Search rightsnet
Search options

Where

Benefit

Jurisdiction

Jurisdiction

From

to

Forum Home  →  Discussion  →  Disability benefits  →  Thread

Updated PIP guidance on drawing inferences from level of pain relief

Stuart
Administrator

rightsnet editor

Send message

Total Posts: 692

Joined: 21 March 2016

Today’s updates to PIP assessment guidance include amendments to part 1 (the assessment process) on assessing pain -

(para 1.6.35) ... HPs should be mindful that the level of analgesia used does not necessarily correlate with the level of pain. GPs are encouraged to avoid prescribing strong painkillers for long-term pain as the harms usually outweigh the benefits and there could also be specific reasons why painkillers are not prescribed, for example intolerance, or the use of other methods of pain relief.

Although it’s an ESA decision, Judge Poynter in [2018] UKUT 446 (AAC) (rightsnet summary Whether absence of treatment is an adequate basis from which to infer existence of function…) also considers the issue.

[ Edited: 1 Oct 2019 at 10:45 am by shawn mach ]
Mr Finch
forum member

Benefits adviser - Isle of Wight CAB

Send message

Total Posts: 421

Joined: 4 March 2011

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

CHAC Adviser
forum member

Caseworker - CHAC, Middlesbrough

Send message

Total Posts: 63

Joined: 14 September 2017

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.

Oldestrocker
forum member

Principal - Forensic Accountants, Canterbury

Send message

Total Posts: 79

Joined: 26 September 2011

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.

Stainsby
forum member

Welfare rights adviser - Plumstead Community Law Centre

Send message

Total Posts: 316

Joined: 17 June 2010

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

[ Edited: 4 Oct 2019 at 05:28 pm by Stainsby ]

File Attachments

Mike Hughes
forum member

Senior welfare rights officer - Salford City Council Welfare Rights Service

Send message

Total Posts: 2096

Joined: 17 June 2010

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?

John Birks
forum member

Welfare Rights and Debt Advice - Stockport Council

Send message

Total Posts: 1052

Joined: 16 June 2010

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.

 

File Attachments

Peter Turville
forum member

Welfare rights worker - Oxford Community Work Agency

Send message

Total Posts: 1414

Joined: 18 June 2010