Psychiatric causation and apportionment
A reasoned opinion on what caused the claimant’s psychiatric condition: the abuse or negligent care relied on, earlier vulnerability, other events in their life, or a combination, and in what proportion. Free initial screening call and fixed fees with no hidden charges.
- Claimant, defendant and SJE
- Structured for CPR Part 35
- Reports usually 1–2 weeks from assessment
Separating the causes in a complicated history
Few claimants come to a psychiatric assessment with a clean history. Earlier episodes, family adversity, other trauma, physical illness and life events all leave their mark. Dr Pradhan’s causation reports weigh each of these against the events relied on and say how far each explains the present condition.
The analysis starts from chronology. When did the symptoms begin, what was recorded at the time, how did they change, and what else was happening in the claimant’s life? The report sets that timeline against the records before reaching an opinion on causation, material contribution and apportionment.
Dr Pradhan is dual-accredited for claimant and defendant work and is regularly appointed as a single joint expert where causation is disputed.
What the report covers
Causation reports commonly address:
- The chronology of symptoms against the GP, hospital and mental health records
- Whether the events relied on caused the psychiatric condition
- Whether they materially worsened an existing condition
- Whether the condition would have developed in any event
- Competing causes, including other abuse, trauma and life events
- Pre-existing vulnerability and earlier psychiatric history
- Apportionment between causes, where there is a basis for it
- Acceleration: whether a deterioration was brought forward, and by how long
- Apportionment between abusers or between periods of care
- Substance misuse and physical illness as alternative explanations
- Inconsistencies in the records and the history, and their significance
- Joint statements, supplementary questions and second opinions
Send a short summary of the events relied on, the relevant dates and a note of any earlier mental health history, and Dr Pradhan will confirm the scope of opinion and a fixed fee.
Submit an enquiryThe three causation questions
In abuse and clinical negligence claims alike, the report deals with each of these in turn:
- Would the psychiatric condition have developed in any event?
- Did the abuse or the negligent care cause it, or materially worsen it?
- Is there a rational basis for apportioning the condition between its causes?
Each answer is reasoned from the chronology and the records, with the alternative explanations considered and the reasons for rejecting them set out.
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Causation in abuse and clinical negligence claims
In abuse claims, causation is often complicated by other adversity in childhood, abuse by more than one person and later trauma. In England and Wales, apportionment can now affect limitation as well as damages: since 29 June 2026 there is no time limit for injury attributable to sexual abuse suffered under 18, but other abuse keeps the ordinary limits.
In clinical negligence claims, the question is often whether different care would probably have prevented the psychiatric harm, or whether the condition would have run the same course anyway. The report addresses the psychiatric side of that question; the standard of non-psychiatric care is for the relevant medical expert.
Sources of competing causes
- Other abuse or trauma
- Family adversity in childhood
- Earlier psychiatric illness
- Physical illness and chronic pain
- Bereavement and life events
- Substance misuse
Opinions given
- Cause or material contribution
- Exacerbation of an existing condition
- Acceleration, and by how long
- Apportionment, where possible
- Effect on prognosis
- Points of agreement for a joint statement
Apportionment and the court
Whether a psychiatric injury can be divided between its causes is a question for the court, but the court needs psychiatric evidence to answer it. The report explains whether there is a rational basis for apportionment, what it would be, and the reasons, or why the condition cannot sensibly be divided.
For claims in England and Wales the report is structured for CPR Part 35 and Practice Direction 35. Reports for proceedings in Scotland and Northern Ireland are prepared to the requirements of those courts.
The Court of Appeal held that psychiatric harm should be apportioned where there is a rational basis for identifying the part caused by the wrong. Where there is none, the injury is treated as indivisible. The court decides which, largely on the psychiatric evidence.
Related pages
Causation questions
If your question is not answered here, call and Dr Pradhan will advise on scope and timescale.
Call 0121 752 6065Can the report give a percentage for apportionment?
Where the evidence provides a rational basis, the report can give one and explain it. Where it does not, the report says so and explains why, rather than giving a figure that cannot be supported.
The records show earlier mental health problems. Does that defeat causation?
Not necessarily. The report explains whether the events relied on caused a new condition, worsened an existing one or brought forward a deterioration that would have happened anyway.
Can the report deal with abuse by more than one person?
Yes. It considers each period or source of abuse and explains how much of the present difficulties can reasonably be attributed to each, where the evidence allows.
Is causation part of the psychiatric injury report?
Usually, yes. Diagnosis, causation and prognosis are normally addressed in one report. A separate causation report is useful where causation is the only issue, or where a second opinion is needed.
How quickly can a report be delivered?
Usually 1–2 weeks from assessment, and urgent reports can often be provided in 2–5 working days where the papers and appointment can be arranged promptly.
Instruct Dr Pradhan on a causation dispute
Send a short summary of the events relied on and the issues, the funding route and any limitation or hearing dates.
- Phone0121 752 6065
- Emailinfo@
doctorpradhan.co.uk - Consulting Rooms NationwideAbacus Court, Harborne, Birmingham B17 0HH
Please do not include medical records or a detailed personal history in this form. Dr Pradhan will confirm how to send the papers once the instruction is agreed.
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If the matter is urgent, call 0121 752 6065.