Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER Case No: UI-2026-000451
First-tier Tribunal No:
HU/02266/2024

THE IMMIGRATION ACTS

Decision & Reasons Issued:
On 4th of September 2026

Before
DEPUTY UPPER TRIBUNAL JUDGE PICKERING

Between
LOVEKUMAR AMRUTAL PATEL
(ANONYMITY NOT ORDERED)
Appellant
and

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Mr Lourdes, of Counsel
For the Respondent: Mr Tufan, Senior Presenting Officer

Heard at Field House on 9 June 2026

DECISION AND REASONS

1. The appellant appeals, with permission of the Upper Tribunal, against the decision of the First-tier Tribunal dismissing his appeal on human rights grounds.
2. The appeal came before me at an error of law hearing. For the reasons set out below, I have concluded that the First-tier Tribunal did not make a material error of law and I therefore decline to set aside its decision. The decision of the First-tier Tribunal shall stand.

Background
3. The appellant made an application for leave to remain the UK on the basis of his health on 11 October 2022. His application was refused on 15 November 2024. The appellant sadly has a health condition, idiopathic thrombocytopenic purpura (ITP) which is a blood disorder that causes low platelet counts and leads to easy bruising and bleeding. The appellant said that doctors had told him he was not well enough to fly and the appellant did not consider that he could get the treatment he required in India.
4. The respondent refused the appellant's application. The respondent did not consider that the appellant had produced medical evidence to show his reduced life expectancy. The respondent highlighted the availability of treatment.
5. The Judge dismissed the appellant’s appeal. She made findings which are at paragraphs 20 to 36 of her determination. She accepted that the appellant had IPT. She went onto find that:
a. The appellant had family and connections to India;
b. That care and medication was available if needed;
c. The appellant had lived in India for 27 years and that he retained social and cultural there;
d. He had family and social connections there.
e. The appellant had not produced medical evidence to show that he was not fit to fly;
f. The appellant had not demonstrated that his health was such he would face a real risk of being exposed to a serious, rapid and irreversible decline in his state of health resulting in intense suffering or a significant reduction in his life expectancy as a result of the absence of appropriate treatment or lack of access to it.

6. The appellant's application for permission to appeal to the First-tier Tribunal was refused. Upon renewal to the Upper Tribunal, permission was granted. Upper Tribunal Judge Grey helpfully recast the grounds, which were lengthy, but she made it clear that permission was granted only on the Judge’s treatment of Article 3.
7. It is notable that, in granting permission, Upper Tribunal Judge Grey described the grant as a marginal one and expressly sought to manage the appellant's expectations. It is worth setting out part of her reasoning when granting permission.
2. In fairness to the appellant and to manage his expectations, I consider it appropriate to indicate that the decision to grant permission was marginal and is based only on the Judge’s treatment of his Article 3 claim. A factor which has persuaded me to grant permission is my lack of confidence, despite efforts to do so, that I have been able to access all of the evidence the appellant adduced in his appeal in the First-tier Tribunal (“FtT”). In examining whether the Judge made an error of law, the Upper Tribunal will take into account the evidence which was before the FtT at the hearing and will not take into account any deterioration in the appellant’s condition since that time. account any deterioration in the appellant’s condition since that time.
3. I take into consideration the fact that the appellant is not legally represented and was not represented throughout proceedings in the FtT. However, it has been difficult to work through the appellant’s lengthy grounds. The grounds contain 15 ‘topics’ which significantly overlap, are very repetitive and mostly fail to engage directly with the findings of the Judge. The grounds appear to be largely a repetition of the grounds before the FtT. In essence the appellant’s position is that he has a serious illness and has been advised that his life expectancy is limited to a matter of a few months.
4. I am not persuaded that the findings of the Judge were arguably irrational, that it is arguable that there was any procedural unfairness, that the Judge arguably applied the wrong legal framework in assessing Article 8, or that the findings were based on assumptions and conjecture as asserted by the appellant. The appellant should understand that the burden of proof is on him in relation to his appeal.
5. My concerns regarding the FtT decision relate to the Judge’s treatment of Article 3 which appears to have been very briefly addressed within the Article 8 assessment.
6. The only discernible consideration by the Judge of Article 3 (medical) and the test from AM (Zimbabwe) v Secretary of State for the Home Department [2020] UKSC 17 is the second sentence at [30] of the decision which adopts the wording from AM (Zimbabwe) in relation to whether there are substantial grounds for believing that the appellant would be “exposed to a serious, rapid and irreversible decline in his state of health resulting in intense suffering or significant reduction in his life expectancy as a result of the absence of appropriate treatment or lack of access to it”. In addition, there is a reference at [28] to there being no evidence from health professionals that the appellant “is not fit for travel or has a limited chance of survival in the UK”. Whilst these references in the decision indicate that the Judge was addressing at least part of the test from Article 3 ECHR, the difficulty with the decision is that these matters were addressed in the context of the Article 8 proportionality assessment. The legal issues and standard of proof for Articles 3 and 8 are distinct and this is not reflected in the Judge’s analysis.
7. Materiality - From the evidence before the Judge (as far as I can tell) and the findings regarding the appellant’s circumstances, there would appear to be an overwhelming likelihood that any error the Judge may have made in this regard would not have been material to the outcome of the appeal. Although the appellant’s medical diagnosis has been accepted, the medical evidence in the bundle is relatively old and I have not been able to identify anything from those who treat the appellant which confirm his claim that he only has a few months to live. This information should be easily obtainable by the appellant in light of the extensive treatment he states he receives (which appears to be supported by his substantial NHS debt). However, the appellant is entitled to know from the decision that Article 3 has been properly considered and applied. Taking into account the fact that the appellant is not legally represented, his claim regarding the seriousness of his health condition, and the possibility that some medical evidence from the substantial non-indexed bundle of documents may have been overlooked, I consider the appropriate forum to address the materiality of any error is at an error of law hearing

8. The respondent filed a Rule 24 response. The respondent acknowledged, consistently with Upper Tribunal Judge Grey's grant of permission, that the First-tier Tribunal had erred in conflating its assessment of the appellant's Article 3 medical claim with its Article 8 assessment. It was submitted, however, that any such error was not material to the outcome of the appeal.

Discussion and analysis
9. Mr Lourdes had very helpfully in close proximity to the hearing offered representation to the appellant. Mr Tufan and Mr Lourdes agree that in light of the grant of permission and the Rule 24 the crucial issue was materiality.
10. In response to my questions Mr Lourdes confirmed that the only evidence where limited life expectancy and fitness to travel was addressed was in the appellant’s own representations rather than there being a doctor or medical letter addressing this. I explained that I was grateful for his assistance and he acknowledged that before the First-tier Tribunal the Judge would have been greatly assisted by medical evidence of this nature.
11. The Judge’s decision does give the impression of conflating the article 3 and article 8 assessment. However I am not satisfied that this is material.
12. The respondent's decision letter addressed the appellant's medical claim by reference to the Article 3 threshold and concluded that he had not demonstrated that his removal would expose him to a real risk of treatment contrary to Article 3 ECHR. The respondent noted that India has a functioning healthcare system and identified sources of treatment said to be available to the appellant. The respondent was not satisfied that the appellant had shown either that appropriate treatment was unavailable in India or that he would be unable to access such treatment upon return.
13. The appellant's own evidence before the First-tier Tribunal did not grapple with the issues needed. Whilst there was evidence that the appellant has IPT there was little by way of prognosis save for the appellant’s own evidence.
14. At paragraph 14 of the Judge’s decision, it is recorded that the appellant had not made enquiries regarding treatment in India and did not know whether equivalent treatment would be available to him there. Whilst he expressed understandable concerns regarding his health, there was no evidential basis upon which the Tribunal could assess the availability, accessibility, or adequacy of treatment in India beyond the appellant's own speculation. The appellant further stated that his general practitioner had advised hospital admission, but that he had declined such treatment because he wished to repay his substantial NHS debt. That evidence was capable of demonstrating that treatment continued to be available to him in the United Kingdom, but it shed little light on the central Article 3 question of whether removal would expose him to the high threshold of a health claim.
15. The law to be applied in health claims relying upon article 3. The test is contained in AM (Zimbabwe) v SSHD [2020] UKSC 17 and AM (Art 3; health cases) Zimbabwe [2022] UKUT 00131 (IAC) the states are distilled as follows:
(1) Has the person (P) discharged the burden of establishing that he or she is "a seriously ill person"?
(2) Has P adduced evidence "capable of demonstrating" that "substantial grounds have been shown for believing" that as "a seriously ill person", he or she "would face a real risk":
[i] "on account of the absence of appropriate treatment in the receiving country or the lack of access to such treatment,
[ii] of being exposed
[a] to a serious, rapid and irreversible decline in his or her state of health resulting in intense suffering, or
[b] to a significant reduction in life expectancy"

16. In assessing materiality, I have had regard to the structured approach set out in AM (Zimbabwe). The first question is whether the appellant established that he is a seriously ill person. There was plainly evidence before the First-tier Tribunal of a significant medical condition and ongoing treatment. The more difficult question, however, is whether the appellant adduced evidence capable of demonstrating substantial grounds for believing that, on account of the absence of appropriate treatment in India, or a lack of access to such treatment, he would face a real risk of a serious, rapid and irreversible decline in his health resulting in intense suffering, or a significant reduction in life expectancy.
17. It was at that second stage that the appellant's case encountered substantial evidential difficulties. During submissions before me, I specifically enquired where, within the evidence that had been before the First-tier Tribunal, there was material supporting the appellant's assertion that his life expectancy had been reduced to a matter of months. Despite best efforts Mr Lourdes was unable to identify any medical opinion to that effect and was able to point only to the appellant's own account. Whilst I do not doubt that the appellant genuinely believes his condition to be grave, the burden rested upon him to establish his case with evidence.
18. The documentary medical evidence demonstrated a history of treatment and ongoing health difficulties. However, there was no expert evidence from a treating consultant or other healthcare professional confirming that the appellant's life expectancy was limited to a matter of months. Equally, there was no medical evidence stating that the appellant was unfit to travel, that removal itself would place him at a particular risk of catastrophic deterioration, or that he had only a limited chance of survival in the United Kingdom. Such evidence, had it existed, would plainly have been highly material to an assessment under Article 3 and would have greatly assisted the Judge in understanding the severity, prognosis and practical consequences of the appellant's condition.
19. As noted by Upper Tribunal Judge Grey when granting permission, the medical evidence before the First-tier Tribunal was relatively dated. There was a notable absence of clear and up to date evidence from treating clinicians confirming the appellant's assertion that his life expectancy was limited to a matter of months. Nor was there evidence addressing the availability of treatment in India, the appellant's ability to access such treatment, or the likely consequences of any interruption in care.
20. In addition, there was no medical evidence indicating that the appellant was unfit to travel or had a limited chance of survival in the United Kingdom. Whilst the appellant repeatedly asserted that his condition was terminal and that he had only months to live, those assertions were not supported by contemporaneous clinical evidence. The burden of proof rested upon the appellant and, notwithstanding his unrepresented status before the First-tier Tribunal, the evidential shortcomings in his case remained significant.
21. In those circumstances, even had the First-tier Tribunal conducted a separate and more structured Article 3 assessment, the evidential deficiencies would have remained. The appellant had not produced evidence capable of demonstrating substantial grounds for believing that his removal would expose him, on account of the absence of appropriate treatment or lack of access to such treatment in India, to a serious, rapid and irreversible decline in his state of health resulting in intense suffering, or to a significant reduction in life expectancy.
22. I therefore accept that the First-tier Tribunal's treatment of Article 3 was inadequate in that it was conflated with the Article 8 assessment. However, I am not satisfied that the error was material to the outcome. On the evidence that was before the First-tier Tribunal, a properly directed Tribunal applying the Article 3 framework identified in AM (Zimbabwe) would inevitably have reached the same conclusion. That is because the evidential gaps identified above would have remained irrespective of the structure of the Tribunal's reasoning. The appellant did not establish that he met the high threshold required by Article 3, whether by reference to his prognosis, his fitness to travel, or the availability and accessibility of treatment in India. The error was therefore not material, and the decision of the First-tier Tribunal shall stand.

Conclusion
23. None of the grounds of appeal discloses a material error of law in the reasoning or conclusions of the First-tier Tribunal. I decline to set the decision aside.

Notice of Decision
The decision of the First-tier Tribunal did not involve the making of a material error of law.
The appellant's appeal is dismissed.

RA Pickering
Deputy Judge of the Upper Tribunal
Immigration and Asylum Chamber
28 August 2026