ZG (Iran) v Secretary of State for the Home Department

In asylum appeals, a medical report prepared long after alleged ill-treatment is not determinative of credibility. Its corroborative value depends on a clear opinion directed to the particular injuries and, where relevant, an assessment of alternative explanations. The fact-finding tribunal remains responsible for evaluating the account and the medical evidence together. A finding that injuries are consistent with the alleged trauma means only that the trauma could have caused them. It does not establish that the account is highly consistent, diagnostic, or more likely than competing explanations. Even where a doctor gives a favourable opinion, the tribunal may reject the account if it gives adequate reasons and has properly considered the medical evidence.

The appellant, an Iranian national, claimed asylum on the basis of political activity, imprisonment and torture by falaka. Her first appeal was dismissed by the tribunal on 22 November 2005. Reconsideration was ordered on 2 August 2006, principally because medical evidence had not been properly considered. Following a further hearing, the Asylum and Immigration Tribunal, in AIT case AA/10623/2005, again rejected her account and found no Convention risk on return.

She applied for permission to appeal, arguing that the tribunal had failed to give sufficient weight to Dr Hughes’s report concerning injuries to her feet. The central issue was whether the tribunal had lawfully evaluated that report and was entitled to reject the appellant’s account despite the medical findings.

1. Application refused. The tribunal had given detailed and persuasive reasons for rejecting the appellant’s account and had sufficiently considered the medical evidence.
2. Where a medical report is made long after the alleged persecution, its corroborative value depends on a clear statement of opinion addressing consistency with the particular injuries relied upon. It is desirable for the report also to identify alternative or everyday causes and physical features which make the suggested cause more or less likely. The Court of Appeal adopted the approach stated in SA (Somalia) v SSHD [2006] EWCA Civ 1302.
3. The medical expert’s role is not to assume the tribunal’s fact-finding function. The tribunal must assess the report alongside the other evidence. It was entitled to note that Dr Hughes had not addressed possible alternative causes, including consequences of surgery, and that his general conclusion went beyond the clinical material he had analysed.
4. Under the Istanbul principles, a finding of consistency means that the lesion could have been caused by the alleged trauma. It is distinct from a finding of high consistency, where there are few other possible causes, or a diagnostic finding, where other causes are effectively excluded. The word “entirely” did not elevate Dr Hughes’s opinion into either of those higher categories.
5. The tribunal was therefore entitled, notwithstanding the favourable medical opinion, to conclude that the appellant had not established that she was tortured as alleged. The renewed grounds depended on an error in the medical-evidence analysis and consequently failed.

• Court of Appeal (Civil Division) — permission to appeal refused.
• Asylum and Immigration Tribunal — following reconsideration ordered on 2 August 2006, the tribunal’s further decision, promulgated on 6 June 2007, rejected the appellant’s account and found no Convention risk on return. The earlier appeal had been dismissed on 22 November 2005.