Paul Lule v. SOC, LLC (Board decision, September 16, 2025)

BRB final decision. The Benefits Review Board affirmed the denial of benefits under the Longshore Act as extended by the Defense Base Act. 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

Paul Lule worked as a security guard at a base in Iraq and sought benefits for a claimed work-related psychological condition. The judge found that his testimony and treatment records initially triggered a presumption that the condition was related to his work. The employer rebutted it with a psychologist's opinion, and the judge then weighed the full record. The Board upheld the judge's decision to give limited weight to inconsistencies in Lule's reports and to credit the psychologist's documented evaluation over the treating providers' less explained diagnoses. It affirmed the denial of benefits.

Decision snapshot

• Authority: Work injury presumption under 33 U.S.C. § 920(a).
• Outcome: Denial of benefits affirmed.
• Key point: After rebuttal of the presumption, the judge could weigh conflicting testimony and medical opinions to decide whether a work-related injury was proved.

Full text (DOL BRB public release)

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

BRB No. 24-0126

PAUL LULE
)
)
Claimant-Petitioner
)
)
v. )
)
NOT-PUBLISHED
SOC, LLC
)
)
and
) DATE ISSUED: 09/16/2025
)
CNA INSURANCE COMPANY
)
)
Employer/Carrier-
)
Respondents
)
DECISION and ORDER
Appeal of the Decision and Order Denying Benefits of Stewart F. Alford, Administrative Law Judge, United States Department of Labor.

Andrew Nyombi (KNA Pearl), Silver Spring, Maryland, for Claimant.

Krystal L. Layher and Rebecca R. Sonne (Brown Sims), Houston, Texas, for Employer and its Carrier.

Before: GRESH, Chief Administrative Appeals Judge, ROLFE and JONES, Administrative Appeals Judges.

PER CURIAM:

Claimant appeals Administrative Law Judge (ALJ) Stewart F. Alford’s Decision and Order (D&O) Denying Benefits (2021-LDA-02651) 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). 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 law. 1 33 U.S.C. §921(b)(3); O’Keeffe v. Smith, Hinchman & Grylls Associates, Inc., 380 U.S. 359 (1965).

Claimant alleges he sustained a psychological injury due to his work for Employer at LSA Anaconda in Balad, Iraq. Employer’s Exhibit (EX) 1 at 20-23. He began working for Employer on July 27, 2007, as a security guard, searching and scanning vehicles and their drivers when they attempted to enter the base. Id. Specifically, he testified that during his employment he experienced mortar attacks that caused loud explosions. Id. at 30-39. When the mortar attacks instigated an “incoming” attack alarm, which occurred about twenty times per week, he testified they would “startle” him and cause him to fear for his life. Id. at 30, 37-38, 39, 83-84. He further detailed one occasion when he was approximately twenty meters away from one of the attacks in 2010 and witnessed victims who lost limbs and sustained other serious injuries. Id. at 30. In addition, he described being half of a kilometer away from a suicide bombing, during which he again observed severe injuries including lost limbs. Id. at 39-42. He indicated multiple people were killed during the 2008 and 2010 mortar attacks, as well as the suicide bombing. Id. at 32, 36, 40.

Claimant testified he continued working for Employer despite these incidents because he was inspired by the fact that he had survived and was well-paid. EX 1 at 27, 40-41. However, Claimant ultimately quit his job with Employer when his pay decreased from $600 to $500 per month and his work hours increased. Id. at 28. His last day working for Employer was May 5, 2010. Id. at 27-28. After returning home to Uganda in May 2010, Claimant purchased a small truck and operated a business transporting building and construction materials to construction sites. Id. at 41-42. He ran this business until 2014, when he stopped because of damage to his vehicle and allegedly because of his psychological symptoms. Id. at 43-44.

Claimant testified he experienced a gradual reduction in appetite in 2008, which he attributed to his experiences working for Employer. EX 1 at 54. Regarding other symptoms, he testified he began suffering from nightmares, sleep problems, irritability, social isolation, depression, anxiety, and headaches after leaving Iraq at the end of 2010 and into 2011. Id. at 48, 51, 53, 55-58. He indicated his irritability caused many verbal and physical altercations with his wife, leading to the end of their marriage, and his nightmares typically included visions of blood, body parts, and past traumatic events he

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

the First Circuit because the office of the district director who filed the ALJ’s decision is located in Boston, Massachusetts. 33 U.S.C. §921(c); Global Linguist Solutions, L.L.C. v. Abdelmeged, 913 F.3d 921 (9th Cir. 2019); McDonald v. Aecom Tech. Corp., 45 BRBS 45 (2011).

2 had witnessed in Iraq. Id. at 48-49, 51-52. His depression and anxiety episodes peaked in 2011 but have decreased in frequency over time. Id. at 55-57. From 2011 to 2019, he sought treatment for his alleged symptoms with traditional healers, but there was no change or improvement in his condition. EX 1 at 62-64. The first recorded evidence of psychological treatment is an unsigned treatment note from Butabika Hospital dated September 12, 2019, which includes a depression diagnosis, a plan for psychiatric evaluation and psychotherapy, a prescription for medication, and a list of symptoms such as headache, increased irritability, disturbed sleep, excessive sadness and worries, reduced appetite, and social withdrawal. Claimant’s Exhibit (CX) 1 at 1.

On September 19, 2019, at Butabika Hospital, Claimant visited psychiatrist Dr.
Apio Irene Wengi (Dr. Apio), who diagnosed him with post-traumatic stress disorder (PTSD) and depression due to exposure to warzone conditions and opined he cannot return to work for Employer.2 CX 1 at 2-3, 4 at 1-2; EX 1 at 58. Claimant saw Dr. Apio seven more times from October 17, 2019, through July 9, 2021, and she repeated her PTSD and depression diagnoses based on Claimant’s symptoms of a bad or sad mood, irritability, and headaches.3 CX 1 at 4-10. On July 31, 2021, Dr. Apio stated Claimant had hearing loss from gunshots, explosions, and jet engines, nausea from the smell of blood, and a poor appetite. Id. at 11. She opined that, by 2010, he had experienced insomnia, disturbed sleep, nightmares, irritability, aggressive moods, and social isolation. In addition, she listed other various symptoms such as panic-inducing flashbacks, suicidal thoughts, and problems with memory and concentration. Id. at 12. She diagnosed Claimant with PTSD and depression based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders,

2 The ALJ and the parties refer to “Dr. Wengi” as “Dr. Apio” throughout the D&O

and the parties’ briefs. While the record indicates her last name is “Wengi,” we use “Dr. Apio” for consistency and clarity. See CX 4 at 1-14.
3 Claimant testified that Dr. Apio referred him to “Dr. Florence,” who he saw from

2019 to 2021. EX 1 at 66-67. Specifically, Claimant stated he saw Dr. Florence approximately once a month and that Dr. Florence participated when Dr. Apio conducted some of Claimant’s testing, but she did not conduct any independent testing. Id. at 67. However, there are no treatment notes or reports from Dr. Florence in the record. Additionally, Claimant’s answers to interrogatories indicated he was also seen by Drs. Musuto Bwonya Alex and Tagane Rhona, see EX 16 at 10, 14, but in his deposition, he testified he had not been seen by either of these doctors. EX 1 at 59.

3
Fifth Edition (DSM-5).4 Id. Further, she opined his condition has not changed and he may need to be on medication indefinitely. Id.

In 2021, Claimant also saw Geoffrey Mubangizi, a psychiatric clinical officer (PCO), at Butabika Hospital. CX 4 at 15-26. On October 15, 2021, PCO Geoffrey diagnosed Claimant with depression based on his reported symptoms such as disturbed sleep, nightmares, increased heart rate, headaches, and irritability. CX 1 at 13. Claimant saw PCO Geoffrey eight more times between December 2021 and August 2022 and, based on his reported symptoms and his work in a warzone, PCO Geoffrey changed his diagnosis to “PTSD, Depression.” Id. at 14-23.

At Employer’s request, clinical neuropsychologist Dr. Joshua A. Barras examined Claimant on April 18, 2022, and administered various tests. EXs 7, 9. Based on Claimant’s reported symptoms and experiences, his test results, and his review of medical records, Dr. Barras opined there is no reliable evidence that Claimant has any mental illness or condition causing significant distress or dysfunction, or any interference with his ability to function in any occupation for which he has training and experience. EX 7 at 7-8.

Claimant filed a claim under the Act on August 20, 2020, seeking benefits for his alleged psychological condition. CX 3 at 2; EX 2 at 1. Employer, who first became aware of Claimant’s injury on September 8, 2020, controverted the claim on January 14, 2021. EXs 3-5. The parties agreed to a decision on the record and on December 13, 2023, the ALJ issued his Decision and Order. The ALJ found Claimant established a prima facie case of a compensable injury and invoked the Section 20(a) presumption, 33 U.S.C.
§920(a), based on his testimony and Dr. Apio’s and PCO Geoffrey’s documented diagnoses of PTSD or depression. D&O at 24-25; see CX 1. However, the ALJ determined Employer rebutted the presumption with Dr. Barras’s medical opinion that Claimant does not have any psychological condition causally related to his work. D&O at 26; see EX 7.

4 The DSM-5 Criteria A through H for diagnosing PTSD include exposure to a traumatic event, followed by the presence of specific symptoms in four categories: intrusion (at least one symptom required), avoidance (at least one symptom required), negative alterations in cognition and mood (at least two symptoms required), and arousal and reactivity (at least two symptoms required). These symptoms must be present for at least one month and cause significant distress or impairment in functioning. See American Psychiatric Association (March 2022) Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.), https://doi.org/10.1176/appi.books.9780890425787; see also EX 7 at 5.

4
Considering the evidence as a whole, the ALJ assigned limited weight to Claimant’s self-reporting of his symptoms due to inconsistences in his testimony and the results of the validity testing Dr. Barras performed. D&O at 30. The ALJ was persuaded by Dr. Barras’s qualifications and found his opinion more reasoned and documented than the treatment records of Dr. Apio and PCO Geoffrey, to which he assigned no weight because he found them “sparse,” “conclusory,” inconsistent, and lacking sufficient reasoning and explanations. Id. at 27-30; see CX 1; EX 7. Therefore, he assigned Dr. Barras’s report greater weight, concluded Claimant did not establish he suffered a work-related psychological condition, and denied his claim. Id. at 29-30.

Claimant appeals the ALJ’s denial of benefits for his psychological condition, contending the ALJ erred in finding Dr. Barras’s opinion rebutted the Section 20(a) presumption and in giving it greater weight upon weighing the evidence as a whole. He further asserts the ALJ erred in assigning diminished weight to his testimony and to the opinions of his treating physicians. Employer responds, urging the Board to reject Claimant’s arguments.5

Section 20(a) Rebuttal

When, as in this case, the Section 20(a) presumption is invoked, Rose v. Vectrus Sys. Corp., 56 BRBS 27 (2022) (en banc), appeal dismissed (M.D. Fla. Aug. 24, 2023); see also Rainey v. Director, OWCP, 517 F.3d 632, 634 (2d Cir. 2008), the burden shifts to the employer to produce substantial evidence that is “specific and comprehensive enough” to sever the connection between the claimant’s condition and his employment. Am. Stevedoring Ltd. v. Marinelli, 248 F.3d 54, 65 (2d Cir. 2001); Port Cooper/T. Smith Stevedoring Co. Inc. v. Hunter, 227 F.3d 285, 288 (5th Cir. 2000); see Noble Drilling Co. v. Drake, 795 F.2d 478, 481 (5th Cir. 1986) (substantial evidence is that which a reasonable mind could accept to support a conclusion). A physician’s unequivocal opinion that no relationship exists between the alleged injury and a claimant’s employment is sufficient to rebut the presumption. Suarez v. Serv. Emps. Int’l, Inc., 50 BRBS 33, 36 (2016); Cline v. Huntington Ingalls, Inc., 48 BRBS 5, 6-7 (2013); O’Kelly v. Dep’t of the Army/NAF, 34 BRBS 39, 41-42 (2000); Duhagon v. Metro. Stevedore Co., 31 BRBS 98, 100 (1997), aff’d,

5 As the parties do not challenge the ALJ’s findings on invocation of the Section 20(a) presumption for Claimant’s alleged PTSD, depression or psychological condition, we affirm them. Scalio v. Ceres Marine Terminals, Inc., 41 BRBS 57, 58 (2007); D&O at 25.

5
169 F.3d 615 (9th Cir. 1999); Holmes v. Universal Mar. Serv. Corp., 29 BRBS 18, 20 (1995).

Claimant contends the ALJ erred in finding Dr. Barras’s opinion sufficient to rebut the Section 20(a) presumption because the ALJ disregarded substantial evidence from Claimant that establishes his psychological injury arose out of his work for Employer within a zone of special danger.6 Cl.’s Brief at 20-28. We disagree, as Claimant conflates the standards for rebutting the Section 20(a) presumption and proving there is a work- related injury.

The inquiry at rebuttal concerns “whether the employer submitted evidence that could satisfy a reasonable fact finder that [Claimant’s injury] is not work-related.” Haw. Stevedores, Inc. v. Ogawa, 608 F.3d 642, 651 (9th Cir. 2010). Consequently, the employer’s burden on rebuttal is one of production only. Rainey, 517 F.3d at 637 (“As the Seventh Circuit has helpfully explained, the employer’s burden in rebutting the Section 20(a) presumption is a burden of production, not a burden of persuasion.”); Truczinskas v. Director, OWCP, 699 F.3d 672, 678 (1st Cir. 2012); Rose, 56 BRBS at 35. The weighing of conflicting evidence or of the credibility of evidence “has no proper place in determining whether [employer] met its burden of production.” Ogawa, 608 F.3d at 651. The weight given to Claimant’s supporting evidence does not affect Employer’s burden of production on rebuttal – as the credibility of the evidence is not a consideration at the presumption’s invocation or rebuttal stages of the causation analysis. Ogawa, 608 F.3d at 651; Rose, 56 BRBS at 35. If the employer successfully rebuts the presumption, then the ALJ may resolve the issue of causation based on the evidence as a whole. Rainey, 517 F.3d at 634;

6 We reject Claimant’s suggestion that the ALJ erred in failing to apply “the zone

of special danger” doctrine in this case. Cl.’s Brief at 20-22, 26, 35. Under the Act, an injury generally occurs in the course of employment if it occurs within the time and space boundaries of the employment and during an activity whose purpose is related to the employment. See Battelle Mem’l Inst. v. DiCecca, 792 F.3d 214 (1st Cir. 2015); Palumbo v. Port Houston Terminal, Inc., 18 BRBS 33 (1986); Mulvaney v. Bethlehem Steel Corp., 14 BRBS 593 (1981). However, in cases arising under the DBA, the Supreme Court of the United States has held that the injury may be determined to have occurred within the course of employment even if it did not occur within the time and space boundaries of work, so long as the employment creates a “zone of special danger” out of which the injury arises. O’Leary v. Brown-Pacific-Maxon, Inc., 340 U.S. 504, 507 (1951). In this case, the issue does not concern the time and space boundaries of work but whether Claimant’s injuries were caused by or resulted from his employment. See 33 U.S.C. §902(2). The “zone of special danger” doctrine does not aid Claimant in this inquiry.

6
Marinelli, 248 F.3d at 65; Universal Mar. Corp. v. Moore, 126 F.3d 256, 262 (4th Cir. 1997); Santoro v. Maher Terminals, Inc., 30 BRBS 171, 175 (1996).

Employer relied on Dr. Barras’s conclusion that there is no reliable evidence Claimant has a “mental health condition that is causing significant distress or disfunction...[or] that prevents him from working in any occupation for which he has appropriate training and experience” based on his testing and interview with Claimant. 7 EX 7 at 7. Dr. Barras further opined Claimant’s self-reported symptoms are “not reliable due to the presence of symptom magnification or feigning as indicated by the elevated scores on validity scales in psychological testing.”8 Id. at 5-6. He also opined Claimant “appears to be primarily motivated by secondary gain” and his “lack of motivation” to work would be “overcome when his claim is settled.” Id. at 7. As Dr. Barras’s opinion directly contradicts the Section 20(a) presumption that Claimant has a psychological injury and is the kind of evidence “a reasonable mind might accept as adequate” to support that conclusion, it constitutes substantial evidence that is legally sufficient to rebut the presumption. Rainey, 517 F.3d at 637; Cline, 48 BRBS at 6-7; Suarez, 50 BRBS at 36; O’Kelley, 34 BRBS at 41-42; Duhagon, 31 BRBS at 100; Holmes, 29 BRBS at

20. Consequently, we affirm the ALJ’s determination that Employer rebutted the Section
    20(a) presumption with Dr. Barras’s opinion. D&O at 26.

    7 Dr. Barras administered the Mental Status Exam (MSE), the Clinician -
    Administered PTSD Scale-5 (CAPS-5), the Generalized Anxiety Disorder Questionnaire- 7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), the Pain Disability Index (PDI), the Minnesota Multiphasic Personality Inventory- 2 Restructured Form (MMPI-2-RF); the Modified Somatic Perception Questionnaire (MSPQ); the PTSD Checklist for DSM-5 (PCL-5); and the Inventory of Problems (IOP). EX 7 at 2.
    8 Specifically, on the GAD-7, Claimant’s scores indicated mild anxiety. EX 7 at 6.
    On the PCL-5, Claimant’s score was below the threshold for PTSD requiring treatment. Id. Dr. Barras determined Claimant’s score on the PDI, and Claimant’s rating of himself as moderately disabled, was inconsistent with his self-report of independence during his interview. Id. Additionally, Dr. Barras believed “the substantive clinical scales cannot be interpreted” because Claimant had an invalid profile on the MMPI-2-RF and “markedly elevated” scores on validity scales that assess symptom exaggeration or feigning. Id. at 5. In fact, the IOP results indicated a 78% likelihood that Claimant’s symptoms were feigned. Id. Moreover, Claimant’s score on the MSPQ suggested he is “likely deliberately exaggerating physical symptoms and disability.” Id. at 6.

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    Weighing the Evidence

    Having affirmed the ALJ’s findings on invocation and rebuttal of the Section 20(a)
    

    presumption, we next consider the ALJ’s finding regarding the issue of causation, which the ALJ had to resolve based on the evidence in the record as a whole with Claimant bearing the burden of persuasion by a preponderance of the evidence. Director, OWCP v. Greenwich Collieries, 512 U.S. 267, 271 (1994); Rainey, 517 F.3d at 634; Rose, 56 BRBS at 39; Bolden v. G.A.T.X. Terminals Corp., 30 BRBS 71 (1996); Santoro, 30 BRBS at 174. Preponderance of the evidence is not a quantitative standard; rather, it is a standard which denotes a superiority of weight, requiring that the party having the burden of persuasion prove his position by more convincing evidence than the opposing party’s evidence. Santoro, 30 BRBS at 174-175; see Black’s Law Dictionary (12th ed. 2024); see also Barron’s Law Dictionary (1984).

    Claimant argues the ALJ erred in weighing the evidence as a whole because
    substantial evidence does not support his discrediting of Claimant’s testimony and his weighing of the treatment records. Cl.’s Brief at 17-20, 28-34. He also contends the ALJ erred in assigning Dr. Barras’s opinion greater weight, as it asserts his opinion contained multiple deficiencies. Id. at 32-35. We are not persuaded.

     As a preliminary matter, questions of witness credibility are for the ALJ as the trier-
    

    of-fact. 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. Ne. Marine Terminals, 671 F.2d 697, 700 (2d Cir. 1982); John W. McGrath Corp. v. Hughes, 289 F.2d 403, 405 (2d Cir. 1961); Calbeck v. Strachan Shipping Co., 306 F.2d 693 (5th Cir. 1962), cert. denied, 372 U.S. 954 (1963). The ALJ may accept parts of a witness’s testimony and reject others, Banks v. Chi. Grain Trimmers Ass’n, 390 U.S. 459, 467 (1968); Pimpinella v. Universal Mar. Serv. Inc., 27 BRBS 154, 157 (1993), and he may draw his own inferences and conclusions from the evidence, Compton v. Avondale Indus., Inc., 33 BRBS 174, 176- 177 (1999). If the ALJ’s conclusion upon weighing the evidence is rational and supported by substantial evidence, it must be affirmed. Carswell v. E. Pihl & Sons, 999 F.3d 18, 27 (1st Cir. 2021), cert. denied, 142 S. Ct. 1110 (2022); Mendoza v. Marine Pers. Co., Inc., 46 F.3d 498, 500-501 (5th Cir. 1995). When weighing the evidence as a whole, the ALJ is entitled to evaluate the credibility of all witnesses, weigh the medical evidence, and draw his own inferences and conclusions from the record. Pietrunti v. Director, OWCP, 119 F.3d 1035, 1042 (2d Cir. 1997). The Benefits Review Board may not reweigh the evidence or substitute its opinion for that of the ALJ even if the evidence could support other inferences or conclusions. See Sealand Terminals, Inc. v. Gasparic, 7 F.3d 321, 323 (2d Cir. 1993); Volpe v. Ne. Marine Terminals, 671 F.2d 697, 700 (2d Cir. 1982).

                                           8
    

    Contrary to Claimant’s first assertion, the ALJ acted within his discretion when
    assessing Claimant’s credibility. The ALJ permissibly assigned limited weight to Claimant’s self-reporting of his symptoms due to the inconsistencies in his testimony and the validity testing Dr. Barras administered. D&O at 30. Specifically, the ALJ found Claimant was “conspicuously inconsistent” about various details he provided, such as whether his symptoms commenced in Iraq or after he returned home. Id. at 30 n.14. The ALJ also pointed out that Claimant did not adequately explain the circumstances surrounding the alleged suicide bombing event, nor did he even mention the event to Dr. Barras. Id.; see EX 7 at 2-3. These inconsistencies further informed the limited weight the ALJ assigned to the symptoms Claimant self-reported to Dr. Apio and PCO Geoffrey. D&O at 30 n.14. Considering the broad discretion accorded ALJs in weighing the evidence, Gasparic, 7 F.3d at 323, and as the ALJ’s determination is not “inherently incredible or patently unreasonable,” we affirm the ALJ’s finding that several discrepancies between Claimant’s testimony, self-reporting of his symptoms, and other evidence in the record undermined Claimant’s credibility. Carswell, 999 F.3d at 55; see also Ceres Gulf. Inc. v. Director, OWCP, 683 F.3d 225, 228 (5th Cir. 2012); Cordero v. Triple A Mach. Shop, 580 F.2d 1331, 1335 (9th Cir. 1978).

    As for the medical evidence of record, the ALJ initially discredited the treatment
    records from PCO Geoffrey. D&O at 26-27. The ALJ noted Claimant testified that PCO Geoffrey did not conduct his own testing to diagnose Claimant. D&O at 26; EX 1 at 65. In addition, the ALJ found there is nothing in the record indicating PCO Geoffrey did anything other than list Claimant’s complaints and “accept the prior diagnosis uncritically,” as he did not provide any explanation or reasoning for his methodology, diagnoses, or medical conclusions. D&O at 26; see CX 1 at 13-21. The ALJ also emphasized that PCO Geoffrey’s diagnosis of Claimant changed from only depression to both PTSD and depression without any clarification.9 D&O at 26; see CX 1 at 13-21. For these reasons, the ALJ permissibly found PCO Geoffrey’s treatment notes are “inconsistent, sparse, and conclusory” and assigned them no weight. D&O at 27.

     The ALJ next comparatively weighed the opinions of Drs. Apio and Barras and
    

    initially found Dr. Barras possesses greater qualifications,10 documented experience, and

    9 PCO Geoffrey diagnosed Claimant with depression from October 2021 to January

21. CX 1 at 13-15. He then opined Claimant has both PTSD and depression from March 2022 to June 2022, and in August 2022. Id. at 16-19, 21. His treatment note from July 2022 includes no diagnosis. Id. at 20.
    10 While Dr. Apio is referred to as a “doctor” and “psychiatrist,” the ALJ noted her

master’s degree would not allow her to be qualified as a psychiatrist in the United States.
9 training in diagnosing and treating mental illness than Dr. Apio, despite the latter physician’s advantage of treating Claimant for a longer time.11 D&O at 29-30; CXs 1, 4; EX 7, 9. He also found Dr. Barras’s opinion more reliable than Dr. Apio’s opinion because Dr. Apio’s treatment notes “misdescribe[d] Claimant’s symptoms” and “contained far more contradictions to Claimant’s testimony than Dr. Barras’s evaluation.” Id. at 28-29. For instance, the ALJ noted Dr. Apio stated Claimant has “death wishes,” but Claimant testified he has not had suicidal thoughts. D&O at 28; see CX 1 at 12; EX 1 at 58. The ALJ also noted Dr. Apio mentioned hearing loss, whereas Claimant denied hearing loss during his testimony. Id. Further, the ALJ observed Dr. Apio’s statement in her report that Claimant was “losing hope” and not seeing great improvement contradicted her own treatment record which indicated Claimant reported “great improvement” and had no major complaints. D&O at 28; CX 1 at 8, 12.

As the ALJ highlighted, Dr. Apio also did not explain her reasons for Claimant’s diagnosis beyond invoking the DSM-5 criteria. Instead, she merely identified Claimant’s self-reported symptoms. In comparison, Dr. Barras provided detailed explanations of the DSM-5 criteria and the multiple tests indicating symptom feigning, and the doctor explained why he did not believe Claimant’s subjective reporting of his symptoms.12 Id. The ALJ relied on Dr. Barras’s symptom validity tests and the doctor’s adequate

D&O at 11 n.8 (citing “Psychiatrist, APA Dictionary of Psychology (2018)”); CX 4 at 1- 2.
11 To the extent Claimant is arguing his providers’ opinions are entitled to special

deference by virtue of their status as treating physicians, we reject this argument. Where there are conflicting medical opinions, as in this case, the ALJ is not required to give “special weight” to the treating physician’s opinion. Kkunsa v. Constellis Group/Triple Canopy, Inc., 59 BRBS 1, 4 (2025). Rather, the ALJ must consider all relevant evidence, assess the weight and credibility of each opinion, and explain his rationale in reaching a decision on the evidence. Id. at 4-5.
12 Based on Dr. Barras’s CAPS-5 interview, per the DSM-5 criteria, of the twenty

PTSD symptoms identified in the interview, Claimant endorsed eight and denied twelve. EX 7 at 5. These symptoms included intrusion symptoms like nightmares and unwanted memories of trauma (Criterion B); avoidance behavior and avoiding troubling thoughts (Criterion C); negative alterations in cognition and mood such as difficulty remembering his traumatic experiences in Iraq (Criterion D); and marked alterations in arousal and reactivity including sleep disturbances and irritability (Criterion E). Id.

10 explanation.13 Overall, the ALJ’s observed inconsistencies in Dr. Apio’s report and treatment notes, coupled with her “lack of reasoning” and supporting documentation for her methodology and diagnoses, led him to afford Dr. Apio’s “sparse” and “conclusory” opinion little to no weight. D&O at 27-30. Conversely, based on Dr. Barras’s thorough analysis of Claimant’s background and treatment records, his clinical evaluation, his objective and subjective testing, his extensive interview, his qualifications, and the

13 We reject Claimant’s argument that the ALJ should have afforded less weight to

Dr. Barras’s opinion because the doctor never adjusted his report to consider Claimant’s cultural and linguistic differences. Cl.’s Brief at 33; Cl.’s Closing Brief at 13-15. As the ALJ correctly found, Dr. Barras acknowledged the potential difficulties in cross-cultural testing and addressed these issues through the combined use of many different methodologies to evaluate Claimant. D&O at 16, 30; see EX 7 at 1-2, 7, 9. As Dr. Barras stated, a court-certified translator, Gerald Mutabule, who has experience translating and interpreting psychological tests and is familiar with Claimant’s Ugandan culture, was present. EX 7 at 1. The translator was available to Claimant throughout the evaluation and while completing the psychological questionnaires. Id. As the administered tests were “not standardized or normed on people from Uganda,” Dr. Barras indicated his psychological status was “determined by multiple sources of information.” Id. Claimant has neither explained nor provided any legal or evidentiary support as to how Dr. Barras’s opinion failed to account for linguistic and cultural differences.

11 reasoning behind his determination that Claimant does not have a psychological condition, the ALJ permissibly assigned significant weight to his opinion. Id. at 29-30.

For these reasons, the ALJ concluded Dr. Barras’s opinion carries greater evidentiary weight than Claimant’s testimony and the treatment records from Dr. Apio and PCO Geoffrey. D&O at 30. Because the ALJ’s weighing of the evidence is rational and supported by substantial evidence in the record, Pietrunti, 119 F.3d at 1042; Gasparic, 7 F.3d at 323; Hughes, 289 F.2d at 405; Pisaturo, 49 BRBS at 81, we affirm the ALJ’s finding that Claimant has not established a work-related psychological injury by a preponderance of the evidence. Sistrunk v. Ingalls Shipbuilding, Inc., 35 BRBS 171, 174 (2001); Coffey v. Marine Terminals Corp., 34 BRBS 85, 87 (2000); D&O at 30-31.

Accordingly, we affirm the ALJ’s Decision and Order Denying Benefits.

SO ORDERED.

DANIEL T. GRESH, Chief
Administrative Appeals Judge

JONATHAN ROLFE
Administrative Appeals Judge

MELISSA LIN JONES
Administrative Appeals Judge