CICA Medical Reports and Criminal Injury Claims 2026. What the Scheme Pays, What Evidence Decides It and How Reports Are Prepared
The Criminal Injuries Compensation Authority pays awards to people physically or mentally injured by a crime of violence in England, Scotland or Wales, and the evidence decides almost everything. The scheme is a tariff, meaning the award is set by matching your injury to a defined description rather than by argument, so the wording of the medical evidence determines the band your injury falls into. Awards run from £1,000 at the lowest tariff level to £250,000 for the most serious single injuries, with a maximum total of £500,000 once loss of earnings and special expenses are included. Multiple injuries are paid on a sliding scale, with the highest-value injury paid in full, the second at 30% and the third at 15%. Two rules catch more applicants than any other. The time limit is 2 years from the incident for adults, extended in specific circumstances including childhood abuse. And the incident must have been reported to the police, with the report reference required on the application. Psychological injury is compensable in its own right, but a disabling mental injury award requires a diagnosis from a psychiatrist or clinical psychologist, which is the single most common reason a claim is undervalued. The Wellness Medico-Legal Wing prepares CPR-compliant medical reports for CICA applications and appeals, from £1,950 plus VAT. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated 1 September 2026.
Discuss a CICA report on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
How does the CICA tariff actually work
The scheme does not assess your injury and decide what it is worth. It matches your injury to a description in a published tariff and pays the figure attached to that description. That distinction governs everything about how evidence should be written.
A fractured rib and multiple fractured ribs sit at different levels. Continuing significant disability and continuing seriously disabling disability are separate descriptions paying materially different sums. Scarring is banded by visibility and severity. Loss of function is banded by degree and by whether recovery is expected. The medical report either places the injury clearly within a band or it leaves an assessor to choose the lower one.
Multiple injuries are paid on a sliding scale. The highest-value injury is paid in full, the second at 30% of its tariff value and the third at 15%. Injuries beyond the third attract nothing, which means identifying and correctly grading the 3 most valuable injuries matters more than listing everything.
Loss of earnings is payable only where you have no or limited capacity for paid work for more than 28 weeks, is calculated at a statutory rate rather than your actual salary, and requires evidence of incapacity. Special expenses cover items such as care, equipment, adaptations and NHS treatment costs, and are also only available where incapacity has exceeded 28 weeks.
What evidence does CICA actually need
The police report reference, because an application will not proceed without evidence that the crime was reported and that the applicant cooperated with the investigation.
Medical records covering the injury, which CICA will usually obtain directly with your authority, and which frequently contain less than applicants expect. Emergency department notes are brief, GP entries are short, and neither is written with a tariff in mind.
A medical report where the records do not establish the tariff level. This is the step most applicants skip and the one that changes awards. A report sets out the mechanism of injury, the findings on examination, the current functional effect, the treatment received and required, and, critically, the prognosis, because most tariff descriptions turn on whether disability is continuing and on how disabling it is.
For psychological injury, a diagnosis from a psychiatrist or clinical psychologist. The scheme distinguishes a disabling mental injury lasting at least 6 weeks from more serious and permanent presentations, and the higher bands require a formal diagnosis of a recognised psychiatric condition rather than a description of distress. A GP note recording low mood will not place a claim in the band a diagnosed post-traumatic stress disorder would.
Ask what evidence your claim needs on WhatsApp or email team@thewellnesslondon.com.
Why claims are reduced or refused
Late application. The limit is 2 years from the incident for adults. Extensions are possible where exceptional circumstances explain the delay and the evidence still allows a decision without extensive further enquiry, and childhood abuse cases carry their own provisions, but the extension is discretionary rather than automatic.
No police report, or insufficient cooperation with the investigation. Reporting late, withdrawing a statement or declining to assist can reduce or extinguish an award.
Unspent criminal convictions, which can reduce or bar an award under the scheme's rules depending on the sentence, and conduct before, during or after the incident that contributed to it.
Incomplete medical evidence, which is the failure this page exists to address. Where the records do not establish which tariff description applies, the assessment defaults to the lower band or to nothing at all for that injury.
And undervalued psychological injury, where distress is documented but no formal psychiatric diagnosis exists. A significant proportion of applicants with genuine post-traumatic stress disorder are paid at a level reflecting the absence of a diagnosis rather than the absence of the condition.
How a report should be constructed
Instruction first, setting out the questions to be answered, the tariff descriptions in issue and the documents provided. A report written without knowing which bands are contested will address the wrong things.
Records review, building a chronology from the emergency department attendance through primary care, imaging, specialist input and treatment. Gaps and inconsistencies are identified and addressed rather than ignored, because an assessor will find them.
Examination, conducted in person at Marylebone or at the applicant's home where mobility, anxiety or vulnerability requires it. Findings are recorded objectively with measurements rather than impressions, since scarring, range of movement and neurological deficit are all gradable.
Investigation where objective evidence is needed. Ultrasound imaging at a specialist centre with consultant radiologist reporting where soft tissue injury is disputed, and blood analysis at an accredited laboratory where relevant.
Opinion written to the tariff, identifying the applicable descriptions, explaining why the findings meet them, and giving a prognosis that addresses whether disability is continuing and to what degree. Where a description is not met, the report says so, because a report that overreaches damages the rest of the claim.
And a declaration compliant with Part 35 of the Civil Procedure Rules, with a statement of truth, which is the standard expected even where the tribunal is not a court.
What do CICA medical reports cost
Medico-legal reporting in London runs from around £1,500 plus VAT for a straightforward single-injury report to £5,000 and above for complex multi-injury and life expectancy work, with consultant psychiatric reports for psychological injury commonly £1,800 to £3,500 plus VAT. Records collection and chronology preparation are charged separately by most providers. Court attendance runs £2,000 to £4,000 per day. Below that sits a tier defined by its conditions rather than its price, template reports produced without examination, which are the reports most often challenged.
At The Wellness Medico-Legal Wing the instruction, the records review and the report are quoted as one figure. All figures are from prices, plus VAT.
Complex life expectancy report in catastrophic injury, from £5,450.
Clinical negligence report addressing breach and causation, from £4,950.
Complex multi-injury report, from £3,450.
CICA report addressing psychological injury alongside physical injury, prepared with psychiatric input, from £2,950.
CICA medical report, single or limited injuries, including instruction, records review, examination and CPR Part 35 compliant opinion, from £1,950.
Rebuttal report or joint statement, from £1,450.
Ultrasound imaging arranged at a specialist centre with consultant radiologist reporting, from £995 per region. Blood analysis at an accredited laboratory from £495.
Records collection and chronology, from £395. Part 35 questions answered, from £650. Hourly rate for additional work, £450.
Court attendance £3,500 per day and £2,250 for a half day. Domiciliary examination within the M25, additional £750. Expedited preparation within 5 working days, additional 50%.
Appointments at 10 Portman Square, Marylebone, or at the applicant's home where required, across England, Scotland and Wales.
Why The Wellness Medico-Legal Wing is the best choice for CICA reports
Because the report is written to the tariff rather than to a general template. An assessor is matching your injury to a published description, so a report that identifies the applicable descriptions and explains why the findings meet them does the assessor's work for them. A report that describes an injury without reference to the scheme leaves that work undone and the lower band applied.
Because the 3 highest-value injuries are identified deliberately, since the sliding scale pays the second at 30% and the third at 15% and nothing beyond. Getting that ordering right is worth more than length.
Because psychological injury is taken as seriously as physical injury. Where the presentation suggests a recognised psychiatric condition, a formal diagnosis is arranged with a consultant psychiatrist rather than left as a description of distress in a GP record.
Because objective findings are produced rather than described. Ultrasound imaging at a specialist centre with consultant radiologist reporting where soft tissue injury is contested, and measured examination findings rather than impressions.
And because the report says where a tariff description is not met. A report that overclaims invites challenge across the whole document, and an assessor who finds one unsupported assertion reads everything else differently.
Related reading
The Wellness Medico-Legal Wing sets out the full service range, instructing a medical expert witness covers the process for solicitors, accident at work and employers' liability covers workplace injury claims, and life expectancy in catastrophic injury covers the highest-value reports.
Instruct a report on WhatsApp or call 020 3951 3429.
Frequently asked questions
How much does CICA pay
Awards run from £1,000 at the lowest tariff level to £250,000 for the most serious single injuries, with a maximum total of £500,000 once loss of earnings and special expenses are included. Multiple injuries are paid on a sliding scale, with the highest-value injury paid in full, the second at 30% and the third at 15%.
What is the time limit for a CICA claim
Two years from the incident for adults. Extensions are discretionary and require exceptional circumstances explaining the delay, with the evidence still allowing a decision without extensive further enquiry. Childhood abuse cases carry their own provisions. The incident must also have been reported to the police.
Do I need a medical report for a CICA claim
Where your medical records clearly establish which tariff description applies, sometimes not. Where they do not, and emergency department and GP records frequently do not because they are not written with a tariff in mind, a report is what places the injury in the correct band rather than the lower one.
Is psychological injury covered by CICA
Yes, in its own right. A disabling mental injury lasting at least 6 weeks is compensable, and the higher bands require a formal diagnosis of a recognised psychiatric condition from a psychiatrist or clinical psychologist. Distress documented in a GP record without a diagnosis is the commonest reason these claims are undervalued.
How much does a CICA medical report cost
At The Wellness Medico-Legal Wing a CICA report covering single or limited injuries, including instruction, records review, examination and a CPR Part 35 compliant opinion, is from £1,950 plus VAT, rising to £2,950 where psychological injury requires psychiatric input. Medico-legal reporting in London generally runs £1,500 to £5,000 and above plus VAT.
Can a report be prepared at home
Yes. Domiciliary examination is available where mobility, anxiety or vulnerability makes attending impractical, at an additional £750 within the M25. Expedited preparation within 5 working days is available at an additional 50%.
The Wellness Medico-Legal Wing provides independent medico-legal reporting from 10 Portman Square, Marylebone, London. All doctors are GMC-registered and reports comply with Part 35 of the Civil Procedure Rules. Imaging is arranged at specialist centres and reported by consultant radiologists, and blood analysis is performed by accredited laboratories. Scheme rules, tariff values and time limits are set by the Criminal Injuries Compensation Authority and should be confirmed on the official CICA website. This article is general information and not legal or medical advice about your own case.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. Criminal Injuries Compensation Scheme, published tariff of injuries, eligibility rules, time limits and the multiple injury sliding scale. Criminal Injuries Compensation Authority published guidance on applications, police reporting requirements, unspent convictions and conduct. Civil Procedure Rules Part 35 and Practice Direction 35, duties of experts and the form of expert reports. Academy of Medical Royal Colleges guidance on acting as an expert witness. Published 2026 UK medico-legal reporting market pricing.
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