Moses Musisi v. SOC, LLC (Board decision, September 25, 2025)

BRB final decision. The Benefits Review Board affirmed the administrative law judge's denial of Defense Base Act benefits for a claimed work-related psychological condition. 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

Moses Musisi sought benefits for psychological symptoms he attributed to security work in Iraq. A labor judge found that Musisi invoked the work injury presumption, but that the employer's psychologist rebutted it with an opinion finding no reliable evidence of a work-related condition. After weighing the full record, the judge gave that opinion more weight than Musisi's testimony and treatment records. The Board held that the judge adequately explained the inconsistencies he found in Musisi's reported history and the reasons he assigned less weight to the treating providers' reports. It affirmed the finding that Musisi had not established a compensable work-related psychological injury and upheld the benefits denial.

Decision snapshot

• Authority: Work injury presumption under 33 U.S.C. § 920(a); Board review under § 921(b)(3).
• Outcome: Denial of Defense Base Act benefits affirmed.
• Key point: The judge's supported assessment of competing psychological evidence controlled after rebuttal of the work injury presumption.

Full text (DOL BRB public release)

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

BRB No. 24-0153

MOSES MUSISI
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Claimant-Petitioner
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v. )
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NOT-PUBLISHED
SOC, LLC
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)
and
) DATE ISSUED: 09/25/2025
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CONTINENTAL INSURANCE COMPANY
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)
Employer/Carrier-
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Respondents
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DECISION and ORDER
Appeal of the Decision and Order of Tracy A. Daly, Administrative Law Judge, United States Department of Labor.

Moses Musisi, Nakasaja Village, Uganda.

Lauren E. Wilson and Anutida L. Srilamsingha (Brown Sims), Houston, Texas, for Employer and its Carrier.

Before: GRESH, Chief Administrative Appeals Judge, JONES, Administrative Appeals Judge, and ULMER, Acting Administrative Appeals Judge.

PER CURIAM:
Claimant, without representation,1 appeals Administrative Law Judge (ALJ) Tracy A. Daly’s Decision and Order (2020-LDA-02197) 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). On appeal, Claimant generally challenges the ALJ’s denial of benefits; therefore, the Benefits Review Board will review the findings adverse to him and address whether substantial evidence supports the ALJ’s Decision and Order (D&O). See Pierce v. Elec. Boat Corp., 54 BRBS 27 (2020). We must affirm the ALJ’s decision if it is rational, supported by substantial evidence, and in accordance with applicable law.2 33 U.S.C. §921(b)(3); O’Keeffe v. Smith, Hinchman & Grylls Assocs., Inc., 380 U.S. 359 (1965).

Claimant alleges he sustained a work-related psychological injury due to his work for Employer as a security guard in Iraq. Joint Hearing Exhibits (HX) 11 at 31-32, 37, 57,

59. He began working for Employer on April 11, 2006, at Camp TQ, and thereafter worked
    at Camps Isecan, Scania, Summeral, and VBC. Id. at 25-26. His testimony described continuous exposure to gunfire, bombs, sniper, rocket and mortar attacks, as well as improvised explosive device (IED) detonations during the course of this employment. Id. at 33-34, 37, 59. When the mortar attacks instigated an “incoming” alarm, he would run to a bunker for safety. Id. He also detailed fearing for his life and taking cover from an attack while at a dining facility, which he claims caused two vehicles approximately 100 meters away to explode and catch fire. Id. at 33-35. Also, in 2008, while working in a guard tower at Camp Isecan, Claimant said he experienced incoming gunfire and witnessed multiple dead bodies, which caused him fear and trauma. Id. Claimant also testified he was shot at in 2009 while working in a bulletproof tower, which he felt was the most traumatic event he experienced during his work for Employer. Id. at 34-36. He testified he experienced fear of being injured and killed. Id. at 57.

    Claimant testified he continued working for Employer despite these incidents
    because he needed the money. HX 11 at 30. His last day of work for Employer was

    1 Claimant was represented by counsel throughout the proceedings before the Office

of Administrative Law Judges (OALJ). His attorney, Christopher A. O’Brien of Attorneys Jo Ann Hoffman & Associates, P.A., filed a notice of appeal to the Benefits Review Board on January 26, 2024; however, on March 12, 2024, he informed the Board he was withdrawing his representation.
2 This case arises within the jurisdiction of the United States Court of Appeals for

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

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November 19, 2011, when he was laid off because the camps were closing. HXs 7 at 1, 11 at 29. Claimant asserts he has been unemployed since returning home to Uganda in 2011 because he believed he could not apply for a job and worried about being imprisoned. HX 11 at 46- 47. Currently, he derives income from tenants at eight rental properties he owns. Id. at 11-12, 48.

Claimant stated he first began experiencing psychological and physical symptoms such as anger, memory problems, nightmares, flashbacks, headaches, stress, and body aches in 2008 during his time in Iraq. HX 11 at 30-32. He also detailed that he experiences flashbacks about rockets, IEDs, incoming bombs, gunfire, dead bodies, and the time when he was shot at, all of which led him to believe he needed treatment. Id. at 32, 37. Further, he testified about panic attacks he claims he experienced when he thought about being shot at. Id. at 59.

Claimant sought the help of “witch doctors” and prayers to aid with relief for his symptoms. HX 11 at 37-38. The first recorded evidence of medical psychological treatment he received is on August 27, 2019, when Claimant went to Mubende Regional Referral Hospital and was evaluated by Principal Psychiatric Clinical Officer (“PPCO”) Mwiiwa Ivan Leacky. HXs 8 at 1, 9 at 9-11, 14-16. The symptoms in his treatment note from that appointment included severe headaches, fear, irritability, low mood, lack of sleep, flashbacks, threatening dreams, and impaired vision, hearing, and “sexual issues.” HX 8 at 1. PPCO Mwiiwa diagnosed Claimant with post-traumatic stress disorder (PTSD) and depression due to exposure to warzone traumatic events with Employer, prescribed medications, and recommended he continue psychotherapy. Id. at 1-3. Claimant returned to PPCO Mwiiwa for twelve follow-up visits from September 2019 to March 2022. Id. at 4-8, 12-14. During each follow-up visit, the reported symptoms, diagnoses of PTSD and depression, and medical recommendations remained the same. Id.

On September 13, 2021, Claimant treated with PPCO Musuto Bwonya Alex at China-Uganda Friendship Hospital. HXs 8 at 9-11, 9 at 1-2, 6-8. PPCO Musuto wrote a report indicating Claimant’s symptoms began in 2011 after he returned to Uganda and included sleeplessness, sweating, palpitations, anxiety, anger, nightmares, flashbacks, headaches and impaired hearing. HX 8 at 9-11. In addition, PPCO Musuto diagnosed Claimant with PTSD and depression based on the Beck Depression Inventory (BDI), the Self-Reporting Questionnaire (SRQ), and the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).3 Id. at 11. PPCO Musuto’s

3 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 3 treatment notes stated Claimant should not return to work in a war zone and should continue with medication treatment and psychotherapy. Id.

At Employer’s request, Dr. Rose Dunn, a clinical neuropsychologist, examined Claimant on January 5, 2022, and administered various tests. HX 10. Based on Claimant’s reported symptoms and experiences, his test results, his interview, and his medical records, Dr. Dunn opined there is no reliable evidence that Claimant has a psychological injury related to his work with Employer. She also concluded Claimant does not need medical restrictions or mental health treatment. HX 10 at 7-14.

Claimant filed a claim on March 8, 2020, seeking benefits for his psychological condition. HX 1. Employer, who first became aware of Claimant’s injury on March 6, 2020, controverted the claim on January 28, 2021. HX 3. The case was transferred to the Office of Administrative Law Judges (OALJ) for a telephonic hearing, which was held on November 3, 2022.

On December 22, 2023, the ALJ issued his written Decision and Order, finding Claimant did not establish a psychological or mental condition caused by his work for Employer.4 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), by proffering documentation from PPCOs Musuto and Mwiiwa of PTSD and depression diagnoses along with evidence that his work for Employer in Iraq could have caused his psychological condition. D&O at 14. However, the ALJ determined Employer rebutted the presumption with Dr. Dunn’s medical opinion that Claimant does not have any psychological or mental health condition causally related to his work for Employer. Id. at 15. Considering the evidence as a whole, the ALJ assigned diminished weight to Claimant’s reports of his

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 HX 10 at 7, 9.
4 On August 23, 2023, pursuant to the parties’ request, the ALJ held a video hearing

to inform the parties of his findings after considering the entire stipulated record but before issuing a final written decision and order. Video Verdict Hearing Tr. at 1, 4-5. The ALJ specified that his findings at the video hearing were preliminary and would not become final and enforceable until the district director filed and served his signed written decision. Id. at 12. We will refer to the ALJ’s factual and legal findings contained in his final written Decision and Order issued on December 22, 2023.

4 symptoms, treatment, history of trauma, and personal information because he found they contained several inconsistencies. Id. at 5-6. The ALJ was persuaded by Dr. Dunn’s opinion, which he found more reasoned, documented, consistent, and supported than those of Claimant’s treating providers. Id. at 17-19. Therefore, he assigned Dr. Dunn’s opinion greater weight than Claimant’s evidence, concluded Claimant did not establish he suffered a work-related psychological condition, and denied his claim. Id. at 19.

Claimant, without legal representation, appeals the ALJ’s Decision and Order.
Employer responds, urging the Board to affirm it.

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

The ALJ found Dr. Dunn’s opinion that there is no “reliable or valid” evidence that Claimant has any psychological condition related to his work for Employer sufficiently rebuts the Section 20(a) presumption. D&O at 15; see HX 10 at 9-14. We agree. Dr. Dunn reported that Claimant does not have a psychological condition based on his testing and interview.6 HX 10 at 9-10. She opined there was “converging evidence” from the

5 As the ALJ’s findings on invocationof the Section 20(a) presumption are not challenged, we affirm them. Scalio v. Ceres Marine Terminals, Inc., 41 BRBS 57, 58 (2007); D&O at 14.
6 Dr. Dunn administered the Beck Anxiety Inventory (BAI), the Beck Depression

Inventory (BDI-II), the Clinician-Administered PTSD Scale-5 (CAPS-5), the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), the 5 performance and symptom validity tests that demonstrated Claimant’s behavioral presentation was “non-credible” and “inconsistent” with his self-reported symptoms and their corresponding levels of severity and disability. Id. For example, she referenced Claimant having described “atypical/low base rate” symptoms, such as one-hour-long flashbacks, his expression of other symptoms, such as difficulty communicating, which were inconsistent with his presentation, and his symptom magnification. Based on this evidence, Dr. Dunn concluded there is no reliable evidence to support a medical conclusion that Claimant has a psychological condition, is occupationally impaired, or requires work restrictions. Id. at 10, 12-14. As Dr. Dunn’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’Kelly, 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. Dunn’s opinion. D&O at 15.

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 causation, which the ALJ had to determine 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 [Ondecko], 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 v. Maher Terminals, Inc., 30 BRBS 171, 174 (1996). 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).

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.

Neurobehavioral Symptom Inventory (NSI), the PTSD Checklist for DSM-5 (PCL-5), the Structured Inventory of Malingered Symptomatology (SIMS), the Test of Memory and Malingering (TOMM), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). HX 10 at 7.

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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., 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, 119 F.3d at 1042. The 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 Gasparic, 7 F.3d at 323; Volpe, 671 F.2d at 700.

The record supports the ALJ’s finding that Claimant’s subjective reporting of his symptoms, treatment, and the past events he experienced, contains numerous inconsistencies between his deposition testimony and his reports to his doctors. D&O at 6-7; see Cordero v. Triple A Mach. Shop, 580 F.2d 1331, 1339 (9th Cir. 1978), cert. denied, 440 U.S. 911 (1979). For example, Claimant testified he started experiencing some psychological symptoms in 2008 while still in Iraq. HX 11 at 30-32. PPCO Musuto stated Claimant’s psychological symptoms began approximately two months before he stopped working for Employer. HX 8 at 9. However, Claimant informed Dr. Dunn that his psychological symptoms did not commence until after he returned home. HX-10 at 2-3. Claimant also told Dr. Dunn he attempted suicide on December 12, 2021, HX 10 at 6, but he made no mention of a suicide attempt during his deposition. Further, Claimant stated PPCO Mwiiwa informed him he cannot work at all, but the record instead indicates PPCO Mwiiwa advised Claimant to avoid utilizing any lethal weapon or consuming alcohol. HXs 8 at 3, 11 at 42-42. Additionally, Claimant testified he first sought treatment for his psychological symptoms from “witch doctors” for five years beginning in 2011 and sought prayers to aid with relief for his symptoms in 2018, yet he told Dr. Dunn he sought prayers from 2011 to 2015 and saw “witch doctors” from 2015 to 2018. HXs 10 at 5, 11 at 37-39. Thus, there is sufficient evidence to support the ALJ’s finding that Claimant is not credible.

Regarding the medical evidence, the ALJ permissibly gave minimal weight to Claimant’s treatment records. D&O at 7-9, 17-19. He found PPCOs Musuto and Mwiiwa failed to persuasively establish that they possess sufficient education, training, and expertise in diagnosing mental health conditions based on their status as a “PPCO” or “health professional” rather than as a physician who obtained a doctoral degree. Id. at 7- 8; HX 9. The ALJ found he was unable to determine how they arrived at their diagnoses and conclusions, as their opinions contain a repetitive “laundry-list” of Claimant’s “often inconsistent” and subjective complaints with minimal patient history. D&O at 8-9; HX 8.
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Specifically, the ALJ noted PPCO Mwiiwa’s treatment notes did not contain any diagnostic testing or factors that he had considered in reaching his diagnosis. D&O at 8; HX 8 at 1- 2, 4-8, 12-14. The ALJ acknowledged PPCO Musuto’s written report indicated he administered some tests but found he neither identified the tests, other than abbreviating their names, nor explained or interpreted the results. D&O at 8, 19; HX 8 at 9-11. In addition, the ALJ observed the handwritten signatures contained in the treatment records were illegible and, as it was unclear who authored them, their reliability and authenticity were called into question. D&O at 18; HX 8 at 1, 3, 4-8, 12-14. The ALJ further determined, based on a review of Claimant’s treatment records, that other than on Claimant’s initial August 27, 2019 visit, the authors of his treatment records simply copied the previous report and continued the originally prescribed medications. D&O at 18; see generally HX 8. Finally, the ALJ concluded PPCO Musuto’s report is “perfunctory, conclusory, and not well-reasoned,” and he accorded Claimant’s treatment records little weight. D&O at 19.

As for Dr. Dunn’s medical opinion, the ALJ assigned it considerable weight because “it is supported by specific analysis, observations, testing, and review of the medical records provided.” D&O at 19. The ALJ relied on Dr. Dunn’s observations of inconsistencies between Claimant’s evaluation, his testimony, and his treatment records to support his conclusion that Claimant did not suffer from a psychological condition. Id. at 18; see HX 10 at 9-12. Dr. Dunn observed that Claimant reported most symptoms at a markedly elevated level that would have suggested he was experiencing an acute emotional crisis with intermittent psychotic symptoms, but she ultimately determined his reports of his symptoms were “incongruent” with his behavioral presentation during the evaluation. HX 10 at 9. The ALJ found Dr. Dunn provided a “thorough analysis” and “extensive rationale” of Claimant’s test results and provided an adequate opinion on Claimant’s psychological condition based on a review of his medical records.7 D&O at 10, 17; see generally HX 10. In addition, the ALJ stated Dr. Dunn’s opinion was well-supported by specific details, did not contain internal inconsistencies, and was corroborated by documentary evidence “across multiple sources of information.” Id. Consequently, the

7 Specifically, Claimant reported a severe level of anxiety on the BAI, a severe level

of depression on the BDI-II, and elevated symptoms associated with PTSD on the PCL-5. HX 10 at 8. Nonetheless, Claimant’s standalone performance validity test results fell within the “invalid range.” Id. at 7. On the SIMS test, Claimant’s score was also in the invalid range using both the cutoff noted in the SIMS test’s manual and a more conservative cutoff. Id. at 8. On the MMPI-2-FR, there was evidence of overreporting of a “considerably larger than average number of symptoms rarely described by individuals with genuine severe pathology,” along with “fixed, content-inconsistent True responding,” to the degree that the test results are invalid and cannot be interpreted. Id.

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ALJ concluded Dr. Dunn provided the “most detailed, well-supported, and well-reasoned report” and assigned it “considerable weight.” D&O at 18-19.

For these reasons, the ALJ gave Dr. Dunn’s opinion greater evidentiary weight than Claimant’s testimony and treatment records. D&O at 19. 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 v. Logistec, Inc., 49 BRBS 77, 81 (2015), we affirm the ALJ’s finding that Claimant has not established he has a work-related psychological condition or injury by a preponderance of the evidence and the denial of benefits.8 Sistrunk v. Ingalls Shipbuilding, Inc., 35 BRBS 171, 174 (2001); Coffey v. Marine Terminals Corp., 34 BRBS 85, 87 (2000); D&O at 19.

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

SO ORDERED.

DANIEL T. GRESH, Chief
Administrative Appeals Judge

MELISSA LIN JONES
Administrative Appeals Judge

GLENN E. ULMER
Acting Administrative Appeals Judge

8 Having denied benefits for lack of a compensable injury, the ALJ was not required

to address the other issues in dispute such as timeliness of the notice of injury, timeliness of the claim, the nature and extent of the alleged disability, and Claimant’s average weekly wage. D&O at 2.

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