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How should I fill out the Form A?

At the initial stage of lodging your claim and at all times subsequently, it is essential that you are completely satisfied that all of the effects which your injury have had on you are made clear to the Injuries Board. Many of these symptoms will be set out in the medical report which you submit but don’t assume that they are. The following is a list of questions to ask yourself before filling out the section of Form A asking you to give a description of your injuries.

  • Do you still suffer from pain or discomfort or have your injuries fully healed?
  • Do you believe that any condition that you had prior to the accident has been made worse as a result of your injuries?
  • Are your symptoms improving, staying the same, or getting worse?
  • Do you have difficulty sleeping?
  • Do you have to take medication as a result of the accident?
  • Do you believe that your memory has been affected by the accident?
  • Is there any type of work that you cannot do anymore as a result of your injuries?
  • Has your sexual drive or performance been affected by the accident?
  • Do you have nightmares, flashbacks or panic attacks related to the accident?
  • Have you been left with any scarring or other disfiguration?
  • Does your doctor believe that you may suffer from arthritis or any other complications in the future?
  • Have you been told that you may need surgery or other medical procedures in the future?
  • Have any of your physical activities like walking, gardening or playing sport been affected by your injury?
  • Does standing or sitting for any length of time cause you pain?
  • Are you nervous as a passenger when you travel anywhere?
  • Have you developed any eating disorders or gained or lost significant weight since the accident?
  • Have you become dependent on prescription medication, drugs or alcohol since the accident?
  • Do you need to employ anyone to assist you with housework or other day-to-day chores since the accident?
  • Do you need any devices, aids, specially modified vehicles or equipment due to your injuries?
  • Has your relationship with your spouse or partner deteriorated since the accident?
  • Have you lost your job as a result of the accident or have you been passed over for promotion?
  • Have you lost friends or has your relationship with family members been impacted by the accident?

Don’t go into too much detail regarding the circumstances of the accident

Don’t go into too much detail about the factual circumstances surrounding the accident. The Injuries Board process assumes that liability is admitted. You should therefore not write anything down more than the bare minimum needed to describe what happened (essentially when and where the accident took place). Remember that any information which you include in your Form A can be used against you in evidence by the respondent if your claim isn’t finalised at the Injuries Board level and has to proceed to court, so exercise caution in this regard.

Don’t get carried away when describing your symptoms

It’s extremely important that you set out as fully as possible how the injury has affected you, both mentally and physically. You should therefore set out comprehensively all symptoms that you are suffering from, even if you’re not sure if these arose due to the accident or are as a consequence of some pre-existing or subsequent condition you are suffering from.

That said, you should resist any temptation to ‘over-egg the pudding’ when describing your injuries on Form A. This is because if you do this it may be relied upon by a respondent in any subsequent court action in the event that the matter is not resolved in the Injuries Board process.

Section 26 of the Civil Liability and Courts Act 2004 provides that if a plaintiff in a personal injuries action gives evidence that is false or misleading the court hearing the action must dismiss the plaintiff’s claim. In other words, if a court forms the view that a claimant has in any way falsified or exaggerated their claim the court must throw out the claim lock, stock and barrel, even if the claimant did genuinely suffer some injuries due to negligence.

For this reason, you should give an unapologetically frank and complete account of how you believe the injury has affected you. Just don’t allow yourself (or, more importantly, anyone who is assisting you in filling out Form A who might get carried away) to drift into the realm of fiction.

Common pitfalls at the initial application stage

As can be seen above, once there are no complicating factors, the actual process of making an application to the Injuries Board is very straightforward. However, to avoid lulling you into an unwarranted sense of complacency, it’s worth considering some of the more common pitfalls that claimants who don’t have professional expertise in this area can fall foul of which we will do in future posts.

Download the forms and guidance notes

You can download Form A from the Personal Injuries Assessment Board’s website, here. If you are uncertain about any aspect of completing the form, get in touch with our team for assistance.

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