IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON DIVISION ONE CHARLES L. KIMZEY, Respondent,

DEPARTMENT OF LABOR AND INDUSTRIES, Appellant.

RCW 51.08.142. No. 72323-5-1

UNPUBLISHED OPINION

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 disorderwas caused by the cumulative effects ofworking as a paramedic. We reverse the superior court and affirm the decision ofthe Department of Labor and Industries to deny the claim for benefits. Claim for Benefits After serving as a paramedic inthe 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.No. 72323-5-1/2 InJune 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. InJuly, Vashon 

### Health Centerfamily physician Dr. Gary Koch diagnosed Kimzey with PTSD and severe depression. 

### On July 11, 2012, Kimzey filed a claim for benefits with the Department ofLabor 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 inthe Fire Service and with Medic One." Kimzey described the "mosttroublesome" incidents as involving "people Iknew and cared 

### about." Kimzeystates he suffered from "massive, debilitating panic attacks requiring ongoing mental health therapy and medications." The Departmentdenied 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. 

### Kimzeyappealed the decision to the Board of Industrial Insurance Appeals. A numberofwitnesses testified at the hearing before the IndustrialAppeals Judge (IAJ) includingVashon Island Fire and Rescue paramedic and firefighterWilliam Buchanan and Vashon Island Fire and Rescue Battalion ChiefMark 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, "itwas clear.
. . something had affected 

### [Kimzey's] ability" to function at work. Buchanan testified that Kimzey did not "identify the triggers forthat anxiety
.... [T]he identification reallywas having to deal. . . with life-threatening emergencies, kids ingeneral." Battalion ChiefBrownell testified that after Kimzey began experiencing symptoms 

### of PTSD and depression, the "contrastthere
. . . was pretty drastic." 

### Kimzey testified about a number of incidents including a failed intubation, airlifting his sixthgrade Sunday school teacherafter 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 fierycaraccident, 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 effortwould be "beyond myskill." Kimzeydescribed the symptoms he suffered from as follows: Itstarts out with a low-level anxiety, gastrointestinal discomfort, followed by diarrhea. And then Iget projectile vomiting. 

### And then it reallycascades, because Ican't stop. And then Ihave 

### these everything is going to —everyone Icare about is going to die a horribledeath, and I'm going to be standing there, and there's not a darn thing Ican do about it.

... Icould find no joy. 

### Everythingwas a catastrophe. Everything Iloved and cared about 

### was going to be rippedfrom me violently and bloodily, and Icouldn't stop it.No. 72323-5-1/4 

### Inherdeposition, Burgetttestified that on June 18, 2012, Kimzey "presented with symptoms consistentwith" PTSD and a major depressive disorder. Burgetttestified PTSD is "an anxiety disorder" that manifests in "a cluster ofsymptoms" such as "avoidance, severe anxiety, reexperiencing ofthe trauma, nightmares, easy startle reflect, [and] inability to face situations similarto 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 ofdeath 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 ofthe more significant traumatic events intheir career." Burgetttestified that Kimzey's PTSD was "[c]learly from the cumulative effects oftrauma in his work environment." Burgett described the PTSD Kimzey suffered from as "a buildup oftriggers, and Ithink
... the mosttroubling events involved children." But Burgetttestified that although Kimzey referred to incidents with children several times, his PTSD was "a cumulation ofincidents 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 fromsevere depression. "On the PHQ-9[2] depression score [Kimzey] scored 22 points, which is in a severe depression range." Dr. Koch believed Kimzey also "metthe criteria" for PTSD with a bipolar component.

2Patient health questionnaire.No. 72323-5-1/5 Dr. Koch testified that Kimzey was "severely depressed, and Ididn'tthink he should return to work
.... Ididn'tthink 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 Kimzeysuffered from "acumulative memory of many severe traumatic images." Dr. Koch did not recall Kimzey "going into any individual detail aboutspecific cases." Dr. Koch said Kimzey exhibited "classic symptoms" ofcumulative events that resulted in 

### PTSD "caused bythe stresses of his employment." When asked about Kimzey's ability to return to work as a paramedic inthe 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 Kimzeysuffered 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 oras an industrialinjury caused by a sudden and traumatic event. Kimzeyargued his PTSD and depression was caused by separate and distinct traumatic events and the cumulative effect ofthose events. 

### The IAJissued a proposed decision and order. The IAJ affirmed the 

### Department's decision to deny Kimzey's claim forbenefits as an industrial injury or an 

### occupational disease. The IAJ concluded Kimzeywas not entitled to benefitsfor an 

### industrial injury because the record did notsupportfinding 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 isNo. 72323-5-1/6 

### clearthat the type ofstress 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'sjob 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 clearthat 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 underthe Industrial Insurance Act as occupational disease. Kimzey appealed the proposed decision and orderto 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 ofPTSD, as supported by both Gary Koch, M.D., and Rachel Burgett, RN, ARNP, requires thatthere be an initiating event ofan extreme traumatic stressor involving direct personal experience. . . . [B]oth of Mr. Kimzey's experts testified that any one ofthe 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 oftraumatic events Mr. Kimzey had witnessed. Any one ofthese events, or each ofthese 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 insuperior court. Kimzey filed a jury demand. The Departmentfiled a motion to strike thejury demand. The 

### Departmentconceded Kimzey had PTSD and depression caused by his workas a paramedic. However, because the administrative record was undisputed, the 

### Department argued the onlyquestion was whether as a matterof law, Kimzeywas 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, inpertinent part: Based on the Board of Industrial Insurance Appeals record, the pleadings, and Declarations, the courtfinds that there are no facts in dispute. The question ofwhether 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 employmentas a paramedic at VIFR [(Vashon 

### Island Fire and Rescue)], in the sensethat 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 butfor 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 thatthe stress Mr. Kimzey experienced inthe 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. TheNo. 72323-5-1/8 

### Departmentargued the Industrial InsuranceAct(IIA), Title 51 RCW, excludes benefits for an occupational disease or industrial injurycaused by stress. 

### Kimzey
... is seeking allowance of his mental health condition, post traumatic stress disorder (PTSD) and related depression. The 

### Departmentdoes notdispute that he has these conditions, or that they were caused by his employment. Mr. Kimzey's claimwas rejected because mental health conditions caused by stress are specifically and 

### completely foreclosed bystatute as occupational diseases. The other possible avenue ofcoverage is lackingbecause Mr. Kimzeydoes not 

### have an industrialinjury: 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 careeras a paramedic. The undisputed facts show that Mr. Kimzeydoes not have a compensable condition underthe Industrial Insurance Act.

. . . Here, there is no medical testimony suggesting that Mr. 

### Kimzey's PTSD or depression were caused by a specificevent, 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 underthe Act. 

### The court ruled Kimzey was entitled to benefits for PTSD as an occupational disease and reversed the decision and order ofthe Board. The court entered findings 

### of fact and conclusions of law and awarded Kimzeyattorney fees. The findings of fact and conclusions of law state: I. FINDINGS OF FACT 

### 1.1 Charles Kimzey sustained an occupationaldisease, towit, PTSD. 1.2 The findings and conclusions of the Board ofIndustrial Insurance 

### Appeals have been rebutted byMr. Kimzey by a preponderance of the evidence. 

### 1.3 Charles Kimzey's PTSDarose naturally and proximately out of distinctive conditions of his employment as a paramedicforVashon Fire and Rescue.No. 72323-5-1/9 

### 1.4 Charles Kimzey's PTSD arose naturally out ofand was proximately caused by the cumulative effects oftraumatic incidents during his job as a paramedic during his career. 1.5 Inthe course of his work as a paramedic indealing with traumatic incidents and the life and death situations that were stressful to him, Charles Kimzey became symptomatic ofPTSD, a disease caused by trauma. II. CONCLUSIONS OF LAW 2.1 The Findings and Conclusions ofthe Board ofIndustrial 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 paramedicforVashon Fire &Rescue, and he is entitled to coverage underthe Industrial Insurance Act. 2.4 The findings and conclusions ofthe Board ofIndustrial Insurance Appeals have been rebutted by Mr. Kimzey by a preponderance of the evidence. The Department appeals the superior court order reversing the decision ofthe
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 ofproofis 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 inthe superior court shall be de novo, but the court shall not receive evidence or testimony otherthan, or in addition to, that offered before the board or included inthe record filed by the board inthe superior court as provided in RCW 51.52.110.
... In all court proceedings under or pursuant to this title the findings and decision ofthe board shall be prima 

### facie correct and the burden ofproofshall be upon the party attacking the same. Ifthe court shall determine that the board has acted within its power and has correctly construed the law and found the facts, the decision ofthe board shall be confirmed; otherwise, it shall be reversed or modified. In an industrial insurance case, we review the decision ofthe superior court, not the decision ofthe Board. RCW 51.52.140; Rogers v. Dep't ofLabor & Indus., 151 Wn. App. 174, 179-81, 210 P.3d 355 (2009). Our review ofthe superior court's decision is governed by RCW 51.52.140. RCW 51.52.140 states that an "[ajppeal shall lie from the judgment ofthe superior court as in other civilcases." Accordingly, the statutory 

### scheme results in a different role for this courtthan 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, 

### whetherthe trial court's conclusions of law flow from the findings.'" Rogers, 151 Wn. App. at 180 (quoting Watson v. Dep't ofLabor &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. Rollerv. Dep't ofLabor &Indus., 128 Wn. App. 922, 927, 117 P.3d 385 (2005). Preliminarily, the Department contends the finding offact that states Kimzey "sustained an occupational disease, to wit, PTSD;" and the finding offact that states the decision ofthe Board was "rebutted by Mr. Kimzey by a preponderance ofthe evidence"

are conclusions of law subject to de novo review. We agree. We also note the

10No. 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 ofthe Board has "been rebutted by Mr. Kimzey by a preponderance ofthe evidence." The Department does not challenge the findings offact that state Kimzey's PTSD "arose naturally and proximately out ofdistinctive conditions of his employment as a paramedic for Vashon Fire and Rescue;" that his PTSD was "caused by the cumulative 

### effects oftraumatic incidents during his job as a paramedic during his career;" orthat he dealt with "traumatic incidents and the life and death situations
.. . were stressful to him" and he "became symptomatic ofPTSD, a disease caused by trauma." 

### The Departmentcontends thatbecause 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., 142Wn.2d 801, 807, 16 P.3d 583 (2001). Our primary objective is to 

### ascertain and give effectto legislative intent. Cockle, 142 Wn.2d at 807. Ifthe language of a statute is plain and unambiguous, we must give effectto the plain 

### meaning as the expression oflegislative intent. Cockle, 142 Wn.2d at 807. We review Washington Administrative Code regulations underthe same rules ofstatutory interpretation. Overlake Hosp. Ass'n v. Dep't ofHealth, 170Wn.2d 43, 51-52, 239 P.3d 1095(2010).

11No. 72323-5-1/12 Occupational Disease Underthe 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 resulttherefrom." RCW 

### 51.08.100.4 An occupational disease is "such disease or infection as arises naturally and proximately out ofemployment." RCW 51.08.140. In 1988, the legislature directed the Departmentto 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 pursuantto chapter 34.05 RCWthat claims based on mental conditions or 

### mental disabilities caused by stress do not fall within the definition ofoccupational disease in RCW 51.08.140." 

### In accord with the directive ofthe legislature, the Department adopted WAC 296- 

### 14-300.5 WAC 296-14-300(1) expressly states thatclaims "based on mental conditions
or mental disabilities caused by stress do not fall within the definition ofan occupational
4On appeal, Kimzey does not claim that his PTSD is an industrial injury. 5We referto theWAC ineffectat the time ofKimzey'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 eventwill be adjudicated as an industrial injury. See RCW 51.08.100. (b) Examples ofsingle traumatic events include: Actual orthreatened death, actual orthreatened physical assault, actual orthreatened sexual assault, and lifethreatening traumatic injury. (c) These exposures must occur inone ofthe following ways: (i) Directly experiencing the traumatic event; (ii) Witnessing, in person, the event as itoccurred to others; or (iii) Extreme exposure to aversive details ofthe traumatic event. (d) Repeated exposure to traumatic events, none of which are a single traumatic event as defined insubsection (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). Asingle traumatic event as defined in subsection (2)(b) and (c) of this section thatoccurs within a series of exposures will be adjudicated as an industrial injury(see RCW 51.08.100).

12No. 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 bystress that resultsfrom "events thatunfolded 

### gradually over a period oftime," or even "from a series ofincidents over a period ofa few days," is not compensable as an occupational disease.). However, WAC 296-14- 300(2) statesthat a mental condition ordisability caused bystressthat resultsfrom "exposure to a single traumatic event" iscompensable as an industrial injury. WAC 296-14-300 states, in pertinent part: 

### (1) Claims based onmental conditions ormental disabilities caused by stress do not fall withinthe definition of an occupational disease in RCW 51.08.140. 

### Examples of mental conditions or mentaldisabilities caused by stress that do notfall withinoccupational disease shall include, but are not limited to, those conditions and disabilities resulting from: 

### (a) Change ofemploymentduties; (b) Conflicts with a supervisor; 

### (c) Actual or perceived threat of loss of a job, demotion, or disciplinary action; 

### (d) Relationshipswith supervisors, coworkers, or the public; (e) Specific orgeneraljob dissatisfaction; (f) Work load pressures; 

### (g) Subjective perceptions of employment conditions or environment; 

### (h) Loss of job or demotion forwhatever 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, oranticipated financial reversals ordifficulties occurring to the businesses of self-employed individuals orcorporate officers. 

### (2) Stress resulting from exposure to a singletraumaticeventwill be adjudicated with reference to RCW51.08.100. 

### Accordingly, a mental condition ordiseasethat is caused bystressfrom the "[objective or subjectivestresses ofemployment" is not compensable as an 

### occupational disease. WAC 296-14-300(1)(j). Buta claimforwork-related stress

13No. 72323-5-1/14 caused by a sudden, tangible, external traumatic eventthat 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 ofRCW 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 eventfrom the definition of occupational disease. Because the undisputed testimony establishes Kimzey's PTSD and depression was the result of traumatic and stressful events overtime while working as a paramedic, we hold the 

### superior court erred in reversing the Department's denial ofbenefits 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 whetherthe plaintiffs lawsuitfor intentional and negligent infliction ofemotional distress was barred by the IIA. Rothwell, 149 Wn. App. at 776-77. The plaintiffargued 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 notthe result ofexposure to a single traumatic event," her PTSD did not meetthe definition for a compensable injury underthe IIA. Rothwell, 149 Wn. App. at 781. The court concluded that because the plaintiff's PTSD was the result of "a series ofincidents 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.

14No. 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 RCW51.52.104, a party waives an argument "not specificallysetforth" in 

### the petition for review. Leuluaialii, 169Wn. 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 mayfile with the board a written petition forreview
. . . [that] shall setforth in detail the grounds therefor and the party or parties filing the same shall be deemed to have waived allobjections or irregularities not specifically setforth therein. 

### In the notice ofappeal to the Board, Kimzey states the cause of "hispsychological or 

### psychiatric condition" is"on-the-job stress." In hispetitionfor review, Kimzey asserts his PTSD was caused by "aninitiating event of an extreme traumatic stressor" and the "mentalstress to whichMr. Kimzey was exposed and to which he was continually subjected overthe period of his career." 

### In any event, the administrative record does not supportKimzey's argument that hisPTSD was caused byonlytrauma. Underthe IIA, aworkerwho claimsrights is held "to strict proof of theirrightto receive the benefits provided by the act." Olvmpia Brewing Co. v. Dep'tofLabor &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

15No. 72323-5-1/16 

### P.2d 241 (1958).6 Kimzey did not present any experttestimony that draws a distinction between trauma and stress as itrelates 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 overthe 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 

### inreversing the decision and order ofthe Board denying Kimzey's PTSD claim for benefits as an occupational disease. We reverse the superior court decision and the award offees. We affirm the decision and order ofthe Board.

WE CONCUR: 

# %J)jUht&VG,,,^ \f\Mt^ ,o 'fedKeJR, (/

er;

6Kimzey filed a motion asking this court to take judicial notice of two nonconsecutive pagespfthe Diagnostic and Statistical Manual of Mental Disorders (DSM-5)as "the universal authority forpsychratric ' 

### diagnosis." In response, the Departmentsubmitted acopyofthe DSM-5. The Departmentdoes n6T° object provided the courttakejudicial notice of the entire DSM-5. Butappellate 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 takejudicial notice of the DSM-5 because itwas not submitted below or part of the administrative record.

16