A claimant who has experienced a significant, adverse traumatic event such as a road traffic accident, work accident or medical accident may well experience one or more psychological symptoms to their mental health including depression, sleep disturbance, anxiety in one or more areas and have a psychological reaction to the physical pain or injury they have incurred (Koch, 2018).

At a very mild level, many of these experiences can be viewed as normal, unpleasant and do not result in disruption to life, home or work, and typically resolve with time and the claimant’s own resilience.

Psychological compensation claims

However, in many cases these psychological experiences are severe enough that they are continuous, cause significant distress and disrupt the claimant’s everyday psychological and social functioning. With psychological injury or damage, generally, the factors to be taken into account in assessing and valuing a personal injury claim of this nature are as follows:

1. The claimant’s ability to cope with life, home and work
2. The effect on the claimant’s relationships with family, friends and those with whom he/she comes into contact
3. The extent to which treatment should be offered and would be successful
4. Future vulnerability
5. The outlook or future prognosis
6. Whether medical help has been sought

Psychological damage severity

Within the six factors above, a claim for a psychological injury is assessed as having one of four levels of severity, the first three of which are consistent with a recognised psychological disorder (Judicial College, 2015).

1. Severe – marked problems in factors 1-6 above and very poor prognosis.
2. Moderately severe – significant loading on factors 1-6 above but with an optimistic prognosis.
3. Moderate – originally high loading on problem areas 1-6 above but marked improvement by trial or medical review and a good prognosis.
4. Less severe – minor distress and little psychosocial disruption. Often these symptoms do not meet the criteria of a recognised psychological disorder, but if associated with physical injuries (minor or otherwise) can still be claimed for.

Within the first three levels of severity, the range of psychological disorder runs from Post-Traumatic Stress Disorder (PTSD), Acute Stress Disorder, Adjustment Disorders, Depressive Disorders, Specific Phobias and Generalised Anxiety Disorders.

Traumatic index events can often result in Pain Syndromes such as Chronic Pain Syndrome, Fibromyalgia and Somatoform Disorders, all characterised by subjective pain with variable organic/medical basis. The level of psychological factors involved with the maintenance and experience of this pain determines the appropriateness of the diagnosis of Somatic Symptom Disorder with psychological factors (Koch, 2016).

Neuropsychological assessments

A complex area is that of injuries to the head and brain which can be associated with cognitive impairment (e.g. memory, concentration) requiring a neuropsychological assessment and the diagnosis of Post-Concussion Syndrome (e.g. symptoms of headaches, dizziness and nausea).

In addition to the above, a pre-existing recognised psychological disorder which has been exacerbated by the index event or events can be claimed for and the recommendation for specific treatment considered.

All of the above clusters of psychological symptoms require a careful and thorough psychological assessment to provide a rigorous opinion on diagnosis, causation and prognosis (Koch, 2019). The past half-century has seen an appropriate and beneficial growth in such assessments as they have resulted in focussed, time-limited and specific psychological interventions e.g. cognitive behavioural therapy (CBT) which has reduced social and occupational desirability and time off work.

References:

Judicial College (2015) Guidelines for the assessment of General Damages in Personal Injury Cases. Oxford University Press.

Koch HCH (2016) Legal Mind: Contemporary Issues in Psychological Injury and Law. Expert Witness Publications. Manchester.

Koch HCH (2018) From Therapist’s Chair to Courtroom: Understanding Tort Law Psychology. Expert Witness Publications. Manchester.

Koch HCH (2019) Legal Mind Case and Commentary: Publication Directory 2019. Expert Witness Publications. Manchester.