Campaigners have forced a government U-turn after demonstrating that chronically ill claimants suffering severe pain were wrongly denied disability benefits on the basis that they were not taking powerful, opiate-based painkillers.
Bristol Law Centre said disability benefit assessors routinely assumed that if a claimant had been prescribed an “over the counter” drug such as paracetamol then their pain must be mild or moderate, and denied or reduced benefits accordingly.
It estimates that thousands of claimants nationally have been incorrectly refused disability benefits in this way.
Campaigners had argued that it was unfair and dangerous for assessors to use painkiller strength as a proxy for the level of illness because GPs were reluctant to prescribe stronger opiates because of the harmful side effects.
The law centre said the guidance had encouraged ill and disabled people claiming Personal Independence Payments (PIP) and Employment and Support Allowance (ESA) to demand stronger drugs from their GP as a guarantee of benefit eligibility.
“Every year, thousands of claims for disability benefits are refused because of an over-reliance on analgesics as a guide to pain levels. The signal these assessments send to claimants is that they must go back to their doctor and ask for stronger pain relief,” said Andy King, a benefits adviser at Bristol Law Centre.
Public Health England recently warned of the dangers of wrongly prescribed opioid painkillers for joint and back pain. Over half a million people had been on addictive opioid drugs for longer than three years.
The Department of Work and Pensions (DWP) has issued new guidance which makes it clear that “healthcare practitioners [disability benefits assessors] should be mindful that the level of analgesia used does not necessarily correlate with the level of pain”.
The law centre’s study of 39 benefit cases where claimants were in severe pain found that in almost all cases benefits were either wrongly refused or paid at too low a level. In 25 cases the severity of the patients’ condition was underestimated by assessors because they had been prescribed “mild” painkillers.
Several of the cases involved claimants with arthritis, fibromyalgia or degenerative spinal conditions who had reduced their dependency on powerful opiates on the advice of their GP. This was taken as proof by assessors that the claimants could walk 200 metres unaided – a key factor informing eligibility for PIP.
In at least one case assessors’ reliance on painkiller strength as an indicator of pain severity appeared to have more influence on the benefit decision than detailed written evidence of the severity of the illness supplied by the claimant’s NHS doctor.
Many of those refused benefits successfully appealed against the decision at tribunal. There, the court asked detailed questions about the pain and claimants’ daily activities before concluding that the assessors – employed by private contractors Atos and Maximus on behalf of the DWP – were wrong.
Bristol Law Centre said it welcomed the DWP changes – the result of over a year of pressure – but would continue to monitor the situation to ensure that the new advice was properly rolled out to assessors.
A DWP spokesperson said: “The type and level of medication is one of a number of factors taken into account when carrying out an assessment, which considers all aspects affecting a person’s functional ability. We constantly review our guidance and have updated it in line with expert medical opinion.”
Ken Butler of Disability Rights UK said the study showed that assessors were not giving proper consideration to claimants’ own evidence about the severity of their condition. “It’s clear that opioid prescription and use alone cannot be the sole judge of how someone is affected by their ill health condition or disability,” he said.
