IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
DIVISION ONE
CHARLES L. KIMZEY, No. 72323-5-1
Respondent,
UNPUBLISHED OPINION
DEPARTMENT OF LABOR AND
INDUSTRIES,
Appellant. FILED: November 30, 2015
Schindler, J. — The Industrial Insurance Act (MA), Title 51 RCW, expressly
excludes claims for an occupational disease "based on mental conditions or mental
disabilities caused by stress."1 Here, the undisputed record established the claim for
post-traumatic stress disorder was caused by the cumulative effects of working as a
paramedic. We reverse the superior court and affirm the decision of the Department of
Labor and Industries to deny the claim for benefits.
Claim for Benefits
After serving as a paramedic in the military, Charles L. Kimzey worked as a
paramedic for Evergreen Medic One. Beginning in 2002, Kimzey worked as a
paramedic for Vashon Island Fire and Rescue.
RCW 51.08.142.
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In June 2012, mental health advanced registered nurse practitioner (ARNP)
Rachel Burgett diagnosed Kimzey with post-traumatic stress disorder (PTSD). Burgett
prescribed a number of medications including an antidepressant. In July, Vashon
Health Center family physician Dr. Gary Koch diagnosed Kimzey with PTSD and severe
depression.
On July 11, 2012, Kimzey filed a claim for benefits with the Department of Labor
and Industries for an "Industrial Injury or Occupational Disease." Kimzey stated his
PTSD and depression were caused by "[Repeated exposure to some pretty horrific
incidents . . . over a 25 year career in the Fire Service and with Medic One." Kimzey
described the "most troublesome" incidents as involving "people I knew and cared
about." Kimzey states he suffered from "massive, debilitating panic attacks requiring
ongoing mental health therapy and medications."
The Department denied Kimzey's claim for benefits as an industrial injury or an
occupational disease. The "Notice of Decision" states, in pertinent part:
This claim for benefits filed on 7/11/2012 while working for VASHON
ISLAND FIRE & RESCUE is hereby rejected as an industrial injury or
occupational disease for the following reasons:
Claims based on mental conditions or mental disabilities caused by stress
are specifically excluded from coverage by law.
Kimzey appealed the decision to the Board of Industrial Insurance Appeals. A
number of witnesses testified at the hearing before the Industrial Appeals Judge (IAJ)
including Vashon Island Fire and Rescue paramedic and firefighter William Buchanan
and Vashon Island Fire and Rescue Battalion Chief Mark Brownell. Kimzey also
presented the deposition testimony of ARNP Rachel Burgett and Dr. Gary Koch. The
Department did not call any witnesses.
No. 72323-5-1/3
Buchanan testified that Kimzey was "a good paramedic" who "thoroughly
enjoyed" his job. However, by February 2012, "it was clear. . . something had affected
[Kimzey's] ability" to function at work. Buchanan testified that Kimzey did not "identify
the triggers for that anxiety .... [T]he identification really was having to deal. . . with
life-threatening emergencies, kids in general."
Battalion Chief Brownell testified that after Kimzey began experiencing symptoms
of PTSD and depression, the "contrast there . . . was pretty drastic."
Kimzey testified about a number of incidents including a failed intubation, airlifting
his sixth grade Sunday school teacher after a heart attack, and "see[ing] someone in the
grocery store after you've just tried and failed to resuscitate a family member."
Kimzey also described emergency calls involving child fatalities, the death of a
mother and her children in a fiery car accident, and the death of a family in a landslide.
Kimzey testified about "[hjorrible, horrible thoughts" when he responded to a call
involving a child with allergies such as imagining "he was going to be dead" or that the
child's airway would close and the rescue effort would be "beyond my skill."
Kimzey described the symptoms he suffered from as follows:
It starts out with a low-level anxiety, gastrointestinal discomfort, followed
by diarrhea. And then I get projectile vomiting.
And then it really cascades, because I can't stop. And then I have
these everything is going to — everyone I care about is going to die a
horrible death, and I'm going to be standing there, and there's not a darn
thing I can do about it.
... I could find no joy.
Everything was a catastrophe. Everything I loved and cared about
was going to be ripped from me violently and bloodily, and I couldn't stop
it.
No. 72323-5-1/4
In her deposition, Burgett testified that on June 18, 2012, Kimzey "presented with
symptoms consistent with" PTSD and a major depressive disorder. Burgett testified
PTSD is "an anxiety disorder" that manifests in "a cluster of symptoms" such as
"avoidance, severe anxiety, reexperiencing of the trauma, nightmares, easy startle
reflect, [and] inability to face situations similar to the trauma." Burgett said Kimzey was
having nightmares "where he was unable to leave the station, where he felt trapped
there and felt anxious when he woke up," and "[d]reams of death and injury happening
to children, not being able to help children on calls, things like that."
Burgett described the "research that shows that [emergency medical technicians]
and paramedics and firefighters dealing with children is one of the more significant
traumatic events in their career." Burgett testified that Kimzey's PTSD was "[c]learly
from the cumulative effects of trauma in his work environment." Burgett described the
PTSD Kimzey suffered from as "a buildup of triggers, and I think ... the most troubling
events involved children." But Burgett testified that although Kimzey referred to
incidents with children several times, his PTSD was "a cumulation of incidents that
occurred over his work career." According to Burgett, "[m]ore-probably-than-not"
Kimzey's PTSD and depressive disorder were "work related."
Dr. Koch is a family physician at Vashon Health Center. Kimzey saw Dr. Koch
on July 5, 2012. Kimzey told Dr. Koch that he had not been to work since February. Dr.
Koch testified that Kimzey suffered from severe depression. "On the PHQ-9[2]
depression score [Kimzey] scored 22 points, which is in a severe depression range."
Dr. Koch believed Kimzey also "met the criteria" for PTSD with a bipolar component.
2 Patient health questionnaire.
No. 72323-5-1/5
Dr. Koch testified that Kimzey was "severely depressed, and I didn't think he should
return to work .... I didn't think he was fit for duty."
In response to whether Kimzey's PTSD was the result of a single event or
cumulative events, Dr. Koch testified that in his opinion, PTSD "could be either; you can
have one particular bad exposure or you can have cumulative ones." Dr. Koch testified
that Kimzey suffered from "a cumulative memory of many severe traumatic images."
Dr. Koch did not recall Kimzey "going into any individual detail about specific cases."
Dr. Koch said Kimzey exhibited "classic symptoms" of cumulative events that resulted in
PTSD "caused by the stresses of his employment." When asked about Kimzey's ability
to return to work as a paramedic in the future, Dr. Koch said that depended on whether
the work would trigger "stressful stuff if he went back and were placed in a stressful
situation of a paramedic role."
The Department did not dispute Kimzey suffered from PTSD and depression.
The Department argued that as a matter of law, Kimzey's PTSD and depression did not
qualify as an occupational disease or as an industrial injury caused by a sudden and
traumatic event. Kimzey argued his PTSD and depression was caused by separate and
distinct traumatic events and the cumulative effect of those events.
The IAJ issued a proposed decision and order. The IAJ affirmed the
Department's decision to deny Kimzey's claim for benefits as an industrial injury or an
occupational disease. The IAJ concluded Kimzey was not entitled to benefits for an
industrial injury because the record did not support finding that he "sustained a sudden
and traumatic event during the course of his employment." The IAJ concluded Kimzey
was not entitled to benefits for an occupational disease for PTSD because "the law is
No. 72323-5-1/6
clear that the type of stress claim raised ... is not compensable under RCW
51.08.142." The proposed decision and order states, in pertinent part:
The claimant's attorney did a yeomen's job of trying to show that Mr.
Kimzey has separate distinct instances of sudden and traumatic events
that culminated in his PTSD and depression. The record simply does not
support that assertion because the treating experts were very clear that
Mr. Kimzey's mental health conditions resulted from the accumulation of
years of working as a paramedic.. . .
... Mr. Kimzey has worked more than 25 years as a paramedic
and suffers from PTSD and depression resulting from the accumulation of
his stress and experiences. Nonetheless, the legislature has spoken, and
conditions caused by stress are not compensable under the Industrial
Insurance Act as occupational disease.
Kimzey appealed the proposed decision and order to the Board. Kimzey argued
the testimony of Burgett and Dr. Koch established he was entitled to benefits for an
industrial injury and an occupational disease. Kimzey argued, in pertinent part:
By its very definition, PTSD is caused by an event or events that
are traumatic in nature, which results in an injury or injuries to the mind; a
psychological response to intense fear, helplessness or horror. In other
words, Mr. Kimzey's diagnosis of PTSD, as supported by both Gary Koch,
M.D., and Rachel Burgett, RN, ARNP, requires that there be an initiating
event of an extreme traumatic stressor involving direct personal
experience.
. . . [B]oth of Mr. Kimzey's experts testified that any one of the
instances described in his testimony could have resulted in his mental
condition, but his diagnosis was based on the culmination of several
events, due in part by the sheer number of traumatic events Mr. Kimzey
had witnessed. Any one of these events, or each of these events,
resulted in an immediate mental change which soon thereafter manifested
through severe gastrointestinal and weight loss issues.[3]
The Board denied the appeal. The Board adopted the proposed decision and order as
the final decision.
Emphasis in original.
No. 72323-5-1/7
Superior Court Appeal
Kimzey filed an appeal of the Board decision in superior court. Kimzey filed a
jury demand. The Department filed a motion to strike the jury demand. The
Department conceded Kimzey had PTSD and depression caused by his work as a
paramedic. However, because the administrative record was undisputed, the
Department argued the only question was whether as a matter of law, Kimzey was
entitled to benefits for his PTSD and depression as an industrial injury or an
occupational disease. The court agreed and granted the motion to strike the jury
demand. The "Order Striking Jury Demand" states, in pertinent part:
Based on the Board of Industrial Insurance Appeals record, the
pleadings, and Declarations, the court finds that there are no facts in
dispute. The question of whether RCW 51.08.100 or RCW 51.08.140
applies to the factual situation presented here is a question of law for this
Court to decide. The Department's Motion to Strike the Jury Demand
should, therefore, be granted.
In his trial brief, Kimzey argued the evidence established he was entitled to
benefits for PTSD and severe depression as both an occupational disease and an
industrial injury.
The evidence establishes that Mr. Kimzey's mental illness,
diagnosed as PTSD and severe depression, arose naturally and
proximately out of his employment as a paramedic at VIFR [(Vashon
Island Fire and Rescue)], in the sense that there are no other intervening
independent and sufficient causes for the mental illness and that Mr.
Kimzey would not have suffered such illness when he did but for the
conditions of his employment at VIFR. The stress Mr. Kimzey
experienced has been objectively corroborated by co-workers and
supervisors, all of whom highlighted the fact that the stress Mr. Kimzey
experienced in the line of duty was unusual and not experienced in
everyday life.
The Department asserted the undisputed evidence established Kimzey was not
entitled to benefits for PTSD and depression caused by working as a paramedic. The
No. 72323-5-1/8
Department argued the Industrial Insurance Act (IIA), Title 51 RCW, excludes benefits
for an occupational disease or industrial injury caused by stress.
Kimzey ... is seeking allowance of his mental health condition, post
traumatic stress disorder (PTSD) and related depression. The
Department does not dispute that he has these conditions, or that they
were caused by his employment. Mr. Kimzey's claim was rejected
because mental health conditions caused by stress are specifically and
completely foreclosed by statute as occupational diseases. The other
possible avenue of coverage is lacking because Mr. Kimzey does not
have an industrial injury: no discrete event has been identified or causally
linked to his mental health condition; rather, he and his attending providers
have presented this condition as one arising out of the cumulative effects
of his 25-year-long career as a paramedic. The undisputed facts show
that Mr. Kimzey does not have a compensable condition under the
Industrial Insurance Act.
. . . Here, there is no medical testimony suggesting that Mr.
Kimzey's PTSD or depression were caused by a specific event, let alone
that this is more probable than not true. All the medical testimony proved
that Mr. Kimzey is suffering from the cumulative effects of a stressful
career, which unfortunately is not compensable under the Act.
The court ruled Kimzey was entitled to benefits for PTSD as an occupational
disease and reversed the decision and order of the Board. The court entered findings
of fact and conclusions of law and awarded Kimzey attorney fees. The findings of fact
and conclusions of law state:
I. FINDINGS OF FACT
1.1 Charles Kimzey sustained an occupational disease, to wit, PTSD.
1.2 The findings and conclusions of the Board of Industrial Insurance
Appeals have been rebutted by Mr. Kimzey by a preponderance of
the evidence.
1.3 Charles Kimzey's PTSD arose naturally and proximately out of
distinctive conditions of his employment as a paramedic for Vashon
Fire and Rescue.
No. 72323-5-1/9
1.4 Charles Kimzey's PTSD arose naturally out of and was proximately
caused by the cumulative effects of traumatic incidents during his
job as a paramedic during his career.
1.5 In the course of his work as a paramedic in dealing with traumatic
incidents and the life and death situations that were stressful to
him, Charles Kimzey became symptomatic of PTSD, a disease
caused by trauma.
II. CONCLUSIONS OF LAW
2.1 The Findings and Conclusions of the Board of Industrial Insurance
Appeals are in error.
2.2 Charles Kimzey's condition of PTSD is an occupational disease.
2.3 Charles Kimzey's PTSD arose naturally and proximately out of
distinctive conditions of his employment as a paramedic for Vashon
Fire & Rescue, and he is entitled to coverage under the Industrial
Insurance Act.
2.4 The findings and conclusions of the Board of Industrial Insurance
Appeals have been rebutted by Mr. Kimzey by a preponderance of
the evidence.
The Department appeals the superior court order reversing the decision of the
Board.
Standard of Review
In an appeal from the Board, the superior court acts in an appellate capacity and
reviews the decision de novo "based solely on the evidence and testimony presented to
the Board." Leuluaialii v. Dep't of Labor & Indus., 169 Wn. App. 672, 677, 279 P.3d 515
(2012); Ruse v. Dep't of Labor & Indus., 138 Wn.2d 1, 5, 977 P.2d 570 (1999). The
Board's decision is prima facie correct and the burden of proof is on the party
challenging the decision. RCW 51.52.115; Ruse, 138Wn.2dat5.
No. 72323-5-1/10
RCW 51.52.115 states, in pertinent part:
The hearing in the superior court shall be de novo, but the court shall not
receive evidence or testimony other than, or in addition to, that offered
before the board or included in the record filed by the board in the superior
court as provided in RCW 51.52.110. ... In all court proceedings under or
pursuant to this title the findings and decision of the board shall be prima
facie correct and the burden of proof shall be upon the party attacking the
same. If the court shall determine that the board has acted within its
power and has correctly construed the law and found the facts, the
decision of the board shall be confirmed; otherwise, it shall be reversed or
modified.
In an industrial insurance case, we review the decision of the superior court, not
the decision of the Board. RCW 51.52.140; Rogers v. Dep't of Labor & Indus., 151 Wn.
App. 174, 179-81, 210 P.3d 355 (2009). Our review of the superior court's decision is
governed by RCW 51.52.140. RCW 51.52.140 states that an "[ajppeal shall lie from the
judgment of the superior court as in other civil cases." Accordingly, the statutory
scheme results in a different role for this court than is typical for appeals from
administrative decisions. Rogers, 151 Wn. App. at 180. We review" 'whether
substantial evidence supports the trial court's factual findings and then review, de novo,
whether the trial court's conclusions of law flow from the findings.'" Rogers, 151 Wn.
App. at 180 (quoting Watson v. Dep't of Labor & Indus., 133 Wn. App. 903, 909, 138
P.3d 177 (2006)). Where, as here, the facts the Board found are undisputed, we treat
the facts as verities. Roller v. Dep't of Labor & Indus., 128 Wn. App. 922, 927, 117 P.3d
385 (2005).
Preliminarily, the Department contends the finding of fact that states Kimzey
"sustained an occupational disease, to wit, PTSD;" and the finding of fact that states the
decision of the Board was "rebutted by Mr. Kimzey by a preponderance of the evidence"
are conclusions of law subject to de novo review. We agree. We also note the
10
No. 72323-5-1/11
conclusions of law repeat these two findings. Conclusion of law 2.2 states, "Kimzey's
condition of PTSD is an occupational disease." Conclusion of law 2.4 states the
decision of the Board has "been rebutted by Mr. Kimzey by a preponderance of the
evidence."
The Department does not challenge the findings of fact that state Kimzey's PTSD
"arose naturally and proximately out of distinctive conditions of his employment as a
paramedic for Vashon Fire and Rescue;" that his PTSD was "caused by the cumulative
effects of traumatic incidents during his job as a paramedic during his career;" or that he
dealt with "traumatic incidents and the life and death situations .. . were stressful to
him" and he "became symptomatic of PTSD, a disease caused by trauma."
The Department contends that because the legislature categorically excluded
benefits for PTSD as an occupational disease, the court erred in concluding Kimzey
was entitled to benefits as an occupational disease.
Statutory construction is a question of law we review de novo. Cockle v. Dep't of
Labor & Indus., 142 Wn.2d 801, 807, 16 P.3d 583 (2001). Our primary objective is to
ascertain and give effect to legislative intent. Cockle, 142 Wn.2d at 807. Ifthe
language of a statute is plain and unambiguous, we must give effect to the plain
meaning as the expression of legislative intent. Cockle, 142 Wn.2d at 807. We review
Washington Administrative Code regulations under the same rules of statutory
interpretation. Overlake Hosp. Ass'n v. Dep't of Health, 170 Wn.2d 43, 51-52, 239 P.3d
1095(2010).
11
No. 72323-5-1/12
Occupational Disease
Under the IIA, a worker is entitled to disability benefits for an industrial injury or
an occupational disease. RCW 51.32.010, .180. An industrial injury is "a sudden and
tangible happening, of a traumatic nature, producing an immediate or prompt result, and
occurring from without, and such physical conditions as result therefrom." RCW
51.08.100.4 An occupational disease is "such disease or infection as arises naturally
and proximately out of employment." RCW 51.08.140.
In 1988, the legislature directed the Department to adopt rules excluding claims
for mental conditions or disabilities caused by stress from the definition of occupational
disease. Laws of 1988, ch. 161, § 16. RCW 51.08.142 states, "The department shall
adopt a rule pursuant to chapter 34.05 RCW that claims based on mental conditions or
mental disabilities caused by stress do not fall within the definition of occupational
disease in RCW 51.08.140."
In accord with the directive of the legislature, the Department adopted WAC 296-
14-300.5 WAC 296-14-300(1) expressly states that claims "based on mental conditions
or mental disabilities caused by stress do not fall within the definition of an occupational
4 On appeal, Kimzey does not claim that his PTSD is an industrial injury.
5 We refer to the WAC in effect at the time of Kimzey's claim throughout the opinion. However,
we note that the WAC was recently amended. As amended, WAC 296-14-300(2) states:
(a) Stress resulting from exposure to a single traumatic event will be adjudicated as an
industrial injury. See RCW 51.08.100.
(b) Examples of single traumatic events include: Actual or threatened death,
actual or threatened physical assault, actual or threatened sexual assault, and life-
threatening traumatic injury.
(c) These exposures must occur in one of the following ways:
(i) Directly experiencing the traumatic event;
(ii) Witnessing, in person, the event as it occurred to others; or
(iii) Extreme exposure to aversive details of the traumatic event.
(d) Repeated exposure to traumatic events, none of which are a single traumatic
event as defined in subsection (2)(b) and (c) of this section, is not an industrial injury (see
RCW 51.08.100) or an occupational disease (see RCW 51.08.142). A single traumatic
event as defined in subsection (2)(b) and (c) of this section that occurs within a series of
exposures will be adjudicated as an industrial injury (see RCW 51.08.100).
12
No. 72323-5-1/13
disease in RCW 51.08.140." See Boeing Co. v. Key, 101 Wn. App. 629, 634, 5 P.3d 16
(2000) (A mental condition caused by stress that results from "events that unfolded
gradually over a period of time," or even "from a series of incidents over a period of a
few days," is not compensable as an occupational disease.). However, WAC 296-14-
300(2) states that a mental condition or disability caused by stress that results from
"exposure to a single traumatic event" is compensable as an industrial injury.
WAC 296-14-300 states, in pertinent part:
(1) Claims based on mental conditions or mental disabilities caused by
stress do not fall within the definition of an occupational disease in RCW
51.08.140.
Examples of mental conditions or mental disabilities caused by
stress that do not fall within occupational disease shall include, but are not
limited to, those conditions and disabilities resulting from:
(a) Change of employment duties;
(b) Conflicts with a supervisor;
(c) Actual or perceived threat of loss of a job, demotion, or
disciplinary action;
(d) Relationships with supervisors, coworkers, or the public;
(e) Specific or general job dissatisfaction;
(f) Work load pressures;
(g) Subjective perceptions of employment conditions or
environment;
(h) Loss of job or demotion for whatever reason;
(i) Fear of exposure to chemicals, radiation biohazards, or other
perceived hazards;
(j) Objective or subjective stresses of employment;
(k) Personnel decisions;
(1) Actual, perceived, or anticipated financial reversals or difficulties
occurring to the businesses of self-employed individuals or corporate
officers.
(2) Stress resulting from exposure to a single traumatic event will
be adjudicated with reference to RCW 51.08.100.
Accordingly, a mental condition or disease that is caused by stress from the
"[objective or subjective stresses of employment" is not compensable as an
occupational disease. WAC 296-14-300(1 )(j). But a claim for work-related stress
13
No. 72323-5-1/14
caused by a sudden, tangible, external traumatic event that produces an immediate
result is compensable as an industrial injury under RCW 51.08.100. WAC 296-14-
300(2); Boeing, 101 Wn. App. at 634.
The plain and unambiguous language of RCW 51.08.142 and WAC 296-14-
300(1) exclude mental conditions and disabilities caused by stress that is not the result
of a single traumatic event from the definition of occupational disease. Because the
undisputed testimony establishes Kimzey's PTSD and depression was the result of
traumatic and stressful events over time while working as a paramedic, we hold the
superior court erred in reversing the Department's denial of benefits as an occupational
disease.
Rothwell v. Nine Mile Falls School District, 149 Wn. App. 771, 206 P.3d 347
(2009), supports our analysis. In Rothwell, the court addressed whether the plaintiffs
lawsuit for intentional and negligent infliction of emotional distress was barred by the IIA.
Rothwell, 149 Wn. App. at 776-77. The plaintiff argued her action was not barred by the
IIA because her claim for PTSD "does not arise out of an industrial injury or
occupational disease." Rothwell, 149 Wn. App. at 777. The court held the lawsuit was
not barred by the IIA because her "PTSD is not an injury or occupational disease under
the [IIA]." Rothwell, 149 Wn. App. at 782. The court concluded that because the
plaintiff's "mental condition was not the result of exposure to a single traumatic event,"
her PTSD did not meet the definition for a compensable injury under the IIA. Rothwell,
149 Wn. App. at 781. The court concluded that because the plaintiff's PTSD was the
result of "a series of incidents over a period of a few days," her mental condition did not
meet the definition for an occupational disease. Rothwell, 149 Wn. App. at 782.
14
No. 72323-5-1/15
While Kimzey argues on appeal that the medical testimony establishes "trauma"
not "stress" caused his PTSD, he did not make this argument at the administrative
hearing before the Board.
Under RCW 51.52.104, a party waives an argument "not specifically set forth" in
the petition for review. Leuluaialii, 169 Wn. App. at 684; Allan v. Dep't of Labor &
Indus.. 66 Wn. App. 415, 422, 832 P.2d 489 (1992). RCW 51.52.104 states, in
pertinent part:
[A]ny party may file with the board a written petition for review . . . [that]
shall set forth in detail the grounds therefor and the party or parties filing
the same shall be deemed to have waived all objections or irregularities
not specifically set forth therein.
In the notice of appeal to the Board, Kimzey states the cause of "his psychological or
psychiatric condition" is "on-the-job stress." In his petition for review, Kimzey asserts his
PTSD was caused by "an initiating event of an extreme traumatic stressor" and the
"mental stress to which Mr. Kimzey was exposed and to which he was continually
subjected over the period of his career."
In any event, the administrative record does not support Kimzey's argument that
his PTSD was caused by only trauma. Under the IIA, a worker who claims rights is held
"to strict proof of their right to receive the benefits provided by the act." Olvmpia
Brewing Co. v. Dep't of Labor & Indus., 34 Wn.2d 498, 505, 208 P.2d 1181 (1949),
overruled on other grounds by Windust v. Dep't of Labor & Indus., 52 Wn.2d 33, 323
15
No. 72323-5-1/16
P.2d 241 (1958).6 Kimzey did not present any expert testimony that draws a distinction
between trauma and stress as it relates to PTSD. Burgett and Dr. Koch testified that
during his career as a paramedic, Kimzey experienced traumatic events that resulted in
debilitating stress and his PTSD was caused by stress. The undisputed testimony
establishes that Kimzey's PTSD was caused by "intense psychological stress" and
traumatic incidents over the course of a 25-year career as a paramedic.
Because a mental condition caused by cumulative work-related stress is
expressly excluded from coverage as an occupational disease, the superior court erred
in reversing the decision and order of the Board denying Kimzey's PTSD claim for
benefits as an occupational disease. We reverse the superior court decision and the
award of fees. We affirm the decision and order of the Board.
WE CONCUR:
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6 Kimzey filed a motion asking this court to take judicial notice of two nonconsecutive pagespf the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as "the universal authority for psychratric '
diagnosis." In response, the Department submitted a copy ofthe DSM-5. The Department does n6T°
object provided the court take judicial notice of the entire DSM-5. But appellate review of industrial
insurance cases is "based solely on the evidence and testimony presented to the Board." Leuluaialii, 169
Wn. App. at 677. We decline to take judicial notice of the DSM-5 because it was not submitted below or
part of the administrative record.
16