John Kkunsa v. Constellis Group/Triple Canopy, Inc. (Board decision, February 5, 2025)

BRB final decision. The Benefits Review Board affirmed the administrative law judge's denial of Defense Base Act benefits. Under 20 C.F.R. § 802.406, a Board decision becomes final 60 days after issuance unless a timely petition for judicial review or a timely request for Board reconsideration is filed. A party may request Board reconsideration within 30 days under 20 C.F.R. § 802.407.

Plain-English summary

John Kkunsa sought Defense Base Act benefits for a psychological condition he attributed to his work as an armed security guard in Iraq. The administrative law judge found that Kkunsa had invoked the presumption linking his condition to work, but the employer rebutted it with medical evidence. Weighing the full record, the judge found Kkunsa had not proved a work-related psychological injury and denied benefits. The Board upheld the judge's assessment of conflicting accounts of Kkunsa's claimed memory loss and his decision to give limited weight to the supporting clinical reports. It also upheld the greater weight he gave to Dr. Dunn's explained medical opinion and affirmed the benefits denial.

Decision snapshot

• Authority: Defense Base Act, 42 U.S.C. § 1651; work injury presumption under 33 U.S.C. § 920(a).
• Outcome: Denial of psychological injury benefits affirmed.
• Key point: After rebuttal of the work injury presumption, the judge could weigh the medical evidence and credibility to decide whether the claimed injury was work related.

Full text (DOL BRB public release)

U.S. Department of Labor Benefits Review Board 200 Constitution Ave. NW
Washington, DC 20210-0001

BRB No. 24-0001

JOHN KKUNSA
)
)
Claimant-Petitioner
)
)
v. )
)
PUBLISHED
CONSTELLIS GROUP/TRIPLE CANOPY,
)
INC. )
) DATE ISSUED: 02/05/2025
and
)
)
CONTINENTAL INSURANCE COMPANY
)
)
Employer/Carrier-
)
Respondents
)
DECISION and ORDER

Appeal of Decision and Order Denying Benefits of Jerry R. DeMaio, Administrative Law Judge, United States Department of Labor.

Christopher A. O’Brien (Attorneys Jo Ann Hoffman & Associates, P.A.), Lauderdale-By-The-Sea, Florida, for Claimant.

Edwin B. Barnes (Thomas Quinn, L.L.P.), San Francisco, California, for Employer and its Carrier.

Before: BOGGS, BUZZARD, and JONES, Administrative Appeals Judges.

PER CURIAM:

Claimant appeals Administrative Law Judge (ALJ) Jerry R. DeMaio’s Decision and Order Denying Benefits (2020-LDA-02188) rendered on a claim filed pursuant to the Longshore and Harbor Workers’ Compensation Act, as amended, 33 U.S.C. §§901-950 (Act), as extended by the Defense Base Act, 42 U.S.C. §§1651-1655 (DBA).1 We must affirm the ALJ’s findings of fact and conclusions of law if they are rational, supported by substantial evidence, and in accordance with applicable law. 33 U.S.C. §921(b)(3); O’Keeffe v. Smith, Hinchman & Grylls Assocs., Inc., 380 U.S. 359 (1965).

Claimant worked for Employer as an armed security guard in Iraq from approximately March 2008 through April 2009 and June 2009 through August 2010. Joint Exhibit (JX) 16 at 9-11 (Deposition Transcript (Tr.) at 34, 37-39, 41). Claimant testified he experienced two traumatic events while he was employed in Iraq. The first occurred around October or November 2008. Id. at 25 (Tr. at 100). He was working the night shift in a poorly constructed tower when there were multiple explosions from a nearby mortar attack. Id. at 25-26 (Tr. at 99-102). He took cover in the tower but was afraid it would catch fire. Id. at 25-26 (Tr. at 100, 103).

The second traumatic event occurred around August or September 2009. JX 16 at 28 (Tr. at 109). He was supervising Iraqi workers at an entry control point (ECP) in the red zone when an underground explosion occurred about twenty meters away. Id. at 28- 29 (Tr. at 110, 112-113). He testified there was a river behind him, making him feel trapped; he took cover in a nearby bunker, saw helicopters arrive, and was told people died as a result of this incident. Id. at 28-31 (Tr. at 111-112, 115, 119-122).

Claimant testified he began having nightmares near the end of his second tour in Iraq. JX 16 at 17 (Tr. at 65-66). After that, when he returned to his home in Uganda, he claimed he continued experiencing sleep disturbances, including more frequent nightmares, sleep-talking, and sleepwalking. Id. at 16-17 (Tr. at 62-63, 66-67). Claimant testified he also became violent with his partner2 and their child about one month after he returned from Iraq. Id. at 17 (Tr. at 68). His partner subsequently left with their child, at which point Claimant moved in with his brother. Id. at 17-18 (Tr. at 68-70).

Claimant began treating with Psychiatric Clinical Officer Mwiiwa Ivan Leacky (PCO Leacky) on September 17, 2019. Claimant’s Exhibit (CX) 3 at 1-3. Claimant reported experiencing threatening dreams, severe headaches, low mood, fear, irritability,

1 This case arises within the jurisdiction of the United States Court of Appeals for

the Second Circuit because the district director who filed the ALJ’s decision is located in New York. 33 U.S.C. §921(c); McDonald v. Aecom Tech. Corp., 45 BRBS 45 (2011); see also Global Linguist Solutions, L.L.C. v. Abdelmeged, 913 F.3d 921 (9th Cir. 2019).
2 Throughout his testimony and to his providers, Claimant frequently refers to his

former partner as his wife; however, he testified they were never actually married. JX 16 at 3 (Tr. at 14-15).

2 aggressiveness, poor memory, suicidal ideas, lack of sleep, poor vision, hearing problems, and sexual performance issues. Id. at 1. He testified he has no memory of anything from shortly after he returned to Uganda in 2010 until three months into treatment with PCO Leacky in January 2020, a period of approximately nine years. JX 16 at 19, 21-22 (Tr. at 74-76, 81-86). Specifically, he testified he has no memory of becoming violent with his partner or of her leaving with their child; he stated he discovered these events had occurred when PCO Leacky told him. Id. at 18 (Tr. at 71-72). PCO Leacky diagnosed Claimant with post-traumatic stress disorder (PTSD) and depression, recommended outpatient psychotherapy, and prescribed medication. Id. A questionnaire completed the same day noted that Claimant’s “mental illness was caused by the hard life in the war zone.” Id. at 2.

After the September 2019 visit, PCO Leacky next saw Claimant on October 15, 2019, and thereafter treated him approximately every two months, from January 14, 2020, through May 14, 2022. CX 3 at 4-13, 21-25. The reports from each of these visits are similar, noting the same symptoms, some improvement, and recommending continued treatment and medications. Id. Claimant testified he continues to experience nightmares, flashbacks, “getting angry too fast,” impotence, headaches, poor concentration, and suicidal thoughts. JX 16 at 32-34 (Tr. at 127-129, 133). He stated PCO Leacky told him his symptoms are the result of his employment in Iraq. Id. at 22 (Tr. at 87).

On July 20, 2021, PCO Leacky completed a Mental Health Report. CX 3 at 14-20.
He identified Claimant’s symptoms3 and noted they all “preceded working in the war zone of Iraq,” where Claimant reported seeing vehicles with blood on them and experiencing gunshots, bomb blasts, and mortar attacks. Id. at 14. PCO Leacky noted Claimant suffered “no serious injury” while employed in the war zone and had no difficulties with his short- term or long-term memory. Id. at 14, 16. PCO Leacky administered four tests: the Patient Health Questionnaire-9 (PHQ-9), which indicated severe depression; the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), which indicated severe disability; the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM- 5), which indicated PTSD and depression; and the PTSD Checklist for DSM-5 (PCL-5), which also indicated PTSD. Id. at 16-18. PCO Leacky recommended continued psychotherapy. Id. at 19.

3 Claimant’s reported symptoms were threatening dreams, lack of sleep, flashbacks,

low mood, poor memory, intrusive thoughts, fear, social isolation, lack of interest, suicidal ideas, irritability, aggression, violence at times, severe headache, back and neck pain, and impairments to his vision, hearing, and sexual performance. CX 3 at 14.

3
On August 17, 2021, at Employer’s request, neuropsychologist Rose Dunn, Ph.D., evaluated Claimant in Uganda in person with the assistance of an interpreter. Employer’s Exhibits (EXs) 1; 10 at 12 (Tr. at 46). She reviewed Claimant’s medical records, conducted an interview that lasted approximately one-and-a-half to two hours, and administered nine psychological tests.4 EXs 1 at 1-2, 6; 10 at 8 (Tr. at 31). She considered Claimant’s reported nine years of complete memory loss to be “extremely atypical in psychological conditions.” EX 1 at 4. Testing results indicated he was able to comprehend and respond appropriately but consistently suggested over-reporting of symptoms. Id. at 6-8. She concluded there was “no reliable or valid evidence from this evaluation to indicate [Claimant] has a psychological condition related to his employment with [Employer] or otherwise.” Id. at 8; see also EX 10 at 2, 10 (Tr. at 8, 38-39).

On June 27, 2022, Consulting Psychiatrist Nshemerirwe Sylvia (CP Sylvia) evaluated Claimant and issued a report.5 CX 3 at 26-30. She summarized Claimant’s experiences in Iraq and his psychiatric treatment since 2019. Id. at 26, 28. She also administered testing – the PHQ-9, the PCL-5, and the WHODAS – and noted the results indicated mild depressive symptoms, PTSD requiring clinical management, and mild disability, respectively. Id. at 29. CP Sylvia diagnosed Claimant with “PTSD and other psychiatric symptoms . . . that followed working in Iraq.” Id. She noted Claimant had received only “fragmented care” since 2019 and recommended he begin treating with a clinical psychiatrist. Id. at 30.

4 Dr. Dunn administered the following tests: the Beck Anxiety Inventory (BAI); the

Beck Depression Inventory, 2nd Edition (BDI-II); the Clinical Administered PTSD Scale- 5 (CAPS-5); the Minnesota Multiphasic Personality Inventory – 2 Restructured Form (MMPI-2-RF); the Neurobehavioral Symptom Inventory (NSI); the PCL-5; the Structured Inventory of Malingered Symptomatology (SIMS); the Test of Memory and Malingering (TOMM); and the WHODAS 2.0. EX 1 at 6.
5 CP Sylvia evaluated Claimant one time. It is unclear from the record whether Claimant was referred to her or if he presented to her of his own accord. Likewise, her report does not ask him to return, and it is unclear on what basis she would be considered his “treating” psychiatrist or why she would have greater familiarity with his condition than a non-treating doctor, having evaluated Claimant only once. CX 3 at 30. Claimant’s arguments on appeal do not clarify CP Sylvia’s status, as he includes references to both his “treating physician” (singular) and to his “treating physicians” (plural). Claimant’s Petition for Review and Brief (Cl. Br.) at 2-3, 5, 7-10, 14. We nevertheless assume, for the sake of argument, that Claimant contends CP Sylvia is a treating doctor.

4
On March 6, 2020, Claimant filed a DBA claim for his allegedly work-related psychological injury; Employer controverted the claim. JXs 1, 5. Claimant requested the case be referred to the Office of Administrative Law Judges (OALJ) on May 7, 2020, and the parties agreed to have the claim decided on the record without a formal hearing. JX 3.

The ALJ issued a Decision and Order Denying Benefits (D&O) on August 30, 2023.
He determined Claimant invoked the Section 20(a) presumption, 33 U.S.C. §920(a), relating his condition to his employment, and Employer rebutted the presumption with substantial evidence, namely, Dr. Dunn’s medical report. D&O at 15-16. Without the benefit of the presumption, the ALJ weighed the evidence as a whole and concluded Claimant did not prove by a preponderance of the evidence that he suffered a work-related psychological injury. The ALJ, therefore, denied his claim for benefits. Id. at 16-23.

Claimant appeals. He argues the ALJ improperly weighed the evidence at the final stage of the Section 20(a) analysis by failing to give proper weight to the opinions of his treating physicians, improperly assessing his credibility, and failing to adequately explain the evidentiary and legal bases for his findings in violation of the Administrative Procedure Act (APA), 5 U.S.C. §557(c)(3)(A).6 Claimant’s Petition for Review and Brief (Cl. Br.) at 2. Employer responds, urging affirmance.

Weight Due a Treating Physician’s Opinion

Claimant contends the ALJ improperly failed to give his treating providers’ opinions the “proper” and “presumptively stronger weight,” due to their status as his treating providers and because of their “expertise, experience, and familiarity with Ugandan culture.”7 Cl. Br. at 7, 9. He asserts Dr. Dunn’s report, while “longer” and “more colorful” than his providers’ reports, was based on tests not normed for his population following a single “remote” evaluation, and the ALJ should not have accorded her opinion greater weight than his own providers’ reports. Id. at 8-9. Employer disputes Claimant’s assertion

6 Claimant has not requested review of the ALJ’s findings on invocation or rebuttal

of the Section 20(a) presumption. Therefore, we affirm these findings as unchallenged on appeal. Scalio v. Ceres Marine Terminals, Inc., 41 BRBS 57, 58 (2007).
7 Claimant asserts the ALJ created a higher standard for a foreign national claimant

by requiring the treating physician’s reports to be corroborated before giving them weight. He contends the ALJ should give the treating physician’s reports greater weight at the outset because the doctor’s role is to treat or cure, not to prepare for litigation. Cl. Br. at 8-10.

5 that “presumptive deference” is due a treating physician. Employer’s Brief (Emp. Br.) at 22.

Questions of witness credibility are for the ALJ as the trier-of-fact, and he may draw his own inferences and conclusions from the evidence. Pietrunti v. Director, OWCP, 119 F.3d 1035, 1042 (2d Cir. 1997); Sealand Terminals v. Gasparic, 7 F.3d 321, 323 (2d Cir. 1993); Volpe v. Northeast Marine Terminals, 671 F.2d 697, 700 (2d Cir. 1982); Calbeck v. Strachan Shipping Co., 306 F.2d 693, 695 (5th Cir. 1962), cert. denied, 372 U.S. 954 (1963); John W. McGrath Corp. v. Hughes, 289 F.2d 403, 405 (2d Cir. 1961); Compton v. Avondale Indus., Inc., 33 BRBS 174, 176-177 (1999). This standard applies with equal force to medical evidence – the ALJ is entitled to weigh medical evidence and draw his own inferences from it, and he is not bound to accept the opinion or theory of any particular health care provider. Todd Shipyards Corp. v. Donovan, 300 F.2d 741, 742 (5th Cir. 1962).

Notwithstanding the ALJ’s express authority to weigh medical evidence, courts have held a treating physician’s medical opinion may be given special and deferential weight in certain instances: when there exists no substantial evidence in the record to controvert the treating physician’s opinion or when there are multiple reasonable treatment options and the claimant elects to proceed according to his treating physician’s advice regarding that treatment. Amos v. Director, OWCP, 153 F.3d 1051, 1054 (9th Cir. 1998); Pietrunti, 119 F.3d at 1042-1044.

6
Relying on Pietrunti,8 Amos,9 and Rivera v. Harris, 623 F.2d 212, 216 (2d Cir.
1980),10 Claimant urges the Board to hold his treating physicians’ opinions are entitled to

8 In Pietrunti v. Director, OWCP, 119 F.3d 1035 (2d Cir. 1997), the Second Circuit

held the ALJ’s “reason for dismissing the findings of [the treating psychiatrist] had no substantial evidentiary foundation,” because the record contained “uncontroverted and unanimous evidence” that the claimant suffered a work-related psychological injury. Id. at 1042-1043. Consequently, the court concluded the treating psychiatrist’s opinion “was entitled to great weight, as [the claimant’s] treating physician,” and the ALJ improperly substituted his own medical judgment for the uncontradicted medical evidence. Id.
9 In Amos v. Director, OWCP, 153 F.3d 1051 (9th Cir. 1998), a claimant was presented with conflicting opinions regarding the proper treatment for his work-related shoulder injury. The United States Court of Appeals for the Ninth Circuit held that “neither the employer nor the Secretary [who is authorized to supervise medical care] stands in loco parentis to injured employees.” Id. at 1054. Thus, “when the patient is faced with two or more valid medical alternatives, it is [he], in consultation with his own doctor, who has the right to chart his own destiny.” Id. Although the court stated a treating physician’s opinion is entitled to “special weight,” id., it did not state such opinions are dispositive of all medical issues. Rather, it allowed that a treating physician’s opinion could be “shown by the testimony of the other doctors to be unreasonable” – but under the facts of that case no other physician established the proposed course of treatment was unreasonable, particularly given that the “choice of one reasonable [treatment] option over the other was not [the ALJ’s] to make.” Id. Therefore, where there are conflicting but equally reasonable methods of treatment, the choice of how to proceed belongs to the claimant and his treating physician – not to the ALJ. Id.
10 In Rivera v. Harris, 623 F.2d 212 (2d Cir. 1980), a Social Security disability benefits case, there was no question the claimant suffered from asthma; the question before the Second Circuit was whether her asthmatic condition precluded her from obtaining gainful employment, thereby entitling her to disability benefits under the Social Security Act, 42 U.S.C. §§405(g), 1383(c)(3). The claimant’s physicians were either silent or declined to opine as to the effect of her asthma on her employability. Id. at 214. Conversely, the two physicians who examined the claimant on behalf of the Secretary of Health, Education, and Welfare found her capable of at least sedentary to light duty work. Id. at 214-215. Although noting “the opinions of treating physicians are entitled to considerable weight,” the Second Circuit affirmed the denial of benefits, finding none of the claimant’s treating physicians either “provide[d] clear evidence of the existence of a total disability” or contradicted the Secretary’s experts’ opinions as to the claimant’s ability

7
“presumptively stronger weight” by virtue of their status as “treating” physicians.11 Cl. Br. at 7. We find no error in the ALJ’s declining to do so.

When there are conflicting medical opinions regarding disability or causation, as here, the ALJ is not required to give special weight to a treating physician’s opinion. Carswell v. E. Pihl & Sons, 999 F.3d 18, 31-32 (1st Cir. 2021), cert. denied, 14 S. Ct. 1110 (2022) (reasonable for the ALJ to give greater weight to the employer’s medical expert when the claimant’s treating physician’s opinion, and those of the claimant’s other experts, were vague and conclusory); Sea-Land Services, Inc. v. Director, OWCP [Ceasar], 949 F.3d 921, 925 (5th Cir. 2020) (reasonable for ALJ to give less weight to treating physician when contrary evidence is more consistent with treatment records); Hice v. Director, OWCP, 48 F. Supp. 2d 501 (D. Md. 1999) (reasonable for ALJ to give less weight to treating physician’s opinion which was not supported by facts). 12 Rather, the ALJ must

to work, and therefore there was “no indication that the ALJ did not give full credence to the reports of [the claimant]’s treating physicians.” Id. at 216.
11 Claimant urges the Board to “defer” to the “rule” that treating physicians are entitled to “considerable and special weight” because they have had “a greater opportunity to know and observe the patient as an individual.” Cl. Br. at 7 (citing Amos, Pietrunti, and Rivera).
12 In a case arising under the Black Lung Benefits Act (BLBA), the United States

Court of Appeals for the Fourth Circuit discussed and rejected the claimant’s assertion that her medical expert’s opinion was entitled to greater weight than the contrary opinions of the employer’s experts because he was the decedent’s treating physician. See Grizzle v. Pickands Mather and Co./Chisolm Mines, 994 F.2d 1093 (4th Cir. 1993), abrogated on other grounds by Director, OWCP v. Greenwich Collieries, 512 U.S. 267 (1994). The court stated: “Neither this circuit nor the Benefits Review Board has ever fashioned either a requirement or a presumption that treating or examining physicians’ opinions be given greater weight than opinions of other expert physicians.” Id. at 1097. It explained:

It is, of course, one thing to say that we give great weight to the treating or examining physician’s opinion; it is quite another to say that as a matter of law we give greater weight to such an opinion than to opinions by other physicians. The ALJ therefore was not required to defer to [the doctor’s] diagnoses or to accord them greater weight than the opinions of other physicians. He was fully entitled to credit the contrary opinions….

8 consider all relevant evidence including opinions from non-treating physicians, assess the weight and credibility of each opinion, and explain his rationale before reaching a decision on the evidence as a whole. See Young v. Newport News Shipbuilding, 45 BRBS 35, 38- 39 (2011) (the Board upheld the ALJ’s consideration of a doctor’s treating physician status as one factor to be considered in weighing his medical opinion); Brown v. National Steel & Shipbuilding Co., 34 BRBS 195, 201 n.6 (2001) (the ALJ did not err in crediting the treating physician’s opinion when the doctor’s status as a treating physician was just one reason for doing so and he fully considered all medical evidence of record); Burns v. Director, OWCP, 7 BLR 1-597, 1-600 (1984) (“[A]n ALJ need not mechanically afford a treating physician’s opinion the greatest weight.”). Therefore, we reject Claimant’s argument that his medical experts are automatically entitled to “stronger” weight by virtue of their status as his treating physicians.

This case, unlike Pietrunti, does not contain “uncontroverted and unanimous” evidence on causation, and the ALJ did not substitute his own judgment for that of Claimant’s treating physicians. The record here contains conflicting reports from three providers addressing whether Claimant has a work-related psychological injury, and therefore the ALJ was obligated to review and weigh the evidence. Pietrunti, 119 F.3d at 1042. Thus, the ALJ permissibly refrained from deferring to the opinions of Claimant’s treating physicians. Carswell, 999 F.3d at 31-33.

Weighing the Evidence

If a claimant invokes the Section 20(a) presumption that his injury is work-related, as is the case here, the burden shifts to the employer to produce substantial evidence that the claimant’s condition is not work-related. Rose v. Vectrus Systems Corporation, 56 BRBS 27, 32 (2022) (en banc), appeal dismissed (MDFL Aug. 24, 2023); see also Rainey v. Director, OWCP, 517 F.3d 632, 634 (2d Cir. 2008); American Stevedoring, Ltd. v. Marinelli, 248 F.3d 54, 64 (2d Cir. 2001). Because the ALJ found Employer rebutted the

Id. at 1097-1098 (internal footnote omitted). Although Greenwich Collieries abrogated the entitlement ruling in this decision because it was reached through application of the “true doubt” rule, the “true doubt” rule did not affect the Fourth Circuit’s holding regarding the weight to be given to treating physicians’ opinions. Thus, the court’s differentiation between giving great weight to a treating physician’s opinion and stating such opinions are dispositive of medical issues as a matter of law remains valid. See also Eastover Mining Co. v. Williams, 338 F.3d 501, 513 (6th Cir. 2003) (“[T]he opinions of treating physicians get the deference they deserve based on their power to persuade.”); Kennellis Energies, Inc. v. Hallmark, 333 F.3d 822, 828 (7th Cir. 2003); Lango v. Director, OWCP, 104 F.3d 573, 576-577 (3d Cir. 1997).

9 presumption, and Claimant does not dispute that finding, he is no longer entitled to the presumption. Therefore, the ALJ was required to resolve the issue of causation based on the evidence in the record as a whole with Claimant bearing the burden of persuasion by a preponderance of the evidence. Universal Maritime Corp. v. Moore, 126 F.3d 256, 262 (4th Cir. 1997); Santoro v. Maher Terminals, Inc., 30 BRBS 171, 174 (1996).

Claimant argues the ALJ’s assessment of his credibility is not supported by substantial evidence or adequately explained in accordance with the APA, 5 U.S.C.
§557(c)(3)(A); Cl. Br. at 4-6, 10-12. As analyzed above, questions of witness credibility are for the ALJ as the trier-of-fact. Pietrunti, 119 F.3d at 1042; Gasparic, 7 F.3d at 323; Volpe, 671 F.2d at 700; Calbeck, 306 F.2d at 695; Hughes, 289 F.2d at 405. He may accept parts of a witness’s testimony and reject others, and he may draw his own inferences and conclusions from the evidence. Banks v. Chicago Grain Trimmers Ass’n, 390 U.S. 459, 467 (1968); Compton, 33 BRBS at 176-177; Pimpinella v. Universal Mar. Serv. Inc., 27 BRBS 154, 157 (1993). The Board is not free to re-weigh the evidence or to make credibility determinations and will not interfere with the ALJ’s credibility determinations unless they are “inherently incredible or patently unreasonable.” Cordero v. Triple A Mach. Shop, 580 F.2d 1331, 1335 (9th Cir. 1978), cert. denied, 440 U.S. 911 (1979); see also Gasparic, 7 F.3d at 323.

Specifically, Claimant contends the ALJ inappropriately found he lacks credibility based on minor inconsistencies in his testimony and in his reports to medical providers. Cl. Br. at 4-5. For instance, the ALJ noted Claimant recalled a traumatic event during which five bombs struck the base where he was working, but he told CP Sylvia only three bombs struck the base. Id. at 4; see D&O at 18; JX 16 at 26 (Tr. at 102); CX 3 at 26. The ALJ also indicated Claimant told Dr. Dunn he was hospitalized for three months, but Dr. Dunn stated none of the medical records supported this. Cl. Br. at 5; see D&O at 18; CX 3 at 1; EX 1 at 5. Claimant argues these inconsistencies exhibit only “minimal variance in [his] reporting” and are insufficient to support a finding that he lacks credibility. Cl. Br. at 5.

We disagree as the ALJ provided many more examples from the record to support his credibility finding beyond the two “minor discrepancies” Claimant identifies. For example, the ALJ found Claimant testified to violence against his wife and child, yet CP Sylvia noted he denied aggressive tendencies, and her report made no mention of domestic abuse. D&O at 17-18; see JX 16 at 17-18 (Tr. at 68-70); CX 3 at 27-28. The ALJ also noted CP Sylvia attributed symptoms to Claimant that he did not mention to any other providers, including “preferring to be alone, rudeness and commanding language, and detesting to be told to do something.” D&O at 18; see CX 3 at 27. The ALJ also found that Claimant testified to suicidal thoughts but denied to CP Sylvia that he had ever acted on them, yet PCO Leacky indicated a history of suicide attempts. D&O at 18; see JX 16 10 at 34 (Tr. at 133); CX 3 at 18, 28. The ALJ also considered the results of Dr. Dunn’s psychological testing indicating invalid presentation and “over-endorsement” of symptoms, which he found further reduced Claimant’s credibility. 13 D&O at 18; see EX 1 at 6-9.

Beyond these discrepancies, the ALJ found Claimant was generally “unclear on what he does and does not remember, stating at various times that either he was told something happened, that he remembers it happening, or he has no memory of it happening at all.” D&O at 18 (citing JX 16).14 While Claimant argues this is consistent with his alleged memory loss, the ALJ found Claimant’s alleged amnesia undermined by his own

13 Dr. Dunn explained during her deposition that of the nine tests she administered,

four either function as stand-alone validity testing or include embedded performance and symptom validity testing: the NSI, the MMPI-2-RF, the TOMM, and the SIMS. EX 10 at 4-5, 7-8 (Tr. at 15, 17-18, 20, 26, 29-30). She stated Claimant’s results on these four tests constituted “converging evidence from multiple validity indicators indicating a non- credible presentation and overreporting of symptoms during the evaluation.” Id. at 8 (Tr. at 30).
14 Claimant did not recall how many times he became violent with his family before

they left, and he was told he “did that for around a week.” JX 16 at 18 (Tr. 69). He testified he would “come back to [his] senses” after a violent episode and “regret,” but he did not remember the episode immediately preceding his family leaving him and did not recall moving in with his brother. Id. (Tr. at 70-71). He testified he was unaware for nine years that he had separated from his wife and only learned of the separation after being told by his doctor following three months of treatment. Id. at 18-19, 22 (Tr. at 71-73, 86). He recalled coming home from Uganda, and he remembered a “bit” of becoming violent with his family “when it was just starting;” however, he claimed he had no memories of anything from 2010 through 2019. Id. at 19 (Tr. at 73-76). He did not recall experiencing panic attacks and nightmares while he lived with his brother; he was told about them later. Id. at 20 (Tr. at 78-79). He testified his siblings told him they took him to “traditional healers” and pastors during this time, but he could not recall it at all. Id. (Tr. at 79-80). However, he then testified he could “maybe” remember being told to take local herbs or being tied with ropes and seeing the pastor, but he could not provide any details, including when this occurred and the names of the local healers or pastor. Id. at 20-21 (Tr. at 80-82). He testified during this time he would get “some relief” but then would “switch completely” and not be able to remember anything. Id. at 21 (Tr. at 82-83). He had no personal recollection of his siblings taking him to the hospital or what he told the doctor upon his first evaluation; he testified he only knows what he was told by his siblings. Id. at 21-22 (Tr. at 83-86).

11 self-reporting: Claimant testified PCO Leacky had to tell him his wife had left him, yet PCO Leacky’s reports are clearly based on Claimant’s own reporting. D&O at 18-19; see JX 16 at 18 (Tr. at 71-72); CX 3. The ALJ also found Claimant’s reported nine-year total memory loss at variance with his providers’ records, which made no mention of any long- term amnesia and instead indicated Claimant’s short-term and long-term memory were functioning normally. D&O at 18; see JX 16 at 18-19, 21-22 (Tr. at 69-76, 81-86); CX 3 at 16, 30; EX 10 at 9-10 (Tr. at 35-37).

Thus, contrary to Claimant’s assertions, the ALJ’s finding that Claimant lacked credibility is based on more than two minor variances between his testimony and reporting. Rather, the ALJ provided a well-supported explanation of how the inconsistencies in the record, as related to Claimant’s description of his symptoms and experiences, support his determination that Claimant is not a credible witness. Carswell, 999 F.3d at 27. Consequently, we affirm this finding.

We further hold the ALJ adequately explained and supported his weighing analysis in compliance with the APA, 5 U.S.C. §557(c)(3)(A), which requires that every adjudicatory decision contain “findings and conclusions and the reasons or basis therefor, on all the material issues of fact, law or discretion presented on the record.” See 33 U.S.C.
§919(d). An ALJ, therefore, must adequately detail the rationale behind his decision and specify the law and evidence upon which he relied. Gelinas v. Electric Boat Corp., 45 BRBS 69, 71 (2011); see Ballesteros v. Willamette W. Corp., 20 BRBS 184, 187 (1988).

In addition to Claimant’s testimony, the ALJ weighed the medical opinions of three providers: PCO Leacky, CP Sylvia, and Employer’s expert neuropsychiatrist Dr. Dunn. The ALJ declined to give significant weight to PCO Leacky’s and CP Sylvia’s reports. D&O at 19. He found PCO Leacky’s clinical records documenting Claimant’s treatment were frequently illegible and/or unsigned, contained little to no background information, and lacked specifics regarding Claimant’s treatment or progress. Id. at 19-20; see CX 3 at 1, 4-13, 21-25. Further, he found the clinical notes followed a “basic formula, with a rote list of essentially the same symptoms, offering little insight into the source, extent, or nature of the symptoms, or how they define [Claimant]’s condition.” D&O at 19. The ALJ also found the clinical notes frequently contradicted other record evidence 15 and offered “no

15 For instance, the clinical notes indicated Claimant underwent psychotherapy treatment, yet Claimant never testified to such treatment, it is not documented anywhere else in the record, and CP Sylvia specifically noted Claimant had been unable to meet with a clinical treating psychiatrist. D&O at 20 (citing CX 3 at 1, 4-13, 21-25, 30).

12 real insight into [Claimant’s] alleged psychological injury, its potential causes, and his alleged ongoing treatment,” and he therefore afforded them minimal weight. Id. at 20.

The ALJ likewise afforded no weight to PCO Leacky’s medical questionnaire and minimal weight to his Mental Health Report. D&O at 21-22; see CX 3 at 2-3, 14-18. He found the questionnaire was completed by two different individuals with different handwriting, yet it contained only PCO Leacky’s signature block, a defect he determined “severely calls into question its authenticity as well as its credibility.” 16 D&O at 20; see CX 3 at 2-3. He also found the questionnaire lacked critical information. For instance, it failed to identify any specific traumatic or triggering events, gave no details or insight into Claimant’s mental condition or experiences, and only generally suggested that Claimant undergo treatment to “clear the symptoms of mental illness and promote mental health.” D&O at 20-21; see CX 3 at 2-3.

The ALJ found PCO Leacky’s Mental Health Report, like his clinical notes and the questionnaire, also failed to offer insight into Claimant’s specific symptoms or how he exhibited them and identified a different potentially triggering event than those Claimant described during his testimony.17 D&O at 21; see CX 3 at 14. The ALJ also found PCO Leacky’s Report indicated Claimant presented with no short-term or long-term memory issues, which contradicted Claimant’s testimony that he suffered complete memory loss for a period of nine years. D&O at 21; see CX 3 at 16. Lastly, the ALJ found the psychological testing PCO Leacky administered was based solely on Claimant’s self- reporting of symptoms. D&O at 21; see CX 3 at 16-18; EX 10 at 4 (Tr. at 13-15).

The ALJ likewise afforded minimal weight to CP Sylvia’s report because it lacked context, support, and “any or new insight” into Claimant’s condition and its causes. D&O at 22; see CX 3 at 26-30. The ALJ also found it significant CP Sylvia noted Claimant denied being aggressive or violent, contradicting his testimony that he became violent with his family, and made no mention of Claimant’s alleged significant memory loss. D&O at 22; see CX 3 at 28.

Most importantly, the ALJ noted neither PCO Leacky nor CP Sylvia provided clear statements as to causation. He noted PCO Leacky’s report indicated Claimant’s symptoms

16 Claimant does not challenge this ground for discrediting the medical questionnaire, and we affirm it. Scalio, 41 BRBS at 58.
17 The ALJ noted the Mental Health Report indicated Claimant reported he “could

see vehicles with blood dropping [sic] meaning dead bodies inside, gunshots, bomb blasts, motors [sic] and rockets.” CX 3 at 14. The report did not mention the two specific events Claimant testified about during his deposition.

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“preceded” his time in Iraq, and the questionnaire’s statement that Claimant’s “mental illness” was related to his employment in Iraq was both unsupported and within a document suffering from authenticity issues as it was clearly completed by two different hands. D&O at 20-21; see CX 3 at 2-3, 14. He further noted CP Sylvia’s causation opinion – that Claimant’s PTSD and psychological symptoms “followed working in Iraq” – was temporal in nature and insufficient, without further explanation, to establish a definitive causal connection. D&O at 23; see CX 3 at 29.

Conversely, the ALJ found Dr. Dunn provided a clear, well-reasoned, and supported causation opinion. D&O at 22; see EX 1; EX 10. Her report and testimony made it clear that she spent considerable time interviewing Claimant, reviewed all available records, and conducted significant testing. D&O at 22; see EX 1 at 1, 6-8; EX 10 at 2-8 (Tr. at 8-31). Moreover, the ALJ found Dr. Dunn provided more than merely conclusory results of the testing administered, instead explaining both the results and each test’s significance relevant “to symptomatology, validity, and the[ir] strengths and weaknesses.” D&O at 22; see EX 1 at 6-8; EX 10 at 2-8 (Tr. at 7-31). He concluded the “limited and lacking” reports of PCO Leacky and CP Sylvia could not withstand comparison to Dr. Dunn’s “better- reasoned and documented opinion,” to which he gave great weight. D&O at 22-23.

The ALJ rationally weighed all evidence of record, including all medical opinions, and adequately detailed and explained his findings in compliance with the APA. Gelinas, 45 BRBS at 71; Ballesteros, 20 BRBS at 187. Further, his credibility assessments are neither inherently incredible nor patently unreasonable but are supported by substantial

14 evidence. Gasparic, 7 F.3d at 323; Cordero, 580 F.2d at 1335. Therefore, we affirm his finding, upon weighing the evidence of record, that Claimant failed to carry his burden of proving he suffered a work-related psychological injury within the meaning of the Act.

Accordingly, we affirm the Decision and Order Denying Benefits.

SO ORDERED.

JUDITH S. BOGGS
Administrative Appeals Judge

GREG J. BUZZARD
Administrative Appeals Judge

MELISSA LIN JONES
Administrative Appeals Judge

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