When the CICA make an offer of compensation on a case, a lot of Applicants don’t know that they can reopen their claim later down the line if new injuries arise or if previous conditions that occurred as a result of the incident, worsen. Please do note that this applies to primarily settled cases, as the procedure for a rejected case is slightly different (Appeal/Tribunal)
CICA may consider reopening a settled claim if there has been the following or similar reasons:
The Applicant has died as a result of their injuries – This would apply if a victim later passed away due to injuries sustained as a direct result of the incident that occurred. Medical evidence would be needed to support this.
A change or development in injuries sustained as a result of the incident– This would apply in cases where there is extensive medical evidence to support that the injuries previously sustained, mental or physical, have deteriorated or developed further over time. It is often described as being reopened ‘if the original decision would be an injustice’ to the Applicant.
It is often requested that claims are aimed to be reopened two years after the original decision was made. However, the CICA may still consider any requests received after this time, based on the following:
Extensive further evidence – This means that when the request is presented to the CICA, all evidence is provided with it. This evidence must also be substantial and detailed enough to support the new developments. For example, medical records detailing the development in injuries and written reports from specialists and treatment plans/prognosis would likely be sufficient. A poor example would be simply presenting the CICA with a written letter from a GP, as it would not be detailed.
No further enquiries required – This means that all evidence is presented to the CICA then and there, along with the initial written request for why the Applicant believes the claim should be reopened. Because the CICA already did all of their investigations initially, they do not want to be presented with a reopening request where they have to make further enquiries themselves. If all the evidence is there, then they will likely consider it.
In order to reopen a claim, a formal written request must be made to the CICA. It would need to clearly detail why the matter should be reopened and have supporting evidence to back up the claims made in the written request. This is very important that these two are sent together, as the onus is on the Applicant or their representative to prove the claims that are being made in the request.
The amount that can be further awarded is dependent on the injuries that have developed and the amount that was originally offered. For example, if an Applicant was originally offered £2,500 and the development in injuries led to a new offer of £11,000 being made, the CICA would subtract the initial offer of £2,500 from the £11,000.
A common occurrence we see is specifically with rape cases. If an applicant chooses for the CICA to only consider police evidence, the case can settle rather fast, for a minimum of £11,000. However, this is only compensating for the physical act, rather than the complex lasting issues.
It can take years for mental health issues to develop and be diagnosed, which is often why Applicants find themselves reopening their claims several years later. Conditions such as PTSD, BPD and Complex PTSD can take a considerable amount of time to diagnose, due to extensive wait times to see professionals associated with these conditions but also due to personal factors for the individual. We often see in victims of sexual crimes denial and disgust about what has happened. This is particularly common in men, due to the stigma surrounding men being victims of sexual crimes. Whatever the personal reasons may be, these can also lead to a delay in seeking treatment and ultimately a delay in a diagnosis.
You may be wondering why a GP is not satisfactory when it comes to presenting evidence to the CICA. When a claim is initially made, the CICA often contact the GP to have them fill out an injury form or to provide a medical report. However, there is only a certain amount of information a GP can provide before it crosses the threshold into specialist territory. It is frustrating for Applicant’s, especially when it comes to mental health, as it can be very difficult and long to get a referral to a Psychiatrist or Psychologist. Ultimately, the CICA would not accept any evidence from a GP pertaining to mental health. They would acknowledge it, but for the CICA to properly assess mental injuries, they must have been diagnosed or treated by a mental health professional. Another example of this would be if an Applicant further developed a brain injury as a result of an incident that occurred. It would be useless to have a GP comment on the injuries, as they would be out of their league of knowledge, so to speak. In this case, it would be a neurologist that evidence would be sought from.
If you have previously claimed through the CICA and feel as though you may have grounds to medically reopen your case, please contact us now and we can assess the case prospects and factors and advise you professionally on the best course of action.