Applying for a medical assessment

Applications for an assessment by iMMO can be submitted – on behalf of the person concerned – by various parties. Examples include the lawyer or legal aid provider, an employee of the Refugee Council or a health care or youth protection worker. Support workers of asylum seekers who have questions regarding medical aspects in their client’s asylum procedure can also appeal to the iMMO.

If you are unsure whether a medical assessment can help involved persons, fill out this checklist (Dutch).

An assessment is free of charge to the person concerned, but the applicant is asked to make an effort for the costs of the expert opinion report to be reimbursed during the decision-making phase at the IND or in the court proceedings.

There are several options for an application:

To find out if a case may qualify for an iMMO assessment or consultation, you can submit a question online or contact us by phone: 020 – 368 2850
(Monday-Thursday 09:00 – 12:30 and 13:30 – 17:00).
If you are sure it is a case for an iMMO assessment, you can also immediately download and complete the comprehensive Application Form iMMO 2023.
As a caregiver, if you suspect physical or psychological symptoms, you can complete the list of alerts.

iMMO requires written consent from the person undergoing the assessment. An iMMO assessment consent form is available for this purpose. It is possible that during or after the assessment it turns out that the (anonymized) data have value for the trainings iMMO gives internally and externally and/or scientific dossier research. We ask permission for this with the consent form for use of data.

The individual is free to cooperate with this or not, but the assessment consent form is required for an assessment to take place. Both documents are available in English: Consent iMMO Assessment 2023 and Consent Educational Use.

List of alerts

The list of alerts is an aid for legal aid providers and supervisors of asylum seekers in identifying physical and psychological complaints. It involves observable behavior of the asylum seeker, and information that can be inquired from the person. The form has its origins in the Istanbul Protocol. The list of alerts can be brought into the asylum procedure and must be weighed as prescribed in IND work instructions. It does not have the same value as an iMMO assessment.

There is a list of alerts for adults and a list for adolescents.

Criteria for an iMMO assessment

Prior to the actual assessment, the iMMO reviews whether the application fits the objectives of the iMMO and whether an assessment will contribute to the proceedings.

The application for an iMMO assessment is evaluated on the basis of a complete file with all existing medical and legal information and on the basis of a fully completed application form. To avoid delays and enable a careful review, you, the applicant, should send all documents with the application prior to submitting a request for an assessment.

Not all applications are accepted. The iMMO staff decides in the weekly evaluation meeting whether to consider the application and which question is applicable in the particular dossier. Sometimes additional information is needed and the decision on the application is deferred. For selection criteria, please complete this checklist.

Below are additional explanations of the questions the assessment aims to answer.

1. Assessment of medical issues that affect the asylum seeker’s ability to properly present his/her story.

The applicant signals that the medical condition differs from a previous Medical Advice Hearing and Decision and it is not possible to organise a new advice through the IND.
The applicant claims that medical issues were overlooked at an earlier stage and wants this documented.
Depending on the stage of the proceedings, the various legal and medical documents available are considered in deciding whether or not to conduct an assessment.

2. Examine medical complaints and scars as supporting evidence in asylum proceedings.

This type of research takes place only after the IND shared an intention (voornemen) to reject, if it is a first application. Only after an intention has been provided to the client can the effectiveness of a medical expert opinion be properly assessed. In many cases, the IND can make a careful decision on the asylum application without a medical assessment.
In exceptional cases it may be desirable to organise a medical examination even before an intention, for example if there are strong indications of recent injury that can be properly examined precisely at this stage. Often this means there are (serious) indications that the asylum seeker has been a victim of torture or other inhumane treatment.
By default, iMMO inquires with the applicant whether the applicant has requested a forensic medical examination in accordance with Article 18 of the Procedural Directive from the IND. If so, iMMO is happy to receive the IND’s response in writing. It is necessary in all cases to inform the IND that an iMMO examination has been requested.

3. The assessment must be balanced against other facts brought in by the asylum seeker that the IND considers implausible.

Research and advice in asylum or immigration cases where medical aspects play an important role and an independent medical assessment may be important.
Medical examinations, or a file review of relevant medical and legal records.
Not in all cases is it necessary that the asylum seeker or foreigner himself be examined.
For each case, the applicable question is determined.

Before and after the examination

When an assessment is promised, iMMO requires an active commitment from the (legal) assistance provider. It is important that the person to be seen is well prepared for the purpose of the assessment so that optimal cooperation is possible. The examination can be emotionally taxing. If desired, a confidant can accompany the person involved. However, it is not desirable for this person to be present during the examination itself.

For the proper functioning of iMMO it is very important that you, as a legal aid provider, keep us informed about the impact and weighting of the submitted reports. Feedback makes an indispensable contribution to the development and improvement of the reports. iMMO depends on your input for this and would be thankful of an active attitude on your part. This includes including our bill in the procedure and proactively tracking reimbursement opportunities.

For the person concerned

You have been registered for a forensic medical assessment at iMMO. Here you will find information about what this entails. The information is general in nature. If you have further questions, please ask the iMMO rapporteur – a doctor, psychiatrist or psychologist – who is examining you.

Why this assessment

The reason you have been registered for an iMMO assessment has to do with your physical and/or psychological complaints and their possible connection to your asylum application and/or your current stay in the Netherlands. The examination that takes place is not medical treatment but has the sole purpose of writing a report on your complaints.

An independent medical assessment is required and you will therefore be examined by an independent doctor, psychologist or psychiatrist. He or she does not work for the Immigration and Naturalization Service (IND), not for the Central Agency for the Reception of Asylum Seekers (COA), not for the Asylum Seekers’ Health Center (GCA), nor for Refugee Council or your lawyer.

Permission

Before the research takes place, you must have given your written consent. (Dutch: toestemmingsformulier iMMO-onderzoek / ENGLISH Consent iMMO Assessment)

You usually do this together with your health care provider. Without your written consent, the assessment cannot take place. In this statement, you consent to three things:

Having the assessment conducted by iMMO medical experts
Processing your data within the organisation of iMMO
Issuing the report to the person who requested the investigation.

Rapporteur and interpreter

During the preparation for the examination, you will be asked whether you prefer a female or male rapporteur. An interpreter will be present during the assessment itself. During the preparation you indicate in which language you can express yourself best and whether you prefer a man or a woman. If you have doubts as to whether the iMMO expert is investigating you fairly and objectively, you may request a different rapporteur than the one iMMO assigned to you.

Place of examination

Where the examination takes place depends on where the rapporteur works. You will have to travel there yourself. You may bring a confidant with you but, in principle, they cannot be present during the investigation, so they will usually have to wait for you to come out again. This usually takes about four hours.

There is often an assessment of physical symptoms as well as psychological symptoms. This usually cannot take place on the same day.

The assessment

At the beginning of the assessment, the reporter will discuss again the nature and purpose of the examination. During the examination, your complaints will be discussed in detail. Your physical complaints will be examined but also your psychological complaints are discussed. Usually during the examination various tests and questionnaires are taken. For example, to examine your memory and concentration. Sometimes photographs have to be taken. After completion of the examination, the rapporteur will ask you again if you have understood everything well and if you have been able to tell everything you find important.

Reporting and confidentiality

You have the right to inspect the draft report to correct it for facts and to receive a copy of the final report that iMMO sends to the person who requested the study with you.

The doctor or psychologist and all employees of the iMMO have medical confidentiality. This means that the data from the report and your file are confidential information and will only be shared with other staff members if necessary. Provision of information to other agencies outside the iMMO, other than the one who requested the research, will only occur at your request or with your written permission.

We do ask you if we may use the anonymized data from the report for our internal training and possible scientific research. For this we have a consent form in Dutch and English.

Questions or complaints?

If there are things you do not understand or are dissatisfied with, the doctor, psychiatrist or psychologist will be happy to discuss them with you. If this does not lead to a solution, you may contact the iMMO office. If you wish to file a complaint about the assessment or report, please submit it in writing or by email (info@stichtingimmo.nl) to the iMMO management. You can read more about this in the Complaints Procedure Regulations (DUTCH) or Complaints Procedure (ENGLISH).

Cost

An iMMO assessment is a very extensive and therefore labor-intensive forensic medical examination by multiple disciplines. One assessment means an average of 55 hours of work. The medical assessment is free of charge to the applicant. However, iMMO does expect the applicant and the care provider to make an effort to have the costs of the iMMO assessment reimbursed. The research applicant signs an obligation of effort to submit the costs of the assessment – as expenses for an expert opinion – in a timely manner in the proceedings.

iMMO is funded by donations from its founders, large and small funds and individuals. In addition, the foundation relies on the selfless efforts of volunteer doctors, psychologists and others. The goal of iMMO is to make a forensic medical examination, an accepted part of an asylum procedure. This includes striving for cost-covering compensation from the government for iMMO’s assessments. The current fee does not cover costs. As of 01-01-2024, the cost reimbursement for an iMMO assessment is €7,865, calculated in accordance with the Decree on Rates of Expertise Notices in Criminal Law. The fee for comprehensive written advice is €600. iMMO is not subject to VAT.

For more information, see the Statement of Effort and the Explanatory Statement of Effort.