Section 4 support, pregnancy and health issuesThis page explores eligibility for s4 support for pregnant women and for those with serious health issues.

3(2)(b) Unable to leave UK due to physical impediment to travel or some other medical reason

To qualify under reg 3(2)(b), applicants must show that they are unable to travel due to a physical or mental health problem. It is not enough simply to be receiving treatment in the UK or to have a doctor’s opinion that it would be preferable not to travel. They must have a medical condition which makes them unable to travel on any given day. See R (SSHD v The Asylum Support Adjudicator, Osman & Others [2006] EWHC 1248.

Written evidence must be obtained from a medical practitioner confirming the individual is unable to travel, explaining the reason why, and indicating how long this will persist. This information should be written on the “Section 4 Medical Declaration” form. The Home Office provides medical practitioners with a fee for completing a Medical Declaration (see p11 of ‘Asylum support, s4(2): policy and process’) and the completed invoice and form should be sent to the s4 team.

Generally, the greater level of detail that can be provided, the better (particularly if the client has mental health problems); a client who is particularly unwell may still potentially qualify for s4 support under reg 3(2)(e), even if they do not meet the Osman test for reg3(2)(b). For more details see the note below on mental health and s4 eligibility.


Home Office policy accepts that women in the late stages of pregnancy (around six weeks before their expected due date, or earlier if there have been complications), or those with a baby under six weeks old, are unable to travel. In some cases the Tribunal has awarded support to a pregnant woman earlier than six weeks before her due date (see Factsheet 8 – Support for Pregnant Refused Asylum-Seekers).

Nov 2021 - Mental health & eligibility for s4 support

This note explore eligibility for s4 support for those with severe mental health conditions. Clients with mental health problems can be successful in obtaining (or retaining) s4 support, even though they do not currently have outstanding further submissions. Nov 2021.

Factsheet 8 - s4 support for pregnant refused asylum seekers

This factsheet provides information about applying for Section 4 support on the grounds of pregnancy or having recently given birth. It also provides general information about access to maternity services for refused asylum seekers and the particular risks such women face when pregnant. Updated Oct 2018