‘Appears to be a complex case with multifactorial elements including psychological.’
‘Assessment of the arms and legs was rendered difficult because of his reluctance to co-operate. This, again, in my opinion, reflected depression and doubt at his own capability rather than a deliberate attempt at deception.’
‘it was very clear during the interview and the examination that this Claimant is profoundly depressed and is lacking adequate treatment and psychiatric input currently.’
“61. Psychiatric diagnosis is intrinsically subjective and ultimately a matter of subjective professional opinion, of which there is commonly a range. We currently have no objective methods, such as blood tests or brain scans, that can confirm or refute the presence of subjective psychological symptoms or pain. It follows that the accuracy of the subject’s account, corroborated if possible by preferably disinterested sources, of which contemporaneous clinical records are among the most important, for a reliable psychiatric diagnosis. … 64. Falsification of symptoms can have a relatively benign motive, in that symptoms are exaggerated to convey the level of suffering, rather than reflecting a deliberate desire to deceive. Such falsification can amount to diagnosis of a psychiatric disorder – factitious disorder against the self; but if the motive is conscious deceit, whether for financial or other gain, this is malingering, which is not a psychiatric diagnosis, but a matter of evidence and therefore ultimately to be determined by the Court, rather than by medical expert opinion. … Condition (Diagnosis) 67.If Mr Atuanya’s reported pain is held to be disproportionate to what might be expected to be due to the verifiable underlying physical damage, two diagnoses vie for acceptance. These diagnoses overlap considerably phenomenologically. 68.Of the two diagnoses, I on balance prefer a diagnosis of adjustment disorder with mixed anxiety and depressed mood (DSM-5-TR F43.23). This reflects a disproportionate, pathologically amplified, psychological response to the overall predicament, including Mr Atuanya’s sense of having been ill treated and, as he puts it, ‘let down’ by his chain of command and the medical officers whom he saw, and whom he feels unfairly traduced him with regard to ‘alleged forgeries’ in his record. I see Mr Atuanya’s amplified psychological reaction as part of that general context, with his persistent reported pain playing a part. … Psychiatric/Psychological Causation 72.Causation is undoubtedly complex here. The waters are muddied by Mr Atuanya’s sense of having been ill-used and not listened to when he was in the army, leading, it seems to me, him down the pathway of exaggerating his symptoms in an attempt to convey his suffering. As to the alleged forgeries in his records, this is a matter of evidence in the end, and for the Court to determine. However, such reported symptoms would be in keeping with an attempt to convey suffering, rather than as a calculated issue. 73.All that said, there are times in the medical record where Mr Atuanya seems to be saying that it is only when at work that he feels the symptoms and that he can manage them perfectly well outwith work. Although this can occur with a physical condition, it is also plausible that his pain or, more correctly, the effects of his pain, are predominantly psychologicalrather than being explicable in terms of his underlying physical injury.”
“In summary in my opinion there is a marked discrepancy in the appearance and behaviour of the Claimant between the two days of video surveillance. …. In my opinion both his conditions are variable and there are a number of psychological factors (anticipatory anxiety before the medico legal assessments, relief at completing them, and anticipatory joy to seeing a friend and relative) as well as a good night’s sleep and reduced medication which are plausible explanations for the discrepancy.”
‘Ultimately, weight on which to put any apparent discrepancies between accounts at interview and accounts when videoed is for the Court, having regard to the totality of the evidence before it. I defer to the relevant experts as to whether in this instance Mr Atuanya’s surveilled behaviour differs sufficiently from his reports at interview to call into question the diagnostic formulations that proceed from those interviews.’
‘If he avoids taking his drowsy medications then he is able to walk, with a limp in his left leg, up to 10 minutes on the best of days, then he would have to stop. Other days he has stop earlier than that. If he takes his drowsy medication, then he cannot do as much.’
‘This pain has been there for long. Sometimes the pain leaves me for a minute. Sometimes PTSD is intertwined.’
‘I do see that you struggle to get along. I’ve seen you in a state that wasn’t you. I couldn’t say mental illness but it wasn’t you, the person I know.’
“Guess who I see. Wilson. I started crying. Every time I smell smoke, I smell a body. I hear Wilson. I call Crisis helpline. I call my therapist. Maybe I misrepresented myself.”
“Orders for costs made against the claimant may be enforced to the full extent of such orders with the permission of the court where the claim is found on the balance of probabilities to be fundamentally dishonest.”
“CPR Pt 44.16(1) uses the present tense. In the circumstances of the present case that means the assessment must be made either by reference to the position appertaining immediately before the discontinuance or, which comes to the same thing, without having regard to the fact of discontinuance. The duration of the dishonesty will be relevant as to whether the claim is properly to be characterised as fundamentally dishonest but even a claim which was wholly genuine when commenced can become fundamentally dishonest for the purposes of CPR Pt 44.16.”
“…When dishonesty is in question the fact-finding tribunal must first ascertain (subjectively) the actual state of the individual’s knowledge or belief as to the facts. The reasonableness or otherwise of his belief is a matter of evidence (often in practice determinative) going to whether he held the belief, but it is not an additional requirement that his belief must be reasonable; the question is whether it is genuinely held. When once his actual state of mind as to knowledge or belief as to facts is established, the question whether his conduct was honest or dishonest is to be determined by the fact-finder applying the (objective) standards of ordinary decent people. There is no requirement that the defendant must appreciate that what he has done is, by those standards, dishonest.”
“…If the Claimant knew that he was not in substance reporting his symptoms accurately and that he was thereby giving a false impression of the effects of the NFCI [Non-Freezing Cold Injuries] and reporting those symptoms as being worse than they in fact were there will be no scope for a contention that his conduct was anything other than dishonest by the standards of ordinary decent people.”