Reopening a CICA claim: How new medical evidence can change the outcome

For many survivors of abuse, the conclusion of a Criminal Injuries Compensation Authority claim can feel like the end of a very long process. However, what many people don’t realise is that in certain circumstances, a CICA claim can be reopened if significant new medical evidence becomes available after a decision has been made.

The CICA has the discretion to reopen a claim if there has been a material change in the circumstances or if significant new evidence emerges that could have affected the original award i.e had that evidence been available at the time of the decision then the decision is likely to have been different.

A claims officer may reopen an application after a final award has been made due to an applicant subsequently dying from the injuries suffered initially or if there has been a significant material change in the medical condition of the applicant and allowing the original decision to stand would give rise to an injustice to the applicant.

Medical evidence is often the key piece of evidence that the CICA use to determine an award.  If the original decision was made before the applicant had fully recovered in line with the prognosis, then the award may not accurately reflect the long-term impact of the injuries.

Case Study

This was the exact scenario of a case we handled recently.  The applicant was awarded £13,500 for a mental injury award which lasted 5 years or more but was not permanent.  The medical evidence available at the time advised that if the applicant underwent further therapy, they would be able to return to some sort of employment and therefore the loss of earnings claim was limited from the date they ceased their employment to 2 years after the date of the decision, an award of £150,060 was made.

However, the Applicant was unable to return to work after 2 years as the original medical evidence suggested.  Further medical evidence was obtained from the Consultant Psychologist who confirmed that their condition had deteriorated significantly and they would now not be able to return to work at all.  The CICA deemed that a material change had taken place which would undermine the original decision and cause an injustice.

The tariff award of £13,500 was increased to £22,000 as their symptoms were now deemed to be permanent.

Their employment prospects had now changed, and a further loss of earnings claim was sought from the date they ceased employment up until retirement age.  This resulted in an award of around £285,170 being made for loss of earnings.

Overall this applicant was awarded a further £143,610 as a result of reopening their claim.

Reopening a CICA claim can be complex, particularly where medical evidence must establish a direct link between the criminal injury and the worsening condition.  Specialist legal advice can help ensure that the evidence is presented effectively and that all procedural requirements are met. An experienced CICA Solicitor, such as at Jordans Solicitors can help assess the evidence and submit a request for the original claim to be reopened. 

A CICA decision therefore does not have to be the final word, if your injuries have worsened, a new diagnosis has emerged, or fresh medical evidence has become available since your award was made there may be grounds to ask the CICA to reopen your claim.