Updated PIP guidance on drawing inferences from level of pain relief

Much overdue, but something that probably shouldn’t have needed explaining to them.

I always enjoyed it when HCPs would say “this is a low level analgesic” and when you’d check the NHS website you’d find out that it was actually nearly the top dose of which ever painkiller they were on and described as a “strong painkiller”. So the top of permissible dosages of a strong painkiller only qualifies as a low level analgesic? Yeah right…

Hopefully this change will make a difference but I’ll not be holding my breath.

But then how does a HP decide that the pain claimed is actually the truth and not overstated.
I have seen many ESA and DLA applicants who claim extreme pain denied any award on the evidence that a GP was willing to prescribe strong pain relief but that the patient refused it citing that they could not live with the side effects of that medication - they preferred the level of pain instead. The argument has always stood that no pain relief taken probably means that the pain claimed is only mild in nature.
Conversely hence why there is a portion of society that obtains the medication and then throws it away - leaving a record that the medication is being used.

The mystery of determining the level of pain felt will always cause issues.

I have uploaded what are now my standard paragraphs in submissions on pain. As I often cite CDLA/0902/2004 , I have uploaded that as well

Oldestrocker - 02 October 2019 07:17 PM

But then how does a HP decide that the pain claimed is actually the truth and not overstated.
I have seen many ESA and DLA applicants who claim extreme pain denied any award on the evidence that a GP was willing to prescribe strong pain relief but that the patient refused it citing that they could not live with the side effects of that medication - they preferred the level of pain instead. The argument has always stood that no pain relief taken probably means that the pain claimed is only mild in nature.
Conversely hence why there is a portion of society that obtains the medication and then throws it away - leaving a record that the medication is being used.

The mystery of determining the level of pain felt will always cause issues.

What’s the mystery?

Oldestrocker - 02 October 2019 07:17 PM

But then how does a HP decide that the pain claimed is actually the truth and not overstated.
I have seen many ESA and DLA applicants who claim extreme pain denied any award on the evidence that a GP was willing to prescribe strong pain relief but that the patient refused it citing that they could not live with the side effects of that medication - they preferred the level of pain instead. The argument has always stood that no pain relief taken probably means that the pain claimed is only mild in nature.
Conversely hence why there is a portion of society that obtains the medication and then throws it away - leaving a record that the medication is being used.

The mystery of determining the level of pain felt will always cause issues.

From CPIP/381/2019

13. Pain is notoriously difficult to measure. There is no objective clinical pain test. But that probably doesn’t really matter in the context of assessing entitlement to PIP given the way the PIP Regulations approach things. The scheme of the PIP Regulations approaches disability in a practical and claimant-centred way. It isn’t
concerned with diagnoses but rather with the impact that a claimant’s health condition has on the individual claimant’s ability to do things. The claimant’s subjective account of their experience of pain and discomfort is one factor to be taken into account. The tribunal is obliged to consider such evidence as there is (exercising its inquisitorial function to seek further evidence if appropriate), to evaluate that evidence in the light of all the other evidence, and to make findings of fact accordingly. Having done so it must explain its decision with adequate clarity.

https://www.theguardian.com/society/2019/oct/09/bristol-charity-campaign-leads-to-benefits-claims-change

Andy & Ken get some media spotlight for the case / issue!