CICA Claim Appeal - How A Rejected Claim Was Overturned with an Award of over £153,000.00

How a CICA Claim Appeal Led to a Big Compensation Award 

Being refused compensation by the Criminal Injuries Compensation Authority (CICA) does not necessarily mean the end of your CICA claim. One anonymous client of Winston Solicitors experienced this first-hand. Her claim followed a sexual assault when she was just 15 years old. It was initially rejected by the CICA and remained unsuccessful after a review. It was only after a CICA claim appeal to the First-tier Tribunal that the decision was overturned.

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She was ultimately awarded £153,733.48.
The case demonstrates why a rejected CICA claim should not always be accepted as the final word, particularly where there is significant evidence that has not been properly considered or where the CICA has applied the Scheme incorrectly.

A Sexual Assault That Changed a Young Woman's Life [H2]

Our client was 15 when she was sexually assaulted in 2006. She had been drugged or spiked, and then was raped by between three and five potential suspects. Given the drugging, she had no recollection of the assault itself. When she regained consciousness, she was in a public place, disorientated and only able to remember what had happened afterwards.

As a result of the assault, she became pregnant. She continued with the pregnancy and gave birth to her child. The consequences of what happened were profound. Her mental health deteriorated rapidly. She struggled to care for her baby, became involved with drugs and experienced homelessness.

Almost ten years after the assault, in 2015, she reported what had happened to the police. The police interviewed three suspects. Each blamed the others. DNA testing was carried out on two of the suspects, but the results did not establish paternity. A third potential suspect was not on the police database, meaning there was no DNA comparison available.

Ultimately, nobody was charged. However, for our client, the fact that nobody was prosecuted did not mean that the assault had not happened.

The CICA Claim was Initially Rejected 

In September 2021, approximately 15 years after the assault, we applied to the CICA for compensation on our client's behalf. The claim was rejected at the first decision stage. The reasons given included insufficient evidence because no suspect had been charged, the delay in reporting the assault to the police, and the fact that the application for compensation had been made outside the usual time limit.

For someone who has already lived through the consequences of a traumatic assault, receiving a decision like this can be devastating. Our client had already experienced significant mental health difficulties following what happened to her. She had eventually found the strength to report the assault and seek compensation, only to be told that the lack of a prosecution and the passage of time counted against her.
We did not believe the evidence had been properly assessed.

Building The Evidence for the Review [H2]

Our CICA experts applied for the CICA decision to be reviewed and gathered comprehensive supporting evidence.
This included antenatal and maternity records, which helped establish the dates of conception and delivery. We also obtained mental health records that supported the reasons for the delay in reporting the assault and the delay in making the compensation application.

We put detailed arguments to the CICA about why our client's circumstances should be considered in the context of the evidence as a whole.
A crucial issue was the CICA's interpretation of the fact that nobody had been prosecuted. The police had not concluded that the assault had not happened. Rather, they had been unable to establish who was responsible to the standard required for a prosecution. Those are very different things.

The CICA Scheme concerns whether an applicant was a victim of a crime of violence. It does not require the person responsible to have been prosecuted or convicted before an application can be considered.
However, despite the evidence and arguments presented, the CICA rejected the claim again at review.

Why The Review Decision Was Challenged [H2]

The second decision raised another important issue.

The CICA placed weight on the fact that our client had not told medical professionals the true circumstances surrounding how she became pregnant. It considered that there was insufficient corroborating information in her medical records.

We disagreed with that assessment.

The evidence needed to be considered as a whole rather than treating the absence of a particular disclosure in medical records as decisive.
There was evidence about the timing of the pregnancy. On top of that, there was the police investigation and DNA evidence relating to two of the suspects. There was also information about the potential third suspect. All of this led to a decline in our client's mental health and the impact the assault had on her life, which was evidenced in addition.

The fact that she had not disclosed the full circumstances to medical professionals at the time needed to be considered alongside all of that evidence. Importantly, the circumstances in which the assault had occurred.

The CICA Scheme applies the balance of probabilities when determining whether the relevant circumstances are established. This means the question is whether something is more likely than not to have happened. It was our position that the evidence, taken together, supported our client's account.

The CICA Claim Appeal [H2]

Following the second rejection, we appealed to the First-tier Tribunal.

The CICA claim appeal focused on the significant psychological and mental health trauma our client had experienced as a result of the assault. The medical evidence supported the impact that the assault had had on her, as well as providing evidence relevant to the exceptional circumstances surrounding the delays in reporting the incident and making her application.

We also challenged the way in which the CICA had approached the absence of a prosecution. Our client had been a child when the assault happened. She had subsequently experienced severe difficulties in her life, including mental health problems, drug involvement and homelessness. These were not simply matters that could be separated from the history of her claim. They formed part of the circumstances in which she had tried to cope with what had happened.

We supported her throughout the appeal process and prepared detailed arguments for the Tribunal panel. This proved to be a significant turning point.

The CICA Conceded Before the Hearing [H2] 

Following the submission of our arguments before the hearing, the CICA conceded the issues relating to the delay in making the claim and the time limit. This meant that the case could move forward on the basis that those parts of the original decision had been wrongly determined.

The Tribunal hearing remained an important moment for our client. Stacey Flegg, who represented her, described the case as deeply personal because of the way in which our client had been scrutinised despite the circumstances surrounding the assault and its consequences.

Stacey Flegg, Head of CICA at Winston Solicitors said:
“This was an important turning point in our client's claim. Before the Panel at the hearing, it was clear the CICA had erred in their judgement of this application and the Judge on the day expressed her disappointment that our client had been made to endure such scrutiny where it was evidently obvious, she was a rape survivor.

“It became a deeply personal case to me, one that I felt wholeheartedly should not have been subject to such criticism by the Authority. Our client was a child when this happened to her, and shaped every aspect of her life from that point. I admire her resilience and strength, and I am very grateful she put her trust in me to fight for her justice. It was owed to her and long overdue.”

An Award of £153,733.48 

Following the appeal, our client received an award of £153,733.48. The award recognised the significant mental health difficulties she had experienced following the rape. It also included compensation relating to the pregnancy, recognising that the pregnancy had resulted from the assault.
The award also included past loss of earnings and future loss of earnings for a period of two years, intended to support her further treatment and recovery.
For our client, the financial award was about more than the money itself. After years of living with the consequences of what had happened, followed by the rejection of her claim, the decision provided recognition of the impact the assault had had on her life.

Stacey said:
“It has been a privilege to achieve this result for her. Finally, she has been given the recognition she has deserved for so long. To be believed, to feel validated, and to be given a sum of money that will help re-shape her future.”

What Our Client Said About Her CICA Claim 

Our client has given permission for us to share the story of her case anonymously because she hopes that doing so may help other young women who have experienced similar circumstances.
She said:
“I cannot thank Stacey at Winston Solicitors enough. She did some amazing work with very little information. This case wasn’t just for me, but for all young girls out there in a similar situation. I want others to know that there are people willing to fight for us, and I highly recommend Stacey Flegg to deal with your case.”

Her decision to allow her experience to be shared reflects an important part of this case.

She had been through an experience that affected her from childhood into adulthood. By allowing the case to be discussed anonymously, she hopes another survivor may see that a rejected CICA claim does not necessarily mean that there is nowhere else to turn.

What Does This Case Tell Us About CICA Claim Appeals? [H2]

Every CICA claim is different, and the outcome of one case cannot guarantee the outcome of another. However, this case demonstrates why it can be important to obtain specialist legal advice if the CICA has rejected your application.

A claim may involve complicated questions about evidence, reporting delays, time limits, the impact of trauma and how the Scheme's requirements should be applied to the individual circumstances of the case.

In this case, the absence of a criminal prosecution was particularly important. The fact that nobody had been charged did not mean that the assault had not taken place. The police had investigated the allegations but had been unable to establish who was responsible. The wider evidence therefore needed to be considered carefully.

The case also demonstrates why medical and other supporting records can be important. Our client's antenatal, maternity and mental health records helped provide evidence that supported the account and the circumstances surrounding the delays in reporting and claiming.

A CICA claim is not simply about whether a person was prosecuted. It is about whether the requirements of the Criminal Injuries Compensation Scheme are met and whether the evidence supports the claim.

What If Your CICA Claim Has Been Rejected? [H2]

If the CICA has rejected your claim, you may have the right to ask for a review and, in appropriate circumstances, appeal the decision to the First-tier Tribunal.
The relevant deadlines are important, so you should obtain advice as soon as possible after receiving a decision.

A specialist solicitor can review the reasons given by the CICA and consider whether the evidence has been properly assessed and whether the Scheme has been correctly applied.

Depending on the circumstances, this may involve gathering additional evidence, obtaining medical or other records, preparing detailed legal arguments and representing you through the appeal process.

The fact that your claim has been rejected does not automatically mean that you were not a victim of a crime of violence or that you cannot receive compensation. Equally, an appeal does not guarantee a successful outcome. The important thing is to understand why the claim was rejected and whether there are grounds to challenge that decision.

You Do Not Have to Face A CICA Appeal Alone 

For our client, the journey from the original assault to receiving compensation lasted many years. She was a child when the assault happened. She lived through severe consequences afterwards. She eventually reported what happened to the police, but nobody was charged. Years later, her compensation claim was rejected by the CICA, and that rejection was upheld at review.

Nevertheless, we continued to support her and continued with the appeal to the First Tier Tribunal. The eventual award of £153,733.48 cannot undo what happened to her. It can, however, provide recognition of the harm she experienced and financial support for her future. Most importantly, this case shows why a CICA decision should be understood before it is accepted as final.

If your CICA claim has been rejected, or you are unsure whether you have grounds to challenge a decision, our specialist Criminal Injuries Compensation team can explain your options.

You do not need to know exactly what evidence you need or understand the appeal process before you contact us. We can review the decision and explain what it means for your circumstances.

If you have received a CICA rejection, speak to Winston Solicitors about your options for a CICA claim appeal.