Case Study - CICA Claim, July 2025

The Applicant was subjected to a series of sexual abuse by her boyfriend’s uncle during her early teens.

He pleaded guilty to his crimes and was sent to prison for 14 months.

As a consequence, the Applicant developed mental health issues including emotional unstable personality disorder, panic attacks, anxiety and depression for which she received treatment.

She found herself unable to hold down a job and had not been able to work for many years.

An application to the CICA was duly submitted, together with supporting records, with a plea for an award to include damages for mental injury in accordance with the Scheme’s tariff and loss of earnings. The CICA returned with an offer of £2,000 in line with the level of the assaults but rejected her claim for mental injury on the basis that these events were not the significant and sole cause of her issues and that other life events had impacted on her mental health.

They also decided against an award for loss of earnings stating that there was no evidence available that as a direct result of the incident she had no or very limited capacity for paid employment.

An application for review was submitted but the decision was upheld. The Applicant applied to appeal.

It was argued that the opinion of the CICA was outside of their medical expertise on simple reading of the medical records. Further, that her claim was not dependent upon the abuse being the sole factor in her mental health but that it had merely had to have had a significant contribution and that their decision to oppose an award for loss of earnings was unfounded and incorrect.

A report was obtained from a suitably qualified independent medical expert whose opinion was supportive of her case. The expert concurred with her diagnoses and concluded that;

• On the balance of probabilities, the abuse was the most significant cause of her developing mental health problems in her teens which affected the rest of her life
• In terms of work, she would not be able to sustain employment until she had been in receipt of trauma-focused treatment
• Even with considerable improvement, it was likely she would remain vulnerable to low mood and anxiety
• The injury was considered to be seriously disabling. If she was to engage with treatment, it was expected that this would reduce to moderately disabling
• She had very limited capacity to work. If she was able to engage in the recommended treatment, this may allow her to engage in work to some extent, although it was very difficult to predict at that stage and was envisaged not to be possible until toward the end of the therapy.

Based on the weight of evidence provided, the CICA changed their view and agreed that she was entitled to a higher award to include both mental injury, valued at £22,000, and loss of earnings, £80,841, resulting in a total award of £102,842, and without the need for a formal hearing. They also agreed to fund the cost of the expert’s report.