suite 2900 M/S 221A 7 Seattle, WA 98104-7075 State Bar No. WA36808 8 Fax: (206) 615-2531 benjamin.groebner@ssa.gov 9 Telephone: (206) 615-2494 10 Of Attorneys for the Defendant 11 IN THE UNITED STATES DISTRICT COURT 12 DISTRICT OF ARIZONA 13 Arthur James Beighley, Jr., No. CV- CV-17-08203-PCT-SPL 14 15 Plaintiff, 16 DEFENDANT'S BRIEF vs. 17 Nancy A. Berryhill, 18 Deputy Commissioner for Operations, 19 Performing the duties and functions not reserved to the Commissioner of 20 Social Security, 21 Defendant. 22 23 DISPUTED ISSUE 24 Plaintiff, Arthur Beighley, Jr. (Beighley), appealed the final decision from the 25 Social Security Administration (agency) finding him not disabled. In his opening brief, 26 he raised a single issue––whether the ALJ properly considered a Residual Functional 27 28 Capacity Questionnaire. Dkt. #12 at pp. 1-13. The Defendant disputes Beighley's 1 assignments of error with respect to this piece of evidence, and any error that occurred 2 was invited. Therefore, the Court should affirm the agency's decision. 3 ARGUMENT 4 5 I. The ALJ reasonably considered the Residual Functional Capacity Questionnaire. 6 On April 27, 2015, Beighley's representative sent the agency a Residual 7 Functional Capacity Questionnaire (Tr. 432-35). The transmittal letter stated the 8 questionnaire was from "Richard Cardone" (Tr. 432), one of Beighley's treating doctors 9 10 (see Tr. 404). Thus, when the ALJ discussed the questionnaire, the ALJ attributed the 11 opinion to Dr. Cardone (Tr. 34-35). 12 Beighley now argues that the ALJ erred by attributing this questionnaire to Dr. 13 14 Cardone because it was actually completed by Nabila Aslam, M.D. Dkt. #12 at p. 8 15 (stating, "[A] review of the medical record shows that this opinion was provided by Dr. 16 Nabila Aslam through Dadiki Sherpa, PA" and "[i]t is clear that the opinion was not 17 18 provided by Dr. Cardone"). However, when it comes to interpreting the evidence, the 19 Court should not second-guess the ALJ's interpretation when it is reasonable and 20 supported by substantial evidence. Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 21 2001). Here, Beighley advances a theory as to why the evidence suggests that Dr. Aslam 22 23 completed this form, Dkt. #12 at pp. 8-9, but the transmittal letter from Beighley's 24 representative stated that the questionnaire came from Dr. Cardone (Tr. 432). Thus, the 25 ALJ's interpretation was reasonable. 26 27 Even if the ALJ had erred in attributing this questionnaire to Dr. Cardone, 28 Beighley's argument should be barred under the doctrine of invited error. The "invited 2 1 error doctrine holds that 'one may not complain on review of errors below for which he is 2 responsible[.]'" Sovak v. Chugai Pharmaceutical Co., 280 F.3d 1266, 1270 (9th Cir. 3 2002) (quoting Deland v. Old Republic Life Ins. Co., 758 F.2d 1331, 1336-37 (9th Cir. 4 5 1985)); see also Johnson v. INS, 971 F.2d 340, 343-44 (9th Cir. 1992) (applying invited 6 error doctrine in context of review of administrative decision). Here, Beighley's 7 representative submitted this questionnaire to the agency with a transmittal letter stating 8 the questionnaire came from "Richard Cardone" (Tr. 432), and the questionnaire was not 9 10 clearly attributable to another doctor (see Tr. 434-35 (see illegible signatures)) as 11 Beighley now contends. If, as Beighley now suggests, the opinion was not authored by 12 Dr. Cardone, Beighley misled the ALJ into believing that it was, inviting the ALJ's 13 14 alleged error. Thus, the Court should reject Beighley's argument that the ALJ erred. 15 Furthermore, regardless of who completed this questionnaire, the ALJ provided 16 several valid reasons for giving it no weight (Tr. 34-35). The questionnaire suggested 17 18 that Beighley had significant physical limitations stemming from his chronic obstructive 19 pulmonary disease (COPD) (Tr. 433-35). This assessment was at odds with the opinions 20 of Efren Cano, D.O., an examining doctor, and the state agency medical consultants, all 21 of whom concluded that Beighley's COPD caused no work-related limitations (Tr. 397- 22 23 402, 67-68, 77-79). 24 The ALJ is responsible for resolving these types of conflicts in the medical 25 opinion evidence. Batson v. Comm'r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 26 27 2004). Where the ALJ decides to discount the contradicted opinion of treating or 28 examining physician, the ALJ must give "specific and legitimate" reasons supported by 3 1 "substantial evidence." Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005). Here, 2 the ALJ gave no weight to this questionnaire for several reasons that satisfied that 3 standard. 4 5 First, the ALJ discounted this questionnaire because it was "significantly 6 incongruent and contradicted by the available evidence" (Tr. 35). A medical opinion's 7 consistency with the rest of the record is a proper factor to consider when evaluating what 8 weight to give the opinion. 20 C.F.R. § 416.927(c)(4). Here, tests showed that Beighley 9 10 had relatively normal pulmonary function and was relatively unimpaired physically (Tr. 11 386, 392, 395, 396, 401, 486, 488, 490, 492, 494, 496, 498, 501, 516, 550). Additionally, 12 he frequently denied fatigue, acute pain, and shortness of breath (Tr. 355, 369, 376, 388, 13 14 398, 415, 417, 420, 461, 471, 480, 523, 529, 536, 544, 567, 570, 585). Thus, the ALJ 15 reasonably concluded that the record undermined this opinion. 16 Second, the ALJ reasonably concluded that the opinion "relied too heavily on the 17 18 subjective complaints of the claimant" (Tr. 35). An ALJ may discount the opinion of a 19 medical source whose conclusions are based largely on the subjective complaints of a 20 claimant who has been found to lack credibility. Tonapetyan v. Halter, 242 F.3d 1144, 21 1149 (9th Cir. 2001). Here, the ALJ reasonably concluded that this questionnaire 22 23 reflected Beighley's reported limitations. Next to assessments of how long Beighley 24 could walk and how much he could lift, it appears the doctor wrote "per [patient]" and 25 nowhere did the doctor explain what clinical findings, if any, supported these opinions 26 27 (Tr. 433-34). 28 Third, the ALJ noted that this form was competed on February 23, 2015, and the 4 1 opinions contained therein were inconsistent with Dr. Cardone's last physical 2 examination, which was completed almost a year earlier (Tr. 35). An ALJ may discount 3 a medical opinion, especially when presented on a questionnaire, when the opinion is 4 5 inconsistent with the medical provider's own treatment notes. Tommasetti v. Astrue, 533 6 F.3d 1035, 1041 (9th Cir. 2008) ("The incongruity between Dr. Nachenberg's 7 Questionnaire responses and her medical records provides an additional specific and 8 legitimate reason for rejecting Dr. Nachenberg's opinion of Tommasetti's limitations."). 9 10 In this case, Dr. Cardone performed a colonoscopy in April 2014 and the pre- 11 colonoscopy physical examination, conducted in March 2014, showed normal findings 12 and Beighley had no complaints (Tr. 405-07). In another physical examination on 13 14 December 15, 2014, Beighley was in no distress and denied acute palpitations, fatigue, or 15 shortness of breath during the examination (Tr. 547). He did not have any wheezing, 16 bronchi, or crepitation (Tr. 547). These findings are inconsistent with the significant 17 18 COPD-related limitations assessed on the questionnaire and the inconsistency supported 19 the ALJ's decision to give the questionnaire no weight. 20 Beighley argues that contrary to the ALJ's interpretation of the record, various 21 records supported this questionnaire. Dkt. #12 at pp. 9-10. As is often the case, the 22 23 record may leave room for alternative interpretations. However, presenting an alternative 24 interpretation of the evidence is not a sufficient reason to find the ALJ erred. Batson, 359 25 F.3d at 1193; Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). The "key question is 26 27 not whether there is substantial evidence that could support a finding of disability, but 28 whether there is substantial evidence to support the Commissioner's actual finding that 5 1 claimant is not disabled." Jamerson v. Chater, 112 F.3d 1064, 1067 (9th Cir. 1997). 2 Substantial evidence supported the ALJ's conclusion that this opinion was inconsistent 3 with the bulk of the medical evidence and therefore warranted no weight. The fact that 4 5 the record contained some evidence that may have supported this opinion does not show 6 that the ALJ's interpretation was unreasonable. Thus, Beighley has not shown error. 7 Finally, Beighley argues that the ALJ erred by relying on the opinions of the state 8 agency medical consultants who did not provide an opinion regarding the residual 9 10 functional capacity. Dkt. #12 at pp. 11-12. However, the ALJ did not rely solely on 11 these doctors' opinions (Tr. 35). The ALJ also "afforded the claimant's subjective 12 complaints some persuasiveness when formulating the residual functional capacity" (Tr. 13 14 35). Accordingly, the ALJ limited Beighley to lifting and carrying a maximum of 20 15 pounds occasionally and ten pounds frequently; standing and/or walking six hours out of 16 eight; sitting six hours out of eight; occasionally climbing stairs and/or ramps; never 17 18 climbing ladders, ropes, or scaffolds, occasionally stooping, kneeling, crouching, and 19 crawling; and avoiding concentrated exposure to fumes, odors, dusts, gases, and 20 unprotected heights (Tr. 35). In assessing a claimant's residual functional capacity, the 21 ALJ must consider the whole record and weigh the medical and testimonial evidence. 22 23 Social Security Ruling 96-8p, available at 1996 WL 374184, at *1. Here, the ALJ did 24 just that. Beighley's argument provides no basis for reversal of the ALJ's decision. 25 CONCLUSION 26 27 The Court should affirm the Commissioner's final decision that Beighley was not 28 disabled. 42 U.S.C. § 405(g). 6 1 DATED this 27th day of March 2018. 2 Respectfully submitted, 3 ELIZABETH A. STRANGE 4 First Assistant United States Attorney 5 District of Arizona 6 s/ Benjamin J. Groebner BENJAMIN J. GROEBNER 7 Special Assistant United States Attorney 8 9 Of Counsel for the Defendant: 10 MATHEW W. PILE 11 Acting Regional Chief Counsel, Social Security Administration 12 Office of the General Counsel, Region X 701 Fifth Avenue, Suite 2900 M/S 221A 13 Seattle, WA 98104-7075 14 15 16 17 18 CERTIFICATE OF SERVICE 19 I hereby certify that the foregoing DEFENDANT'S BRIEF was filed with 20 the Clerk of the Court on March 27, 2018, using the CM/ECF system, which will 21 22 send notification of such filing to the following: Edward A Wicklund. 23 24 s/ Benjamin J. Groebner BENJAMIN J. GROEBNER 25 Special Assistant U.S. Attorney 26 Office of the General Counsel 27 28 7

REPLY BRIEF by Arthur James Beighley, Jr re [13] Brief - Response.

1 Edward A. Wicklund 2 Attorney for Plaintiff Admitted Pro Hac Vice 3 One Park Place 4 300 South State St., Suite 420 5 Syracuse, New York 13202 Phone: (315) 701-5780 6 Facsimile: (315) 701-5781 7 Email: twicklund@windisability.com 8 IN THE UNITED STATES DISTRICT COURT 9 DISTRICT OF ARIZONA 10 Arthur James Beighley, Jr., No. 3:17-cv-08203-PCT-SPL 11 12 Plaintiff, PLAINTIFF'S REPLY BRIEF [Dist. Ariz. Local Rule Civil 16.1] 13 vs. 14 15 Nancy A. Berryhill, 16 Acting Commissioner of Social 17 Security, 18 Defendant 19 20 Plaintiff reasserts and relies upon the arguments set forth in his Opening Brief 21 (Dkt. No. 12), and replies to the following particular points raised by Defendant in 22 her Brief (Dkt. No. 13). 23 24 1. The ALJ's interpretation is not rational; Plaintiff's argument is not barred. 25 26 Defendant argues that because the cover sheet prepared by a case manager 27 working for Plaintiff's hearing representative stated that the residual functional 28 Page 1 1 capacity questionnaire was completed by Dr. Cardone, the ALJ's interpretation of 2 the evidence was reasonable and should not be second-guessed, and Plaintiff is 3 4 barred from arguing otherwise under the doctrine of invited error. Dkt. 13 Pages 5 2-3. 6 7 With respect to questions of fact, the role of the Court is to review the record 8 as a whole to determine whether it contains evidence that would allow a reasonable 9 10 mind to accept the conclusions of the ALJ. Richardson v. Perales, 402 U.S. 389, 11 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971). The ALJ is responsible for determining 12 credibility and resolving conflicts in medical testimony, Allen v. Heckler, 749 F.2d 13 14 577, 579 (9th Cir.1984), resolving ambiguities, see Vincent ex. rel. Vincent v. 15 Heckler, 739 F.2d 1393, 1394–95 (9th Cir.1984), and drawing inferences logically 16 17 flowing from the evidence, Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir.1982). 18 Where the evidence is susceptible to more than one rational interpretation in a 19 disability proceeding, the reviewing court may not substitute its judgment or 20 21 interpretation of the record for that of the ALJ. Flaten v. Sec'y of Health & Human 22 Servs., 44 F.3d 1453, 1457 (9th Cir.1995); Key v. Heckler, 754 F.2d 1545, 1549 23 24 (9th Cir.1985). 25 In this case, the only rational interpretation is that the ALJ and hearing 26 27 representative both made a mistake of fact regarding the opinion of Plaintiff's 28 treating physician Dr. Nabila Aslam, MD. Plaintiff advances not so much a theory, Page 2 1 as Defendant contends, but an explanation of truth to replace a prejudicial 2 falsehood. As Plaintiff contends in his brief, the treatment records of Dr. Aslam 3 4 make it clear that the RFC questionnaire was completed by Dr. Aslam. Dkt. 12 5 Pages 8-9. Dr. Cardone's involvement in Plaintiff's treatment, an exam and 6 7 colonoscopy, was approximately ten months prior to the date on the RFC 8 questionnaire. T 405-407. In no way is it rational to conclude that Dr. Cardone 9 10 completed the questionnaire based on a cover-sheet error. 11 Plaintiff's argument is not barred by the invited error doctrine. Defendant 12 has provided no authority indicating that that doctrine would apply in this context. 13 14 And, as noted above and in Plaintiff's brief, Plaintiff provided medical evidence 15 explicitly indicating that Dr. Aslam completed the RFC Questionnaire. Dkt. 12 16 17 Pages 8-9, T 577, 581. 18 The first case cited by Defendant, Sovak v. Chugai Pharmaceutical Co., 280 19 F.3d 1266, 1270 (9th Cir. 2002), concerned a choice of law dispute, with the Court 20 21 ultimately finding that the district court's error was not invited. 22 In the second case, Johnson v. INS, 971 F.2d 340, 343-44 (9th Cir. 1992), 23 24 Johnson's attorney offered an affidavit containing incriminating testimony 25 regarding Johnson's involvement in her boyfriend's drug dealings into evidence to 26 27 support her motion to transfer venue of the deportation hearing to San Diego. 28 Johnson then complained when that evidence was used against her. Id. The Court Page 3 1 stated, "Johnson cannot later be heard to complain that her tactic backfired and that 2 the INS's consideration of this affidavit was error." Id. 3 4 As can be seen, those cases are not analogous to this case; this is not a 5 district court choice of law argument, or a backfiring tactic in an immigration 6 7 proceeding. This is a simple mistake by a case manager on a cover sheet to a 8 medical records submission which the ALJ took for fact, without proper 9 10 consideration of the evidence in the record showing the falsity of the cover sheet. 11 This mistake resulted in harmful error, as it skewed the analysis of treating 12 physician Dr. Aslam's opinion. 13 14 Conclusion 15 Based on the foregoing and Plaintiff's Opening Brief, it is respectfully 16 17 requested that the case be remanded for a de novo hearing and new decision. 18 Respectfully submitted, 19 20 /s/ Edward A. Wicklund Edward A. Wicklund, Esq. 21 Attorney for Plaintiff 22 Olinsky Law Group One Park Place 23 300 South State St., Suite 420 24 Syracuse, New York 13202 25 Phone: (315) 701-5780 Email: twicklund@windisability.com 26 27 28 Page 4 1 2 CERTIFICATE OF SERVICE 3 I hereby certify that on April 11, 2018, I electronically filed Plaintiff's Reply 4 5 Brief with the Clerk of the District Court using the CM/ECF system, which sent 6 notification of such filing to the following: 7 To: Elizabeth A. Strange 8 First Assistant United States Attorney 9 District of Arizona 10 Benjamin J. Groebner 11 Special Assistant United States Attorney 12 Office of the General Counsel Social Security Administration 13 701 Fifth Avenue, Suite 2900 M/S 221A 14 Seattle, WA 98104-7075 State Bar No. WA36808 15 Fax: (206) 615-2531 16 benjamin.groebner@ssa.gov 17 Telephone: (206) 615-2494 /s/ Edward A. Wicklund 18 Edward A Wicklund, Esq. 19 Attorney for Plaintiff 20 21 22 23 24 25 26 27 28 Page 5

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Description
1
10/02/2017
COMPLAINT filed by Arthur James Beighley, Jr. (submitted by Edward Wicklund).
1
Exhibit A
2
Civil Cover Sheet
3
Letter)(SLQ
3 Attachments
2
10/02/2017
APPLICATION for Leave to Proceed In Forma Pauperis by Arthur James Beighley, Jr.
3
10/02/2017
SUMMONS Submitted by Arthur James Beighley, Jr. (submitted by Edward Wicklund).
1
Summons
2
Summons)(SLQ
2 Attachments
4
10/02/2017
This case has been assigned to the Honorable Steven P Logan. All future pleadings or documents should bear the correct case number: CV-17-08203-PCT-SPL. Notice of Availability of Magistrate Judge to Exercise Jurisdiction form attached.
5
10/03/2017
ORDER that the Application 2 is granted. Plaintiff may proceed in forma pauperis without prepayment of costs or fees or the necessity of giving security. IT IS FURTHER ORDERED that Plaintiff shall be responsible for service by waiver or of the summons and complaint. Signed by Judge Steven P. Logan on 10/3/17.
6
10/03/2017
SCHEDULING ORDER (See Order for details). Signed by Judge Steven P Logan on 10/3/17.
7
10/04/2017
Summons Issued as to Commissioner of Social Security Administration, U.S. Attorney and U.S. Attorney General.
1
Summons
2
Summons)(BAS
2 Attachments
10/04/2017
Remark: Pro hac vice motion granted for Edward A Wicklund on behalf of plaintiff. This is a TEXT ENTRY ONLY. There is no PDF document associated with this entry. (Text entry; no document attached.)
8
11/06/2017
SERVICE EXECUTED filed by Arthur James Beighley, Jr: Return of Service re: Summons, Complaint and Scheduling Order upon US Attorney's Office, Office of General Counsel, Attorney General on 11/1/2017.
9
12/29/2017
NOTICE OF ATTORNEY APPEARANCE: Benjamin J. Groebner appearing for Commissioner of Social Security Administration.
10
01/02/2018
ANSWER to [1] Complaint by Commissioner of Social Security Administration.
11
01/02/2018
NOTICE of Filing Certified Copy of Administrative Transcript re: [10] Answer to Complaint filed by Commissioner of Social Security Administration.
1
Certification Page
2
Court Transcript Index
3
Documents Related to Administrative Process Including Transcript of Oral Hearin
4
Payment Documents and Decisions
5
Jurisdictional Documents and Notices
6
Non Disability Related Development
7
Disability Related Development
8
Medical Records Part 1
9
Medical Records Part 2
9 Attachments
12
03/05/2018
OPENING BRIEF by Arthur James Beighley, Jr.
13
03/27/2018
RESPONSE BRIEF by Commissioner of Social Security Administration re [12] Brief - Opening.
14
04/11/2018
REPLY BRIEF by Arthur James Beighley, Jr re [13] Brief - Response.
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