Table 3.

Characteristics of Effective Evaluations

Codes	Representative Quotes
Documents the physician’s evaluation process and all sources of evidence	“With the PTSD case, a history of how often they met with the individual, how many meetings, how much time they spent with them, you know what kind of testing they did as well, like psychological testing…we’ve got to have an understanding how we got to that opinion.” (Non pro bono/private firm)
	“We’ll have a doctor read their declaration, and talk about the types of injuries or the way they present. Someone who’ll take the time and walk through and say, ’in preparation for this, I reviewed this, and then I examined the person in this way, or I met with this person three times.” (Pro bono/university clinic)
Provides corroborative evidence unique to the applicant’s history	“We were representing an Iraqi asylum seeker. He said he had been tortured during the Hussein regime, and that he had scarring on his wrists and back. We sent him to see a doctor who we’d worked with in the past, who was able to write an evaluation saying that those injuries were consistent with what had happened to him there. Based at least in part on that, the case was approved.” (Non pro bono/private firm)
Describes psychological consequences of persecution	“We had a psych report talking about [how] they were traumatized and the PTSD… sometimes that can affect memory and describing that was helpful as well.” (Non pro bono/nonprofit)
	“The rape has occurred somewhere else in the past, so getting medical evidence of that…you’re not going to get. But from the PTSD standpoint and getting the client to being willing to open up and talk to somebody in that context I think is very helpful.” (Non pro bono/private firm)
Describes and documents all physical evidence	“For instance in an FGM case, you have to have it. If you don’t have it, you don’t have a shot because your entire case is based on this physical characteristic. If there was torture or physical abuse that should result in some kind of scarring or manifestation, what happens is that if you don’t have the medical exam, that’s seen as a lack of corroboration, a lack of credibility that will absolutely kill a case.” (Pro bono/university clinic)
	“The most powerful was the scar on a young boy’s head from Cameroon where the police meant to hit the mother who was applying for asylum, and instead they hit the young boy with a baton on his head, and so he still had this scar, and it showed up very well on a photo.” (Pro bono/university clinic)
	“Do you prefer photos to be included in the affidavit?” “No. I do not. Because it’s so hard to capture scars. I find most of the time that it ends up minimizing what they’ve written.” (Pro bono/nonprofit)
Yields new information	“We knew he had been injured but we didn’t know that his back had been broken, because he hadn’t told us about that. He had told about being electric shocked and all these other things, so we found out about his broken back [from the evaluation].” (Pro bono/university clinic)
	“I had one client that didn’t tell us she had undergone FGM, and that became part of her claim after we did the medical evaluation…sometimes it’s just a question of the client being more comfortable with the doctor.” (Pro bono/university clinic)