i have been advising a client who worked as a dental nurse for approx 14 years,in the last 15 months or so she has undergone several tests which have shown a definite sensitivity to mercury.last october she submitted an unsuccessful claim for i.i.d.b which i am now helping her to appeal,the tribunal should be held within 6-8 weeks.due to the uniqueness of this case i would appreciate any input or thoughts that anybody may have concerning this matter.i have got alot of information on mercury poisoning relating to dental nurses off the internet but having consulted a barrister on this matter who could offer no insights i am now broadening my search for any pointers.if anybody has any comments thanx...

I'm not too clear on what you mean by "sensitivity" to mercury. Also, on what grounds was the claim refused? The precise terms of PDC5A are "Central nervous system toxicity characterised by tremor and neuropsychiatric disease" caused by exposure to mercury or inorganic compounds of mercury over 10 years in aggregate. A generalised diagnosis of "mercury poisoning" without the specified criteria wouldn't qualify the client for IIDB.

"sensitivity to mercury" were how some test results were described but client has undergone other tests which do state clients brain activity is much slower than that of a person of a similar age and she subsequently finds it difficult to fit actions to thoughts.a couple of the test results have also stated that at this time it cannot be ruled out that the client has in the past suffered from mercury poisoning.also,she has experienced many other symptons associated with mercury poisoning,ie:depression,hair loss,memory loss,muscle weakness,dermatitis,fatigue etc.the claim was refused because when the client was examined by a dr from the medical services they stated that the client had never been diagnosed with either chronic or acute mercury poisoning,and the dr also went on to state that they weren't aware if being a dental nurse was a prescribed occupation re:mercury poisoning?it is quite a detailed and ongoing case and from the research i have done,and from speaking with the client,i would argue that the client does have reason to suspect that she may have been poisoned by mercury but unfortunately i feel that from what you have typed her symptoms are such that she does not have an "extreme" enough case of mercury poisoniong to satisfy the criteria of a pdc5a prescribed disease.thanx for your thoughts on this matter and if you have any others r.s.v.p...

(Not meaning to speak on her behalf but) I don't think that Ruth is saying your case isn't 'extreme' enough, I think she's saying that because the criteria for this disease are so specific then you have to meet them head on and woolly terms won't help (correct me if I'm wrong Ruth).

The BAMS doctor has effectively not started to look at the case at all without a formal diagnosis, and that puts the onus back on you to get the diagnosis. (The BAMS doctor's sideshow of prescribed occupation is a red herring - there is no specific occupation in this case and if she has been exposed to mercury in her work for 10 or more years (a letter from the practice should clinch that) then this aspect should not be a problem).

Test results are different to a clear diagnosis and report written to address the points within C5 (a) or (b). Has the client got a refferal to someone who could diagnose this? Presumably a neurologist and/or a psychiatrist would need to be involved.

If the client either is not getting referred or it is taking time you could try and get your own report if your client was legally adiable and either you had a contract and could apply for a disbursement and/or could refer your client to a practitioner who was. (Or ask for an adjournment and even ask the tribunal to do it themselves but that is rather relying too much on the tribunal wanting to and even if they did get a report it would probabay only be got from the GP and so not much use anyway)

Finding someone to do such a report may be a totally different matter. Googling on mercury poisoning and consultant I got the name of Virginia Murray, consultant at Guy's and St Thomas' Hospital Trust and director of the UK's Chemical Incident Response Service from a news report on mercury poisoning in Siberia. They ought to have access to experts on the subject and they may be able to do private work, or may know someone near where you live.

Another problem is that even if you get a diagnosis then there is no report assessing how disabled it has made your client and I imagine that it would be very hard to quantify. But a IIDB appeal at least has the chance for an examination, and if you had a report from an expert it is more likely that the effects on your client will be taken into account properly.

You should also check whether the client is entitled to DLA and advise them about claiming for personal injury through the courts.

cheers for the response and i'm more than sure that ruth didn't mind you speaking on her behalf...both the client and i have obtained further test results but they state that though mercury poisoning cannot be ruled out in the past the client is presently not suffering from this,how far in the past does the mercury poisoning have to be and does this illness come and go depending upon whether a person is coming into contact with mercury?one of the test results came from guys&st thomas hospital and the outcome was that the client had to return in 12 months for a further assessment.i think i have covered all aspects of this case that i can and as i stated in the submission that i wrote to the appeals service several weeks ago the tribunal should refer the client for further tests if they cannot conclusively decide that the client has in no way in the past suffered from mercury poisoning.i'm sorry if i sounded woolly earlier but everything about his case is a bit sheepish.finally,thanx for mentioning the claim for personal injury which had gone completely over my head.