Evidence in Plain Sight: Why Are Compelling Claims Being Rejected?

What should count as evidence when the official record is incomplete—not because of anything a claimant did, but because files were lost, destroyed, never created or written in the guarded language of another era?

This question sits at the centre of many infected blood compensation claims. Families report submitting transfusion histories, diagnoses, clinical notes, witness statements and timelines that appear to point in one direction, only to face more questions, long delays or decisions they believe ignore the overall picture.

Evidence must be tested. Public compensation must be administered consistently. But consistency does not mean refusing to see what the available evidence, taken together, is plainly saying.

“A missing record is not proof that an event did not happen—especially when the institutions responsible for those records have already admitted historic failure.”

IBCA recognises that records are missing

IBCA’s own published guidance acknowledges that many medical records have been lost, damaged or destroyed. It says claim managers will work with people to find other supporting information and that missing records do not automatically prevent a claim.

IBCA has also said it may use existing support-scheme records, medical records and, in some cases, statements and exhibits provided to the Infected Blood Inquiry. Its published community feedback states that it will consider all forms of evidence, although it requires official documentation to support personal testimony.

Those commitments matter. But families need to know how they operate in practice.

Evidence is a picture—not a single perfect document

Historical claims rarely arrive with one document stating every required fact in modern terminology. The evidence may instead be spread across a sequence: NHS treatment involving blood, a later hepatitis diagnosis, abnormal liver results, treatment history, specialist correspondence, registration with a support scheme, family testimony and the absence of a more plausible infection route.

Individually, one item may not answer every question. Together, they may create a compelling and coherent picture.

IBCA’s own Freedom of Information material refers to seeking clinical advice and reaching decisions on the balance of probabilities when linking an infection to a historical event. That standard does not demand absolute certainty. It asks what is more likely than not.

So families are entitled to ask: is the whole body of evidence genuinely being weighed, or is each piece being dismissed because it cannot prove the entire case on its own?

Hepatitis B exposes the problem

IBCA publishes specific information it may use to confirm chronic hepatitis B, including test results more than six months apart, a clear statement from a medical professional, or evidence of antiviral treatment. It also acknowledges that older records may not contain the required tests because testing did not exist, records were destroyed, or follow-up testing never happened.

When a diagnosis is unclear, IBCA says all supporting information can be referred to a clinical adviser for a specialist opinion.

Yet families continue to describe cases in which the surrounding history appears compelling but the conclusion does not reflect it. They report medical terminology being read without sufficient historical context, transfusion evidence being undervalued, or uncertainty being used against the claimant rather than examined fairly.

The concern is not that IBCA should accept every claim without scrutiny. The concern is that people may be rejected because the evidence produced by a damaged historical system does not fit a modern evidential template.

The reasoned decision matters

A family receiving a refusal should not be left guessing which evidence was accepted, which was rejected and why.

Every decision should clearly set out the evidence considered, the weight given to each item, the alternative explanation relied upon, the standard of proof applied and the route for challenging any factual or clinical error.

A generic conclusion is not enough. Without a transparent chain of reasoning, families cannot know whether their evidence was genuinely assessed or merely processed.

Questions IBCA must answer

How many claims have been delayed or rejected because medical records are incomplete? How often are cases referred to clinical advisers? What quality checks compare decisions across similar claims? How does IBCA apply the balance of probabilities? And how many initial conclusions change after review or appeal?

Publishing anonymised figures would reveal whether these are isolated difficulties or a repeating systemic problem. Clear evidence guidance would help claimants understand what is required before months are lost. Independent clinical review could prevent one narrow interpretation from deciding a family’s future.

Families are keeping the record

Across infected blood groups and online communities, families are comparing requests, timescales, evidence requirements and decisions. Patterns are becoming visible. Contradictions are being recorded. People who once believed their difficulty was unique are discovering that others have faced the same barriers.

This is why documentation matters. Not to prejudge every individual claim, but to test whether the system is delivering the fair, timely and consistent compensation it promises.

Families have already lived through an era in which obvious warning signs were fragmented, minimised or ignored. The compensation process must not repeat that failure by looking at each piece of evidence in isolation and refusing to see the truth they form together.

Where evidence is compelling, it must be recognised. Where doubt remains, it must be explained. Where a decision is wrong, it must be corrected quickly.

Justice cannot depend upon families producing perfect records from an imperfect and discredited past.

— The Unheard Voice

Sources and further reading IBCA: Documents you might need IBCA: Information used to show chronic hepatitis B IBCA: Community feedback themes, April–June 2026 IBCA FOI 0101: Hepatitis B and C claims