He Came Home From The War Zone Broken. The Insurance Company Said He Was Fine

The TV lawyer on the billboard has never been inside a Defense Base Act courtroom. He does not know what the DBA is. He cannot find the Office of Administrative Law Judges on a map. He signs injury cases, hands them to a secretary, and waits for a check. When a contractor comes home from a war zone with nightmares he cannot shake and years of his own life he cannot remember, that lawyer has nothing to offer. A real case decided by the Benefits Review Board shows you exactly what happens when the insurance company’s one hired doctor goes up against a man who was never in any shape to fight back alone.

In Kkunsa v. Constellis Group/Triple Canopy, Inc., decided by the U.S. Department of Labor Benefits Review Board, a security contractor worked in Iraq, witnessed mortar attacks, felt trapped during an underground explosion that killed people nearby, and came home shattered. He developed nightmares, flashbacks, violent episodes he cannot remember, and what his treating psychiatrist diagnosed as PTSD and depression. He filed a claim under the Longshore and Harbor Workers’ Compensation Act as extended by the Defense Base Act, which covers American contractors injured working overseas in support of U.S. military operations. The employer controverted the claim and sent in their own neuropsychologist.

That one hired doctor changed everything. She flew to Uganda, spent one and a half to two hours with the claimant through an interpreter, ran nine psychological tests, and concluded there was no reliable evidence of any work-related psychological condition. Her testing showed consistent over-reporting of symptoms. She found his claim of nine years of complete memory loss after returning from Iraq to be, in her words, extremely atypical. The ALJ agreed with her. He gave great weight to her well-reasoned, documented opinion and minimal weight to the claimant’s treating doctors, whose reports he found vague, unsupported, and lacking any clear causation statement. Benefits denied. The Board affirmed.

How The DBA Medical Fight Works And Why Most Claimants Lose It

Here is the machinery, because you need to understand it. Under the DBA and the Longshore Act, a claimant gets the benefit of a legal presumption that his condition is work-related once he shows he was hurt and was working. The burden then shifts to the employer to rebut that presumption with substantial evidence. Once the employer puts in a strong enough medical report, the presumption disappears, and the claimant has to prove his case by the preponderance of the evidence on his own. That is where most DBA claimants get buried.

The employer does not need to prove the man is lying. The employer just needs one credible doctor with a thorough, documented opinion. The ALJ then weighs all the medical evidence, and under longshore law he is not required to give the treating doctor’s opinion greater weight just because that doctor treated the man. He can give more weight to the employer’s hired expert if that expert’s report is better reasoned and better documented. In this case the treating doctors wrote short, vague reports that said the symptoms followed Iraq without explaining how or why. The employer’s doctor wrote a detailed report backed by nine specific tests. The ALJ chose the detailed report. That choice is almost never overturned on appeal.

What A DBA Claimant Needs That The TV Lawyer Will Never Build

The lesson in this case is not that the man was lying. He may have been genuinely destroyed by what he saw in Iraq. The lesson is that the legal fight over a DBA psychological injury is a medical paper war, and the side with the better paper wins. A treating doctor who writes a short note saying symptoms followed employment is handing the other side a gift. A claimant who waits years to file, whose treating records contradict pieces of his own testimony, and who has never been guided on how to document the connection between the trauma and the diagnosis is walking into that fight unarmed.

The billboard lawyer who does not know what a DBA claim is will not know how to build the medical proof, will not know how to prepare the treating doctors to write causation opinions that hold up, and will not know how to challenge the employer’s hired expert before the hearing. He will not know any of it. And by the time you find out he does not know, the record is closed and the decision is in.

I am not going to lay out on a public blog the full strategy for winning the medical fight in a DBA or longshore case. The insurance carriers read these posts. What I will tell you is that it is buildable, and it starts long before any hearing. I put the landmines that destroy these claims, and how to avoid them, in my free book. If you were injured working overseas as a contractor, or on the docks, read the book before you talk to anyone.

You do not owe me a phone call. Read the book first. Decide for yourself.

If you were injured working as a contractor overseas or on the water on the Mississippi Gulf Coast, you can read more about how I handle a Mississippi longshore and DBA case. Workers based in Ocean Springs who commute to Ingalls or work the waterfront can read about how I handle an Ocean Springs longshore case. If you work at or near the Pascagoula port and shipyard corridor, you can also read about how I handle a Pascagoula longshore case specifically. The case discussed here is Kkunsa v. Constellis Group/Triple Canopy, Inc., BRB No. 24-0001, decided by the U.S. Department of Labor Benefits Review Board. This article is commentary on a published administrative decision and general information, not legal advice about your situation.