CICA Tribunal claim

Summary

The CICA is a government run scheme that compensates blameless victims of crimes of violence including those who have been sexually abused.  Often victims submit their own application as the CICA suggest legal representation is not necessary.  However, the procedures and legal principles can be complicated, particularly when dealing with an historic claim involving mental health issues and a loss of earnings claim.  Medical expert evidence will be needed and an analysis of the employment history should be carried out.  

We are regularly approached by individuals who have been offered an award by the CICA for the physical aspect of the sexual assault.  Applicants often assume this to be the correct amount and do not realise they are also entitled to an award for mental health issues and sometimes loss of earnings.

The Process

Some applicants come to us long after they accepted the first offer of an award.  Should this be the case we can help applicants either by way of an Appeal to the Tribunal against the 1st decision of the CICA, or we can apply to the CICA to medically re-open the case if the applicant’s condition has deteriorated after acceptance of the award.  

If the applicant has not yet accepted the offer of an award, we can help by applying to review the decision so as to include an improved award that takes account of mental health issues and includes a loss of earnings claim.  We obtain details of the applicants work and benefits history to ascertain whether and when they have been unable to work.  We review all medical records to ascertain whether the applicant has suffered any mental health issues.  We can then instruct a medical expert, usually a consultant psychiatrist or psychologist to prepare a report on the applicants psychiatric injury caused by their abusive experiences. We then review this, and together with the applicant’s employment history, this will allow us to prepare a schedule of loss to include a claim for mental health issues and loss of earnings.  An application to Review will then be submitted to the CICA together with legal reasons why the CICA should improve upon the award.  If the CICA refuse to improve upon the award then we can assist applicants by submitting a Notice of Appeal to the Tribunal.  The Tribunal is independent of the CICA and considers decisions made by the CICA.  

In this case we were instructed by an applicant who, as a young girl had been sexually abused by her mother’s partner.  In her early 50’s our client had submitted her own CICA claim under the 2008 scheme.  Whereas the CICA were prepared to offer the applicant an award for the sexual assaults and consequent mental health issues, her loss of earnings claim was not considered.  Our client was highly intelligent and worked intermittently into her 40’s despite having long periods where she suffered disabling mental health issues which prevented her from working.  She then had to totally give up work.  It was clear to us she deserved considerably more compensation that had been initially offered to her by the CICA.

We obtained our client’s medical records and commissioned a report from a leading Professor of Psychiatry. We also applied for her HMRC employment details.  We then applied to the CICA to Review its decision and submitted the medical report and Schedule of Loss to support the loss of earnings claim.  The CICA then changed its position by maintaining that our client was not entitled to a loss of earnings award as the reason why she could not work was due to unrelated bowel problems and not due to mental health issues arising from the sexual assaults.  

We appealed to the First Tier Tribunal. In support of our Appeal, we obtained a medical report from a colorectal surgeon who confirmed the bowel problems that she suffered did not prevent her from working.  This was the main issue in the case and the Appeal turned on whether the Tribunal agreed with our expert.  The Tribunal is a separate organisation from the CICA.  The hearings are heard in private and are led by a Principal Judge, usually with two tribunal members, one a medical and a lay member who hear the evidence alongside the Judge. The process is formal and most Applicants are represented by either a solicitor experienced in dealing with Tribunal hearings, or a specialist barrister (or counsel).  On this occasion we instructed specialist Counsel to represent the Applicant. We were successful in arguing the Applicant should be entitled to loss of earnings.  The Tribunal accepted the Applicants claim for loss of earnings and she was awarded the £500,000 for mental health issues and loss of earnings.  The 2008 Scheme was capped at £500,000 and even if the Applicants losses exceeded this sum, this was the maximum possible award.