Magistrate Judge Johnson rejects strict application of DSM-IV in Defense Base Act psychiatric claim

by Matthew H. Ammerman on March 14th, 2011

The Defense Base Act (DBA) is an extension of the Longshore & Harbor Workers' Compensation Act to private contractors involved in defense or public work contracts outside the U.S. In the Fifth Circuit, appeals of DBA claims from the Benefits Review Board go to the U.S. District Court in which the District Director's office is located. 33 U.S.C. § 921(c) n2 and 42 U.S.C. § 1653(b), n3 as confirmed by AFIA/CIGNA Worldwide v. Felkner, 930 F.2d 1111 (5th Cir. 1991).

This case involved a mechanic who worked for ITT in Kuwait who claims benefits for PTSD and depression. ITT Indus. v. S.K., 2011 U.S. Dist. LEXIS 21721 (S.D. Tex. Mar. 1, 2011). The worker alleged his co-workers called him names such as "terrorist," "Taliban," "al Qaeda," "Hezbollah" on an almost daily basis because of his Arabic heritage. He returned to the United States due to psychiatric complaints.

At trial, the administrative law judge awarded benefits for PTSD and depression. The Board affirmed and held that the DSM-IV should not be strictly applied to determine whether benefits should be awarded for a psychiatric condition. Judge Johnson agreed with the premise that a medical text should not control legal determinations based on Fifth Circuit case law:

"[strict application of the DSM-IV would] ... surrender to mental health experts the ultimate responsibility of adjudicating" that determination "and just as improperly would take that decision away from the court." United States v. Long, 562 F.3d 325, 332-33 (5th Cir. 2009).

Judge Johnson held that the criteria of the DSM-IV need not be established or even discussed by the ALJ in every instance. However, she rejected the worker's claim for medical benefits based on PTSD. Dr. Salameh relied on the DSM-IV in reaching his diagnosis even though Claimant did not meet all the criteria for PTSD. Consequently, the doctor's diagnosis was internally inconsistent and unreliable for that reason. Judge Johnson affirmed, however, the award of benefits for depression because it was supported by substantial medical evidence. ITT Indus. v. S.K., 2011 U.S. Dist. LEXIS 21721, 37-38 (S.D. Tex. Mar. 1, 2011).


Posted in LHWCA: Evidence; Psychiatric Claims    Tagged with no tags

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