Commentary

This is yet another case in which a medical report has been given little weight in immigration and asylum proceedings.

Learning points

• Unless you are fully conversant in the subject’s language, use an interpreter.

• It is unwise to rely on a family member or friend as an interpreter.

• It should not matter that the court or tribunal does not have a fully copy of the general practitioner records if the expert’s report sets out, either in the body of the report or in a medical chronology as an appendix, those entries relied upon and with references, such as ‘p. 5/236’, so that if the court or tribunal wants to do so, the entry can be checked when the full records are available to the court.

• A high level of disability has to be supported by other objective evidence in particular the subject's GP records.

• Where there is evidence from family members that they assist the subject with activities of daily living such as cooking, taking the subject to medical appointments, taking them for a walk, helping her with medication and emotional support this needs to be considered carefully and tested against what is in the medical record and any other evidence available.

• Where there is a complaint of severe arthritis and chronic pain, have regard to whether analgesia has been prescribed and the frequency with which repeat prescriptions have been requested. 

• Where there are claims of cognitive decline, it is incumbent on the expert to carry out bedside cognitive testing and, if appropriate, advise an expert assessment by a psychiatrist or neuropsychologist.

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