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  • FIRST POST
    • 50Twuncle
    • By 50Twuncle 27th Sep 19, 8:21 AM
    • 9,695Posts
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    50Twuncle
    PiP and painkillers
    • #1
    • 27th Sep 19, 8:21 AM
    PiP and painkillers 27th Sep 19 at 8:21 AM
    How is someone assessed for PiP mobility - when they are on strong painkillers - which hides the true state of their ability to get around ?
    I am on Codeine - which helps me considerably - without them - I would be virtually imobile !
    WW3 is coming - it's been almost 75 years since the last one - the next one will be FAR worse !
    So what's a few squabbles between politicians ??
Page 1
    • ClaireB182
    • By ClaireB182 27th Sep 19, 9:09 AM
    • 21 Posts
    • 11 Thanks
    ClaireB182
    • #2
    • 27th Sep 19, 9:09 AM
    • #2
    • 27th Sep 19, 9:09 AM
    The PIP assessors job is to assess how your disability affects your day to day life. They are NOT there to medically assess you. Its really important to remember this and not be bullied by assessors.
    • _shel
    • By _shel 27th Sep 19, 9:12 AM
    • 2,426 Posts
    • 4,477 Thanks
    _shel
    • #3
    • 27th Sep 19, 9:12 AM
    • #3
    • 27th Sep 19, 9:12 AM
    They take into account anything you use to assist you including medicine. You get points for needing aids and if you need help with medicine but if the medicine enables you to do the task you likely won't get points for not being able to do it!
    • 50Twuncle
    • By 50Twuncle 27th Sep 19, 9:16 AM
    • 9,695 Posts
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    50Twuncle
    • #4
    • 27th Sep 19, 9:16 AM
    • #4
    • 27th Sep 19, 9:16 AM
    They take into account anything you use to assist you including medicine. You get points for needing aids and if you need help with medicine but if the medicine enables you to do the task you likely won't get points for not being able to do it!
    Originally posted by _shel

    Doesn't this imply that my best way is to stop taking the pain killers for the actual assessment - so I can be seen at my worst ?
    WW3 is coming - it's been almost 75 years since the last one - the next one will be FAR worse !
    So what's a few squabbles between politicians ??
    • _shel
    • By _shel 27th Sep 19, 9:17 AM
    • 2,426 Posts
    • 4,477 Thanks
    _shel
    • #5
    • 27th Sep 19, 9:17 AM
    • #5
    • 27th Sep 19, 9:17 AM
    Doesn't this imply that my best way is to stop taking the pain killers for the actual assessment - so I can be seen at my worst ?
    Originally posted by 50Twuncle
    that would be lying
    • Alice Holt
    • By Alice Holt 27th Sep 19, 10:20 AM
    • 3,415 Posts
    • 3,966 Thanks
    Alice Holt
    • #6
    • 27th Sep 19, 10:20 AM
    • #6
    • 27th Sep 19, 10:20 AM
    How is someone assessed for PIP- when they are on strong painkillers...
    Originally posted by 50Twuncle
    For most people there will be parts of the day when the ameliorating effects of the painkillers are considerable reduced or non-existent. First thing in the morning, or between doses, or when the maximum dosage has been reached.

    A PIP claimant in that position should have explained on the PIP form, that there are times during the day when their ability to do PIP activities is considerably reduced due to pain. An example might be having to delay dressing in the morning until the painkillers take effect. Therefore, because they can't do that activity reliably (and are limited to the times in the day when the painkillers are effective), they should be assessed as not able to perform the activity to an acceptable standard, and be awarded PIP points.

    There is no need to resort to silly deceptions "my best way is to stop taking the pain killers for the actual assessment"; if full information (and a sensible approach) has been given on the PIP form, and the effect of variability fully disclosed at the assessment.
    Alice Holt Forest situated some 4 miles south of Farnham forms the most northerly gateway to the South Downs National Park.
    • poppy12345
    • By poppy12345 27th Sep 19, 1:19 PM
    • 6,162 Posts
    • 5,696 Thanks
    poppy12345
    • #7
    • 27th Sep 19, 1:19 PM
    • #7
    • 27th Sep 19, 1:19 PM
    Doesn't this imply that my best way is to stop taking the pain killers for the actual assessment - so I can be seen at my worst ?
    Originally posted by 50Twuncle
    That could otherwise be known as benefit fraud.
    • 50Twuncle
    • By 50Twuncle 27th Sep 19, 1:54 PM
    • 9,695 Posts
    • 2,619 Thanks
    50Twuncle
    • #8
    • 27th Sep 19, 1:54 PM
    • #8
    • 27th Sep 19, 1:54 PM
    For most people there will be parts of the day when the ameliorating effects of the painkillers are considerable reduced or non-existent. First thing in the morning, or between doses, or when the maximum dosage has been reached.

    A PIP claimant in that position should have explained on the PIP form, that there are times during the day when their ability to do PIP activities is considerably reduced due to pain. An example might be having to delay dressing in the morning until the painkillers take effect. Therefore, because they can't do that activity reliably (and are limited to the times in the day when the painkillers are effective), they should be assessed as not able to perform the activity to an acceptable standard, and be awarded PIP points.

    There is no need to resort to silly deceptions "my best way is to stop taking the pain killers for the actual assessment"; if full information (and a sensible approach) has been given on the PIP form, and the effect of variability fully disclosed at the assessment.
    Originally posted by Alice Holt

    I am just concerned that if I am on strong painkillers - they will believe that I can walk as anyone else can (albeit with a limp) - but I can't remain on painkillers forever.
    I take them 4 times a day
    WW3 is coming - it's been almost 75 years since the last one - the next one will be FAR worse !
    So what's a few squabbles between politicians ??
    • _shel
    • By _shel 27th Sep 19, 3:28 PM
    • 2,426 Posts
    • 4,477 Thanks
    _shel
    • #9
    • 27th Sep 19, 3:28 PM
    • #9
    • 27th Sep 19, 3:28 PM
    This is not a medical you are attending but a face to face assessment. It's all based on a conversation between you about the activities. If you say you can't do it that's what they should note. They're not going to ask you to prove it by walking round the room etc.

    Just be honest about what you take and your limitations.
    • lisyloo
    • By lisyloo 27th Sep 19, 3:46 PM
    • 25,523 Posts
    • 13,715 Thanks
    lisyloo
    I am just concerned that if I am on strong painkillers - they will believe that I can walk as anyone else can (albeit with a limp) - but I can't remain on painkillers forever.
    I take them 4 times a day
    Originally posted by 50Twuncle
    Is there a reason you can’t stay on the pain killers?
    This is a genuine question as I’m not medically qualified.

    My MiL has severe arthritis and she’s been on pain killers for 50 years although I note you said strong ones.

    Even if you have to stop or reduce at some point shouldn’t the assessment show what you can do now?
    • venison
    • By venison 27th Sep 19, 10:10 PM
    • 3,923 Posts
    • 5,601 Thanks
    venison
    I think confusion arises in that for DLA the medication you took was taken as proof of the problem to some extent, with PIP this is definitely not the case, my OH was turned down for mobility even though they take morphine daily.
    Last edited by venison; 28-09-2019 at 4:45 PM.
    For the many NOT the few
    • 50Twuncle
    • By 50Twuncle 28th Sep 19, 7:11 AM
    • 9,695 Posts
    • 2,619 Thanks
    50Twuncle
    I think confuses arises in that for DLA the medication you took was taken as proof of the problem to some extent, with PIP this is definitely not the case, my OH was turned down for mobility even though they take morphine daily.
    Originally posted by venison
    Is there a reason you can’t stay on the pain killers?
    This is a genuine question as I’m not medically qualified.

    My MiL has severe arthritis and she’s been on pain killers for 50 years although I note you said strong ones.

    Even if you have to stop or reduce at some point shouldn’t the assessment show what you can do now?
    Originally posted by lisyloo
    Yes - I have no idea how long I will be allowed to continue on them by my GP. !
    Codeine = Morphine
    WW3 is coming - it's been almost 75 years since the last one - the next one will be FAR worse !
    So what's a few squabbles between politicians ??
    • Prinzessilein
    • By Prinzessilein 28th Sep 19, 8:16 AM
    • 2,956 Posts
    • 13,884 Thanks
    Prinzessilein
    Doesn't this imply that my best way is to stop taking the pain killers for the actual assessment - so I can be seen at my worst ?
    Originally posted by 50Twuncle
    Why would you want to be seen at your worst? The assessor will want to see the way you are on an average day...for you that means having taken painkillers.

    The assessor WILL want to see what meds you are on, I usually offer a copy of my current repeat prescription.

    If your are on long-term opiates, the GP may well decide to reduce the dose as current medical thinking is that for many (not all) people there are more effective methods of dealing with chronic pain. ...You will not simply stop taking the painkillers, you will be weaned off the higher dose (it is important that this is done under medical supervision)...there will also be other options for your pain management which your GP or specialist will possibly consider.
    • 50Twuncle
    • By 50Twuncle 28th Sep 19, 8:27 AM
    • 9,695 Posts
    • 2,619 Thanks
    50Twuncle
    Why would you want to be seen at your worst? The assessor will want to see the way you are on an average day...for you that means having taken painkillers.

    The assessor WILL want to see what meds you are on, I usually offer a copy of my current repeat prescription.

    If your are on long-term opiates, the GP may well decide to reduce the dose as current medical thinking is that for many (not all) people there are more effective methods of dealing with chronic pain. ...You will not simply stop taking the painkillers, you will be weaned off the higher dose (it is important that this is done under medical supervision)...there will also be other options for your pain management which your GP or specialist will possibly consider.
    Originally posted by Prinzessilein
    I have only been on Codeine for a few weeks !
    WW3 is coming - it's been almost 75 years since the last one - the next one will be FAR worse !
    So what's a few squabbles between politicians ??
    • Spoonie Turtle
    • By Spoonie Turtle 28th Sep 19, 12:46 PM
    • 255 Posts
    • 156 Thanks
    Spoonie Turtle
    I am just concerned that if I am on strong painkillers - they will believe that I can walk as anyone else can (albeit with a limp) - but I can't remain on painkillers forever.
    I take them 4 times a day
    Originally posted by 50Twuncle
    This is understandable, but in your application and in your assessment you need to make clear what your mobility is like throughout the day and on different days if it's variable. They assess you based on your functional ability for the majority of the time, as if you were using any reasonable aids or having any treatment you could reasonably be expected to have. You've been prescribed painkillers and are taking them, so they certainly count. However, if there are side effects that affect your daily functioning you must include those, and if there's a wearing off between doses and your functional ability drops in that time, include that too.

    If you're concerned about them assessing your ability based on how you present at the assessment, that's kind of a separate issue. The assessment is supposed to be based on what you can reliably do overall - repeatedly, in a reasonable time, to an acceptable standard, and safely. If you can walk 100m once in the day but it causes so much pain you can't function for a few hours, then you shouldn't be assessed as being able to do it. If you can walk 100m with lots of little stops so that it takes you 20 mins, that's not in a reasonable time so you shouldn't be assessed as being able to do it. However, if with the painkillers you *can* actually get about okay for most of the time - repeatedly, safely, in a reasonable time - then you won't be entitled to mobility payments because you don't meet the criteria. Only you know the reality of your situation and I strongly suggest looking up the assessment info on how they decide descriptors.
    • Lanzarote1938
    • By Lanzarote1938 28th Sep 19, 1:55 PM
    • 587 Posts
    • 1,539 Thanks
    Lanzarote1938
    Codeine can be bought over the pharmacy counter, albeit not as strong as the prescription tablets but this would lead me to think that it isn't that strong but like most painkillers needs to be taken regularly.
    • antrobus
    • By antrobus 29th Sep 19, 8:57 PM
    • 16,900 Posts
    • 23,894 Thanks
    antrobus
    Codeine can be bought over the pharmacy counter, albeit not as strong as the prescription tablets but this would lead me to think that it isn't that strong but like most painkillers needs to be taken regularly.
    Originally posted by Lanzarote1938
    Codeine is a Class B drug and is prescription only. You have to ask your GP very nicely to get a scrip and avoid a criminal conviction for possession. You can buy low strength co-codamol containing 8mg of codeine from a pharmacy, but anything more and you need a prescription for that as well.

    Yes - I have no idea how long I will be allowed to continue on them by my GP. !
    Codeine = Morphine
    Originally posted by 50Twuncle
    Codeine and morphine are both opioids. (As indeed is Heroin. ) But they aren't the same thing. I should know, I've had both.
    • 50Twuncle
    • By 50Twuncle 30th Sep 19, 9:33 AM
    • 9,695 Posts
    • 2,619 Thanks
    50Twuncle
    Codeine is a Class B drug and is prescription only. You have to ask your GP very nicely to get a scrip and avoid a criminal conviction for possession. You can buy low strength co-codamol containing 8mg of codeine from a pharmacy, but anything more and you need a prescription for that as well.



    Codeine and morphine are both opioids. (As indeed is Heroin. ) But they aren't the same thing. I should know, I've had both.
    Originally posted by antrobus

    Approx 15% of Codeine metabolizes to Morphine in the liver - so whilst they do start as different drugs - they end up the same !
    https://www.pharmgkb.org/pathway/PA146123006
    I have been prescribed 2 * 30mg tabs - 4 times per day for pain
    I have already cut this down to 1 * 30mg - 3 times per day
    Last edited by 50Twuncle; 30-09-2019 at 9:37 AM.
    WW3 is coming - it's been almost 75 years since the last one - the next one will be FAR worse !
    So what's a few squabbles between politicians ??
    • antrobus
    • By antrobus 1st Oct 19, 9:24 PM
    • 16,900 Posts
    • 23,894 Thanks
    antrobus
    Approx 15% of Codeine metabolizes to Morphine in the liver - so whilst they do start as different drugs - they end up the same !
    https://www.pharmgkb.org/pathway/PA146123006
    I have been prescribed 2 * 30mg tabs - 4 times per day for pain
    I have already cut this down to 1 * 30mg - 3 times per day
    Originally posted by 50Twuncle
    Actually what that source says is that;

    Between 0 and 15% of codeine is O-demethylated to morphine, the most active metabolite, which has 200-fold greater affinity for the MOP compared with codeine. This metabolic reaction is performed by CYP2D6

    Which is not "approx 15%". Besides that, the debate over whether or not morphine causes liver damage is hardly the point, it's what it does to your head before it gets that is more to the point.

    Codeine is a painkiller, that can be misused and cause deaths, which is why it's a Class B drug. But morphine is happy land, step into another world, which is why it's Class A.
    • poppy12345
    • By poppy12345 2nd Oct 19, 6:41 AM
    • 6,162 Posts
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    poppy12345
    I've taken 30mg Codeine a few years ago. I now take morphine and have done for 4 years, they are definitely not the same.
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