Michaelides & Anor, R (on the application of) v Police Medical Appeal Board

A police medical appeal board must determine the factual, medical and legal issues raised in an appeal and give reasons sufficient to explain why one party succeeded. It must address material allegations relied on as causative of disablement and make clear whether those allegations are proved, rejected or left unresolved.

Under the police injury pension regulations, an appeal board is bound by the earlier selected medical practitioner’s answers as to the existence and permanence of disablement, but not by the diagnosis underpinning those answers. A board may therefore assess the medical evidence afresh, subject to the statutory scheme. Delay will not ordinarily justify refusing relief where the defendant is in no worse position to contest the matter than at the time of the challenged decision.

The claimant, a former Merseyside police officer, sought an injury award after retiring on grounds of permanent disablement. The Police Medical Appeal Board rejected his appeal from the selected medical practitioner, finding that his condition was not caused by an injury received in the execution of duty.

The claimant challenged the Board’s decision by judicial review, alleging that it had failed to respect the finality of the earlier medical decision, mishandled the evidence, and failed to give adequate reasons. The central issues were the scope of the Board’s review, its treatment of allegations of bullying and racism said to have caused the claimant’s illness, the adequacy of its reasons, and whether delay should lead to refusal of relief.

1. Ground 1. The claim could not succeed on the argument that the Board was bound by the selected medical practitioner’s diagnosis or reasoning. The court was bound by R (on the application of Colene Boskovic) v Chief Constable of Staffordshire Police [2019] EWCA Civ 676, which held that the later decision-maker is bound by the earlier answers as to whether the officer is disabled and whether the disablement is likely to be permanent, but not by the diagnosis underpinning those answers. The court rejected the submission that this part of Boskovic was obiter and held that it was consistent with Metropolitan Police Authority v Laws [2010] EWCA Civ 1099.
2. The Board was entitled to treat the ICD-10 Z56.0 reference to problems with employment as a descriptive code rather than a medical condition. The change from depressive episode to mixed anxiety and depressive disorder was not material on the facts. The Board was also entitled to conclude that the evidence did not establish a causal connection between the six identified incidents and the claimant’s condition.
3. Grounds 2 and 3. The Board acted unlawfully in failing to reach, or explain, conclusions on the wider allegations of bullying, racism and harassment contained in the psychiatric evidence. Those allegations formed part of the claimant’s case and were material to whether an injury had caused or substantially contributed to disablement. The report did not make clear whether the allegations were rejected as unproved, disregarded, or treated as unnecessary to determine.
4. The Board acted in a quasi-judicial capacity in an adversarial process and its decision was determinative of the claimant’s rights. Procedural fairness therefore required adequate reasons dealing with the substantial factual and legal issues raised. Regulation 31(3) did not confine that duty to cases in which the Board disagreed with the selected medical practitioner.
5. Delay did not justify refusing relief because the defendant was in no worse position to contest the matter than it had been in 2016. The Board’s decision was quashed. The court indicated that reconsideration by a fresh Board would be preferable, subject to submissions.

This was a first-instance judicial review in the Administrative Court. Permission had been granted by Lane J on 29 November 2018. The court quashed the decision of the Police Medical Appeal Board.