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Income Protection Claim Turned Down

Dear Brian

I have been turned down on my income protection claim because of a report commissioned by my insurance company from a company doing CPAD (chronic pain abilities determination). The tests were conducted by an osteopath who is also a functional capacity assessor. I have been unable to locate details of any clinical trials on CPAD, have found no evidence that the test has been medically proven nor that a CPAD assessment has been published in a peer reviewed medical journal. Is CPAD medically proven?




Dear Elaine

I have not come across CPAD, but the clue to this is that the osteopath is a functional capacity assessor. The tests that you have had to undergo sound very much like functional capacity assessments.

These assessments are notorious amongst fibromyalgia sufferers. They are often very technical, complex and detailed to the point where the reports are extremely hard to understand. The crucial point is that such assessments have very little relevance to fibromyalgia sufferers. They may well be extremely useful in evaluating functional impairment in those with structural musculo-skeletal damage, but fibromyalgia sufferers will generally have entirely normal musculo-skeletal structures. Their difficulties are the constant symptoms of pain, stiffness and feelings of weakness.

Therefore, fibromyalgia sufferers may well be able to carry out many of the tasks, slowly and in pain as a one-off activity, but that is very unlikely to translate into being able to do these normal daily tasks on a regular and sustained basis. In other words, these types of tests are not a fair reflection of the functional impairment of the fibromyalgia sufferer. It is also true to say that on the day of the assessment the fibromyalgia sufferer may have fewer symptoms than on other days.

My advice is to try to avoid undergoing these assessments wherever possible. Insurers should be told that they are simply not meaningful for fibromyalgia sufferers. If the insurer insists, however, the assessments may have to be done, but it is then always advisable to have a report from a consultant rheumatologist who would be able to comment on your ability to sustain activity and who is a “bigger hitter” than the osteopath or similar who carries out the functional capacity evaluations.


Brian Barr

The question and answer originally appeared in Fibromyalgia Magazine

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