Murphy v Ministry of Defence

In a claim involving chronic widespread pain, the ordinary but for test applies. The claimant must prove, on the balance of probabilities, that the accident caused the condition and any consequential psychiatric injury. A temporal association, continuing symptoms and expert evidence may establish causation, but chronic widespread pain cannot automatically be attributed to every earlier trauma.

Where an accident foreseeably leads to medical investigations, the consequences of those investigations may fall within the scope of liability. This may include loss flowing from a medical decision made because of findings revealed by the investigation, even where the underlying condition was pre-existing and unrelated to the accident.

For future earnings, the Ogden Tables may be unsuitable where a claimant is technically disabled but has a limited labour-market handicap. A broad-brush Smith v Manchester award may then be appropriate.

The claimant, a serving soldier, suffered physical injuries in Afghanistan when a heavy roll of fabric struck his head. The defendant admitted breach of duty, and judgment on liability was entered on 27 October 2014. The trial concerned causation and quantum.

The claimant alleged that the accident caused chronic widespread pain, mixed anxiety and depressive disorder, loss of his Army career and consequential financial losses. The defendant accepted the initial injuries and the genuineness of the ongoing symptoms, but disputed causation. It contended that the physical injuries resolved within about three months and that the later pain and psychiatric condition arose spontaneously or from other events.

The central issues were whether the accident caused the chronic widespread pain and psychiatric condition, whether loss of parachute duties and pay was recoverable, and how future loss of earnings should be assessed.

1. Causation. The ordinary but for test applied. The claimant had to establish on the balance of probabilities that, but for the accident, he would not have developed chronic widespread pain and the additional mental illness. The court rejected any special material-contribution approach.
2. The court preferred the evidence of Dr Munglani and Dr Spencer. The medical records showed an early onset and continuing, undulating symptoms, rather than a symptom-free interval followed by spontaneous chronic widespread pain. The accident was a recognised potential trigger and had a close temporal and clinical association with the condition. Causation was established. The claimant also developed mixed anxiety and depressive disorder attributable to the accident and its consequences.
3. The claimant had no pre-existing chronic pain syndrome. Earlier knee pain and possible vulnerability did not relieve the defendant of liability for the consequences of injury to the claimant as found.
4. The MRI scan would not have occurred but for the accident. The scan revealed pre-existing spinal degeneration and led to the claimant being prevented from parachuting. That consequence was foreseeable and was not an unpredictable or freakish consequence of the breach. Loss of parachute pay was therefore recoverable.
5. The claimant would probably have remained in the Army for 24 years and reached the promotion stages identified by the claimant’s employment expert. He was disabled within the Equality Act 2010, but his disability was modest and his employment prospects remained strong. The Ogden Tables would produce an unrealistic result and required too contrived an adjustment.
6. A Smith v Manchester award was more appropriate for future disadvantage on the labour market. The court awarded £50,000 under that head, in addition to the conventional earnings calculation. General damages were £30,000, with further awards for treatment, care, dental treatment and other losses. Pension loss was put over, and the parties were invited to agree the final order.

First instance. The defendant admitted breach of duty, and judgment on liability was entered on 27 October 2014. The trial determined causation and quantum.