PTSD and Psychiatric Injury Expert Reports 2026. What the Law Requires, What Awards Turn On and How Reports Are Prepared

Written By Dr Jones

In a psychiatric injury claim, the medical report does more work than in almost any other kind of case, because the injury cannot be seen on a scan. English law compensates a recognised psychiatric illness, not distress, grief or upset however severe, so the first question is always diagnosis, and the answer must meet ICD-11 or DSM-5-TR criteria on a structured assessment rather than a questionnaire alone. Post-traumatic stress disorder is common after serious events, with a meta-analysis putting it at around 22% of road traffic accident survivors, and it frequently sits alongside depression, travel anxiety and chronic pain. The 18th edition of the Judicial College Guidelines, published on 9 April 2026 with an uplift of around 8.26%, places PTSD awards between £5,210 and £132,990, and where a case sits in that range is decided by the report's findings on severity, causation, pre-existing history and prognosis with treatment. Consultant psychiatric reports in the UK market commonly run from £1,800 to £3,500 plus VAT, with senior experts charging around £400 an hour and £3,000 a day for court. The Wellness Medico-Legal Wing provides CPR Part 35 compliant consultant psychiatric reports from £2,950 plus VAT, with a fee quotation and examination date returned within one working day. Instructions are accepted nationally from claimant firms, defendant firms and insurers.

Reviewed by the medical team at The Wellness. Last updated 30 September 2026.

Discuss a psychiatric injury instruction on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

What does the law require in a psychiatric injury claim

The claimant must have a recognised psychiatric illness. Fear, distress, anxiety and grief, even when intense, are not compensable on their own, which is why the diagnosis is the foundation of the claim rather than a formality.

The route to recovery depends on the claimant's position. A primary victim, someone within the range of foreseeable physical injury, can recover for psychiatric harm alone following Page v Smith. A secondary victim, someone who witnesses harm to another, faces the control mechanisms set out in Alcock, including a close tie of love and affection and presence at the event or its immediate aftermath.

In clinical negligence, the Supreme Court in Paul v Royal Wolverhampton NHS Trust in 2024 held that relatives witnessing a death or medical crisis caused by negligent failure to diagnose cannot generally recover as secondary victims. Instructing firms should frame the questions to the expert with that decision in mind.

How is PTSD diagnosed for legal purposes

PTSD requires exposure to a traumatic event and a defined pattern of symptoms. Under ICD-11 those are re-experiencing the event in the present, such as intrusive memories, flashbacks or nightmares, avoidance of reminders, and a persistent sense of current threat, such as hypervigilance or an exaggerated startle response. The symptoms must last several weeks and cause significant impairment. ICD-11 also recognises complex PTSD, which adds lasting problems with emotional regulation, self-worth and relationships.

DSM-5-TR uses 4 symptom clusters, including negative changes in mood and thinking, and requires symptoms to persist for more than 1 month.

A defensible diagnosis rests on a structured clinical interview. The Clinician-Administered PTSD Scale for DSM-5, known as CAPS-5, is the most widely used structured interview. Self-report measures such as the PCL-5, PHQ-9 and GAD-7 are useful supporting evidence but are open to challenge when relied on alone.

Ask about a specific instruction on WhatsApp or email team@thewellnesslondon.com.

What should a psychiatric injury report cover

Diagnosis, with the criteria applied and the evidence for each. Where the claimant does not meet the criteria for PTSD, the report says so, and considers whether another condition such as an adjustment disorder, depressive episode or specific phobia is present.

Causation. Whether the index event caused the condition, materially contributed to it, or accelerated a condition that would have arisen anyway, and over what period.

Pre-existing history. The GP and any mental health records are reviewed in full, because an earlier episode of anxiety or depression is the most common ground on which causation and quantum are attacked. A vulnerable claimant is still entitled to compensation for the harm caused, but apportionment has to be addressed openly.

Consistency and validity. The account given at interview is compared with the records, the claimant's presentation and any collateral information, and any inconsistency is identified and explained rather than ignored.

Prognosis with and without treatment, and the effect on work, relationships, driving and daily life.

Treatment recommendations, specific and costed, so they can be claimed as special damages.

What treatment will the report recommend

NICE guideline NG116 recommends trauma-focused cognitive behavioural therapy for adults with PTSD, usually 8 to 12 sessions and more where there are multiple traumas or complex PTSD. Eye movement desensitisation and reprocessing, known as EMDR, is recommended for PTSD following non-combat trauma. NICE advises against psychologically focused debriefing to prevent PTSD, and places medication, such as venlafaxine or an SSRI such as sertraline, as an option where the person prefers it or cannot engage with therapy.

A good report states which treatment is indicated, how many sessions, over what timescale, and the likely outcome, since many people with PTSD improve substantially with evidence-based treatment. That forecast drives the prognosis and much of the valuation.

How are PTSD awards valued in 2026

The 18th edition of the Judicial College Guidelines sets 4 brackets for PTSD. Less severe cases, with a virtually full recovery within 1 to 2 years and only minor symptoms after that, from £5,210 to £10,800. Moderate cases, with a large recovery and no grossly disabling continuing effects, from £10,800 to £30,580. Moderately severe cases, with a better prognosis than severe cases through professional help but significant effects for the foreseeable future, from £30,580 to £79,080. Severe cases, where the claimant cannot work or function at pre-trauma level, from £79,080 to £132,990.

The report is what places a claimant in a bracket. Severity, response to treatment, the effect on work and the likelihood of recovery are all matters of medical opinion, which is why a vague or poorly reasoned report reduces the value of a sound claim.

How do different claim types treat psychiatric injury

Road traffic claims. Under the Whiplash Injury Regulations 2021, minor psychological injury suffered alongside a whiplash injury is compensated within the fixed tariff, and most road traffic injury claims up to £5,000 proceed through the small claims track. PTSD and other recognised psychiatric illnesses outside that tariff require full expert evidence.

Criminal injury. The Criminal Injuries Compensation Authority pays for disabling mental injury only where it is diagnosed by a psychiatrist or clinical psychologist, so the qualification of the expert matters as much as the content.

Employment and stress at work. Claims turn on foreseeability, following Hatton v Sutherland, so the report must address when symptoms began and what the employer knew. Our employment tribunal reports page covers disability status and psychiatric injury in discrimination claims.

Clinical negligence. The psychiatric consequences of a negligent treatment or missed diagnosis are assessed separately from breach of duty, with causation often the central issue.

Request our fee schedule on WhatsApp or call 020 3951 3429.

Should you instruct a psychiatrist or a psychologist

Both can diagnose PTSD, and both are accepted by the courts and by the Criminal Injuries Compensation Authority. The choice depends on the questions.

A consultant psychiatrist is medically qualified, so a psychiatrist is the right expert where medication, physical injury, chronic pain, alcohol or drug use, head injury or capacity are in issue, or where the interaction between physical and psychiatric symptoms matters to causation.

A clinical psychologist is often the right expert where detailed psychometric or cognitive testing is central, such as in some brain injury claims.

In complex cases both may be needed, and the letter of instruction should say which questions go to which expert.

What do psychiatric expert reports cost

Across the UK market, consultant psychiatric reports for psychiatric injury commonly run from £1,800 to £3,500 plus VAT, with complex and clinical negligence work above that. Senior psychiatric experts publish hourly rates around £400 and court attendance around £3,000 a day, and standard agency reports start lower but rarely include full records review.

At The Wellness Medico-Legal Wing all figures are from prices plus VAT.

  • Court or tribunal attendance, from £3,500 per day and £2,250 per half day.

  • Clinical negligence psychiatric opinion on causation and quantum, from £4,950.

  • Complex psychiatric report covering multiple diagnoses, pre-existing history and apportionment, from £3,450.

  • PTSD or psychiatric injury condition and prognosis report with full records review, from £2,950.

  • Joint statement and expert discussion, from £1,450. Commentary on opposing evidence, from £1,450.

  • Screening or merits opinion on records, from £750. Part 35 questions, from £650.

Deferred payment terms are available to instructing solicitors, and fees are never conditional on outcome.

Why instruct The Wellness Medico-Legal Wing

Because psychiatric questions go to psychiatrists. Reports are prepared by consultant psychiatrists, not by physicians offering an opinion outside their field.

Because the records are read in full. Pre-existing history is the most common line of attack on a psychiatric claim, and a report that has addressed it openly holds up under cross-examination.

Because diagnosis rests on a structured interview, with self-report measures used as support rather than as the whole case.

Because treatment is specified and costed, so the report supports special damages as well as general damages.

And because the process is fast. A fee quotation and a confirmed examination date are returned within one working day, with examination in Marylebone or by secure video where the instruction permits.

Related reading

Instructing a medical expert witness covers CPR Part 35 and the letter of instruction, CICA medical reports covers criminal injury claims, employment tribunal reports covers disability status and psychiatric injury at work, clinical negligence reports covers breach and causation, and private mental health care covers the clinical side of anxiety, depression and trauma.

Instruct a report on WhatsApp or call 020 3951 3429.

Frequently asked questions

What is a psychiatric injury report

A psychiatric injury report is an independent expert report, prepared under CPR Part 35, that addresses diagnosis, causation, pre-existing history, prognosis and treatment for a claimant who says an event caused a psychiatric illness such as PTSD, depression or anxiety.

How much is a PTSD claim worth in 2026

The 18th edition of the Judicial College Guidelines places PTSD between £5,210 and £132,990, across less severe, moderate, moderately severe and severe brackets. The bracket depends on the medical evidence on severity, effect on work and daily life, and prognosis with treatment.

Can you claim for stress or anxiety without a diagnosis

Not generally. English law compensates a recognised psychiatric illness, so a diagnosis meeting ICD-11 or DSM-5-TR criteria is needed. Distress, fear and grief alone are not compensable, however severe.

Should I instruct a psychiatrist or a psychologist for PTSD

Both can diagnose PTSD. A psychiatrist is preferable where medication, physical injury, chronic pain, substance use or capacity are in issue. A psychologist suits cases centred on detailed psychometric or cognitive testing.

How much does a psychiatric expert report cost

Consultant psychiatric reports in the UK commonly run from £1,800 to £3,500 plus VAT. At The Wellness Medico-Legal Wing a PTSD or psychiatric injury report is from £2,950 plus VAT and a complex report from £3,450 plus VAT, with deferred payment terms available.

How quickly can a psychiatric report be arranged

A fee quotation and a confirmed examination date are returned within one working day of receiving a letter of instruction, with examination in Marylebone or by secure video where the instruction permits.

The Wellness is a doctor-led private healthcare group providing medical care and independent medico-legal reporting from 10 Portman Square, Marylebone, adjacent to Harley Street. All doctors are GMC-registered. Expert reports are prepared in accordance with CPR Part 35 and the expert's overriding duty to the court. In an emergency call 999. This article is general information and not legal or medical advice about any individual case.

Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

References

Dr Jones
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